BACKGROUND AND PURPOSE:

• Previous reviews of the literature have not found enough evidence to recommend a certain step count target
• Ding et al. (The Lancet Public Health, 2025) synthesized the dose-response relationship between daily steps and health outcomes including all-cause mortality, cardiovascular disease and other health outcomes

METHODS:

• Systematic review and meta-analysis
• Inclusion criteria
  • Prospective studies
  • Studies that examined the relationship between device-measured daily steps and health outcomes among adults
• Study design
  • Risk of bias was assessed
  • Hazard ratio (HR) from individual studies were synthesized with random-effects dose-response meta-analysis
  • Certainty of evidence was assessed with GRADE criteria
• Primary outcomes
  • Mortality
  • Cardiovascular disease
  • Cancer
  • Type 2 diabetes
  • Cognitive outcomes
  • Mental health outcomes
  • Physical function
  • Falls

RESULTS:

• 57 studies | 35 cohorts
  • Used for meta-analysis: 31 studies | 24 cohorts
• There was an inverse, non-linear dose-response association with steps and several health outcomes, with inflection points at approximately 5000 to 7000 steps/day
  • All-cause mortality
  • Cardiovascular disease
  • Dementia
  • Falls
• There was an inverse linear association between steps and the following health outcomes
  • Cardiovascular disease mortality
  • Cancer
  • Cancer mortality
  • Type 2 diabetes
  • Depressive symptoms
• Compared with 2000 steps per day, 7000 steps per day was associated with lower
  • All-cause mortality
    • HR 0.53 (95% CI, 0.46 to 0.60) | I2=36.3
    • Moderate certainty | 14 studies
  • Cardiovascular disease incidence
    • HR 0.75 (95% CI, 0.67 to 0.85) | I2=38.3%
    • Moderate certainty | 6 studies
  • Cardiovascular disease mortality
    • HR 0.53 (95% CI, 0.37 to 0.77) | I2=78.2%
    • Low certainty | 3 studies
  • Cancer mortality
    • HR 0.63 (95% CI, 0.55 to 0.72) | I2=64.5%
    • Moderate certainty | 3 studies
  • Type 2 diabetes
    • HR 0.86 (95% CI, 0.74 to 0.99) | I2=48.5%
    • Moderate certainty | 4 studies
  • Dementia
    • HR 0.62 (95% CI, 0.53 to 0.73) | I2=0%
    • Moderate certainty | 2 studies
  • Depressive symptoms
    • HR 0.78 (95% CI, 0.73 to 0.83) | I2=36.2%
    • Moderate certainty | 3 studies
  • Falls
    • HR 0.72 (95% CI, 0.65 to 0.81) | I2=47.5%
    • Very low certainty | 4 studies

CONCLUSION:

• A daily step count of 7000 steps per day is associated with significant improvements in a range of health outcomes
  • 7000 daily steps may be more achievable than the often suggested 10,000 daily steps
• Limitations include lack of age-specific analyses, few studies for some outcomes, and residual confounding
• The authors state

Although risk reductions occur even at lower step counts, they continue with increasing steps per day

Approximately 7000 steps per day was associated with risk reductions for all outcomes examined and might serve as a practical quantitative public health target

Learn More – Primary Sources:

Daily steps and health outcomes in adults: a systematic review and dose-response meta-analysis