How many steps do you need to reap health benefits?

A new study by investigators from Harvard and Mass General Brigham examined 13,547 older women, comparing their step counts over a one-week period against their mortality and cardiovascular disease rates over the next decade. The researchers found that achieving just 4,000 steps one or two days per week was associated with lower risk of mortality and cardiovascular disease — and with more steps came even greater benefits, up to a point when risk reductions leveled. The results were published in the British Journal of Sports Medicine.

“In countries like the United States, advances in technology have made it such that we don’t really move very much, and older individuals are among those least active,” said senior author I-Min Lee, an epidemiologist at Mass General and at the Harvard Chan School. “Because of today’s low step counts, it’s increasingly important to determine the minimum amount of physical activity required to improve health outcomes, so that we can offer realistic and feasible goals for the public.”

In this federally funded study, researchers conducted a prospective cohort study of 13,574 older women (71.8 years old on average) without cardiovascular disease or cancer from the long-running Women’s Health Study. The women wore ActiGraph GT3X+ accelerometers to track their steps over seven days between 2011 and 2015. For the next 10 years, the researchers monitored mortality and cardiovascular disease incidence.

Participants were sorted by how many days per week they achieved step thresholds at or above 4,000, 5,000, 6,000, or 7,000. Those who got 4,000 steps one or two days per week had 26 percent lower mortality risk and 27 percent lower cardiovascular disease risk compared to those who never hit 4,000 on any day. What’s more, reaching 4,000 steps three or more days in a week decreased mortality risk further to 40 percent. As for women who reached the higher step thresholds, cardiovascular disease risk leveled out.

Interestingly, the health benefits seem to be associated with the total volume of steps taken, rather than how many days per week a particular threshold was achieved. This suggests that there isn’t a “better” way to get steps — women with a similar total volume of steps, achieved either by consistent steps throughout the week or sporadic steps in just a few days, had similar health benefits.

Future research will need to explore whether these effects hold in populations beyond older, mostly white women in the U.S. Additionally, the researchers are curious to analyze even lower step count thresholds to determine whether fewer than 4,000 steps can produce similar health benefits.

“I hope our findings encourage the addition of step count metrics to physical activity guidelines, including the upcoming 2028 U.S. Physical Activity Guidelines,” said lead and corresponding author Rikuta Hamaya of Harvard and Brigham and Women’s Hospital. “If we can promote taking at least 4,000 steps once per week in older women, we could reduce mortality and cardiovascular disease risk across the country.”

The other authors on the study were Kelly R. Evenson of UNC, Chapel Hill, and Daniel Lieberman of Harvard.