Every step counts to reduce the risk of cancer and cardiovascular disease

In a recent study published in JAMA internal medicineresearchers in Australia, Denmark and the United States looked for evidence of an association between daily walking and its intensity with the risk of cancer and cardiovascular disease (CVD) in a cohort of 78,500 people aged 40 to 79 years old in the United Kingdom (UK).

Study: Prospective associations of daily step count and intensity with cancer and cardiovascular disease incidence and mortality and all-cause mortality. Image Credit: dolphfyn/Shutterstock

About the study

In the current study, researchers looked at 236,462 people in the UK Biobank with a legitimate email address between February 2013 and December 2015. They asked these people to wear an accelerometer for seven consecutive days to measure physical activity . The team analyzed data from only people who wore the accelerometer for three or more valid monitoring days, including periods of sleep and at least one weekend. The accelerometers collected data with a sampling rate of 100 hertz in a dynamic range of ±8 g.

The team classified types of physical activity with an accelerometer-based machine learning scheme encompassing sedentary behavior, small utilitarian movements, walking and running. Next, they calculated daily walking steps using the Verisene step counting algorithm for wrist accelerometers. The primary endpoint was the number of daily walking steps, calculated as the average per day over all valid study days.

The researchers obtained mortality data for deaths between September 30 and October 31, 2021, through the National Health Service (NHS) and cancer data from national cancer registries. They limited the analyzes to cancer findings in 13 sites associated with low physical activity, assessed in a previous study. Similarly, cardiovascular disease outcomes covered fatal and non-fatal coronary heart disease, heart failure and stroke. Additionally, they included diagnoses of primary and secondary cancer and CVD.

Statistically, the researchers described the samples by tertiles of average daily walking steps and maximum cadence of 30. They reported the results as logarithmic hazard ratios (HR) and 95% confidence intervals (CI). associates. Note that cadence-based step metrics show <40 steps per minute as incidental steps; ≥40 steps/min as target steps. This also reflects step intensity, where the maximum cadence of 30 steps corresponds to a maximum of 30 average steps per minute, but not necessarily consecutive. The team compared the magnitude of associations between cadence-based metrics. They reported the MRC for each 10% increment of the pre-specified nodes of the 10th, 50th, and 90th percentiles of the exposure distribution. Finally, the team estimated the linear mean rate of change (MRC) in log-relative HRs for morbidity and mortality outcomes for each 2000 daily step increment.

Study results

A total of 103,684 people agreed to wear the AX3 accelerometers on their dominant wrist 24 hours a day for seven days. They were in good health, had a higher socio-economic status and were mostly women. Similarly, the study sample for mortality outcomes included 78,500 participants, with an average age of 61, and 55% were female. There were 10,245 incident cardiovascular events during the median follow-up of 6.8 years and 2,813 incident cancer events during almost the same follow-up period.

The authors noted an association of daily steps with mortality and morbidity up to 10,000 steps per day. Accordingly, the MRC for each 2,000 step increment for all-cause mortality, cancer, and cardiovascular disease were 0.08, 0.11, and -0.10, respectively, indicating reduced risk with a number of higher daily step. While this observation is similar to that observed in younger participants, it is 20% higher than that observed previously in participants aged 60 or older. Furthermore, the authors observed a similar trend for the incidence of cancer and cardiovascular disease. For the incidence of cancer and cardiovascular disease, they observed a lower risk with a higher number of walking steps and light intensity steps. However, the moderate-intensity and moderate-to-vigorous stages had additional associations with incident cancer risk. Sensitivity analyzes revealed that changing participants’ age, sleeping habits, body mass index, or diet did not alter the observed patterns of association.


The results of the current study showed that deliberate steps and the maximum cadence of 30 were consistently associated with a lower risk of all-cause mortality outcomes, cancer and CVD incidence, and morbidity and mortality related to cancer and CVD. Additionally, a higher stepping intensity could provide additional benefits. The study thus highlighted the potential value of 10,000 or more daily steps for optimal health. The study data could contribute significantly to step count-based recommendations to current physical activity guidelines, which may be particularly relevant for people who primarily engage in incidental, unstructured, and non-organic physical activity. planned.

Journal reference:

  • Prospective associations of daily step count and intensity with cancer and cardiovascular disease incidence and mortality and all-cause mortality, Borja del Pozo Cruz, Matthew N. Ahmadi, I-Min Lee, Emmanuel Stamatakis , Prospective Associations of Daily Step Count and Intensity with Cancer and Cardiovascular Disease Incidence and Mortality and All-Cause Mortality. Intern JAMA Med. 2022. DOI:10.1001/jamainternmed.2022.4000, https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2796058

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