How many steps/day are enough? For adults

Catrine Tudor-Locke, Cora L Craig, Wendy J Brown, Stacy A Clemes, Katrien De Cocker, Billie Giles-Corti, Yoshiro Hatano, Shigeru Inoue, Sandra M Matsudo, Nanette Mutrie, Jean-Michel Oppert, David A Rowe, Michael D Schmidt, Grant M Schofield, John C Spence, Pedro J Teixeira, Mark A Tully, Steven N Blair, Catrine Tudor-Locke, Cora L Craig, Wendy J Brown, Stacy A Clemes, Katrien De Cocker, Billie Giles-Corti, Yoshiro Hatano, Shigeru Inoue, Sandra M Matsudo, Nanette Mutrie, Jean-Michel Oppert, David A Rowe, Michael D Schmidt, Grant M Schofield, John C Spence, Pedro J Teixeira, Mark A Tully, Steven N Blair

Abstract

Physical activity guidelines from around the world are typically expressed in terms of frequency, duration, and intensity parameters. Objective monitoring using pedometers and accelerometers offers a new opportunity to measure and communicate physical activity in terms of steps/day. Various step-based versions or translations of physical activity guidelines are emerging, reflecting public interest in such guidance. However, there appears to be a wide discrepancy in the exact values that are being communicated. It makes sense that step-based recommendations should be harmonious with existing evidence-based public health guidelines that recognize that "some physical activity is better than none" while maintaining a focus on time spent in moderate-to-vigorous physical activity (MVPA). Thus, the purpose of this review was to update our existing knowledge of "How many steps/day are enough?", and to inform step-based recommendations consistent with current physical activity guidelines. Normative data indicate that healthy adults typically take between 4,000 and 18,000 steps/day, and that 10,000 steps/day is reasonable for this population, although there are notable "low active populations." Interventions demonstrate incremental increases on the order of 2,000-2,500 steps/day. The results of seven different controlled studies demonstrate that there is a strong relationship between cadence and intensity. Further, despite some inter-individual variation, 100 steps/minute represents a reasonable floor value indicative of moderate intensity walking. Multiplying this cadence by 30 minutes (i.e., typical of a daily recommendation) produces a minimum of 3,000 steps that is best used as a heuristic (i.e., guiding) value, but these steps must be taken over and above habitual activity levels to be a true expression of free-living steps/day that also includes recommendations for minimal amounts of time in MVPA. Computed steps/day translations of time in MVPA that also include estimates of habitual activity levels equate to 7,100 to 11,000 steps/day. A direct estimate of minimal amounts of MVPA accumulated in the course of objectively monitored free-living behaviour is 7,000-8,000 steps/day. A scale that spans a wide range of incremental increases in steps/day and is congruent with public health recognition that "some physical activity is better than none," yet still incorporates step-based translations of recommended amounts of time in MVPA may be useful in research and practice. The full range of users (researchers to practitioners to the general public) of objective monitoring instruments that provide step-based outputs require good reference data and evidence-based recommendations to be able to design effective health messages congruent with public health physical activity guidelines, guide behaviour change, and ultimately measure, track, and interpret steps/day.

Figures

Figure 1
Figure 1
Steps/day scale schematic linked to time spent in MVPA.

References

    1. U.S. Department of Health and Human Services. 2008 Physical Activity Guidelines for Americans: Be Active, Healthy, and Happy! Washington, D.C; 2008.
    1. Tudor-Locke C, Williams JE, Reis JP, Pluto D. Utility of pedometers for assessing physical activity: convergent validity. Sports Med. 2002;32:795–808. doi: 10.2165/00007256-200232120-00004.
    1. Tudor-Locke C, Johnson WD, Katzmarzyk PT. Accelerometer-determined steps per day in US adults. Med Sci Sports Exerc. 2009;41:1384–1391. doi: 10.1249/MSS.0b013e318199885c.
    1. Haskell WL, Lee IM, Pate RR, Powell KE, Blair SN, Franklin BA, Macera CA, Heath GW, Thompson PD, Bauman A. Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Med Sci Sports Exerc. 2007;39:1423–1434. doi: 10.1249/mss.0b013e3180616b27.
