impact of steps and walking speed on disease and mortality risk
For years, we're told about the importance of regular exercise for health and longevity. And for many people, that makes them think of a time-bound, intensity-based workout routine often in a gym. But we now know that the simple action of walking can affect your chances of developing cancer, cardiovascular disease and a whole host of other ailments as we age.
Today’s post explores the associations of daily step counts and intensity with cancer, cardiovascular disease incidence and all-cause mortality. For anybody who's got a tracking device, you'll know that the magic number of steps per day is 10,000. But it turns out that this number actually wasn't based on any research.
Originally, it came from a marketing campaign for a Japanese pedometer company way back in the 1960s with no evidence behind it whatsoever. However, a recent study of physical activity patterns of 111 countries using smartphone data showed how much, on average, people move in various countries.
Results ranged from three and a half thousand steps a day in Indonesia to a maximum of 7000 steps a day in Hong Kong, with Aussies, Yanks and Brits all coming in about 5000 steps a day on average. We can see that on average, in all of these countries, none of them hit that 10,000 steps.
Previous research discovered that walking as few as 4400 steps per day was linked to reduced mortality amongst older women and older people. This finally became the basis for more comprehensive evidence to inform some of the step-based recommendations.
Now, more recent studies have suggested that exceeding six to 8000 steps a day if you're 60 years of age or older, or eight to 10,000 steps a day for people who are younger than 60 years, could have additional reduction for all-cause mortality or additional risk reduction. So increased steps per day have also been associated with lower cardiovascular disease mortality and lower risks of cancer.
Yet evidence for those two findings remain a little bit limited. This is where a recent UK Biobank study comes in. This particular part of the ongoing study sampled 103,000 odd UK adults, all aged 61 and above, to look at the associations of their daily step counts and step intensity with cancer and cardiovascular disease incidents and all-cause mortality.
By having the guys wear risk trackers and analysing the data, the researchers found that participants who wore the trackers 24/7 were generally healthier, had higher socioeconomic status and were predominantly women. Then the data collected from the devices was considered to be valid if the individuals wore it for 16 hours or more per day generally and included at least one weekend day and wore during sleep.
Trackers, which researchers refer to as accelerometers, obviously don't just track steps, but also general physical activity, for most of them do anyway. Hence, this study classified the activities using an accelerometer-based activity machine learning scheme that covered or classified activities into sedentary behaviour, small utilitarian movements, then walking and running.
To add a little bit more depth, the separate meta-analysis referred to earlier was able to determine that the risk of all-cause mortality for all ages is about 40% lower. For those who take 5800 steps a day, it's 45% lower at about 7800 steps a day and then 53% lower at 10,900, so almost 11,000 steps a day. Overall, they classified the lowest risk at between seven and 9000 steps a day.
When they dug into it, for adults younger than 60, the lowest risk for all-cause mortality was observed at eight to 10,000 steps a day range, with no additional benefit over this level of physical activity. For adults 60 and older, the lowest incidence of all-cause mortality was observed at six to 8000 steps a day. And again, researchers didn't notice a significant additional benefit for those doing more.
After calculations were made using a step count algorithm, it was found that the biggest contributor to people's overall daily physical activity were basically the number of steps, be it incidental or purposeful, that was a much bigger contributor to dedicated exercise. The classifications they used for steps were light intensity, which was below 100 steps a minute moderate intensity, which is 100 to 129 steps a minute and then vigorous, which was more than 130 steps a minute.
They then followed these guys for between six and seven years—and the results were pretty astounding. The mortality outcomes included 78 and a half thousand participants aged 61 and above.
Unfortunately, 2179 of them died during this period. Of the six to seven year follow-up, 1325 died of cancer while 664 of them passed away due to cardiovascular disease, which included stroke, heart disease and heart failure. In addition to the deaths, there were 10,245 cardiovascular disease incidents reported during the follow-up period and 2813 incidents of a cancer diagnosis were also recorded.
Overall, this study found that participants who took more steps per day had lower BMI. That's not surprising, but they also experienced better sleep and they did not smoke or drink alcohol. This means that they are maintaining an overall healthy lifestyle. Meanwhile, participants with higher steps per minute, referred to by the researchers as peak 30 cadence, were found to be healthier, younger, and they took more steps than the average. This means that higher daily step count, incident steps and purposeful steps were all associated with lower risk of all-cause mortality, cancer incidents and mortality, and CBD incidents and mortality.
So, the takeout is getting more steps a day up to about 10,000 with a higher pace or cadence is linked to a decline in mortality, morbidity and incident risk of several diseases. If you've been using a tracker, this should be a dose of motivation to keep stepping for longer, healthier life ahead.
If you don't have one, hopefully this is a bit of motivation to take the plunge. Because as US behavioural scientists say, what gets measured gets managed.
However, be aware that these observational studies are limited. It doesn't mean that just getting 10,000 steps from walking is going to put you in optimal health and optimise your health span. But this limitation should also not hinder you from reaching the step goal. So for now, just keep moving.
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