February 2023

CARDIOVASCULAR

INVESTIGATING THE CONNECTION BETWEEN STEPS AND HEART DISEASE RISK

Featuring: Mercedes Carnethon, PhD

The recommendation to reach 10,000 steps a day has long been the gold standard for staying fit and improving heart health, but new research suggests that it might not be the magic number after all.

In a new study published in Circulation, Northwestern Medicine investigators conducted a meta-analysis of eight prospective studies that previously tracked steps per day and risk of cardiovascular disease in adults. They found that older adults who took 6,000 to 9,000 steps per day had a 40 to 50 percent lower risk of developing new-onset cardiovascular disease when compared to adults over 60 who took 2,000 steps per day. The lowered risk was present regardless of the speed of the steps, meaning that older adults who can’t run can still reap the benefits by simply walking more.
This is encouraging news for older adults who might not be physically able to reach 10,000 steps a day, said Mercedes Carnethon, PhD, vice chair and the Mary Harris Thompson Professor of Preventive Medicine and a co-author of the study.

“We want to set evidence-based fitness goals for people that are meaningful, but not so overwhelming that upon hearing the goal they give up completely,” Carnethon said. “The significance of this study is that we can now say that any amount of movement older adults can take at any pace can help improve their overall health and lower the likelihood of cardiovascular disease.”

Older adults are markedly more likely than younger ones to experience cardiovascular disease, which is the leading cause of death in the U.S., according to the Centers for Disease Control and Prevention.

The study also compared steps per day for younger adults but found no association between steps taken and cardiovascular disease risk.

That doesn’t mean younger adults should skip their next walk, Carnethon said, since lifestyle behaviors like physical inactivity are one of the biggest risk factors for cardiovascular disease as people age.

“Oftentimes younger people with cardiovascular disease have other factors outside of lifestyle behaviors causing it, so I think that’s why we didn’t see an association here,” said Carnethon, who is also co-director of the NUCATS Institute’s Center for Education and Career Development. “But we do know that young people who are active now tend to stay active as they age, which can help prevent heart disease.”

Clinicians can use steps as a simple metric for patient communication and public health communication, Carnethon added.

“From a public health recommendation standpoint, walking more may decrease disease risk,” she said. “We don’t have to put barriers up; It doesn’t matter if you walk slowly or need to take a break. For older adults, every step counts.”

So where did 10,000 steps come from?

The origins of the 10,000 steps recommendation are murky, Carnethon said, but most scientists agree the number caught on after a marketing campaign run by a Japanese pedometer company ahead of the 1964 Tokyo Olympics.

The company branded the pedometer Manpo-kei; which literally translates to 10,000 step-meter.

“It’s a nice round number and it’s easy to remember,” Carnethon said. “It’s just not evidence-based. While we have more research now that shows that the number of steps needed for heart health is lower, it’s important to note that taking more steps certainly won’t harm you. It just means you could lower your risk even further.”

The study was supported by an Intergovernmental Personnel Act Agreement through the Centers for Disease Control and Prevention. Additional support was provided by the National Institutes of Health, National Heart, Lung, and Blood Institute, and Department of Health and Human Services grants HHSN268201700001I, HHSN268201700002I, HHSN268201700003I, HHSN268201700004I and HHSN268201700005I.

This article was originally published in the Feinberg School of Medicine News Center on February 1, 2023. ​
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Mercedes Carnethon, PhD, vice chair of the Department of Preventive Medicine, was a co-author of the study published in Circulation.

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