This article covers the findings and implications of a meta-analysis published in the European Journal of Preventive Cardiology. The meta-analysis examines the relationship between daily step count and health outcomes, specifically focusing on all-cause mortality and cardiovascular mortality.

Patients frequently ask about the number of steps they should take daily to achieve maximum health benefits. While a 10,000-step goal is often touted as the benchmark—based on a 1965 exercise device out of Japan called Manpo-kei, or the ‘10,000 steps meter’—a recent meta-analysis published in European Journal of Preventive Cardiology found that patients can reap benefits at lower step counts.

More and more people live a largely sedentary lifestyle—leading to increased disease risk and all-cause mortality. In fact, the authors of the meta-analysis share that epidemiological data has found nearly 30% of people worldwide aren’t moving enough. Worsening the matter, the authors found that 81% of adolescents worldwide don’t get enough physical activity. This probably isn’t surprising, as the  COVID-19 pandemic also led to lower daily step counts—from which the world hasn’t yet bounced back.

The goal of the meta-analysis, says the authors, was to evaluate the relationship between step count and all-cause mortality and cardiovascular (CV) mortality since the actual number of steps per day—and how they impact health—is still unclear. 

The meta-analysis is the first to look at age and sex in addition to how regional differences (including temperate, subtropical, subpolar, and mixed zones) affect participants. It also looked at the health impact of 20,000 steps per day to assess the idea of whether more steps were better. 

The researchers noted a few key findings:

1. A 1,000-step increment was associated with a 15% reduction in all-cause mortality risk, while a 500-step increase was associated with a 7% decrease in CV mortality. 
2. Compared to the reference quartile (3,967 steps/day), quartiles 1 (5,537 steps/day), 2 (7,370 steps/day) and 3 (11,529 steps/day) saw 48%, 55%, and 67% (respectively) lower risk for all-cause mortality. 
3. Compared to the lowest quartile (2337 steps/day), higher quartiles (from 3,982 steps/day to 10,413 steps/day) were linearly associated with a lower risk of CV mortality at 16%, 49%, and 77%, respectively). 
4. Walking more than 5,000 steps/day dramatically lowered the risk of all-cause mortality. Taking more than 5,500 steps/day, the risks sharply decreased, regardless of the global region. 
5. The authors used a restricted cubic splines model, observing a strong inverse dose–response association between step count and all-cause death.  In people over 60, the sharpest phase of the curve was at about 6,000–10,000 steps/day; in people younger than 60, the sharpest phase was at about 7,000–13,000 steps. It was similar for men and women. 
6. More research needs to be done on the health benefits of walking 20,000 steps/day.

The researchers summarised that the analysis showed a significant inverse association between daily step count and all-cause mortality and CV mortality, “with the more the better over the cut-off point of 3967 steps/day for all-cause mortality and only 2337 steps for CV mortality.”

But patients can’t stop there, Banach adds, recommending patients try adding 500-1000 steps/day, as it’s associated with mortality reduction. A solid goal? Banach says physicians should tell patients, “The more steps, the better,” with a goal of between six and 13,000 steps per day. 

Patients, he says, should simply start moving immediately.

“Irrespective of what number of steps per day you start at, be regular and consistent, and try to improve yourself and increase the number of steps.”

Disclaimer: This story is contributed by Lisa Marie Basile and is a part of our Global Content Initiative, where we feature selected stories from our Global network which we believe would be most useful and informative to our doctor members.