09/06/2021 12:49
Clarín.com
Good Life
Updated 09/06/2021 12:53 PM
Walk lady, walk.
Lita de Lazzari's recommendation that encouraged women to move in search of better prices can today be reissued as a
public health advice
aimed at the entire population.
It is known that promoting walking is one of the
easiest,
most
accessible and effective
ways
to promote physical activity, a pillar of the prevention of chronic non-communicable diseases (cardiovascular, diabetes and some types of cancer, among others).
A new study published in the journal
JAMA Network
provides more evidence in this regard.
Developed by researchers from several universities in the United States (Massachusetts, Alabama, Minnesota, Northwestern, Iowa) and the Centers for Disease Control and Prevention, it investigated whether the number of daily steps and intensity can be associated with a lower risk of mortality.
The research concluded that higher daily step volume was associated with a
lower risk of premature
all-cause
mortality
among middle-aged women and men.
The contribution is substantial, since studies of this type are usually carried out in older people.
How many?
the million dollar question
The question they tried to answer was how many steps did you see that benefit from? Spoiler: it was not 10,000, a widely publicized goal, but which
did not arise from scientific evidence
, but from the advertising strategy launched in the 1960s by the Japanese company Yamasa Clock to promote its Manpo-Kei, one of the first pedometers ( a step counter device), which literally translates to "10,000 step meter".
"Steps per day are a significant metric for
promoting physical activity in clinical and population settings
. To guide strategies for promoting step goals, it is important to understand the association between them with critical end points, including mortality." , the authors argued.
Add steps, an extended public health council.
Photo Shutterstock.
Measure steps
The study included 2,110 women and men between the ages of 38 and 50 (mean age 45) who were part of a larger sample corresponding to the
Coronary Artery Risk Development in Young Adults
(CARDIA) study, which began in 1985-1986.
In the follow-up exam in year 20 (2005-2006) they were asked to use an accelerometer to
measure the number of steps they took per day
.
They were instructed to wear it for 7 days, attached to the hips by an elastic belt, and to remove it only during sleep and water activities.
According to the volume of daily steps taken, they were divided into three groups:
low
(less than 7,000 daily steps),
moderate
(7,000 to 9999) and
high
(more than 10,000).
The researchers calculated the steps per minute (steps / min) performed in 30 minutes, not necessarily consecutive, throughout the day, and calculated an average for all days.
They also quantified intensity:
100 steps per minute or more
was suggested as moderate intensity.
Participants in the group that took fewer daily steps (there were more women -62.5% - and black participants -53.8% -) had higher body mass index (BMI), lower self-rated health, and a higher prevalence of hypertension and diabetes compared to those between the moderate and high groups.
Participants who took
at least 7,000 steps per day
compared to those who took fewer had
a 50% to 70% lower
risk of mortality
from
all causes.
The follow-up lasted almost 11 years, in which there were 72 deaths among the more than 2000 participants.
The main causes of death registered were cancer and cardiovascular diseases.
According to the results of this work, taking
more than 10,000 steps per day was
not associated with a greater reduction in the risk of mortality.
Nor was there an association between the intensity of the gait and mortality.
An active life is associated with a lower risk of death.
Photo Shutterstock.
Background
The authors state that the findings obtained in this study are consistent with two other prospective studies conducted nationwide in the United States.
The NHANES, whose results were published in 2020 also in the journal JAMA, conducted on men and women with an average age of 57 years found that taking 8,000 to 12,000 steps per day was associated with a reduction of between 50% and 65% in the risk of mortality compared to people who took
4,000 steps a day
.
In contrast, the
Women's Health Study
, which used data from a cohort of nearly 17,000 women with an average age of 72, found that approximately 4,400 daily steps were significantly associated with lower death rates compared to approximately 2,700 daily steps .
With more steps per day, death rates progressively decreased until they leveled off at approximately 7,500 steps.
The authors of the current study suggest in this regard that "older adults may require a
lower volume of activity
to obtain similar improvements in physical and functional condition and achieve health benefits."
And they state that they did not investigate the potential mortality benefit of taking fewer than 7,000 steps per day due to the size of the sample studied and that it was a
younger and more active population
.
In addition to its strengths, the study has several limitations, they say.
Among them, they point out that because it is an observational design,
cause-effect cannot be established
between the number of steps and mortality.
And that a low death rate is expected in the studied group given that the mean age of the participants at almost 11 years of follow-up was 56 years.
They also clarified that the device used (the ActiGraph 7164) can estimate between
15% and 25% more steps
compared to others, so that "the specific step count values provided in this study may not be applicable with accuracy to all portable activity monitors. "
However, the members of the team led by Amanda Paluch, from the Institute of Applied Life Sciences, University of Massachusetts emphasize that "the
improvement of the levels of physical activity
in the less active segment of the population by promoting the increase of the number of daily steps may be associated with a lower risk of mortality ".
Minutes or steps
"Regular physical activity is one of the most important behaviors that people can engage in to improve or maintain good health. Physical activity provides
substantial health benefits for many conditions
, such as cardiovascular disease, diabetes, and various cancers, as well as improving the quality of life ", they emphasize.
In relation to that they say that "the number of steps that people take each day is a significant metric to quantify total daily activity" due to the
simplicity of the metric
and how easy it is to access that monitoring (there are applications for mobile devices that offer it).
However, they note that guidelines for physical activity do not include step counting as a public health goal as a consequence of the
limited number of studies
demonstrating prospective associations of step volume and intensity with clinical outcomes, including mortality.
The results of the work just published aim to nurture the field of evidence in this regard.
Meanwhile, World Health Organization (WHO) guidelines recommend at least 150 to 300 minutes of moderate to vigorous aerobic activity per week for all adults, including people living with chronic conditions or disabilities, and an average of 60 minutes per day for children and adolescents.
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