The more you walk, the lower your risk of death?

Insufficient physical activity affects more than a quarter of the world's population, with more women than men (32% vs 23%). According to the World Health Organization, insufficient physical activity is the fourth most common cause of death worldwide, with 3.2 million deaths each year related to lack of physical activity. There is strong evidence that a sedentary lifestyle may lead to an increase in cardiovascular disease and a shortened lifespan.

Walking is the easiest physical activity, so how many steps should you take each day to see health benefits?
The result may be less than you think.

A large-scale survey study recently published in the European Journal of Preventive Cardiology found that walking at least 3,967 steps a day can reduce the risk of death from all causes, and walking 2,337 steps a day can reduce the risk of death from cardiovascular disease.

The new analysis, which involved 226,889 people from 17 different studies around the world, shows that the more you walk, the greater the health benefits. For every additional 500 to 1,000 steps you walk, the risk of dying from any cause or from cardiovascular disease is significantly reduced. For every additional 1,000 steps per day, the risk of dying from any cause is reduced by 15%, and for every additional 500 steps per day, the risk of dying from cardiovascular disease is reduced by 7%.
Furthermore, even at 20,000 steps per day, the health benefits continue to increase. No upper limit has yet been found.

Professor Maciej Banach, Professor of Cardiology at the Medical University of Lodz in Poland, said: “The study confirms that the more you walk, the better. This holds true for both men and women, regardless of age, and whether you live in temperate, subtropical, subpolar or mixed climates. Moreover, our analysis shows that walking just 4,000 steps a day can significantly reduce death from any cause, and even less from cardiovascular disease.”
"Until now, it has been unclear what the optimal number of steps is, both in terms of a cut-off point where health benefits can start to be seen, and in terms of an upper limit, if there is one," said Dr. Ibadete Bytyçi of the University of Kosovo Clinical Center.

Not only was the first meta-analysis to assess the effects of walking 20,000 steps a day, it also looked at whether there were differences by age, sex, or where people lived around the world.

The researchers followed the subjects for an average of seven years. The average age was 64, and 49% of the participants were women. Among people aged 60 and over, the reduction in risk of death was less than that of people under 60. People over 60 who walked 6,000 to 10,000 steps a day had a 42% lower risk of disease, while people under 60 who walked 7,000 to 13,000 steps a day had a 49% lower risk of disease.

Professor Banach noted that in a world with an increasing number of advanced drugs to target specific diseases such as cardiovascular disease, it should always be emphasized that lifestyle modifications, including diet and exercise, which were the mainstay of our analysis, may be at least as effective, or even more effective, in reducing cardiovascular risk and extending lifespan.

"Further research is still needed to investigate whether these benefits exist in high-intensity exercise, such as marathons and Ironman challenges, and in different populations of different ages and with different associated health problems. However, as with drug treatments, we should always consider individualized lifestyle changes."

Strengths of this meta-analysis include its large size and the fact that it was not limited to studies with a maximum of 16,000 steps per day. Limitations include that this was an observational study, so it cannot prove that increasing step counts led to a lower risk of death, only that it was associated with it; that the effects of step counts were not tested in patients with different diseases, that all participants were healthy when they entered the study analysis; and that the methods of calculating step counts were different in the studies involved.