Tuesday, 25 July 2017

How Many Steps Should You Get in a Day?

The 10,000-step mantra

Get your 10,000 steps in! Practically everyone is familiar with this mantra, and it is traceable as far back as the 1960s in Japan. (1) Depending on a person’s stride length, 10,000 steps correlates to approximately five miles. However, modern-day desk jobs and excessive electronic usage set the stage for a sedentary lifestyle. Some reports estimate that the average U.S. adult only achieves 5,117 steps per day, far below what’s recommended. (2) Chronic disease and obesity plague the Western world. While only one piece of the puzzle, not enough physical activity is part of the problem. We know being sedentary is detrimental to health. Low physical activity is correlated with cardiovascular disease, obesity, insulin resistance, and all-cause mortality. (3, 4) Just one additional hour in a sedentary posture per day is associated with a 22 percent greater risk of type 2 diabetes and a 39 percent greater risk for metabolic syndrome. (5) As a way of measuring physical activity, fitness trackers, including the Apple Watch, Fitbit, and Jawbone Up, have become popular over the last five years. In 2015, consumers bought 50 million wearable devices in a market exceeding $2 billion. And the market is expected to rise.

Do fitness trackers increase physical activity of the wearer?

In intervention studies, fitness trackers do show a moderate effect on increasing step count and/or physical activity. Older patients instructed to aim for 10,000 steps per day lost weight and had decreased LDL levels after 12 to 14 weeks of use. (6) Other studies have confirmed weight loss success from promoting 10,000 daily steps through fitness trackers. (7, 8) In the workplace, fitness challenges often including daily step counts can motivate employees to increase their physical activity. (9, 10) It seems that for some, having a visual, tangible record of their daily activities is what makes a difference. For others, the competition, such as in a workplace challenge, is key. Although short-term intervention studies using fitness trackers can get some people to be more active, the results are often short-lived. Even though fitness tracker sales have skyrocketed, it’s estimated that one-third of people abandon them after six months.

Higher step counts associated with better health outcomes

Designing a double-blind, placebo-controlled clinical trial to determine the health effects of 10,000 steps per day versus 5,000 steps per day over five, 10, or 20 years would be impossible, for a long list of reasons. Such a study could never be blinded, a valid placebo for “steps” doesn’t exist, and it probably wouldn’t be ethical. In determining how many steps a day are optimal for health, the best we can do is look at the associations between daily step count in different populations and health outcomes, trying to adjust for confounding factors. Several studies indicate that people who increase their daily step counts over time decrease their chances of dying, lower their BMIs, decrease their waist-to-hip ratios, and improve their insulin sensitivities. (11, 12) But how many steps are enough? Under 5,000 steps per day might be detrimental to bone mass. (13) Achieving at least 7,500 steps could help with weight loss and improve sleep. (14) And the 10,000-step cutoff might be appropriate for decreasing cardiovascular disease risk, at least in men. (15) But do we see benefits above 10,000 steps? One study continued to show heart benefits at daily steps up to and beyond 12,500 in men, while the relationship between step count and cardiovascular disease risk in women wasn’t as linear. (16) For postmenopausal women to achieve healthy weight, 12,500 steps might be required. (17) And, a recent study looking at postal workers showed that only those who walked over 15,000 steps per day or spent seven hours per day upright had zero features of metabolic syndrome. (18)
The health benefits continue beyond 10,000 steps per day

How to get more steps

A daily goal of 10,000 steps is reasonable for most adults, barring any serious medical issues. Start by adding an extra 500 per day each week until you reach your goal. However, because the health benefits appear to continue beyond 10,000 steps, if you are already achieving that, aim for more! For children and adolescents, especially, 10,000 steps might not be enough. Here are some tips for increasing step count, especially relevant for those who have “desk jobs”:
  • Use the stairs at work instead of the elevator
  • Walk to ask a co-worker a quick question instead of sending an e-mail
  • See if your company would accommodate standing desks as part of a health-promoting program
  • If standing desks are out of the question, use a yoga ball instead of a chair to engage more trunk muscles
  • Walk to a different floor than yours to use the bathroom
  • Start a walking group for before or after lunch instead of spending more time sitting around
  • Set up computer prompts or alarms to remind you to get up and move around every hour
  • Initiate a fitness challenge at the workplace
  • Walk after dinner instead of plopping on the couch for another hour of TV
  • Go on a family hike or walk instead of watching a family movie

The bottom lines

Here’s the takeaway: physical activity throughout the day is good for our health, but sitting or lounging for long periods in a row is NOT. You don’t need to get a pedometer and exactly 10,000 steps per day, especially if you are engaging in activities that pedometers won’t necessarily count, such as swimming, yoga, and heavy weight lifting. Thirty minutes of moderate-to-vigorous physical activity is usually considered equivalent to around 3,000 steps. Even with intervention studies where participants are given a pedometer and instructed to aim for 10,000 steps per day, the health differences in those with higher step counts is usually accounted for by waist circumference differences alone (but not always). The key, therefore, is maintaining a healthy weight through staying active. While pedometers work well for many, what is best is to incorporate daily exercise that YOU enjoy and won’t abandon in a few months time, along with changing some sedentary habits. Now I’d like to hear from you. Do you use a fitness tracker? What motivates you to keep exercising after the initial novelty of the device wears off? Let us know in the comments!

from Chris Kresser https://chriskresser.com/how-many-steps-should-you-get-in-a-day/
via Holistic Clients

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