If you walk just 1.5 to 2 km for about 15 to 20 minutes everyday, or 4,000 steps a day, in any setting, you may reduce your risk of dying from any cause. And even if you manage to walk a little more than half of that, you can reduce your risk of dying from cardiovascular diseases. These are the findings of a study, the largest till date and published in the European Journal of Preventive Cardiology.
The research, conducted by Maciej Banach, a professor of cardiology at the Medical University of Lodz in Poland, is significant because he collected data of 226,889 people, who were followed for an average of seven years to assess the health impacts of different daily step counts. Says Dr Ranjan Shetty, HOD and Consultant, Interventional Cardiology, Manipal Hospital, Bengaluru, “What this study does is establish the fact that the first move you make from zero activity has the maximum benefit and that it is doable. If we divide your exercise or physical activity pattern from zero to ten, then remember that zero to one has the maximum benefit than one to 10. Of course there are incremental benefits, with the study showing that an increase of 1,000 steps a day was associated with a 15 per cent risk reduction in all-cause mortality and an increase of 500 steps a day was associated with a seven per cent risk reduction in cardiovascular disease. But if you commit to the first level of activity and stick with it daily because it is doable, then it sets you on a course correction. Studies on walking are many but this one, for the first time, sets a prescription dose for lifestyle correction like a doctor does for any other pill. It says exercise is also a tablet to be had with whatever drugs you have for your physical condition. So this study changes the perspective of what you need to do.”
This study works best as a recommendation for the Indian population, feels Dr Abhishek Srivastava, Director, Centre for Physical Medicine & Rehabilitation, Kokilaben Hospital, Mumbai. “Most Indians, genetically and physically, are not up to extreme physical exercises. Broadly, 5,000 steps daily work for them. Many people even count their minutes, usually ranging between 35 and 45 minutes. But by focussing on step counts, which you can monitor on your smart watches, you can walk the perimeter of your house if you cannot step outdoors. This way it clarifies the difference between physical activity (walking, household chores) and exercise (which people associate with a gym). Also the recommendation that if you increase your steps by 1,000, you have 15 per cent extra protection, is new and was not shown by earlier studies,” he says.
With sedentary lifestyle emerging to be another co-morbidity trigger, Dr Shetty feels that this study tells us to “do something” rather than “do nothing.” The concept of daily fitness and walking as a key component of physiology has gained ground ever since a UK study found that the bus driver had a higher chance of a heart attack because he is stationary for longer hours than a conductor who moves around. “Without physical activity and in a restful state, your body metabolism slows down, which allows fatty acids to build up in blood vessels. Did you know that lipoprotein lipase, the enzyme that breaks down fat in your blood, drops by about 90 per cent when you sit around all day? So your fat just keeps getting stored, leading to obesity. You develop insulin resistance, which can cause Type 2 diabetes. Your bones weaken, body inflammation goes up and all of these taken together increase your risk of heart disease. The blood flow to the brain slows down too. Any exercise helps fight the effects of the stress hormone cortisol,” he says,
He has clearly seen four benefits in his patients with just a 15 to 20-minute walk. “The BP tends to come down by 5mmHg, both systolic and diastolic. Your blood sugar and HbA1c (average blood sugar) levels come down, you look younger and prevent ageing and can even halve your risk of cancer,” Dr Shetty adds.
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Among the younger age group, the maximum health improvement was seen in those who walked between 7,000 and 13,000 daily steps, while for those aged 60 years and over, it was between 6,000 and 10,000 steps. The team even assessed the impact of walking up to 20,000 steps a day, for those who wanted to be extreme, and found that the health benefits continued to increase.
“Walking is a simple yet profound exercise. This study draws a clear roadmap to better health through daily step counts that do not seem difficult to achieve. What sets these findings apart is the universality of benefits across gender, age and climate. Remarkably, even walking up to 20,000 steps or roughly 10 miles escalates health gains without diminishing effects,” says Vijay Thakkar, functional medicine expert. “In a world driven by advanced medical interventions, this research underscores that lifestyle changes like walking could be our most potent ‘wonder drug.’ Amid a pandemic that has led to a decline in global physical activity, this serves as a timely reminder that the pathway to health might lie in putting one foot in front of the other. As I often emphasize in my practice, personalised lifestyle changes are not just complementary to medical treatments but are the treatment themselves,” he adds.
However, all experts feel that large-scale studies are required to investigate if these benefits may exist for rigorous activities such as marathon-running for various populations of various ages and with varied pre-existing health conditions.