Prospective Associations of Daily Step Counts and Intensity With Cancer and Cardiovascular Disease Incidence and Mortality and All-Cause Mortality.

Del Pozo Cruz B, Ahmadi MN, Lee I, et al. (2022) JAMA internal medicine
Title and abstract of Prospective Associations of Daily Step Counts and Intensity With Cancer and Cardiovascular Disease Incidence and Mortality and All-Cause Mortality.

Key Takeaway

UK Biobank study of 78,500 adults found that 10,000 steps/day was associated with 53% lower all-cause mortality, 65% lower cancer mortality, and 73% lower cardiovascular mortality compared to 2,000 steps/day.

Summary

This large prospective cohort study used accelerometer data from 78,500 UK Biobank participants (ages 40-79) followed for a median of 7 years to examine how daily step count and stepping intensity relate to cancer, cardiovascular disease, and all-cause mortality.

The study found strong dose-response associations between daily steps and all three outcomes. Compared with 2,000 steps/day, walking 10,000 steps was associated with dramatically lower risks: 53% lower all-cause mortality, 65% lower cancer mortality, and 73% lower cardiovascular mortality. The relationship was nonlinear, with the steepest risk reductions occurring between 2,000 and 7,000 steps.

Notably, the study also examined stepping intensity (peak 30-minute cadence) and found that higher-intensity stepping provided additional benefits beyond total step count. This suggests that both volume and intensity of walking matter, though volume appears to be the stronger predictor.

Methods

  • Prospective cohort from UK Biobank (2013-2015 enrollment)
  • 78,500 adults aged 40-79 with valid accelerometer data
  • Steps measured by wrist-worn accelerometer over 7 days
  • Median follow-up of 7 years
  • Outcomes: incident cancer, incident CVD, all-cause mortality
  • Step intensity measured via peak 30-minute cadence
  • Adjusted for age, sex, ethnicity, education, BMI, smoking, diet, alcohol, sleep, and comorbidities

Key Results

  • 10,000 steps/day vs. 2,000: 53% lower all-cause mortality
  • 10,000 steps/day vs. 2,000: 65% lower cancer mortality
  • 10,000 steps/day vs. 2,000: 73% lower cardiovascular mortality
  • Optimal dose for all-cause mortality: ~9,800 steps/day
  • Optimal dose for cancer incidence: ~7,000 steps/day
  • Higher stepping intensity associated with additional benefits beyond volume
  • Dose-response was nonlinear with steepest drops at lower step counts

Figures

Limitations

  • UK Biobank participants are healthier than general population
  • Single 7-day accelerometer measurement period
  • Wrist-worn accelerometer may be less accurate than hip-worn for step counting
  • Predominantly white British cohort (limited generalizability)
  • Residual confounding possible despite extensive adjustment

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Source

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DOI: 10.1001/jamainternmed.2022.4000