By Nicole Lou

A meta-analysis pooled data on dose-response associations between daily steps and a broad range of health outcomes.

Increasing daily step counts above 2,000 was associated with risk reductions in mortality and cardiovascular, cancer, and other outcomes.

A goal of 5,000 to 7,000 steps per day was deemed appropriate for achieving good health.

Study after study, higher daily step counts were shown to track with better health outcomes, even well below the oft-touted target of 10,000 steps.

Based on a meta-analysis of studies published since 2014, increasing daily step counts above 2,000 was associated with a risk reduction, according to Ding (Melody) Ding, PhD, MPH, of the University of Sydney, and colleagues.

There was a significant reduction in risks of all-cause mortality, cardiovascular disease incidence, dementia, and falls in people logging more steps; these outcomes were best around 5,000 to 7,000 steps per day, with no extra benefit beyond that range. Meanwhile, more steps consistently tracked with reduced cardiovascular disease mortality, cancer incidence, cancer mortality, type 2 diabetes incidence, and depressive symptoms.

"Although 10,000 steps per day, an unofficial target for decades without a clear evidence base, was associated with substantially lower risks for all-cause mortality, cardiovascular disease incidence, cancer mortality, dementia, and depressive symptoms than 7,000 steps per day, the incremental improvement beyond 7,000 steps per day was small, and there was no statistical difference between 7,000 steps per day and a higher step count for all the other outcomes," the investigators wrote.

"Therefore, 7,000 steps per day might be a more realistic and achievable recommendation for some, but 10,000 steps per day can still be a viable target for those who are more active," they suggested.

The typical American is said to walk just under 5,000 steps a day based on previous work.

Ding and colleagues acknowledged the step count/health relationship may depend on age, physical function, and other factors that were not controlled for in their study. Their meta-analysis may also have been affected by the small number of studies available for most outcomes: evidence certainty was deemed moderate for all outcomes except for cardiovascular disease mortality (low), cancer incidence (low), physical function (low), and falls (very low).

Nevertheless, they maintained that more walking is still likely to be a good thing.

"Similar to current moderate-intensity to vigorous-intensity physical activity recommendations, the message that every step counts for those who are able should be emphasized as a core public health message, regardless of the specific quantitative target," the study authors wrote.

When the 2018 U.S. physical activity guidelines and the 2020 WHO guidelines were being created, the evidence on step counts had been deemed insufficient for making recommendations.

HHS guidelines currently advise 150-300 minutes of moderate exercise or 75-150 minutes of vigorous exercise each week, along with muscle and strength training twice per week to achieve the most health benefits for adults.

Ding's group had performed a systematic review pooling 57 studies on daily steps and health outcomes. From those, they had 31 studies to use for a meta-analysis on outcomes with at least two studies from similar cohorts.

Sample sizes for each outcome ranged from 61,594 for incident type 2 diabetes to 161,176 for all-cause mortality.

Compared with 2,000 steps per day, walking 7,000 steps per day was associated with:

- A significant 47% lower risk of all-cause mortality

- A significant 25% lower risk of incident cardiovascular disease incidence

- A significant 47% lower risk of cardiovascular disease mortality

- A non-significant 6% lower risk of cancer incidence

- A significant 37% lower risk of cancer mortality

- A significant 14% lower risk of type 2 diabetes

- A significant 38% lower risk of dementia

- A significant 22% lower risk of depressive symptoms

- A significant 28% lower risk of falls

Outside research has shown that physical activity can be done daily or saved for just 1 or 2 days of the week to show associations with health benefits.