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How to Lower Your Mortality (And Your Patients) – One Step at a Time

November 14, 2023

Editor’s note: We usually don’t cover preventive medicine. But I found this article to be very encouraging for my own wellness and thought you might as well. ~Clay Smith

Written by Vivian Lei

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There is a nonlinear inverse dose-response trend between daily step count and all-cause death and cardiovascular disease, with progressive risk reductions starting at as few as 2500 to 2700 steps/day, independent of sex. Walking faster provided additive health benefits.

A short walk a day keeps the doctor away
Wouldn’t it be nice to know the “dose” of regular physical activity that will reduce the risk of cardiovascular disease and all-cause mortality? In this systematic review and meta-analysis, researchers examined the relationship between step counts and health outcomes. Using data from 111,309 individuals in 12 studies, they found a statistically significant reduction in all-cause mortality at a “minimum” step count of 2,517 steps/day and reduction in incidence of cardiovascular disease (CVD) at 2,735 steps/day. The “optimal” dose, defined as the maximal risk reduction at the least effort, was 8,763 steps/day for all-cause mortality and 7,126 steps/day for incident CVD. Increasing daily steps beyond this did not lead to significant reductions in either endpoint.

Walking faster was also associated with decreased all-cause mortality, such that those with an intermediate (63 steps/min) and high cadence (88 steps/min) led to a 22% and 21% risk reduction, respectively, compared to those with low cadence (29 steps/min), after adjusting for daily step count. 

No significant differences in risk reduction were found between men and women and the minimum and optimal step counts were not affected by the pedometer device type or location.

From cited article

How will this change my practice?
When counseling patients on physical activity for better health, this study supports a tangible, attainable, and reassuring goal for walking that reinforces the message of “every step counts.”

Relationship of Daily Step Counts to All-Cause Mortality and Cardiovascular Events. J Am Coll Cardiol. 2023 Oct 10;82(15):1483-1494. doi: 10.1016/j.jacc.2023.07.029. Epub 2023 Sep 6.

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