Maximum Wellness, Episode 02: At least 4400 Steps Per Day Decreases Mortality Rate in Older Women

A recent issue of JAMA (Journal of the American Medical Association) Internal Medicine reported on research, which concluded that, “among older women, as few as approximately 4400 steps/d (steps per day) was significantly related to lower mortality rates compared with approximately 2700 steps/d. With more steps per day, mortality rates progressively decreased before leveling at approximately 7500 steps/d.”

With the advent of pedometers,  accelerometers, smart phones, and other wearable devices that can chart movement patterns (GPS), intensity (heart rate), heart rate variability, sleep patterns, and many more physical and emotional activity behaviors, it’s been determined that, “worldwide, the average number of steps accrued daily (measured by smartphones) is approximately 5,000; in the United States it is 4800.”

The authors of the JAMA step data – Association of Step Volume and Intensity in Older Women with All-Cause Mortality – include researches from Harvard Medical School, National Institute on Aging in Baltimore, Maryland, Universities of Tokyo and Tennessee, and the National Cancer Institute.

These investigators note that the commonly accepted –media driven – belief of 10,000 steps per day to achieve good health may not be determined in scientific research – which led them to examine not only the proper number of daily steps, but also the step intensity, as they pertain to all-cause mortality.

The original 1992 to 2004 Women’s Health Study (WHS), which evaluated the potential benefits of taking low dose aspirin and vitamin E to prevent cancer and cardiovascular disease (CVD) in women forty-five years and older in the United States, was the starting point for the step research.

In follow-up between 2011 to 2015, 17,708 of the WHS women, agreed to wear accelerometers  on their hip for 7 consecutive days, removing it only during sleep and water-based activities.

Women returned the devices by mail, and data were screened for wear time using. Only women wearing the device for 10 hours or more per day on 4 or more days was included in the analysis.

Annual questionnaires examined sociodemographic data, health habits, personal and family medical history – with medical records obtained for reported cancer and CVD to confirm diagnoses. Weight, height, smoking status, alcohol intake, diet history, any hormone usage, hypertension, elevated cholesterol, diabetes, CVD, and cancer-screening status was also evaluated.

Family members or postal authorities reported deaths, which were backed up by medical records, death certificates, or the National Death Index.

Some of the step criteria included number of steps per day, single highest minute step rate, steps per minute from the thirty highest minutes of the day, sporadic and purposeful steps, and stepping rate greater than 100 steps per minute.

It was concluded that in, “older women with a mean age of 72 years, we observed the second quartile of step volume distribution (approximately 4400 steps/d) to be associated with a 41% reduction in mortality rate compared with the lowest quartile (approximately 2700 steps/d).”

In addition, “we observed a steady decline in mortality rates with more steps accrued up to approximately 7500 steps/d, beyond which rates leveled. After accounting for number of steps taken, all stepping-intensity associations were attenuated (reduced) with most becoming no longer significant, which suggests that step volume, rather than step intensity, may be more important in this population.”

The researchers further note that this data may provide encouragement to those individuals, who find that the 10,000 step per day perception an unachievable goal.

From my own personal experience in tracking countless adults and adolescents in my various hospital-affiliated wellness and weight management programs, I can attest that it takes between 10,000 to 12,000 steps per day to take weight off – with 8,000 to 9,000 steps to maintain a target weight.

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