    1. Physical Activity Guidelines Advisory Committee. Physical Activity Guidelines Advisory Committee Report, 2008. Washington, D.C.: U.S. Department of Health and Human Services; 2008.
    1. Public Health Agency of Canada and the Canadian Society for Exercise Physiology. Canada's Physical Activity Guide to Healthy Active Living. Ottawa, Ont.: Public Health Agency of Canada; 1998.
    1. O'Donovan G, Blazevich AJ, Boreham C, Cooper AR, Crank H, Ekelund U, Fox KR, Gately P, Giles-Corti B, Gill JM. et al.The ABC of Physical Activity for Health: a consensus statement from the British Association of Sport and Exercise Sciences. J Sports Sci. 2010;28:573–591. doi: 10.1080/02640411003671212.
    1. U.S. Department of Health and Human Services; U.S. Department of Agriculture. Dietary Guidelines for Americans. 6. Washington, DC; 2005.
    1. Institute of Medicine. Dietary Reference Intakes for Energy, Carbohydrates, Fiber, Fat, Protein and Amino Acids (Macronutrients) Washington, DC: National Academy of Sciences; 2002.
    1. Tudor-Locke C. Steps to better cardiovascular health: how many steps does it take to achieve good health and how confident are we in this number? Curr Cardiovasc Risk Rep. 2010;4:271–276. doi: 10.1007/s12170-010-0109-5.
    1. Tudor-Locke C, Bassett DR Jr. How many steps/day are enough? Preliminary pedometer indices for public health. Sports Med. 2004;34:1–8. doi: 10.2165/00007256-200434010-00001.
    1. Tudor-Locke C, Hatano Y, Pangrazi RP, Kang M. Revisiting "How many steps are enough?". Med Sci Sports Exerc. 2008;40:S537–543. doi: 10.1249/MSS.0b013e31817c7133.
    1. Tudor-Locke C, Craig CL, Beets MW, Belton S, Cardon GM, Duncan S, Hatano Y, Lubans DR, Olds TS, Raustorp A. et al.How many steps/day are enough? For children and adolescents. Int J Behav Nutr Phys Act. 2011;8:78. doi: 10.1186/1479-5868-8-78.
    1. Tudor-Locke C, Craig CL, Aoyagi Y, Bell RC, Croteau KA, De Bourdeaudhuij I, Ewald B, Gardner AW, Hatano Y, Lutes LD. et al.How many steps/day are enough? For older adults and special populations. Int J Behav Nutr Phys Act. 2011;8(1):80. doi: 10.1186/1479-5868-8-80.
    1. Tudor-Locke C, Myers AM. Methodological considerations for researchers and practitioners using pedometers to measure physical (ambulatory) activity. Res Q Exerc Sport. 2001;72:1–12.
    1. Bohannon RW. Number of pedometer-assessed steps taken per day by adults: a descriptive meta-analysis. Physical Therapist. 2007;87:1642–1650. doi: 10.2522/ptj.20060037.
    1. Whitt MC, DuBose KD, Ainsworth BE, Tudor-Locke C. Walking patterns in a sample of African American, Native American, and Caucasian women: the cross-cultural activity participation study. Health Educ Behav. 2004;31:45S–56S. doi: 10.1177/1090198104266034.
    1. Bassett DR Jr, Schneider PL, Huntington GE. Physical activity in an Old Order Amish community. Med Sci Sports Exerc. 2004;36:79–85. doi: 10.1249/01.MSS.0000106184.71258.32.
    1. Le Masurier GC, Lee SM, Tudor-Locke C. Motion sensor accuracy under controlled and free-living conditions. Med Sci Sports Exerc. 2004;36:905–910.
    1. Le Masurier GC, Tudor-Locke C. Comparison of pedometer and accelerometer accuracy under controlled conditions. Med Sci Sports Exerc. 2003;35:867–871. doi: 10.1249/01.MSS.0000064996.63632.10.
