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A systematic review and meta analysis published in The Lancet Public Health looks at daily steps and health outcomes in adults.
Prof Steven Harridge, Professor of Human & Applied Physiology at the Centre for Ageing Resilience in a Changing Environment (CARICE) at King’s College London, said:
“This is a systematic review of a large number of studies looking at the relationship between increasing step count and multiple health outcomes – as opposed to just all-cause mortality.
“The paper shows clear effects of increasing physical activity (through increasing step count) on reducing disease risk. There has been debate about the amount of activity an individual should be doing with 10,000 steps as a generalised target, not well evidenced. This paper shows that 7,000 steps is sufficient for reducing the risk for most diseases covered, and 10 000 steps does not confer much additional benefit. But further risk reduction might be possible for some diseases.
“Simply put, the paper supports bodies of evidence that increasing levels of physical activity are associated with positive health outcomes. Importantly, increasing to 10,000 streps seems to confer no negative effects!
“Studies of this kind are helpful in the large number of studies and participants combined into the analysis but it lacks mechanistic insight as to how these benefits arise. The likelihood is that increasing step count increases cardiorespiratory fitness, well known to be positively associated with better health and all-cause mortality outcomes.
“There is also another interpretation of these data. Humans are designed to be physically active (our evolutionary heritage as hunter gatherers), so the question could be posed the other way. Let’s say the default is to walk 10,000 or 7,000 steps, what are the negative health outcomes that might be expected of going below this level? Clearly, they are not good. Thus is all depends on the perspective of what should be considered “normal”.
“Whilst step count is a very basic measure of activity (e.g.it does not capture intensity), this study adds to the body of knowledge that shows physical activity is vitally important for health and anything that encourages people to be more active is a good thing for both physical and mental health. This is in the context of most people not adhering to the guidelines for physical activity as set out by the Chief Medical Officer.”
Dr Andrew Scott, Senior Lecturer in Clinical Exercise Physiology, University of Portsmouth, University of Portsmouth, said:
“The press release gives an accurate account of the study. The article is written by an excellent author team, leading to a coherent article summarising the evidence of daily step count and various health outcomes.
“There’s been little research on steps per day, with most research focussing on characterising the exercise in frequency per week, time per day and intensity per minute of exercise. This research does fit the usual narrative of a logarithmic dose-response to exercise of a range of health conditions. This is not surprising; a dose-response is evident in many relationships between interventions/activities and health outcomes, including medications. This dose (amount of intervention) to outcome (health benefit) determines the dose required of particular medications to improve a particular health condition. In this case this information can be used to indicate the number of steps per day should be performed to reduce the risk of developing a health condition by a particular percentage. In most cases the 10,000 steps per day will still be better than 7,000 steps, just by decreasing margins of health benefit return.
“More important than the exact number of steps, it demonstrates that overall more is always better and people should not focus too much on the numbers, particularly on days where activity is limited. The steps per day is useful when people’s exercise is weight-bearing, however cycling, swimming and rowing are not well-represented by the steps per day model.
“This is a meta-analysis so it is representative of a range of studies, but there is a range of ways to be active for health benefit, beyond just steps per day. The team also analysed the rate or cadence of stepping, where faster rates of stepping per 30 minutes were further associated with health benefits, but not everybody can step at this rate to benefit with. There are other ways of exercise that are beneficial for older people, including balance exercise and higher intensity resistance training that can provide benefits beyond walking or jogging.
“The compelling finding is that whilst such walking does not mitigate cancer incidence there is a decrease in cancer mortality, illustrating that enhanced physical activity levels leading to enhanced physical and psychological fitness enhances the resilience of people to deal with cancer and its associated treatments.
“These findings are important for providing a public health message, where targeted exercise intervention, as opposed to discouraging inactivity is not as prevalent compared to medical intervention. So, while these findings have real world implications, the specific number should not receive too much reverence; it just means that 10,000 steps per day is not the only number to aim for, enhancing achievability.”
Dr Daniel Bailey, Reader – Sedentary Behaviour and Health at Brunel University of London, said:
“The press release does accurately reflect the study, showing that walking 7000 steps per day is associated with significantly lower risk of a number of health outcomes like cardiovascular disease, type 2 diabetes, dementia, depression and falls.
“The researchers assessed the strength of evidence in their review of studies. The strength of evidence was moderate for most of the health outcomes, meaning that we can be confident the findings in this paper are true, but there is a possibility they may not be completely accurate.
“This study adds to existing evidence by showing that the more steps people do, the less their risk of developing different health conditions. The finding that doing 5000-7000 steps per day is an important addition to the literature which helps to debunk the myth that 10,000 steps per day should be the target for optimal health.
“This study suggested that 5000-7000 steps per day can significantly reduce the risk of many health outcomes, but that does not mean you cannot get benefits if you don’t meet this target. The study also found that health risks were reduced with each 1000 extra steps per day, up to a maximum of 12,000 steps per day. So just adding more steps from your starting point can have important benefits for health.
“An important limitation is that many of the findings from this review were based on a small number of studies, meaning that the results may not be accurate for some of the health outcomes measured. Also, the findings cannot be easily applied to people living with a chronic condition as the studies in this reviewer were in generally healthy people.
“The real-world implications are that people can get health benefits just from small increases in physical activity, such as doing an extra 1000 steps per day. To achieve the best reductions in risk, aiming for 5000-7000 per day can be recommended, which will be more achievable for many people than the unofficial target of 10,000 steps that has been around for many years.”
‘Daily steps and health outcomes in adults: a systematic review and dose-response meta-analysis’ by Ding Ding et al. was published in The Lancet Public Health at 23:30 UK time on Wednesday 23rd July.
DOI: https://doi.org/10.1016/S2468-2667(25)00164-1
Declared interests
Prof Steven Harridge: I am Professor of Human and Applied Physiology at King’s College London, with a research interest in healthy human ageing and have no funding from manufacturers of physical activity monitors.
Dr Andrew Scott: I do not have any conflicts of interest.
Dr Daniel Bailey: No interests