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The relationship between step count and all-cause mortality and cardiovascular events: A dose-response meta-analysis

PainSci » bibliography » Sheng et al 2021

Five articles on PainSci cite Sheng 2021: 1. The Trouble with Chairs2. The Art of Rest3. Strength Training Frequency4. Does Massage Increase Circulation?5. Vulnerability to Chronic Pain

PainSci notes on Sheng 2021:

This is a review and meta-analysis of sixteen studies of the relationship between step count and the risks of dying from any cause, or developing cardiovascular disease. They found a very clear connection between more walking and reduced risks, but the dose-response was strongly “non-linear.” In other words, you do not have to walk even close to 10,000 steps/day for it to be worth your while. The benefits are “non-linear”: you get a lot of benefit up front, a huge reduction in health hazards by the time you’ve hit 5K steps… at least double what you get out of the next 5K. These results challenge the popular goal of 10,000 steps per day being “optimal” for health.

This is an inexact but correct-in-spirit rendering of the most important graph in Sheng et al.

For more on this study, see: Big health benefits from far fewer than 10k steps per day.

original abstract Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.

BACKGROUND: A goal of 10,000 steps per day is widely advocated, but there is little evidence to support that goal. Our purpose was to examine the dose-response relationships between step count and mortality and cardiovascular disease risk.

METHODS: Cochrane Central Register of Controlled Trials, EMBASE, OVID, PubMed, Scopus, and Web of Science databases were systematically searched for studies published before July 9, 2021, that evaluated the association between daily steps and at least 1 outcome.

RESULTS: Sixteen publications (12 related to all-cause mortality, 5 related to cardiovascular disease, 1 article contained 2 outcomes: both all-cause death and cardiovascular events) were eligible for inclusion in the meta-analysis. There was evidence of a nonlinear dose-response relationship between step count and risk of all-cause mortality or cardiovascular disease (p=0.002 and p=0.014 for nonlinearity, respectively). When we restricted the analyses to accelerometer-based studies, the third quartile had a 40.36% lower risk of all-cause mortality and a 35.05% lower risk of cardiovascular event than the first quartile (all-cause mortality: Q1=4183 steps/day, Q3=8959 steps/day; cardiovascular event: Q1=3500 steps/day, Q3=9500 steps/day; respectively).

CONCLUSION: Our meta-analysis suggests inverse associations between higher step count and risk of premature death and cardiovascular events in middle-aged and older adults, with nonlinear dose-response patterns.

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