    1. Wyatt HR, Peters JC, Reed GW, Barry M, Hill JO. A Colorado statewide survey of walking and its relation to excessive weight. Med Sci Sports Exerc. 2005;37:724–730. doi: 10.1249/01.MSS.0000161750.84096.D4.
    1. Tudor-Locke C, Ham SA, Macera CA, Ainsworth BE, Kirtland KA, Reis JP, Kimsey CD Jr. Descriptive epidemiology of pedometer-determined physical activity. Med Sci Sports Exerc. 2004;36:1567–1573. doi: 10.1249/01.MSS.0000139806.53824.2E.
    1. Bassett DR Jr, Wyatt HR, Thompson H, Peters JC, Hill JO. Pedometer-measured physical activity and health behaviors in United States adults. Med Sci Sports Exerc. 2010;42:1819–1825. doi: 10.1249/MSS.0b013e3181dc2e54.
    1. Inoue S, Takamiya T, Yoshiike N, Shimomitsu T. International Congress on Physical Activity and Public Health; April 17-20; Atlanta, GA. U.S. Department of Health and Human Services; 2006. Physical activity among the Japanese: results of the National Health and Nutrition Survey; p. 79.
    1. McCormack G, Giles-Corti B, Milligan R. Demographic and individual correlates of achieving 10,000 steps/day: use of pedometers in a population-based study. Health Promot J Austr. 2006;17:43–47.
    1. De Cocker K, Cardon G, De Bourdeaudhuij I. Pedometer-determined physical activity and its comparison with the International Physical Activity Questionnaire in a sample of Belgian adults. Res Q Exerc Sport. 2007;78:429–437.
    1. Sequeira MM, Rickenbach M, Wietlisbach V, Tullen B, Schutz Y. Physical activity assessment using a pedometer and its comparison with a questionnaire in a large population survey. Am J Epidemiol. 1995;142:989–999.
    1. Tudor-Locke C, Bassett DR, Shipe MF, McClain JJ. Pedometry methods for assessing free-living adults. J Phys Act Health. 2011;8:445–453.
    1. Krumm EM, Dessieux OL, Andrews P, Thompson DL. The relationship between daily steps and body composition in postmenopausal women. J Womens Health. 2006;15:202–210. doi: 10.1089/jwh.2006.15.202.
    1. Schmidt MD, Cleland VJ, Shaw K, Dwyer T, Venn AJ. Cardiometabolic risk in younger and older adults across an index of ambulatory activity. Am J Prev Med. 2009;37:278–284. doi: 10.1016/j.amepre.2009.05.020.
    1. Cook I, Alberts M, Lambert EV. Relationship between adiposity and pedometer-assessed ambulatory activity in adult, rural African women. Int J Obes (Lond) 2008;32:1327–1330. doi: 10.1038/ijo.2008.26.
    1. Cook I, Alberts M, Brits JS, Choma SR, Mkhonto SS. Descriptive epidemiology of ambulatory activity in rural, black South Africans. Med Sci Sports Exerc. 2010;42:1261–1268.
    1. Bravata DM, Smith-Spangler C, Sundaram V, Gienger AL, Lin N, Lewis R, Stave CD, Olkin I, Sirard JR. Using pedometers to increase physical activity and improve health: a systematic review. JAMA. 2007;298:2296–2304. doi: 10.1001/jama.298.19.2296.
    1. Richardson CR, Newton TL, Abraham JJ, Sen A, Jimbo M, Swartz AM. A meta-analysis of pedometer-based walking interventions and weight loss. Ann Fam Med. 2008;6:69–77. doi: 10.1370/afm.761.
    1. Kang M, Marshall SJ, Barreira TV, Lee JO. Effect of pedometer-based physical activity interventions: a meta-analysis. Res Q Exerc Sport. 2009;80:648–655.
    1. Tudor-Locke C, Lutes L. Why do pedometers work? A reflection upon the factors related to successfully increasing physical activity. Sports Med. 2009;39:981–993. doi: 10.2165/11319600-000000000-00000.
