Emerging Evidence for Experts – Stepping Your Way to Longevity

Context

We’ve all heard it at one time another, probably from an overzealous well-intentioned personal trainer, fitness influencer, or even your local health promotion agency – 10,000 a day will have you well on your way to being the healthiest you and reducing your risk of non-communicable diseases like cardiovascular disease and diabetes. Seems a rather arbitrary and all-encompassing number though, doesn’t it? Well, that’s because it is arbitrary. Following the Tokyo Olympics in 1964, a Japanese pedometer manufacturer (Yamasa Corporation) built a marketing campaign that encouraged individuals to achieve 10,000 steps per day. So, with a catchy marketing campaign, a new era of pedometer-based fitness goals came to life and it seemed as though everyone and their aunt had strapped on a FitBit and was walking their way to health.

In recent years, scientists have begun putting this number to the test, questioning whether this magic number really holds up against empirical methods of inquiry. Do we need 10,000 steps? Is this goal attainable as we get older? Does the number of steps change based on whether we are biologically male or female? Does the pace at which we walk matter? These are all questions the expert committees from the WHO 2020 Physical Activity Guidelines encouraged researchers to examine [1].

The expert committee found that there was a gap in the current literature on the dose-response relationship between volume and intensity of exercise and associated health outcomes, including physical activity measured by step volume and rate [1]. It appears that researchers began to examine this arbitrary threshold prior to the recommendations made by the WHO, In fact, there are two recent studies of interest. The first of the two studies was published in 2019.

This large cohort study examined the relationship between the number and rate of steps with all-cause mortality in older women (mean age 72-years) [2]. The authors reported that women who averaged at least 4400 steps/day had a significantly lower risk of all-cause mortality in comparison to their less active counterparts who only walked 2700 steps per day.

They found that mortality continued to decrease before leveling off at 7500 steps/day. This suggests, for older adults at least, that the 10,000 step threshold may not be appropriate. From a coaching perspective, this is promising, the barrier to entry is significantly reduced and even a little more movement is quantitatively beneficial for clients. A second study, published toward the end of 2021, reported similar findings [3].

This cohort study found that those who took at least 7,000 steps/day had a 50-70% reduction in risk of all-cause mortality. This study included a younger, more diverse population (38-50 years, black and white, males and females). Although only a portion of the literature on physical activity and step-based activity goals, these studies highlight the need to better understand how age, gender, and speed affect step-based goal effectiveness.

A recent meta-analysis, published in 2022, aimed to establish whether the mortality benefits of walking might be likely at a lower daily step threshold, examining the dose-response relationship and attempting to understand whether this varied by age and sex. The following paragraphs outline the methods, results, and meaning we can take away from this research [4].

 

Methods & Results

The authors of this study conducted a meta-analysis of fifteen studies, seven of which were published and eight unpublished. The sample included just shy of 50,000 participants with an average age of 65-years. Within the sample 65% were female and >70% were of the White race. This illustrates a need for more inclusive research in order to establish guidelines that are evidence-based across ethnically diverse populations. The included studies used a range of devices to monitor steps, although the ActiGraph devices were the most common. Results indicate that taking progressively more steps is associated with a progressively lower mortality risk. This risk evened out at 6,000-8,000 steps for older adults (>60-years) regardless of gender and 8,000-10,000 steps for younger adults (<60-years) regardless of gender [4].

“Among the three higher active groups who got more steps a day, there was a 40-53% lower risk of death, compared to the lowest quartile group who walked fewer steps, according to the meta-analysis.”

Whether there is a relationship between step rate (i.e. cadence) and all-cause mortality remains undetermined, the authors found that within their set of studies they were able to establish an association with some rate measure but not all. It is important to remember that the studies included in this meta-analysis were all observational – this means that a causal relationship between step volume and mortality risk cannot be established. To date, many public health studies are observational because they are easier and often cheaper to conduct than randomised control trials. While this research cannot illustrate a causative relationship, the growing number of studies linking daily step count with a reduction in all-cause mortality (alongside other benefits) are nothing to be scoffed at.

 

Meaning

So, what does this study mean in the grander scheme of things? Should we discourage people from walking more than 10,000 steps per day? Probably not. What this study does show is that when working with clients of different age groups, the goal post might be slightly different and that even a little more movement could make a difference. There are many benefits to walking, aside from reducing the risk of all-cause mortality, it is a great way to stave off non-communicable disease, improve your mood, enhance brain function, and might even aid digestion.

 

Getting More Steps

Increasing the number of steps you take each day doesn’t need to be a cumbersome task. Below are a few examples of how you can increase your daily step count.

• If you work in an office or frequently visit shopping malls, park a little further away or use public transport.
• If you work from home take movement breaks throughout the day. It’s so easy to get wrapped up in the never-ending list of emails in your inbox. Set yourself a timer and go for a walk around your house every hour.
• Invest in a walking desk set up. Although a little pricey, if you work long hours a walking desk might be the solution for you.
• Set your alarm a little earlier and go for a walk around the block before the rest of the house wakes up.
• Schedule walking meetings. Instead of sitting down for meetings why not go for a walk and chat? These might not be appropriate for all settings but a walk around the park while you discuss an upcoming project not only gets your steps in but ups your vitamin D intake.
• Join a walking group. Not a fan of walking alone? We hear you! A walking group can be a great way to get out and socialise.
• Invest in a pedometer or activity tracker – or just set a step goal on your phone. The rush of dopamine when you achieve that goal will help you build a walking habit early on.
• Take the stairs whenever and wherever you can.

The barrier to entry with walking is low – you don’t need a gym membership or fancy workout clothes, all you need is a comfortable pair of shoes. For centuries walking was the bread and butter of the human exercise regime, somewhere along the way we have been seduced by high-intensity workouts and overcomplicated strength programs. This is not to say that anaerobic and strength-based exercise are not important – they definitely are – but they should be complementary to good moderate cardiovascular exercise like walking.