Counting your steps daily can 'equally benefit exercise goals', study says

Going outdoor. An elderly woman using a smartwatch.
-Credit: (Image: Getty)

Counting your steps throughout the day is a great way to benefit your health, according to a new study.

Researchers found that both the number of steps and time-based exercise targets are equivalently linked with better health, extended lifespan, and reduced risk of a heart attack or stroke.

Monitoring step counts has never been easier in the age of smartphones and watches but current guidelines for physical health don't explicitly recommend counting your steps.

A new American study that involved thousands of older women has suggested that both step and time-based exercise targets are associated with lower risks of dying prematurely and cardiovascular disease.

Choosing a time or step goal may not be as important as choosing a goal aligned with personal preferences, according to the findings published in JAMA Internal Medicine.

Current UK guidelines, published on the NHS website, recommend that adults do at least 150 minutes of moderate intensity activity a week or 75 minutes of vigorous intensity activity a week.

With wearable devices now common and step counts a popular measure among many fitness tracking platforms, the research team wanted to find out how time-based goals stack up against step-based ones.

Hands of an athlete close-up.
Choosing a time or step goal may not be as important as choosing a goal aligned with personal preferences -Credit:Getty

Study lead author Professor Rikuta Hamaya said: "We recognised that existing physical activity guidelines focus primarily on activity duration and intensity but lack step-based recommendations.

"With more people using smartwatches to measure their steps and overall health, we saw the importance of ascertaining how step-based measurements compare to time-based targets in their association with health outcomes – is one better than the other?"

The research team collected data from 14,399 women who did not cardiovascular disease or cancer at the outset.

Between 2011 and 2015, participants aged 62 years and older were asked to wear research grade wearables for seven consecutive days to record their physical activity levels, only removing the devices for sleep or water-related activities.

Annual questionnaires were completed throughout the study period until the end of 2022.

The findings showed that the participants engaged in an average of 62 minutes of moderate-to-vigorous intensity physical activity per week and clocked up an average of 5,183 steps per day. After nine years around nine per cent of the participants had died while about four per cent developed cardiovascular disease.

Higher levels of physical activity - whether assessed as step counts or time spent active - were associated with large reductions in the risk of dying or developing cardiovascular disease. The most active women saw 30 to 40 per cent risk reductions compared with the least active quarter, according to the findings.

And, those outside the bottom quarter in terms of physical activity outlived those in it by an average of 2.22 and 2.36 months respectively, based on time and step-based measurements.

The survival advantage persisted regardless of differences in body mass index (BMI), according to the researchers.

While both metrics are useful in portraying health status, they explained that each has its advantages and downsides.

Prof Hamaya said step counts may not account for differences in fitness levels. For example, if a 20-year-old and 80-year-old both walk for 30 minutes at moderate intensity, their step counts may differ significantly.

But steps are straightforward to measure and less subject to interpretation compared to exercise intensity.

Steps capture even sporadic movements of every day life, not just exercise, and those kinds of daily life activities are most likely those carried out by older individuals.

Prof Hamaya, of Brigham and Women’s Hospital (BWH) in Boston, Massachusetts, said: "For some, especially for younger individuals, exercise may involve activities like tennis, soccer, walking, or jogging, all of which can be easily tracked with steps.

"However, for others, it may consist of bike rides or swimming, where monitoring the duration of exercise is simpler. That's why it's important for physical activity guidelines to offer multiple ways to reach goals.

"Movement looks different for everyone, and nearly all forms of movement are beneficial to our health."

Prof Hamaya aims to collect more data via a controlled trial to better understand the relationship between time and step-based exercise measures and well-being.

Senior author Professor I-Min Lee, an epidemiologist at BWH, added: "The next federal physical activity guidelines are planned for 2028.

"Our findings further establish the importance of adding step-based targets, in order to accommodate flexibility of goals that work for individuals with differing preferences, abilities and lifestyles."