    1. Marcus BH, Forsyth L. Motivating People to be Physically Active. 2. Champaign, IL: Human Kinetics Publishers; 2008.
    1. Tudor-Locke C, Sisson SB, Collova T, Lee SM, Swan PD. Pedometer-determined step count guidelines for classifying walking intensity in a young ostensibly healthy population. Can J Appl Physiol. 2005;30:666–676. doi: 10.1139/h05-147.
    1. Marshall SJ, Levy SS, Tudor-Locke CE, Kolkhorst FW, Wooten KM, Ji M, Macera CA, Ainsworth BE. Translating physical activity recommendations into a pedometer-based step goal: 3000 steps in 30 minutes. Am J Prev Med. 2009;36:410–415. doi: 10.1016/j.amepre.2009.01.021.
    1. Rowe DA, Welk GJ, Heil DP, Mahar MT, Kemble CD, Calabro MA, Camenisch K. Stride rate recommendations for moderate intensity walking. Med Sci Sports Exerc. 2011;43:312–318.
    1. Welk GJ, Differding JA, Thompson RW, Blair SN, Dziura J, Hart P. The utility of the Digi-walker step counter to assess daily physical activity patterns. Med Sci Sports Exerc. 2000;32:S481–488. doi: 10.1097/00005768-200009001-00007.
    1. MacPherson C, Purcell C, Bulley C. Energy expended when walking 10,000 steps at different speeds. Adv Physiother. 2009;11:179–185. doi: 10.3109/14038190903214530.
    1. Abel M, Hannon J, Mullineaux D, Beighle A. Determination of step rate thresholds corresponding to physical activity classifications in adults. J Phys Act Health. 2011;8:45–51.
    1. Beets MW, Agiovlasitis S, Fahs CA, Ranadive SM, Fernhall B. Adjusting step count recommendations for anthropometric variations in leg length. J Sci Med Sport. 2010;13(5):509–12. doi: 10.1016/j.jsams.2009.11.002.
    1. Ainsworth BE, Haskell WL, Whitt MC, Irwin ML, Swartz AM, Strath SJ, O'Brien WL, Bassett DR, Schmitz KH, Emplaincourt PO. et al.Compendium of physical activities: an update of activity codes and MET intensities. Med Sci Sports Exerc. 2000;32:S498–504. doi: 10.1097/00005768-200009001-00009.
    1. Terrier P, Schutz Y. Variability of gait patterns during unconstrained walking assessed by satellite positioning (GPS) Eur J Appl Physiol. 2003;90:554–561. doi: 10.1007/s00421-003-0906-3.
    1. McArdle WD, Katch FI, Katch V. Exercise Physiology: Energy, Nutrition, and Human Performance. 6. Baltimore, MD: Lippincott Williams & Wilkins; 2007.
    1. Tudor-Locke C, Ainsworth BE, Thompson RW, Matthews CE. Comparison of pedometer and accelerometer measures of free-living physical activity. Med Sci Sports Exerc. 2002;34:2045–2051. doi: 10.1097/00005768-200212000-00027.
    1. Swartz AM, Strath SJ, Bassett DR, O'Brien WL, King GA, Ainsworth BE. Estimation of energy expenditure using CSA accelerometers at hip and wrist sites. Med Sci Sports Exerc. 2000;32:S450–456. doi: 10.1097/00005768-200009001-00003.
    1. Miller R, Brown W. Meeting physical activity guidelines and average daily steps in a working population. J Phys Act Health. 2004;1:218–226.
    1. Behrens TK, Hawkins SB, Dinger MK. Relationship between objectively measured steps and time spent in physical activity among free-living college students. Meas Phys Educ Exerc Sci. 2005;9:67–77. doi: 10.1207/s15327841mpee0902_1.
    1. Jordan AN, Jurca GM, Tudor-Locke C, Church TS, Blair SN. Pedometer indices for weekly physical activity recommendations in postmenopausal women. Med Sci Sports Exerc. 2005;37:1627–1632. doi: 10.1249/01.mss.0000177455.58960.aa.
