dc.description.abstract | Background Although 10000 steps per day is widely promoted to have health benefits, there is little evidence to support
this recommendation. We aimed to determine the association between number of steps per day and stepping rate
with all-cause mortality.<p>
<p>Methods In this meta-analysis, we identified studies investigating the effect of daily step count on all-cause mortality
in adults (aged ≥18 years), via a previously published systematic review and expert knowledge of the field. We asked
participating study investigators to process their participant-level data following a standardised protocol. The primary
outcome was all-cause mortality collected from death certificates and country registries. We analysed the dose–
response association of steps per day and stepping rate with all-cause mortality. We did Cox proportional hazards
regression analyses using study-specific quartiles of steps per day and calculated hazard ratios (HRs) with inversevariance weighted random effects models.
<p>Findings We identified 15 studies, of which seven were published and eight were unpublished, with study start dates
between 1999 and 2018. The total sample included 47 471 adults, among whom there were 3013 deaths (10·1 per
1000 participant-years) over a median follow-up of 7·1 years ([IQR 4·3–9·9]; total sum of follow-up across studies was
297 837 person-years). Quartile median steps per day were 3553 for quartile 1, 5801 for quartile 2, 7842 for quartile 3,
and 10 901 for quartile 4. Compared with the lowest quartile, the adjusted HR for all-cause mortality was 0·60 (95% CI
0·51–0·71) for quartile 2, 0·55 (0·49–0·62) for quartile 3, and 0·47 (0·39–0·57) for quartile 4. Restricted cubic splines
showed progressively decreasing risk of mortality among adults aged 60 years and older with increasing number of
steps per day until 6000–8000 steps per day and among adults younger than 60 years until 8000–10000 steps per day.
Adjusting for number of steps per day, comparing quartile 1 with quartile 4, the association between higher stepping
rates and mortality was attenuated but remained significant for a peak of 30 min (HR 0·67 [95% CI 0·56–0·83]) and
a peak of 60 min (0·67 [0·50–0·90]), but not significant for time (min per day) spent walking at 40 steps per min or
faster (1·12 [0·96–1·32]) and 100 steps per min or faster (0·86 [0·58–1·28]).
<p>Interpretation Taking more steps per day was associated with a progressively lower risk of all-cause mortality, up to a
level that varied by age. The findings from this meta-analysis can be used to inform step guidelines for public health
promotion of physical activity. | en_US |
dc.identifier.citation | Paluch, Bajpai, Bassett, Carnethon, Ekelund, Evenson, Galuska, Jefferis, Kraus, Lee, Matthews, Omura, Patel, Pieper, Rees-Punia, Dallmeier, Klenk, Whincup, Dooley, Pettee Gabriel, Palta, Pompeii, Chernofsky, Larson, Vasan, Spartano, Ballin, Nordström, Nordström AH, Anderssen, Hansen, Cochrane, Dwyer, Wang, Ferrucci, Liu, Schrack, Urbanek, Saint-Maurice, Yamamoto, Yoshitake, Newton, Yang, Shiroma, Fulton. Daily steps and all-cause mortality: a meta-analysis of 15 international cohorts. The Lancet Public Health. 2022;7(3):e219-e228 | en_US |