The Minimum Effective Dose of Walking: Is 10,000 Steps Necessary?
"Walking is the best possible exercise. Habituate yourself to walk very far."
—Thomas Jefferson
That 10,000 number always sounded a little too perfectly rounded. It turns out that it came from a marketing campaign for a pedometer in Japan during the 1960s. The Japanese character for 10,000 looks like a person walking, so the device was called the Manpo-kei, or 10,000 steps meter.
While there’s nothing wrong with aiming to get 10,000 steps in a day, we can get a little more precise in terms of a goal when it comes to the minimum effective dose for walking. With the average American achieving less than 4,000 steps per day, this becomes incredibly important. It’s no secret that walking is remarkably powerful for your health so let’s dive into the least amount of steps we should be taking each day to reap the benefits.
The Health Benefits Of Walking
The older I get, the more important I realize walking is for our mind and body. One of the reasons I find this to be the impact it has on my patient's recovery. After I stress the importance of moving more to aid in their recovery from stroke, amputation, etc. the typical patient says, "Oh, I move a lot." When I tell them they probably have a built-in pedometer on their phone which they tend to always carry around with them and we look at it together, the tone changes and we set a goal to average a couple of thousand more steps per day. There is a stark contrast in the recovery of those who look at their steps and build upon them and those who don't.
Beyond helping support rehabilitation, walking has some pretty remarkable health benefits that extend beyond the physical realm. First, blood pressure. A 2010 systematic review of 27 randomized control trials found that walking briskly can lower blood pressure. A moderate to high-intensity pace, considered "65%–85% of maximum heart rate (HRmax) or greater than 61% VO2max," was needed for 3-5 days a week at multiple short bouts of 10-minute periods or a single bout of 20-60 minutes. For an easier measurement, moderate intensity is also considered 100 steps/minute and high intensity is 130 steps/minute. The longer the walking was studied in the research, the greater the magnitude of the effect. In other words, you need to do it continuously for it to have lasting results.
A 2015 systematic review and meta-analysis on walking groups found that walking participants had improved systolic and diastolic blood pressure, resting heart rate, body mass index (BMI), total cholesterol, and VO2 max. They also showed a reduction in depression. Speaking of depression, another systematic review and meta-analysis from 2012 found that "walking is a promising treatment for depression or depressive symptoms with few, if any, contraindications."
So it's effective at improving these markers but does it prevent them as well? A meta-analysis looked at 18 prospective studies and nearly half a million participants to determine the effectiveness of walking in preventing disease. Researchers found that both walking volume and walking pace were strong independent predictors of the overall risk of all-cause mortality, however, pace (48%) was a stronger predictor than the number of steps a day (26%).
It also improves sleep. In fact, "Walk more" may be my number one recommendation for any of my patients who are having difficulty sleeping. A 2020 cohort study backed this up and found that walking more is correlated with "greater sleep efficiency, lower frequency of awakening after sleep onset, and shorter WASO [awake after sleep onset] and naptime."
Then there's just "feeling better." Who doesn't feel good after they've done a walk? Bonus points if it's with others, on the beach, or during a sunrise or sunset.
The Health Issues Of Sedentary Life
Okay, walking is great for you. But how bad is not walking?
A 2022 study, Inactivity Causes Resistance to Improvements in Metabolism After Exercise, spells it out. The researchers found that a day spent mostly sitting, "prevents a subsequent bout of exercise from causing the normal postprandial increase in fat oxidation and lowering of plasma triglyceride concentration (i.e., “exercise resistance”)." In other words, to ensure that you have a high-fat oxidation rate, regardless of how much you exercise, you need to be active when you're not working out by simply moving more. They identified two ways to do this: walk 8,500 steps/day or bike sprints for as little as several 4-second long sprints throughout the day.
More generally speaking, a sedentary lifestyle is associated with a plethora of health issues: high blood pressure, obesity, heart disease, diabetes, cancer, anxiety, and depression.
Stronger by Science looked at the findings of a 2022 meta-analysis (below) that looked at a link between walking and death and summed it up like this: "I’m sure most readers would agree that cigarette smoking isn’t great for longevity. However, smoking seems to be associated with ~70-80% higher rates of all-cause mortality. Relative to people who walk 16,000 steps per day, walking just 2,700 steps per day is associated with ~200% higher rates of all-cause mortality." And having a BMI of 30 ("obese") compared to a BMI of 23 ("normal") holds a 4% greater all-cause mortality risk.
Okay, walking is good. So how much do I need to do to reap the benefits?
