Post Gazette: Good news – Your goal of hitting 10,000 daily steps might be way too high

Among a group of up-at-dawn runners and walkers on a summery Sunday morning, Amanda Balzer planted a heel in the asphalt of a South Side parking lot and stretched down toward it before waking up her other set of hamstrings the same way. She then took a moment, readying her fitness watch to capture the group’s impending 10-mile run.

It reminded her of how she used to interact with fitness watches.

“I was so OCD over it,” Balzer, 28, of Bethel Park, said. “If I hadn’t reached a goal, I’d walk in circles around my house, or maybe I’d walk up and down the stairs, or take the dog out more than I wanted to, or walk on the treadmill between meetings, because I wanted to get my steps.”

Those behaviors are now four years old. Looking back, she knows they weren’t about health, but about a presumed connection between the 10,000-step idea and maintaining her weight.

A three-day-per-week Fleet Feet Pittsburgh run group and a new type of watch have her thinking differently now, and so do a few recent studies, all of which throw water on the pressure of achieving 10,000 steps per day.

“So many people think, ‘If I walk this many steps per day, I’ll lose weight.’ Or, ‘If I walk this many steps per day, it will help me reach my strength goal,’” said Kate Stache, fitness director at Washington Health System’s Wilfred R. Cameron Wellness Center. “But the main thing with the step goal is that it prolongs life,” even at lower numbers, as it turns out.

According to a study published in the Journal of the American Medical Association Network Open in March, not only do just 8,000 steps confer a lower risk of death (measured at 10 years), but concentrating those step counts on one or two days of the week — “weekend warrior”-style fitness — still substantially lowered the risk of all-cause and cardiovascular mortality.

That study reached its conclusions with just over 3,100 participants, but another study published in JAMA this July looked at nearly 90,000 people who shoved the recommended 150 minutes per week of moderate-intensity exercise — enough of a cardiovascular challenge to speak the words to a song but not sing them — into just one or two days. The “weekend warrior” group participants lowered their risk of cardiovascular outcomes similarly to those who exercised more frequently.

While interesting — and perhaps encouraging — none of these conclusions upends current recommendations.

Spending at least 150 minutes of moderate-intensity exercise or 75 minutes of vigorous exercise — recommended by the Centers for Disease Control and Prevention, the American Heart Association and the World Health Organization — still offers the best chance at cardiovascular health. And taking more than 8,000 steps per day on more days of the week, versus one or two, still may protect people better.

What these results provide, however, is more chances for accomplishment.

“A lot of people get ‘all or nothing’ stuck in their heads,” Stache said. “If they can’t reach 10,000 steps, they get discouraged, and then they’re not even trying. That’s the big thing I saw with this study, saying if you’re able to get 8,000 steps on two days of the week, that is better than nothing.”

With so many people wrapping ribbons of their self-esteem around this 10,000-step goal, it seems appropriate to wonder where it came from.

Marketing.

In the course of her own research, Harvard epidemiologist I-Min Lee discovered that the 10,000-step goal goes back to Japan in 1965, when a company made the Manpo-kei device, which translates to “10,000 step meter.” It was a catchy phrase and impressive number, but hinged on absolutely no scientific evidence.

Since then, there have been plenty of stumbling blocks around the 10,000-step idea.

Lee’s own research showed a plateau of positive effects at 7,500 steps for women in their 70s. Another study demonstrated that major health protections begin at 8,200 steps, but for some parameters, no further benefit was seen past 9,000 steps. A 2022 study looking at 20,000 people from 43 countries showed a 40-to-50% cardiovascular risk reduction starting with just 6,000 steps.

And in a study published in the European Journal of Preventive Cardiology on Wednesday, investigators concluded that cardiovascular benefits begin at just 2,338 steps and all-cause mortality begins to decline at 3,968 steps, though more steps improve outcomes further.

Conversely, a JAMA Neurology study from last year showed that walking any fewer steps than 9,800 was associated with higher dementia risk, which is a pretty strong vote for 10,000 steps.

With the jury still out on steps, the WHO, CDC and AHA all support intensity-time goals, and 76% of Americans fail to meet them.

“When advocating for an increase in physical activity and regular exercise, routine clinicians should set up achievable goals, and explain that every minute or every step counts,” said St. Clair Health cardiologist Katherine Shreyder. “Proceeding with 8,000 steps only one or two days per week may be an important start for many patients that would not only set up a new routine, but also appear to be meaningful for heart health. I think this may encourage patients to begin exercising.”

And when they do, Stache offers a few more motivating tips.

She often reminds clients that all exercise registers to the body, even if it’s in spurts. Take a few minutes to walk during a work break or do a few laps around the basketball court while your kid shoots some hoops.

“If you spend 10 minutes every hour walking around, that would be the same thing as doing a 60-minute workout,” she said.

And so far as reaching the recommended level of intensity, walking can indeed be sufficiently taxing. There are benchmarks like speaking versus singing lyrics, but for more analytical folks — or the huge population of fitness watch-wearers — heart rate tells a more specific story.

For those who’ve gotten the green light for exercise from their health care practitioners, subtract your age from 220, then multiply that number by .45 (to identify the lower end of your target heart rate range) and again by .85 (to identify the higher end of your target heart rate range).

Stache is also careful to note that these goals address only cardiovascular fitness. Ideally, well-rounded fitness routines include two days of strength training and a healthy dose of stretching and flexibility exercises.

Amanda Balzer didn’t know all of this four years ago when she was bouncing around her house at night, staring at her watch and waiting for its colored rings to close.

But she certainly wishes she did.

“Someone who works a 9-to-5, you’re definitely sitting a lot. Six thousand is way more attainable than 10,000,” she said. “I think it would have helped just to do more research, and we, as women especially, are so focused on looking a certain way, being a certain way, thinking this is the best way, and it’s not.

“Had I focused more on that than what the numbers were telling me, I could have had a healthier relationship with the watch — and myself — at the time.”

Resource: https://www.post-gazette.com/news/health/2023/08/13/daily-step-goal-fitness/stories/202308130014

First Published August 12, 2023, 10:32 PM