Here's How Many Steps You Need Every Day to Maximize Health Benefits

Physical activity is crucial to living a healthy lifestyle. Daily step counts are an easy indirect measure of physical activity. The benefits of exercise are immense. It improves our heart and lung function. It lowers our cholesterol and blood sugar. It increases metabolism to help us lose weight. It improves our sleep and mental health. It helps us learn and concentrate.


How much exercise do we need?


We all know any exercise is better than no exercise. But how much exercise do we need?


The American Heart Association recommends 150 minutes of moderate intensity aerobic activity (such as walking) or 75 minutes of vigorous aerobic activity per week.


How many steps per day does that equal?

Is that enough to get health benefits?

Are more steps better?


This post will answer all those questions. And more.


Step counts and mortality


You will live longer the more steps you take in a day.


This study looked at 16,700 women and analyzed whether their step count was associated with all cause mortality. They found that women who achieved 4400 steps per day had significantly lower mortality rates compared to those who got 2700 steps per day. Every additional 1000 steps lowered mortality until 7500 steps per day. After that, any further mortality benefit leveled off.


Researchers from this study also concluded there is a direct relationship between steps and mortality. Those who walked less than 4000 steps per day had the highest mortality. Interestingly, this study found that every additional 1000 steps lowered mortality until 12000 steps per day. At that point, the benefits started to flatten out.


Both studies used accelerometers to see if walking faster provided additional benefit. They found no association between step intensity and mortality. They concluded if you get the steps in, you get the associated mortality reduction.


We know the American Heart Association recommends 150 minutes of moderate intensity aerobic activity per week. A brisk walk pace is about 3 to 4 miles per hour. This is roughly 7000 steps per hour. So 150 minutes of brisk walking per week is about 2500 steps per day.


We can conclude from the above two studies that we should get at least 7500 steps per day. If we follow the AHA recommendations for exercise, we need an additional 5000 steps per day. This can be done through more exercise or more movement in our day to day activities.


Step counts and cardiovascular disease


This systematic review and meta-analysis looked into whether the amount of steps per day correlated with arterial stiffness. Arteries are blood vessels. A stiff artery makes the heart work harder. This increases the risk for heart disease and stroke. Having stiff arteries is a predictor for cardiovascular disease.


Researchers found that there was a significant difference between artery stiffness in those who had less than 5000 steps per day compared with those who had more than 7500 steps per day.


Again, we can conclude that we should get at least 7500 steps per day.


Step counts improve cognition


These researchers assessed the relationship between step count and cognitive performance as measured by two validated neuropsychological battery tests. They found positive correlations between more step counts and better attention, executive functioning, language, and memory.


The study did not publish the number of steps per day of their participants. They only reported that there was a large range, between 1000 and 20000 steps per day. Nevertheless, they concluded that greater physical activity was associated with improved cognition.


Step counts help with infections


This study in Japan examined whether walking an hour a day improved pneumonia related outcomes in adults over 65 years old. Pneumonia is a serious lung infection that can be caused by both viruses and bacteria. According to the American Thoracic Society, it is the most common cause of hospital admissions for adults in the United States.


Researchers found that walking one hour daily (about 7000 steps) significantly reduced the chance of dying from pneumonia among adults older than 65.


Step counts improve mental health


These researchers found that participants who joined a 100 day 10000 step program had improved signs of depression, anxiety, and stress.


It’s important to point out that not all participants in this study reached an average daily step goal of 10000 steps. In their analysis, researchers broke down the two groups to those with less than 10000 steps and those with more than 10000 steps.


They found that BOTH groups had improvements in mental health conditions. It seems just participating in a walking goal oriented program improved depression, anxiety, and stress. The participants who reached 10000 steps per day had better improvements in stress and anxiety. They also rated their well being significantly higher.


Should you get a device to track steps?


This systematic review examined whether using a pedometer or step tracker increased physical activity compared to non users. They found that subjects randomized to the pedometer group increased their steps by about 2500 steps per day compared to non users.


They also found that those with a goal amount of steps (ie. 10000 steps per day) had significantly increased activity than those with no goals. The pedometer group had significant decreases in their body mass index and their blood pressure when compared to non users.


Fortunately, most of us don't need to buy a dedicated pedometer. Most smart phones (as long as you carry them around with you) and smart watches track our daily steps. We just need to turn the features on!


Putting it all together


What should the daily step goal be?


The above studies suggest we should aim for at least 7500 steps per day. This will maximize benefits to all-cause mortality, decrease cardiovascular risk, improve mental function, and boost mental health.


Some of the studies suggest greater benefits can be attained at 10000 steps per day and potentially more by reaching 12000 steps per day.


© 2020 by Jeffrey Peng MD