This comprehensive systematic review and meta-analysis, published in The Lancet Public Health, evaluates the relationship between daily step count and a wide range of adult health outcomes. Unlike previous reviews that mostly focused on all-cause mortality and cardiovascular disease, this study incorporates data from 57 studies across 35 cohorts to examine broader health outcomes such as cancer, type 2 diabetes, dementia, depressive symptoms, physical function, and falls. Data from 24 cohorts were used in meta-analyses.
The analysis revealed that daily steps are consistently and inversely associated with most health risks. For many conditions—like all-cause mortality, cardiovascular disease, dementia, and falls—risk declined in a non-linear fashion, with notable benefits emerging between 5000 and 7000 steps per day. In contrast, for outcomes such as cancer, diabetes, and depression, the relationship appeared linear. Specifically, walking 7000 steps daily was associated with a 47% reduced risk of all-cause mortality compared to 2000 steps, along with 25% lower cardiovascular disease incidence and 37% lower cancer mortality. Dementia and depressive symptoms also saw significant reductions in risk at this step threshold.
While more steps generally led to greater benefits—up to 12,000 steps per day—the incremental gains beyond 7000 steps were modest for most outcomes. Notably, for some measures like falls and cancer incidence, improvements plateaued or showed less statistical significance beyond the 7000-step point. The study suggests that this lower threshold may offer a more attainable and still impactful goal for physical activity recommendations.
The evidence on step cadence (stepping rate) was less conclusive, with only all-cause mortality showing a consistent inverse relationship with higher cadence. The certainty of evidence was rated moderate for most outcomes, though some outcomes like falls and physical function had low or very low certainty due to inconsistencies and limited data.
Ultimately, the study supports the inclusion of step-based metrics in physical activity guidelines, promoting 7000 daily steps as a meaningful and achievable public health target while reinforcing that even small increases in daily steps yield substantial health benefits.
Source: https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(25)00164-1/fulltext
