Current physical activity guidelines generally recommend at least 150 minutes of moderate to vigorous activity per week for health, and otherwise recommend 10,000 steps per day. When doubt arises about which is best and which targets provide the greatest benefit, researchers from Brigham and Women’s Hospital, one of the founding members of Mass General Brigham in the United Kingdom, conducted a study that was just published in JAMA. Medicine of internal organs’.
Research shows that exercise goals based on steps and time are equally associated with a lower risk of premature death and cardiovascular disease. Therefore, choosing a time or step goal may not be as important as choosing a goal that matches personal preferences.
Physical activity reduces the risk of chronic diseases and infections and promotes longevity. Current U.S. guidelines, last updated in 2018, recommend that adults engage in at least 150 minutes of moderate-to-vigorous physical activity (brisk walking) or 75 minutes of vigorous activity (jogging) per week.
At the time, most of the existing evidence for health benefits came from studies in which participants reported their physical activity. There was little data on the relationship between steps and health. Fast forward to the present, as wearables become ubiquitous, step counting has become a popular metric among many fitness tracking platforms. How are time-based goals different from step-based goals? Researchers have tried to answer this question.
“We recognized that existing physical activity guidelines focus primarily on activity duration and intensity, but lack stepwise recommendations,” said lead author Rikuta Hamaya, a researcher in BWH’s Department of Preventive Medicine.
“As more and more people use smartwatches to measure their steps and overall health, we saw the importance of determining how step-based measurements relate to time-based goals as they relate to health outcomes: one is better another? speaks.
For this study, researchers collected data from 14,399 women who participated in the Women’s Health Study and were healthy (no cardiovascular disease or cancer). Between 2011 and 2015, participants aged 62 years and older were asked to wear research-grade wearable devices for seven consecutive days to record their level of physical activity, putting them away only for sleep or water-related activities.
Questionnaires were completed annually throughout the study period to determine health outcomes of interest, specifically death from any cause and cardiovascular disease. The researchers followed the participants until the end of 2022.
While using the device, the researchers found that participants engaged in an average of 62 minutes of moderate-to-vigorous intensity physical activity per week and took an average of 5,183 steps per day. Over a mean follow-up period of 9 years, approximately 9% of participants completed the test and approximately 4% developed cardiovascular disease.
Higher levels of physical activity (measured as number of steps or time of moderate to vigorous activity) were associated with a significant reduction in the risk of death or cardiovascular disease: the most active quarter of women had a 30% to 40% reduction in risk compared with the negative ones. And people in the top three quartiles for physical activity outlived those in the bottom quartile by an average of 2.22 and 2.36 months, respectively, as measured by time and steps, over the nine years of follow-up. This survival benefit persisted regardless of differences in body mass index (BMI).
While both measures are useful for representing health status, Hamaya explains that each has its own advantages and disadvantages. First, step counts may not take into account differences in fitness levels. For example, if a 20-year-old and an 80-year-old walk for 30 minutes at a moderate intensity, their step counts may differ significantly.
In contrast, steps are easy to measure and less subject to interpretation compared to exercise intensity. Moreover, steps capture even sporadic movements from daily life, not just exercise, and these daily activities are more likely to be performed by older adults.
“For some, especially younger people, exercise may include activities such as tennis, soccer, walking or jogging that are easy to follow in steps. However, for others they may consist of cycling or swimming, where the duration of the exercise is easier to follow. That’s why it’s important that physical activity guidelines offer multiple ways to achieve your goals. Movement is different for each person, and almost all forms of movement are beneficial for our health,” Hamaya explains.
The authors note that this study included only one assessment of time- and step-based measures of physical activity. Additionally, the majority of women included in the study were white and had higher socioeconomic status. Finally, this study was observational in nature, so cause-and-effect relationships cannot be proven.
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