Walk More, Die Less? More Data on Daily Step Count and Mortality
It may not be surprising, but new data reveal that individuals with a higher daily step count may not only be healthier, but less prone to dying from any cause.
Walking isn’t the most vigorous exercise, but as a form of physical activity, it’s highly underrated. While you’ll typically see me “speaking out” against blanket prescriptions to get 10,000 steps per day (which was an arbitrary number to begin with), the mental and physical benefits of walking have been proven time and time again.
Even our modern-day hunter-gatherer ancestors have been shown to walk for hours each day, even though they rarely engage in other forms of vigorous activity like the marathon training that is common in our more “advanced” societies.
Though the benefits are pretty well established, there is a lack of data regarding whether walking more (or meeting the recommendations) is actually associated with better health outcomes. Arguably one of the more important health outcomes that is of interest to everyone is death — otherwise known as “all-cause mortality” in epidemiological research.
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To investigate this question, researchers conducted a meta-analysis (a “study of studies”) on 15 individual cohort studies that also looked at the association between step count and all-cause mortality. They then pooled these data together, giving them a total of 47,471 individuals to run the analysis on.
The included participants were separated into quartiles based on how many steps they achieved per day.
Quartile 1: 3553 steps
Quartile 2: 5801 steps
Quartile 3: 7842 steps
Quartile 4: 10,901 steps
It’s interesting that only the highest quartile were getting the “recommended” amount of steps per day.
Results revealed a dose-response relationship between steps per day and mortality — meaning that the greater one’s step count, the lower the risk of death. When the second, third, and fourth quartiles were compared with the first quartile (used as the reference group), the hazard ratio for all-cause mortality was 0.6, 0.55, and 0.47, respectively.
What this means is that getting ~5,800 steps per day reduces one’s risk of death by 40%, ~7,800 steps reduces risk by 45%, and ~11,000 steps per day reduces risk by 53% (all compared to ~3,500 steps per day.
When studies like these are published, myself and others are often curious as to whether there is an “upper limit” for the benefits of exercise —in this case steps. Does going above a certain amount of steps per day eventually stop having benefits?
In this analysis, interestingly, the dose-response associations were age specific.
In adults 60 or older, more steps per day were associated with lower all-cause mortality until about 6,000 - 8,000 steps per day.
For adults younger than 60, all-cause mortality risk was reduced up until 8,000 - 10,000 steps per day. Even though, when one looks at the graph below, it does appear that the hazard ratio continues to go down well past 10,000 steps per day in this cohort.
These data support walking, that’s pretty clear. And although based on these results we cannot definitively say that more walking is better above a certain point, I’m not quite sure it’s a fair conclusion to make.
In all of the studies included, the median steps per day was never over 12,000 or so — most participants in these studies were not “super walkers” logging 15 or 20,000 steps per day. This is likely a limitation inherent in ALL studies looking prospectively at walking habits, since the 10,000 steps per day rule is so mainstream, it’s a number that people seem to naturally gravitate to.
Furthermore, other data do support that walking more than 10,000 steps per day has benefits. In fact, I even wrote about another study showing a linear decline in the risk of all-cause mortality up to a daily step count of 17,000 per day!
For this reason — and given the relative lack of downside associated with walking more during the day — I honestly believe that one should try to walk as much as humanly possible on top of other daily duties and activities (even exercise).
It’s extremely low impact, good for recovery, improves blood flow, and is also a fantastic time to talk with your significant other, walk the dog, or listen to a podcast.
It’s also perhaps one of the best ways to give death the middle finger.
Thanks for reading.