Mounting evidence suggests that low daily step counts are associated with an increased risk of cardiovascular (CV) mortality. However, the optimal number of steps for health benefits remains unclear. A meta-analysis published in the European Journal of Preventive Cardiology examined the relationship between daily step count and all-cause as well as CV mortality.

      The study systematically reviewed data from electronic databases up to June 12, 2022. The primary endpoints were all-cause mortality and CV mortality. An inverse-variance weighted random-effects model was used to analyze the relationship between step count and mortality. The meta-analysis included 17 cohort studies with a total of 226,889 participants (both generally healthy individuals and those at CV risk) and a median follow-up period of 7.1 years.

      The findings revealed that for every 1,000 additional steps per day, the risk of all-cause mortality decreased by 15%, while a 500-step increase was associated with a 7% reduction in CV mortality. Using a restricted cubic splines model, researchers observed a nonlinear dose-response relationship between step count and mortality (P<0.001 for nonlinearity), showing progressively lower mortality risk with higher step counts.

      Key thresholds were identified: a daily step count of 3,867 steps significantly reduced all-cause mortality, while just 2,337 steps reduced CV mortality. Importantly, greater benefits were observed with higher step counts, particularly between 6,000 and 13,000 steps per day, depending on age. This suggests that even a modest start of around 4,000 steps per day can yield health benefits, with the goal of gradually increasing steps to achieve optimal outcomes.

      The meta-analysis highlights a strong inverse association between daily step count and mortality risk, emphasizing that "more is better" when it comes to walking for health. These findings reinforce the importance of incorporating daily walking into lifestyle routines, even at modest levels, as a practical and accessible approach to improving longevity and cardiovascular health.