    1. Macfarlane DJ, Chan D, Chan KL, Ho EY, Lee CC. Using three objective criteria to examine pedometer guidelines for free-living individuals. Eur J Appl Physiol. 2008;104:435–444. doi: 10.1007/s00421-008-0789-4.
    1. Tudor-Locke C, Leonardi C, Johnson WD, Katzmarzyk PT, Church TS. Accelerometer steps/day translation of moderate-to-vigorous activity. Prev Med. 2011. in press .
    1. Troiano RP, Dodd KW. Differences between objective and self-report measures of physical activity. What do they mean? The Korean Journal of Measurement and Evaluation in Physical Education and Sport Science. 2008;10:31–42.
    1. Church TS, Earnest CP, Skinner JS, Blair SN. Effects of different doses of physical activity on cardiorespiratory fitness among sedentary, overweight or obese postmenopausal women with elevated blood pressure: a randomized controlled trial. JAMA. 2007;297:2081–2091. doi: 10.1001/jama.297.19.2081.
    1. Church TS, Martin CK, Thompson AM, Earnest CP, Mikus CR, Blair SN. Changes in weight, waist circumference and compensatory responses with different doses of exercise among sedentary, overweight postmenopausal women. PLoS ONE. 2009;4:e4515. doi: 10.1371/journal.pone.0004515.
    1. Martin CK, Church TS, Thompson AM, Earnest CP, Blair SN. Exercise dose and quality of life: a randomized controlled trial. Arch Intern Med. 2009;169:269–278. doi: 10.1001/archinternmed.2008.545.
    1. McKercher CM, Schmidt MD, Sanderson KA, Patton GC, Dwyer T, Venn AJ. Physical activity and depression in young adults. Am J Prev Med. 2009;36:161–164. doi: 10.1016/j.amepre.2008.09.036.
    1. Dwyer T, Hosmer D, Hosmer T, Venn AJ, Blizzard CL, Granger RH, Cochrane JA, Blair SN, Shaw JE, Zimmet PZ, Dunstan D. The inverse relationship between number of steps per day and obesity in a population-based sample: the AusDiab study. Int J Obes (Lond) 2007;31:797–804.
    1. Tudor-Locke C, Bassett DR, Rutherford WJ, Ainsworth BE, Chan CB, Croteau K, Giles-Corti B, Le Masurier G, Moreau K, Mrozek J. et al.BMI-referenced cut points for pedometer-determined steps per day in adults. J Phys Act Health. 2008;5(Suppl 1):S126–139.
    1. Crouter SE, Schneider PL, Bassett DR Jr. Spring-levered versus piezo-electric pedometer accuracy in overweight and obese adults. Med Sci Sports Exerc. 2005;37:1673–1679. doi: 10.1249/01.mss.0000181677.36658.a8.
    1. Tudor-Locke C, Brashear MM, Johnson WD, Katzmarzyk PT. Accelerometer profiles of physical activity and inactivity in normal weight, overweight, and obese U.S. men and women. Int J Behav Nutr Phys Act. 2010;7:60. doi: 10.1186/1479-5868-7-60.
    1. Hamilton MT, Hamilton DG, Zderic TW. Role of low energy expenditure and sitting in obesity, metabolic syndrome, type 2 diabetes, and cardiovascular disease. Diabetes. 2007;56:2655–2667. doi: 10.2337/db07-0882.
    1. Katzmarzyk PT, Church TS, Craig CL, Bouchard C. Sitting time and mortality from all causes, cardiovascular disease, and cancer. Med Sci Sports Exerc. 2009;41:998–1005. doi: 10.1249/MSS.0b013e3181930355.
    1. Bouchard C. Physical activity and health: introduction to the dose-response symposium. Med Sci Sports Exerc. 2001;33:S347–350. doi: 10.1097/00005768-200106001-00002.
    1. Ham SA, Kruger J, Tudor-Locke C. Participation by US adults in sports, exercise, and recreational physical activities. J Phys Act Health. 2009;6:1–10.
