Tag Archive for: steps

How Many Steps Do We Need?

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Last week, we talked about how to lower blood pressure using a form of weight training called isometrics. As I made clear, you won’t look like a body builder, but it can help your cardiovascular health. This week, we’ll look at two recent studies to clarify how much aerobic exercise we need to reduce the risk of all-cause and cardiovascular disease mortality.

The typical recommendation for aerobic exercise is 10,000 steps per day. That was based more on marketing than on science, but it has stood as the standard for years—until recently. Several studies have shown the actual amount may be between 4,000 and 7,000 steps per day.

In a recently published study, researchers included data from 17 studies and over 225,000 subjects. They tracked the subjects for just over seven years to find out all-cause mortality and cardiovascular disease mortality. One more thing: all the data were collected electronically as opposed to relying on some sort of mechanical device that underestimates or overestimates steps per day.

After using meta-analysis, the researchers used 3,900 steps per day as a baseline for the median risk of mortality. For every 500 additional steps per day, the mortality risk decreased 7% and for every thousand additional steps per day it decreased 15%. As the number of steps increased, the cardiovascular and all-cause mortality risk decreased until about 12,000 steps where it leveled off.

Going with our theme of doing just enough to reduce our mortality rate, it would seem that 4,000 steps per day, whether as part of your regular day or in addition to your everyday activity, gives a baseline of protection. But do you really have to invest that much time? We’ll check that out on Saturday.

What are you prepared to do today?

        Dr. Chet

Reference: Eur J Prev Card (2023) 00, 1–11 https://doi.org/10.1093/eurjpc/zwad2292

Observations and Questions About the Step Study

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Most research papers such as the step study I began to review on Thursday have a main point, sometimes a couple points, and that’s all we take from it. But there some interesting things that may not get headlines but are still worth mentioning. Let’s take a look at some other results from the steps and mortality study.

Observations

Whatever you might believe about exercise was proven true by this study—not the positive outcomes such as the decrease in overall mortality, as well as CVD and cancer mortality, but questions that paint a picture of who exercises. For every category, from education to smoking to alcohol consumption, what we would expect was confirmed. But we also learned that people are high steppers who we would not expect to be.

For example, would we expect obese subjects to be in the fewer than 4,000 steps per day category or in the greater than 12,000 steps per day category? You would be right if you thought most were in the more sedentary category; 36.7% of those with a normal BMI were in the highest step category. But it doesn’t mean that there were no obese subjects in the greater than 12,000 steps per day category; in fact, 24.8% of those with BMI greater than 30 were in the highest step category.

Why? That’s what we really need to find out. What makes them different? Why are they doing what we don’t expect, or did they just do that well when they wore the accelerometer? If we want to change behavior, that’s what we need to find out.

This was an observational study, so it cannot prove cause and effect, but it gives us insight into the type of studies that will be able to determine cause and effect, such as randomized controlled trials. They can be better designed by building on this study.

Questions

Because we’re in a “Stay Home and Stay Safe” environment, there were some logical questions about stepping and coronavirus infections but I couldn’t find a single answer. When I searched for “fitness and coronavirus,” I found the term fitness meant fitness of the virus, not humans.

I used different search combinations and finally decided to try exercise and coronavirus. There were a number of papers that were written in the last couple of months about the safety of exercise during the pandemic as well as exercise to relieve stress for first responders, but those are still not exactly what I wanted. I wanted to see if steps or exercise would reduce the rate of catching coronavirus, any coronavirus.

I didn’t find that, but I discovered an interview with exercise immunologist Dr. Jeffrey Woods. Rather than summarize it for you, I’m giving you a link to this article for you to read. While it’s difficult to prove improved resistance to coronaviruses, Dr. Woods’s creative research has come close. As long as most of us have the time, I suggest that you read it.

The Bottom Line

Research studies such as the one I’ve reviewed this week tell us a lot about what we know and what we still need to find out. There are too many questions left on the table that never get answered related to diet, nutrition, and exercise. Do you really get all the nutrients you need if you eat a perfect diet? No one knows because no one has ever tested it. Let’s hope we get some answers related to diet, fitness, and supplementation as it relates to the prevention and possible treatment of the coronavirus when this challenge is all over, but I’ll go out on a limb and say you’ll never be worse off by being in better shape. Now that many of us have more time, let’s work on that.

What are you prepared to do today?

        Dr. Chet

References:
1. JAMA. 2020;323(12):1151-1160. doi:10.1001/jama.2020.1382.
2. Journal of Sport and Health Science 9 (2020) 105-107.

Step It Out!

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By the looks of it, “Stay Home and Stay Safe” will extend through the beginning of May and perhaps longer. As we adapt to our new normal, here is a little incentive to make exercise a regular part of your life from now on.

Researchers analyzed data from the 2003–2005 National Health and Nutrition Education Survey (NHANES). During that version of this recurring study, they collected seven-day accelerometer data from over 4,850 adults 40 years and older representative of the population of the U.S. They tracked the group of subjects through 2015 to look at all-cause mortality and steps per day.

If you look at the graph, you can see that deaths per 1,000 decreased as the number of steps per day increased. The mortality rate was half the amount at 8,000 steps per day than at 4,000 steps per day. While it continued to decrease slightly, the optimal amount of steps seemed to be between 8,000 and 10,000 steps per day. One surprising outcome was that intensity didn’t seem to matter; just volume.

All-cause means just that: all causes. That’s a real motivating factor to work on stepping it out every day. But it raised a question: could steps per day reduce the risk of getting upper respiratory infections? I won’t make you wait until Saturday. The answer is that no research has answered that question yet. But there was a lot more to this study, and I’ll cover that on Saturday.

Reminder: this week you can save 19% on two items at drchet.com. Use the coupon code virus.

What are you prepared to do today?

        Dr. Chet

Reference: JAMA. 2020;323(12):1151-1160. doi:10.1001/jama.2020.1382.

Happy New Year!

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2,600,000

Think about how much that number represents. If you were to try to count to 2,600,000, at one number per second, 24 hours per day, it would take you over 30 days. If you were to limit yourself to 40 hours per week, it would take you 18 weeks. And you really would have nothing to show for it.

On the other hand, if you walked 10,000 steps per day five days per week, you would also reach 2,600,000. In that case, it would be 2,600,000 steps. If you began the year as a non-exerciser, you would have improved your fitness level. That’s quite an accomplishment.

Or pick a smaller number: 6,500. If you did 25 crunches a day five days a week, you’d have 6,500 crunches and a maybe less fat under your belt this time next year, and more than likely you’d have less lower back pain.

No matter what your health goal or goals are, just a little effort every day can bring you huge results. It really depends on one question that you ask yourself every day:

What am I prepared to do today?

Dr. Chet