Is 10,000 steps per day the ‘magic number’? A cardiologist weighs in

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The latest here:

Is 10,000 steps per day the ‘magic number’? A cardiologist weighs in

Key takeaways:

• The commonly accepted metric of 10,000 steps per day is likely an overestimate, according to research.
• Just 1 to 2 days of high step counts may translate to a reduction in important outcomes.

ARLINGTON, Texas — Data show that the commonly used metric of 10,000 steps per day is associated with improvements to overall and CV health, but the number likely is an overestimate and benefits vary by age and sex, according to a speaker.

The concept of 10,000 steps per day was created by a Japanese marketing company in 1964 to sell a pedometer, called “Manpo-kei,” which translates in English to “10,000 steps meter,” Charles German, MD, MS, assistant professor of medicine and director of cardiac rehabilitation at the University of Chicago School of Medicine, said during a presentation at the American Society for Preventive Cardiology Congress on CVD Prevention.

“The media likes to talk about this magic number of 10,000 steps per day,” German said. “Interestingly enough, this number came about with no scientific evidence for backing. But the number was simple and easy to remember, and the marketing company clearly did their job, because it has carried forward to this day.”

Assessing step count data

The number, while likely an overestimate, is probably not far off from a target number that improves CV health, German said, adding the new studies are demonstrating the power of increased daily step count.

In a study published in JAMA Network Open in March, researchers analyzed data from the National Health and Nutrition Examination Surveys 2005-2006 to determine the potential mortality benefits from walking 8,000 steps a few days per week. The study cohort included 3,101 participants (mean age, 51 years), 51% of whom were women. Of the participants, 20.4% did not take 8,000 steps or more any day of the week, 17.2% took 8,000 steps 1 to 2 days per week and 62.5% took 8,000 steps 3 to 7 days per week.

The researchers found that, compared with those who took 8,000 steps 0 days per week, 10-year all-cause mortality was lower among those who took 8,000 steps 1 to 2 days per week, with an adjusted risk difference of –14.9% (95% CI –18.8 to –10.9). All-cause mortality was lower still for those who took 8,000 steps 3 to 7 days per week, with an adjusted risk difference of –16.5% (95% CI, –20.4 to –12.5).

“You get a very steep reduction in mortality when you go from very little steps to just a little bit of steps, and then the mortality benefit seems to plateau at around 10,000 steps,” German said. “So [the estimate] is pretty accurate. If you are a male, the benefit plateaus a little bit further.”

In addition, 10-year CV morality was lower among those who walked 8,000 steps 1 to 2 days per week and 3 to 7 days per week compared with those who averaged those steps 0 days per week, German said. Data stratified by age showed the benefits of 8,000 steps daily are greatest for those age 65 years and older, with slightly less benefits for younger ages.

In a meta-analysis published in 2022 in Circulation, researchers analyzed data from eight prospective studies with 20,152 participants who had daily steps tracked with devices and were followed for CV events for a mean of 6.2 years. Researchers found that taking 6,000 to 9,000 steps per day was associated with a 40% to 50% lower risk for CVD compared with taking 2,000 steps per day. The benefits were more robust for older vs. younger adults, German said.

‘Move more, sit less’

“Even just 1 to 2 days of high step counts is enough to translate to a reduction in important outcomes,” German said. “Age seems to matter; maximum mortality benefit plateaus at around 8,000 to 10,000 steps per day for those less than age 60 years. For those older than age 60 years, 6,000 to 8,000 steps per day seems to be a magic number.

“The bottom line is we see relationships, whether it is moderate to vigorous physical activity or steps, regardless of how you look at the data,” German said. “Try and tailor these recommendations to your patients. Meet them where they are at. Move more, sit less. Any activity is always better.”

References:

• Inoue K, et al. JAMA Network Open. 2023;doi:10.1001/jamanetworkopen.2023.5174.
• Paluch AE, et al. Circulation. 2023;doi:10.1161/CIRCULATIONAHA.122.061288.