    1. Tudor-Locke C, Bassett DR, Swartz AM, Strath SJ, Parr BB, Reis JP, Dubose KD, Ainsworth BE. A preliminary study of one year of pedometer self-monitoring. Ann Behav Med. 2004;28:158–162. doi: 10.1207/s15324796abm2803_3.
    1. Miller R, Brown W, Tudor-Locke C. But what about swimming and cycling? How to 'count' non-ambulatory activity when using pedometers to assess physical activity. J Phys Act Health. 2006;3:257–266.
    1. Pate RR, Pratt M, Blair SN, Haskell WL, Macera CA, Bouchard C, Buchner D, Ettinger W, Heath GW, King AC. et al.Physical activity and public health. A recommendation from the Centers for Disease Control and Prevention and the American College of Sports Medicine. JAMA. 1995;273:402–407. doi: 10.1001/jama.273.5.402.
    1. Le Masurier GC, Sidman CL, Corbin CB. Accumulating 10,000 steps: does this meet current physical activity guidelines? Res Q Exerc Sport. 2003;74:389–394.
    1. Wilde BE, Soidman CL, Corbin CB. A 10,000-step count as a physical activity target for sedentary women. Res Q Exerc Sport. 2001;72:411–414.
    1. Tudor-Locke C, Jones R, Myers AM, Paterson DH, Ecclestone NA. Contribution of structured exercise class participation and informal walking for exercise to daily physical activity in community-dwelling older adults. Res Q Exerc Sport. 2002;73:350–356.
    1. Payn T, Pfeiffer KA, Hutto B, Vena JE, LaMonte MJ, Blair SN, Hooker SP. Daily steps in midlife and older adults: relationship with demographic, self-rated health, and self-reported physical activity. Res Q Exerc Sport. 2008;79:128–132.
    1. Tudor-Locke C. A short list about what I do and don't know: about objective monitoring of physical activity. Curr Sports Med Rep. 2010;9:71–72.
    1. Schneider PL, Crouter SE, Lukajic O, Bassett DR Jr. Accuracy and reliability of 10 pedometers for measuring steps over a 400-m walk. Med Sci Sports Exerc. 2003;35:1779–1784. doi: 10.1249/01.MSS.0000089342.96098.C4.
    1. Tabata I, editor. Office for Lifestyle-Related Diseases Control; General Affairs Division; Health Service Bureau; Ministry of Health Labour and Welfare of Japan. Exercise and Physical Activity Reference for Health Promotion 2006 (EPAR2006): Physical Activity, Exercise, and Physical Fitness. Japan: National Institute of Health and Nutrition; 2006.
    1. Behrens TK, Dinger MK. Ambulatory physical activity patterns of college students. Am J Health Educ. 2005;36:221–227.
    1. Hornbuckle LM, Bassett DR, Thompson DL. Pedometer-determined walking and body composition variables in African-American women. Med Sci Sports Exerc. 2005;37:1069–1074.
    1. Bennett GG, Wolin KY, Puleo E, Emmons KM. Pedometer-determined physical activity among multiethnic low-income housing residents. Med Sci Sports Exerc. 2006;38:768–773. doi: 10.1249/01.mss.0000210200.87328.3f.
    1. De Cocker KA, De Bourdeaudhuij IM, Cardon GM. What do pedometer counts represent? A comparison between pedometer data and data from four different questionnaires. Public Health Nutr. 2008;12:74–81.
    1. Mitsui T, Shimaoka K, Tsuzuku S, Kajioka T, Sakakibara H. Pedometer-determined physical activity and indicators of health in Japanese adults. J Physiol Anthropol. 2008;27:179–184. doi: 10.2114/jpa2.27.179.
    1. Tudor-Locke C, Johnson WD, Katzmarzyk PT. Relationship between accelerometer-determined steps/day and other accelerometer outputs in U.S. adults. J Phys Act Health. 2011;8:410–419.
    1. Clemes SA, Hamilton SL, Griffiths PL. Summer to winter variability in steps counts of normal weight and overweight adults living in the U.K. J Phys Act Health. 2011;8:36–44.

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