You can improve their health by walking this number of steps per day, researchers say

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People can improve their health in many ways simply by walking 8,000 to 9,000 steps a day, researchers say. 

Evidence has been accumulating over the past decade or so that walking can pay off big when it comes to conditions like hypertension, diabetes and dementia. Though 10,000 steps has been a number that’s been picked up by the media, no one really knew whether it was necessary to take that many steps to improve health.

A study published in Nature on Monday is the latest to link walking to a host of health benefits and adds several new conditions that to the list that had not been discovered before: gastroesophageal reflux disease (GERD), sleep apnea and depression. The new study found 8,000 to 9,000 steps a day gave the biggest bang for the stride when it comes to hypertension and diabetes but benefits occurred even with lower step counts.

Similarly, two earlier studies that used activity data collected over one week found that fewer steps could have an impact on health. One study, published in September, linked 10,000 steps as day to a 50 percent decrease in dementia risk. Walking less also decreased risk, but not as much. Walking at a brisk pace for half an hour diminished the risk even more, by 62 percent.

The other study, in 16,741 women whose average age was 72, revealed that 4,400 steps a day reduced the risk of dying during a four year follow-up. That study tracked women’s activity for seven days and then checked back with the women four years later.

For the Nature study, researchers followed 6,042 volunteers for four years. The volunteers wore a Fitbit device and allowed researchers to have access to their electronic health records.

There were several big differences between the new study and previous ones. First, rather than just a week of data on walking, steps were monitored for the entire length of the study. Next, volunteers’ step counts were linked to their actual medical records during the four years. And finally, the researchers were not looking for associations with specific diseases, but rather, they let the data show them what health conditions were impacted by walking.

“The real strength of our study is that with continuous monitoring we can see how activity changes over the four years,” said study coauthor Dr. Evan Brittain, a cardiologist and an associate professor of medicine at Vanderbilt University School of Medicine. “Also, we started our analysis from a totally unbiased perspective looking for associations between activity and 1,700 different conditions.”

One caveat to the findings is that the people in the study might be healthier than is typical, Brittain said. “These are people who, on their own, bought a Fitbit and wore it and agreed to be part of the program. They are going to be different from randomly selected people. They are mostly middle aged white women who mostly are college educated.”

The study found that there were no greater improvements in hypertension and diabetes after 8,000 to 9,000 steps. But benefits continued to accrue with a greater number of steps for other conditions, such as obesity, depression, GERD and sleep apnea.

People saw improvements even if they didn’t manage to hit 8,000 steps, Brittain said. “There is definitely still a benefit for step counts under 8,000,” he added. “I would absolutely say that people should get as many steps in as they can.”

The new study showed the more steps you took, the more protection you got, said Dr. Lawrence Phillips, an associate professor of medicine and medical director of outpatient cardiology at NYU Langone Health in New York. A focus on steps can allow doctors to engage people who aren’t ready or able to go to the gym, added Phillips who wasn’t involved in the new research.

“This study shows an active lifestyle decreases the risk of many chronic conditions,” Phillips said. “The more you do, the lower the risk of developing conditions like sleep apnea and obesity.”

Still, Phillips said, if you have conditions that restrict your activity, “you shouldn’t ignore your body to hit a target. You can spread your activity throughout the day rather than having one set period.”

Because most new cell phones have the ability to monitor steps in the background, “I’m seeing more and more patients coming in with data,” Phillips said. “If they don’t know about it, I tell them to pull out their cell phone and I show them. That alone allows them to be more active and proactive.”

Phillips says he advises his patients to check their step count throughout the day. If they’re coming up short, they can park further away from the grocery store than usual or if they’re taking the subway, they can get off at an earlier stop, he said.

The major contribution of the study is that it provides a scientific basis to support the notion that people can protect themselves against risk factors for diabetes and hypertension by walking, said Dr. Erwin Bottinger, a professor of medicine at the Icahn School of Medicine at Mount Sinai and co-director of the Hasso Plattner Institute for Digital Health at Mount Sinai in New York. 

Those who can’t make 8,000 to 9,000 steps a day “could work up to it,” Bottinger said. “They should challenge themselves if there is no obvious disability or injury that would make it hard to reach that step count.”

Using Fitbits and cell phones to keep track of activity is just the beginning of how digital devices will help us get healthier, Bottinger said.

The findings from the new study “give physicians a more precise definition of what they should be advising patients to do,” said Dr. Olga Shabalov, a clinical assistant professor of cardiology at the University of Pittsburgh and a cardiologist at the UPMC Heart and Vascular Institute.

“My own advice, even before this, was if you live in a safe neighborhood get out and walk because walking is good for you and it’s not as involved as going to the gym,” Shabalov said. “It’s a good goal to try to avoid weight gain.”

Shabalov hopes future research will look at more diverse populations.

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