Researchers looked at 15,327 adult participants who used a Fitbit, a wearable electronic activity tracker that counts steps, as part of the NIH’s All of Us precision medicine research initiative. (iStock)
Adding as little as 1,700 to 5,500 steps per day can offset the risk of a list of chronic diseases — including obesity, diabetes and sleep apnea — according to a new study from a corresponding author with Vanderbilt Health.
The paper, “Daily Steps Offset Risks of Sedentary Behavior in the All of Us Research Program,” was published April 7 in the journal Nature Communications with corresponding author Evan Brittain, MD, MSCI, professor of Medicine.
Sedentary behavior has been associated with chronic mortality and chronic diseases. The study’s authors found that greater sedentary time was associated with higher risk of obesity, diabetes mellitus, hypertension, coronary artery disease, heart failure, chronic kidney disease, metabolic dysfunction-associated steatotic liver disease (MASLD), chronic obstructive pulmonary disease (COPD), major depressive disorder, sleep apnea and atrial fibrillation.
Researchers set out to discover how many additional steps patients need to reduce those risks.
Researchers looked at 15,327 adult participants who used a Fitbit, a wearable electronic activity tracker that counts steps, as part of the NIH’s All of Us precision medicine research initiative. That database includes nearly 1 million people in the United States who share multiple longitudinal data points, including electronic health records, physical measures and Fitbit data going back years. Vanderbilt Health is the data coordinating center for the initiative.
The goal was to find out how many steps it would take to mitigate risks for chronic disease for patients who had sedentary behavior for eight to 14 hours a day, such as sitting at a desk. Researchers found that by adding between 1,700 and 5,500 steps per day, people could mitigate risks of many chronic diseases, with the exceptions of coronary heart disease and heart failure. For example, reduced risks were found when adding steps for obesity (1,700 daily steps), MASLD (1,700), hypertension (2,200), sleep apnea (2,200), diabetes mellitus (5,300), and COPD (5,500).
Brittain, who holds the Rose Marie Robertson Directorship at Vanderbilt Health, said the cohort and dataset itself were rare in physical activity literature, which has typically relied on self-reporting, which is not always reliable. He said the Fitbit tracking includes data that predates enrollment in All of Us. “This is as real-world as it gets,” he said. “There was no sort of bias about the way they behaved when they were wearing the (Fitbit) device for most of that time.”
Neil Zheng, MD, from Brigham and Women’s Hospital and the first author of the study, said that step count is an intuitive way of suggesting lifestyle changes to patients. Typical standard advice today is to advise patients to increase “moderate to vigorous activity minutes,” Zheng said, “which I thought was a kind of ambiguous concept. Step count is a more intuitive measure for patients.”
Brittain said the study will help inform how clinicians advise their sedentary patients on increasing activity.
“Many of us have to be in seats most of the day,” he said. “This is a bit of an empowering message to say, even if you’re stuck there for a number of hours, this is a strategy to offset that. It’s a practical way to convey evidence around disease risk.”
The study was supported by National Institutes of Health grants R21HL172038, R61/R33HL158941 and R01FD007627.
