I would walk 500 miles and I would walk 500 more...
Ah The Proclaimers. I can hear the song perfectly in my head.
It happens to be my favourite karaoke jam to sing at the top of my lungs. And speaking of lungs and the cardiovascular system, if we really did walk 500 miles (an impressive feat), how much of a benefit would that have on our health?
Step counting has been around since the 1930s, when Thomas Jefferson first introduced Americans to the pedometer. The OG of step counters. Since then, technology has evolved far beyond step counting to measuring heart rate, VO2 max, and more.
In 1964, Y. Hatano presented some research that said 10,000 was the number to hit. He also sold pedometers (can you say conflict of interest). After that, companies ran with the 10,000 step idea to promote their innovations and technological marvels, and of course, as a marketing tactic.
But the question remains: how many steps per day should we be reaching (or stepping) for?
The following information is not to be construed as medical advice. Please seek the guidance of your physician, or primary health care practitioner before making any changes to your health.
All-cause mortality
All-cause mortality (ACM) is a blanket term meaning death from any cause. ACM can be ambiguous because people can die from many causes like the slow progression of cancer or getting squished by a piece of meteorite hurling through space.
Instead, ACM can be considered as a very important trend in reducing your overall risk of death. In the case of total steps per day, one large conglomerate study found that the best bang for your buck for older adults (over 60) is between 6000-8000 steps per day, while for younger adults (under 60), it was 8000-10000 steps per day. After that, the reductions in ACM plateaued.
For the graphically inclined. Notice the sharp decrease, and plateau after around 10,000 steps. Click for source.
Another large conglomerate study looking at similar outcomes noted the following:
Dose-response meta-analysis indicated a strong inverse association, wherein the risk decreased linearly from 2700 to17,000 steps per day. The HR for 10,000 steps per day was 0.44 (95% CI 0.31-0.63). The certainty of evidence was rated strong due to upgrades for large effect size and dose-response gradient.
To summarize, benefits come after 2700 steps to 17,000 steps per day. 17,000 is a lot of walking. The takeaway here is that, in general, more steps are better than less for lowering your risk of ACM.
Heart health
Does step count decrease the risk of heart disease?
One conglomerate trial showed a decreased risk of Myocardial infarction, heart failure morbidity or mortality, composite of time to death from cardiovascular causes, non-fatal myocardial infarction, and composite of cardiovascular disease events with a step count of 500-2000 steps/day.
In summary, there does appear to be a benefit for increased step count, particularly in those outcomes.
Click for link.
Type II diabetes and physical activity
One large conglomerate study looked to see if adding a step counter would increase overall physical activity, thus reducing a certain marker for type II diabetes (HbA1c).
The study compared two main groups. The first were people who used a step counter as motivation to be more physically active. The second was the control group, who were given the “usual care intervention” or “with step counters used only for counting steps.”
For the markers of type II diabetes, there wasn’t much of a difference between the two groups.
Forest plot of RCTs investigating step counter use in HbA1c (%) in T2D patients. Click for link.
However, they did see a notable increase in physical activity using step counters as motivating tools- by 1822 steps per day! The authors note that these studies were statistically heterogeneous (differing in their testing methodology); however, I think this is quite significant as a trend.
Forest plot of RCTs investigating step counter use in PA (steps/d) in T2D patients. Click for link.
This is very interesting, and I have my theory as to why the motivated group had more steps. The study also noted this.
Subgroup analyses suggested step counter use along with a PA [physical activity] goal…significantly increased PA [physical activity] by 3,200 steps/d…compared with the control. Step counter use without a PA [physical activity] goal…did not significantly increase the PA [physical activity]…compared with the control…
I believe this comes from having a goal and tracking your progress along the way. Goal setting is essential. Without a goal, ambition is chaotic. Your arrow has no target to shoot. Whether running a 5k or climbing mount Everest or simply losing a couple of pounds, having a vision with a SMART goal in mind will help narrow your focus and achieve where you want to be. To further reinforce this point:
Step diary use was also associated with a significant increase in PA [physical activity]…whereas without diary, there was no significant increase.
Now, the study doesn’t indicate the purpose of the journal, be it to set an initial step goal or record your progress along the way- however, writing it all down helped. The difference in mean step count was 2186 for the step diary and 115 without.
The authors make a couple of suggestions as to why they didn’t see a difference in HbA1c. But if adding a step counter increased overall physical activity, I consider that a win. This could also translate into other areas of health.
Final thoughts
Going back to our question: how many steps per day should we be reaching (or stepping) for?
My answer is this. While there doesn’t seem to be one correct answer, take as many steps as you can within your schedule, doing something that you enjoy. Start here.
Physical activity is vital, and I believe those benefits increase when you’re doing something enjoyable. For example, walking is one thing, but there may be a benefit to walking, specifically in nature. Or get your heart rate up by walking a difficult trail. Add some friends to the mix. Listen to a podcast. Once you have developed a habit, consider adding a goal of reaching 8000- 10,000 steps a day.
As a Certified Nutritional Practitioner, I look for what is easy, accessible, and effective for people’s health. Working towards a step goal, or creating an intention to add a specific amount of steps into your day, is probably an effective tool to improve your health.
References
https://whyy.org/articles/how-step-counting-became-a-phenomenonwhen-cally/#:~:text=Though%20Thomas%20Jefferson%20introduced%20the,Olympic%20fever%20swept%20the%20globe.
https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667%2821%2900302-9/fulltext#:~:text=Compared%20with%20adults%20in%20the,sex%20but%20varied%20by%20age.
https://pubmed.ncbi.nlm.nih.gov/34417979/
https://ijbnpa.biomedcentral.com/articles/10.1186/s12966-020-00978-9
https://bmcmedicine.biomedcentral.com/articles/10.1186/1741-7015-12-36
