A2 Review article, Literature review, Systematic review
Relationship of Daily Step Counts to All-Cause Mortality and Cardiovascular Events (2023)
Stens, N. A., Bakker, E. A., Mañas, A., Buffart, L. M., Ortega, F. B., Lee, D.-C., Thompson, P. D., Thijssen, D. H. J., & Eijsvogels, T. M. H. (2023). Relationship of Daily Step Counts to All-Cause Mortality and Cardiovascular Events. Journal of the American College of Cardiology, 82(15), 1483-1494. https://doi.org/10.1016/j.jacc.2023.07.029
JYU authors or editors
Publication details
All authors or editors: Stens, Niels A.; Bakker, Esmée A.; Mañas, Asier; Buffart, Laurien M.; Ortega, Francisco B.; Lee, Duck-chul; Thompson, Paul D.; Thijssen, Dick H. J.; Eijsvogels, Thijs M. H.
Journal or series: Journal of the American College of Cardiology
ISSN: 0735-1097
eISSN: 1558-3597
Publication year: 2023
Publication date: 06/09/2023
Volume: 82
Issue number: 15
Pages range: 1483-1494
Publisher: Elsevier BV
Publication country: United States
Publication language: English
DOI: https://doi.org/10.1016/j.jacc.2023.07.029
Publication open access: Not open
Publication channel open access:
Publication is parallel published (JYX): https://jyx.jyu.fi/handle/123456789/91833
Abstract
The minimal and optimal daily step counts for health improvements remain unclear.
Objectives
A meta-analysis was performed to quantify dose-response associations of objectively measured step count metrics in the general population.
Methods
Electronic databases were searched from inception to October 2022. Primary outcomes included all-cause mortality and incident cardiovascular disease (CVD). Study results were analyzed using generalized least squares and random-effects models.
Results
In total, 111,309 individuals from 12 studies were included. Significant risk reductions were observed at 2,517 steps/d for all-cause mortality (adjusted HR [aHR]: 0.92; 95% CI: 0.84-0.999) and 2,735 steps/d for incident CVD (aHR: 0.89; 95% CI: 0.79-0.999) compared with 2,000 steps/d (reference). Additional steps resulted in nonlinear risk reductions of all-cause mortality and incident CVD with an optimal dose at 8,763 (aHR: 0.40; 95% CI: 0.38-0.43) and 7,126 steps/d (aHR: 0.49; 95% CI: 0.45-0.55), respectively. Increments from a low to an intermediate or a high cadence were independently associated with risk reductions of all-cause mortality. Sex did not influence the dose-response associations, but after stratification for assessment device and wear location, pronounced risk reductions were observed for hip-worn accelerometers compared with pedometers and wrist-worn accelerometers.
Conclusions
As few as about 2,600 and about 2,800 steps/d yield significant mortality and CVD benefits, with progressive risk reductions up to about 8,800 and about 7,200 steps/d, respectively. Additional mortality benefits were found at a moderate to high vs a low step cadence. These findings can extend contemporary physical activity prescriptions given the easy-to-understand concept of step count. (Dose-Response Relationship Between Daily Step Count and Health Outcomes: A Systematic Review and Meta-Analyses; CRD42021244747)
Keywords: physical activity; physical training; walking (motion); steps; health effects; mortality; cardiovascular diseases; meta-analysis
Free keywords: exercise; health outcomes; physical activity; population; public health; walking
Contributing organizations
Ministry reporting: Yes
VIRTA submission year: 2023
JUFO rating: 3
