Stepping Up Your Steps: Is More Really Better?

The Garden StepsIn a typical day, most people really don’t move around that much. The simplest way of quantifying this is by counting steps and the average for an American adult is between three and four thousand per day. The default goal for improving on this became 10,000 steps – probably because an early pedometer called the Manpo-kei. The name translates roughly into “ten-thousand step meter” and its makers liked that number. But with the benefit of recent data, it’s becoming clear that the 10,000 step benchmark may fit for everyone.

A new study in Nature Medicine this week offers fresh perspective.

All of Us Research

These new data come from the NIH All of Us research program. Hiral Master and colleagues analyzed data from 6,042 individuals with step data collected of a median of four years. The median daily step count were 7,731. What they found was a robust and linear relationship between daily step counts and the risk of obesity, sleep apnea, gastric reflux, and depression. Step counts above 8,200 predicted less risk for each of these conditions and the risk appeared to keep going down above that magic number of 10,000 daily steps.

But for diabetes and hypertension, the relationship wasn’t linear and they could find no further benefit from step counts above 9,000 daily.

More Is Better?

Prior studies have suggested that more steps per day may not always be better for the health outcomes. a 2019 study showed no mortality benefit for older women with more than 7,500 steps per day. An RCT in female college freshman found no benefit for preventing weight gain with more than 10,000 daily steps.

But the senior author of the new study in Nature Medicine, Evan Brittain, doesn’t equivocate. He says:

“People really can reduce their risk of obesity by walking more.

“The relationship with hypertension and diabetes plateaued after about 8,000 to 9,000 steps but the others were linear, meaning higher steps continued to reduce risk. I would say that the take home messages are that more steps are better.”

The truth of the matter might be found in the old advice that one size does not fit all. A single, rigid goal – especially for physical activity – seldom works well for a diverse population. Physical activity is clearly beneficial for health. It can be useful for preventing weight gain.

But the best approach will vary for each of us.

Click here for the study in Nature Medicine, here and here for further perspective.

The Garden Steps, painting by Pierre Bonnard / WikiArt

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October 12, 2022