Step and time-based exercise targets are equally beneficial for health – study

Step-based and time-based exercise are equally beneficial for heart health and living longer, research suggests.

The findings suggest that whether someone chooses a time or step goal may not be as important as choosing a goal that suits them.

Researchers argue that the study highlights the importance of step-based targets being added to guidelines.

Physical activity reduces the risk of illness and infection, and promotes long life, and the NHS recommends that adults should do some type of physical activity every day.

It suggests that adults aged 19 to 65 should do at least 150 minutes of moderate intensity activity a week or 75 minutes of vigorous intensity activity a week.

But with more and more people able to track the number of steps they take each day, through a mobile phone, smart watch or similar device, researchers from the Brigham and Women’s Hospital (BWH) in Massachusetts, US, wanted to look at how time-based goals stack up against step-based ones.

They found that higher levels of physical activity – whether assessed as step counts or time in moderate-to-vigorous activity – were associated with large risk reductions in death or cardiovascular disease.

The most active quarter of women in the study had 30% to 40% risk reductions compared with the least active quarter.

People in the top three most active groups outlived those in the bottom group by an average of 2.22 and 2.36 months respectively, based on time and step-based measurements.

According to the findings, this was the case regardless of differences in body mass index (BMI).

Lead author Rikuta Hamaya, a researcher in the Division of Preventive Medicine at BWH, explained that both methods for measuring activity have advantages and disadvantages.

For example, step counts may not account for differences in fitness levels – if a 20-year-old and 80-year-old both walk for 30 minutes at moderate intensity, their step counts may differ.

However, steps are straightforward to measure and less subject to interpretation compared with exercise intensity.

Additionally, steps pick up on the movements of everyday life, not just exercise, and these kinds of daily life activities likely are those carried out by older individuals.

Dr Hamaya said: “For some, especially for younger individuals, exercise may involve activities like tennis, soccer, walking, or jogging, all of which can be easily tracked with steps.

“However, for others, it may consist of bike rides or swimming, where monitoring the duration of exercise is simpler.

“That’s why it’s important for physical activity guidelines to offer multiple ways to reach goals.

“Movement looks different for everyone, and nearly all forms of movement are beneficial to our health.”

For the new study, published in Jama Internal Medicine, researchers collected data from 14,399 healthy women who took part in the Women’s Health Study.

Between 2011 and 2015, women aged 62 years and older were asked to wear devices for seven consecutive days to record their physical activity levels.

While wearing the devices, the women in the study took part in an average of 62 minutes of moderate-to-vigorous intensity physical activity per week and accumulated an average of 5,183 steps per day.

Over an average follow-up of nine years, some 9% had died and around 4% had developed heart disease.

Those who did the most physical activity had the greatest reduction in risk of death or cardiovascular disease.

Senior author I-Min Lee, MBBS, ScD, an epidemiologist in the Division of Preventive Medicine at BWH, said: “The next federal physical activity guidelines are planned for 2028.

“Our findings further establish the importance of adding step-based targets, in order to accommodate flexibility of goals that work for individuals with differing preferences, abilities and lifestyles.”