Determining The Minimum Number Of Steps In A Day
A 2022 meta-analysis, Daily Step Count and All-Cause Mortality: A Dose-Response Meta-analysis of Prospective Cohort Studies, looked at steps per day and the risk of dying from anything, also known as all-cause mortality. After looking at all of the available data, they narrowed it down to seven prospective cohort studies, 28,141 participants, 175,370 person-years, and 2,310 deaths.
What the researchers found was that for every 1,000 steps taken, the risk of dying decreased by 12%. This extended to all populations and age groups in the study. By contrasting the lowest step counts with the highest ones, they discovered a significant contrast in risk. Specifically, individuals with a daily step count as low as 2,700 faced a threefold greater mortality risk compared to those achieving the highest step counts of 16,000 per day. This underscores the substantial impact of walking on longevity.
When looking at this data, particularly the graph above, there is a generally linear decrease in the all-cause mortality risk with each step you take, however, this line becomes slightly less sharp after about 8,000 steps per day.
Another study, Daily steps and all-cause mortality: a meta-analysis of 15 international cohorts, dug through 15 studies, 47,471 adults, and 3,013 deaths to determine the link between the number of steps and all-cause mortality for those above 60 years old and below 60 years old. What they found was that "The number of daily steps at which the HR [Hazard Ratio] for mortality plateaus among adults aged 60 years and older was approximately 6000–8000 steps per day and among adults younger than 60 years was approximately 8000–10 000 steps per day." When the data is put into a graphic (below), it’s plain to see that our bodies benefit from a minimum number of steps.
Daily Step Count and All-Cause Mortality: A Dose–Response Meta-analysis of Prospective Cohort Studies
What Is The Minimum Effective Dose Of Walking?
Drawing from robust scientific research, we can confidently establish a practical guideline for the minimum daily step count that promotes health.
The minimum effective dose of walking is 8,000 steps per day.
While it's generally safe to say that the more you walk the healthier you are, the least amount of steps you should take in a day is around 8,000 to decrease your risk of dying of any cause. The minimum effective dose of walking decreases to 6,000 steps per day if you are over the age of 60.
Key Points
More is less. It's worth noting, however, that there is a diminishing rate of return. Going from 3,000 steps per day to 6,000 will provide substantial health benefits whereas going from 15,000 to 18,000 will provide much less of a bang for your buck.
Too little is dangerous. The red and blue above the hazard ratio line indicate that the risk of dying increases significantly with every less step under 5,500/day for those less than 60 years old and ~3,000 steps/day for those older than 60.
Pick up the pace. Walking at a pace that is at least moderate in intensity, or 100 steps/minute, is correlated to greater health benefits.
Spread your steps out. Don’t hit your 8,000 step target before breakfast then park your butt in your office chair. Research has shown that spreading out your bouts of activity throughout the day has a much greater impact.
Consider rucking. Rucking, or carrying weight in a pack on your back, is an incredibly simple and powerful workout. Do this for a good workout and a good ROI with each step. (This is the pack I use.)
What I Do
I love walking. Hikes, city streets, 100-degree weather, snow-laden streets, morning or night; I welcome any situation as long as I get to put one foot in front of the other. This is to the tune of about 10 to 20,000 steps per day. It's less on the weekdays, more on the weekends, and way more if I'm training for a race or on vacation. Walking faster has been shown to be better than going slower so I try to have a quicker pace and spread my bouts throughout the day whenever I can. After lunch is my most consistent time with the added benefit of getting sunlight and getting a post-prandial blood sugar management hack.
To ease any risk of boredom while simultaneously trying to become fitter I also look for hills, push a stroller, throw one of the kids on my back kid carrier, and throwing a rucksack on. With enough weight or speed, these sometimes turn into Zone 2 training days but more often than not I'm just increasing my step count.
Takeaways
As an OT, I've seen firsthand the transformative impact of encouraging patients to incorporate more movement into their recovery journeys, revealing the stark contrast between those who embrace walking and those who don't. Beyond aiding rehabilitation, walking improves blood pressure, BMI, cholesterol, fat oxidation, sleep quality, mood, and more.
As much as walking can elevate health, however, the converse holds equally true: a sedentary lifestyle poses a myriad of health risks, from obesity and heart disease to anxiety and depression. Ultimately, the minimum effective dose of walking emerges as a powerful concept, revealing that even a modest increase in daily steps can significantly enhance overall lifespan and healthspan. The minimum effective dose (MED) of walking is 8,000 steps per day for those under 60 years old (6,000 steps for those over 60) with further improvements in health for every step greater than those numbers. You’ll get more benefits from walking quickly and more often throughout the day, as well.
Reviewed by Jeffrey Sass, DPT.
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