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Step and time-based exercise goals are equally beneficial

In today’s age of smartwatches and fitness trackers, monitoring exercise through step counts has become second nature for many. However, current physical activity guidelines do not specify step goals for health benefits.

A recent study suggests that both step and time-based exercise targets offer similar health benefits. This means choosing a goal that suits personal preferences is more important than the type of goal itself.

Goal of exercise in promoting longevity

Researchers from Brigham and Women’s Hospital have explored the effectiveness of step and time-based exercise goals.

Their study, published in JAMA Internal Medicine, found that both approaches are equally beneficial in reducing the risk of early death and cardiovascular disease.

Regular physical activity is known to reduce the risk of chronic illnesses and infections, promoting longevity.

The current U.S. guidelines recommend adults engage in at least 150 minutes of moderate to vigorous physical activity (like brisk walking) or 75 minutes of vigorous activity (such as jogging) per week.

These guidelines, last updated in 2018, were primarily based on studies using self-reported physical activity data. However, the rise of wearable fitness devices has popularized step counts as a metric for tracking physical activity and exercise goals.

Step-based physical activity guidelines

“We recognized that existing physical activity guidelines focus primarily on activity duration and intensity but lack step-based recommendations,” said lead author Rikuta Hamaya, MD, PhD, MS.

“With more people using smartwatches to measure their steps and overall health, we saw the importance of ascertaining how step-based measurements compare to time-based targets in their association with health outcomes – is one better than the other?”

To explore this, researchers collected data from 14,399 women participating in the Women’s Health Study.

These women, aged 62 and older and free from cardiovascular disease and cancer, wore research-grade wearables for seven consecutive days between 2011 and 2015 to record their physical activity. They only removed the devices for sleep or water-related activities.

Annual questionnaires tracked health outcomes, particularly death from any cause and cardiovascular disease, with follow-ups continuing until the end of 2022.

Long-term health effects of physical activity

During the device wear period, participants averaged 62 minutes of moderate-to-vigorous intensity exercise per week and accumulated a median of 5,183 steps per day.

Over a median follow-up of nine years, approximately 9% of participants passed away, and 4% developed cardiovascular disease.

Higher levels of physical activity, whether measured by steps or time, were linked to significant risk reductions in death or cardiovascular disease.

The most active women had 30-40% lower risks compared to the least active. Additionally, those in the top three quartiles of physical activity outlived those in the bottom quartile by an average of 2.22 to 2.36 months over nine years, regardless of BMI differences.

Steps vs. time: Pros and cons

While both exercise goals effectively portray health status, each has its advantages and downsides.

Step counts may not account for fitness level differences. For example, a 20-year-old and an 80-year-old walking for 30 minutes at moderate intensity will have different step counts.

Steps are straightforward to measure and less subject to interpretation compared to exercise intensity. They also capture sporadic movements in daily life, which are common among older individuals.

“For some, especially 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,” said Hamaya.

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.”

Exercise goals and metrics in shaping guidelines

The study has several limitations. It relied on a single assessment of time and step-based physical activity metrics.

Additionally, the majority of the participants were white women of higher socioeconomic status, and because the study was observational, it does not establish causality.

Furthermore, Hamaya intends to gather more data through a randomized controlled trial to better understand the relationship between time and step-based exercise metrics and health outcomes.

“The next federal physical activity guidelines are scheduled for 2028. Our findings underscore the importance of including step-based targets to allow for flexible goals that can accommodate individuals with varying preferences, abilities, and lifestyles,” stated senior author I-Min Lee, MBBS, ScD.

This study underscores the importance of finding a personal exercise tracking method—whether in steps or minutes—that is sustainable and effective for you, enabling you to reap the health benefits of regular physical activity.

The full study was published in the journal JAMA Internal Medicine.


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