Tracking daily steps has become a staple exercise metric as smart devices keep count with ease. This physical activity stimulates bodily repair and maintenance, which is especially important as we age. But how many steps do you need to reap health benefits? A new study by investigators from Mass General Brigham examined 13,547 older women, comparing their step counts over a one week period against their mortality and cardiovascular disease rates over the next decade. They found that achieving just 4,000 steps one or two days per week was associated with lower risk of mortality and cardiovascular disease—and with more steps came even greater benefits, up to a point when risk reductions leveled. Their results are published in The British Journal of Sports Medicine.
"In countries like the United States, advances in technology have made it such that we don't really move very much, and older individuals are among those least active," said senior author I-Min Lee, MBBS, ScD, an epidemiologist in the Mass General Brigham Department of Medicine and the Division of Preventive Medicine at Brigham and Women's Hospital (BWH). "Because of today's low step counts, it's increasingly important to determine the minimum amount of physical activity required to improve health outcomes, so that we can offer realistic and feasible goals for the public."
In this federally funded study, Mass General Brigham researchers conducted a prospective cohort study of 13,574 older women (71.8 years old on average) without cardiovascular disease or cancer from BWH's Women's Health Study . The women wore ActiGraph GT3X+ accelerometers to track their steps over seven days between 2011 and 2015. For the next 10 years, the researchers monitored mortality and cardiovascular disease incidence.
Participants were sorted by how many days per week they achieved step thresholds at or above 4,000, 5,000, 6,000, or 7,000. Those that got 4,000 steps one or two days per week had 26% lower mortality risk and 27% lower cardiovascular disease risk compared to those that never hit 4,000 on any day. What's more, reaching 4,000 steps three or more days in a week decreased mortality risk further to 40%. As for women that reached the higher step thresholds, cardiovascular disease risk leveled out.
Interestingly, the health benefits seem to be associated with the total volume of steps taken, rather than how many days per week a particular threshold was achieved. This suggests that there isn't a "better" way to get steps—women with similar total volume of steps, either achieved by consistent steps throughout the week or sporadic steps in just a few days, had similar health benefits.
Future research will need to explore whether these effects hold in populations beyond older, American, mostly white women. Additionally, the researchers are curious to analyze even lower step count thresholds to determine whether less than 4,000 steps can produce similar health benefits.
"I hope our findings encourage the addition of step count metrics to physical activity guidelines, including the upcoming 2028 U.S. Physical Activity Guidelines," said lead and corresponding author Rikuta Hamaya, MD, of Mass General Brigham's Department of Medicine and the Division of Preventive Medicine at BWH. "If we can promote taking at least 4,000 steps once per week in older women, we could reduce mortality and cardiovascular disease risk across the country."
Authorship: In addition to Lee and Hamaya, authors include Kelly R. Evenson and Daniel Lieberman.
Disclosures: None.
Funding: This research was supported by grants from the National Institutes of Health (NIH; CA154647, CA047988, CA182913, HL043851, HL080467, and HL099355). The study was also supported by NIH 5R01CA227122: National Cancer Institute, Office of the Director, Office of Disease Prevention, and Office of Behavioral and Social Sciences Research. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.
Paper cited: Hamaya R et al. "Association between frequency of meeting daily step thresholds and all-cause mortality and cardiovascular disease in older women" British Journal of Sports Medicine DOI: 10.1136/bjsports-2025-110311
