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Relationship of Daily Step Counts to All-Cause Mortality and Cardiovascular Events

Stens, NA, Bakker, EA, Mañas, A, Buffart, LM, Ortega, FB, Lee, DC, Thompson, PD, Thijssen, DHJ and Eijsvogels, TMH (2023) Relationship of Daily Step Counts to All-Cause Mortality and Cardiovascular Events. Journal of the American College of Cardiology, 82 (15). pp. 1483-1494. ISSN 0735-1097

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Background: 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)

Item Type: Article
Uncontrolled Keywords: exercise; health outcomes; physical activity; population; public health; walking; 1102 Cardiorespiratory Medicine and Haematology; 1117 Public Health and Health Services; Cardiovascular System & Hematology
Subjects: R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
R Medicine > RC Internal medicine > RC1200 Sports Medicine
Divisions: Sport & Exercise Sciences
Publisher: Elsevier
SWORD Depositor: A Symplectic
Date Deposited: 07 Nov 2023 10:23
Last Modified: 07 Nov 2023 10:23
DOI or ID number: 10.1016/j.jacc.2023.07.029
URI: https://researchonline.ljmu.ac.uk/id/eprint/21803
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