Abstract
IntroductionWalking is free, does not require special training, and can be done almost everywhere. Therefore, walking is a feasible behavior on which to tailor public health messages. This study assesses the prospective association and dose‐response relationship between daily steps and all‐cause mortality.Materials and MethodsDaily steps were measured by waist‐mounted accelerometers in 2183 individuals (53% women) for seven consecutive days at baseline (2008‐09). Participants were followed for a median period of 9.1 years and associations between steps and all‐cause mortality determined by registry linkage were assessed using Cox proportional hazard regression with adjustment for relevant covariates.ResultsMean age was 57.0 (SD 10.9) years at baseline. Median (IQR) daily steps across ascending quartiles were 4651 (3495‐5325), 6862 (6388‐7350), 8670 (8215‐9186), and 11 467 (10 556‐13 110), respectively. During follow‐up, 119 individuals died (68% men). Higher number of daily steps was associated with a lower risk of all‐cause mortality with hazard ratios of 1.00 (referent), 0.52 (0.29‐0.93), 0.50 (0.27‐0.94), and 0.43 (0.21‐0.88) across ascending quartiles of daily steps in the multivariable‐adjusted model with follow‐up commencing 2 years after baseline. Risk differences per 1000 individuals for ascending quartiles were 6.8 (2.9‐9.3), 7.1 (0.8‐11.1), and 8.0 (1.7‐12.1), respectively.ConclusionsDaily steps were associated with lower mortality risk in a non‐linear dose‐response pattern. The risk is almost halved when comparing the least active referent against the second quartile equivalent to a difference of about 2200 daily steps. Encouraging those least active to increase their daily steps may have substantial public health implications.
Highlights
IntroductionDoes not require special training, and can be done almost everywhere
Walking is free, does not require special training, and can be done almost everywhere
Walking has been associated with lower incidence of all-cause mortality[2,3] and cardiometabolic risk,[4] but most studies addressing the longevity benefits associated with walking are limited by the use of self-reported indicators of steps taken per day, time spent walking per day[5,6] or have not quantified the dose-response relationship between steps taken and subsequent reduction in risk of all-cause mortality—with some notable exceptions
Summary
Does not require special training, and can be done almost everywhere. Higher number of daily steps was associated with a lower risk of all-cause mortality with hazard ratios of 1.00 (referent), 0.52 (0.29-0.93), 0.50 (0.27-0.94), and 0.43 (0.21-0.88) across ascending quartiles of daily steps in the multivariable-adjusted model with follow-up commencing 2 years after baseline. The risk is almost halved when comparing the least active referent against the second quartile equivalent to a difference of about 2200 daily steps Encouraging those least active to increase their daily steps may have substantial public health implications. Lee at al[9] showed marked risk reductions for all-cause mortality associated with as few as 4400 daily steps compared to the referent after 4 years of follow-up in a sample of older US women. Most previous studies included mainly older individuals and were non-nationally representative samples.[8,9,11] additional studies including nationally representative samples including potentially more active middle-aged and older individuals are warranted
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