"Every action counts towards fitness

A recent study indicates that setting goals based on either step counts or exercise duration is equally effective in lowering the risk of heart disease and premature death.

Researchers at Harvard-affiliated Brigham and Women’s Hospital analyzed data from healthy women aged 62 and above who used wearable devices to track their physical activity.

Over a median follow-up period of nine years, the study revealed that higher physical activity levels—whether measured by the duration of exercise or step counts—were significantly linked to lower mortality and cardiovascular disease risks.

Women in the most active quarter of the study group experienced a 30 to 40 percent reduction in risk compared to those in the least active quarter.

"Current physical activity guidelines primarily focus on duration and intensity but often omit step-based recommendations," explained Rikuta Hamaya, the study's lead author and a researcher in the Division of Preventive Medicine at BWH.

"With the growing use of smartwatches to track steps and overall health, we wanted to determine how step-based measurements compare to time-based targets in their impact on health outcomes. Is one method superior to the other?"

The latest U.S. guidelines, updated in 2018, recommend that adults engage in at least 150 minutes of moderate to vigorous physical activity (like brisk walking) or 75 minutes of vigorous activity (such as jogging) each week.

At that time, most health benefit data came from self-reported physical activity, with limited information on the relationship between steps and health. Now, with wearables becoming widespread, step counts are a popular metric on many fitness-tracking platforms. Researchers aimed to compare time-based and step-based goals.

The study involved data from 14,399 women participating in the Women’s Health Study, all of whom were free from cardiovascular disease and cancer. Between 2011 and 2015, participants aged 62 and older wore research-grade wearables for seven consecutive days to record their physical activity, only removing the devices for sleep or water-related activities.

Annual questionnaires were used to track health outcomes, particularly death from any cause and cardiovascular disease, with follow-ups continuing until the end of 2022.

At the time of device wear, participants engaged in a median of 62 minutes of moderate-to-vigorous intensity physical activity per week and accumulated a median of 5,183 steps daily.

During the nine-year follow-up, about 9 percent of participants had passed away, and roughly 4 percent developed cardiovascular disease.

Higher physical activity levels, whether measured by step counts or time spent in moderate to vigorous activity, were linked to significant reductions in death and cardiovascular disease risk.

Women in the top three quartiles of physical activity lived an average of 2.22 to 2.36 months longer than those in the bottom quartile, regardless of whether activity was measured by time or steps.

This survival advantage was consistent across different body mass index (BMI) categories.

While both step counts and exercise duration are valuable for assessing health, Hamaya noted that each has its pros and cons.

Step counts may not accurately reflect fitness levels; for instance, a 20-year-old and an 80-year-old walking for 30 minutes at moderate intensity may have vastly different step counts.

On the other hand, step counts are easier to measure and less subjective than exercise intensity.

Steps can also capture everyday movements, not just formal exercise, which is particularly relevant for older adults.

"For some people, especially younger individuals, exercise might include activities like tennis, soccer, walking, or jogging, all easily tracked by steps.

For others, it might involve biking or swimming, where tracking exercise duration is simpler," Hamaya said.

"Therefore, physical activity guidelines should offer multiple ways to achieve goals. Since movement varies for everyone, nearly all forms of physical activity are beneficial to our health."

The authors note that the study only includes a single assessment of time and step-based physical activity metrics. Additionally, most of the women in the study were white and from higher socioeconomic backgrounds. Since the study was observational, it cannot establish causal relationships.

Hamaya plans to collect more data through a randomized controlled trial in the future to better understand the link between time and step-based exercise metrics and health.

“The next federal physical activity guidelines are scheduled for 2028,” said senior author I-Min Lee, an epidemiologist at BWH's Division of Preventive Medicine.

“Our findings highlight the importance of including step-based targets to accommodate goals for individuals with varying preferences, abilities, and lifestyles.”

Disclosures indicate that Hamaya received consulting fees from DeSC Healthcare, Inc., outside of the submitted work.

Co-authors Christopher Moore, Julie Buring, Kelly Evenson, and Lee reported receiving institutional support from the National Institutes of Health during the study.

The research received partial support from the National Institutes of Health (CA154647, CA047988, CA182913, HL043851, HL080467, and HL09935), the National Cancer Institute (5R01CA227122), Office of the Director, Office of Disease Prevention, and Office of Behavioral and Social Sciences Research; and by the extramural research program at the National Heart, Lung, and Blood Institute.

Source: goodmenproject

The opinions shared in the GymNation blog articles are solely those of the respective authors and may not represent the perspectives of GymNation or any member of the GymNation team.