Walk 7000–8000 steps a day, or build up 150–300 minutes of brisk walking a week

Cost

Free. Counted in steps, that is 60–90 minutes of walking a day, which can be split across your commute and shopping. Counted in exercise time, it is 20–45 minutes a day. The hard part is keeping it up over the long term.

What you get

Pooling 15 studies that followed groups of people (observational, not assigning groups), these 15 studies had 47471 people and 3013 deaths in all, people were split into four groups by daily steps; the lowest group had a median of 3553 steps/day. The other three had medians of 5801, 7842 and 10901 steps/day. Their risk of death was lower than the lowest group by about 40%, 45% and 53% (HR 0.60, 0.55, 0.47). For people over 60, the benefit levels off after 6000–8000 steps. For people under 60, it levels off after 8000–10000 steps. Another analysis pooling several studies found that benefit starts from about 3867 steps/day. After that, each additional 1000 steps/day lowers the risk of death by about 15%. By exercise time: pooling several follow-up studies (observational, not assigning groups), people whose activity reached 1 to 2 times the lower limit in the guidelines had about 31% lower risk of death than people who didn't exercise (HR 0.69). That amount is 7.5–15 MET·h/week, roughly 150–300 minutes of brisk walking a week. People who did not reach the lower limit were also about 20% lower (HR 0.80). People who reached 3 to 5 times the lower limit were about 39% lower (HR 0.61), the peak of the reduction. Going higher doesn't lower it further, but does no harm either (at 10 times or more, HR 0.69). Another pooled study measured with accelerometers: the quarter of people with the most moderate-to-vigorous activity had about 48% lower risk of death than the quarter with the least (HR 0.52). An accelerometer is a device worn on the body that measures how much you move.

Notes

Steps and exercise time describe the same thing counted two ways, and meeting either one is enough. The stretch from 4000 to 7000 steps is the best value; you don't have to reach ten thousand. Keep in mind that these studies only followed people: among those who walked least and moved least are people who were already ill and couldn't walk. They moved less because they were close to dying; they did not die early because they moved less. So the calculated gap is often too large. The studies that measured activity with devices followed people for a short time and had older participants, and the real benefit is not as big as “risk drops to 0.52 times.” But the trend that more movement is better is clear.

Evidence grade

A : Specific numbers from meta-analyses, large cohorts or randomized trials; for law and policy, the statute or official text.

Sources

1. Paluch AE 等 (2022). Daily steps and all-cause mortality: a meta-analysis of 15 international cohorts. Lancet Public Health. https://doi.org/10.1016/S2468-2667(21)00302-9
2. Banach M 等 (2023). The association between daily step count and all-cause and cardiovascular mortality: a meta-analysis. European Journal of Preventive Cardiology. https://doi.org/10.1093/eurjpc/zwad229
3. Arem H 等 (2015). Leisure time physical activity and mortality: a detailed pooled analysis of the dose-response relationship. JAMA Internal Medicine. https://doi.org/10.1001/jamainternmed.2015.0533
4. Ekelund U 等 (2019). Dose-response associations between accelerometry measured physical activity and sedentary time and all cause mortality: systematic review and harmonised meta-analysis. BMJ. https://doi.org/10.1136/bmj.l4570

Translated from the Chinese original. Original book, section 2, tip 11. This section is about health and medicines. It is general information, not a substitute for a doctor’s diagnosis or prescription. Content may be out of date and rules differ by place. When you actually deal with an agency, a doctor or a court, follow what local officials, doctors and lawyers tell you. Disclaimer