JOURNAL CLUB PRESENTATION

EVIDENCE BEHIND 10,000 STEPS WALKING

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DR MARYAM DZULKIFLI

26 APRIL 2022

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INTRODUCTION

• “Walking is man’s best medicine” is a quote of Hippocrates

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• Effective physical activities can reduce risks of noncommunicable diseases (NCDs) and to increase health benefits

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• physical activity guidelines recommend adults should participate in regular physical activity (PA) which based on type, intensity and duration of active

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• Walking can be a moderate-intensity PA which beneficial to health

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• As a physically active level, a 10,000 steps/day walking becomes a commonly-acknowledged goal for daily fitness across the world through media

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• The 10,000 steps/day walking is approximately equivalent to 300 and 400 kcal/day of energy expenditure (depending on walking speed and body size)

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• The weekly energy expenditure from 10,000 steps/day for more than 3 days a week is comparable with energy use of 30 minutes of moderate-intensity PA on most days of the week which met a threshold associated with significant reductions in cardiovascular-related mortality (1,000 kcal/week)

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• According to the emerging evidence regarding PA guidelines, moderate- to vigorous-intensity PA (MVPA) is recommended to maintain and improve cardiovascular functions; also reduce health-related risks

Benefits of 10,000 steps walking

1. Body Mass Index and Waist Circumference

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• A study in adults, aged 20 to 70, represented a 3 cm loss in waist circumference after 6 months of a 10,000 steps/day walking programme

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• A longer programme (9 months) showed significant improvements in body weight (-2.4 kg), body mass index (BMI) (-0.8 kg/m2), percentage body fat (-1.9%), fat mass (-2.7 kg), waist circumference (-1.8 cm), and hip circumference (-1.9 cm)

2. Blood Pressure

• Soroush et al. showed a significance of blood pressure improvement (SBP and DBP decreased 5.57 and 4.03 mmHg every 3 months, respectively) among adults aged 20 to 65 years after the 6 months of 10,000 steps/day walking

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3. Bone Health

• a 10,000-step daily walk was sufficient to maintain bone mineral density (BMD) in 49 to 64 years old adults

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4. Improves HDL

• High-density lipoprotein (HDL) increased significantly (3 mg/dl) after a 36-week-10,000 steps/day walking
• This finding, an increase in HDL, was similarly found in older Australians, aged 55 to 85 years. Even a low-intensity exercise which consisted of walking 10,000 steps three times per week with any walking speed for 8 weeks could elevate HDL and reduce low-density lipoprotein (LDL)

5. Mental health

• improves mental health by reducing anxiety, depression, and negative mood and by improving self-esteem and cognitive function

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6. Others

• Improved sleep
• Increased interest in sex
• Better endurance
• Stress relief
• Increased energy and stamina

Recommendations on 10,000 steps walking among adult population

• Adults should have at least 150minutes/week of MVPA

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• Cao et al. investigated the optimal steps per day needed to meet the current PA recommendations by using accelerometer-based monitoring

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• This study recruited 940 adults (460 men and 480 women), aged between 20 and 69 years, in Japan. The analysis consisted of linear regression analysis, and the results showed overall population needed 7,716 steps/day to meet the recommendation, 150 minutes/week of MVPA

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• The studies showed that a 10,000 steps/day goal could increase more walking steps compared to 30 minutes/day recommendations

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• Exercise and fasting are two well-known strategies to increase lipolysis in adipose and muscle tissue, and thereby reduces the amount of body fat mass

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Exercise and Fasting

• Previous studies investigated outcomes of prize reinforcement systems, including monetary prize; gift cards; food items; and clothing, for increasing steps per day to 10,000 steps

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• One study recruited sedentary adults, aged 18 years and over, and the participants were encouraged to achieve 10,000 steps/day over 12 weeks of the programme. The subjects who participated in the prize reinforcement system had the potential to maintain a higher rate of ambulatory activities compared to the control group

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• In sedentary older adults with mild to moderate hypertension, the prize reinforcement interventions showed the similar trend that the programme could increase the participants’ walking steps compared to the control group after a 12-week intervention

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Interventions to reach and maintain 10,000 steps walking

• Using a pedometer as objective monitoring could have a positive effect in increasing walking steps to reach a level of 10,000 steps/day. This approach represented a positive finding that using a pedometer in inactive cigarette smokers for 1 month could significantly increase steps/day of the participants from 7,670 (6,159-9,402) steps/day to 10,310 (9,483-11,110) steps/day

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• An intervention, ‘get off the chair’ campaign, for a whole family, including walking at brisk pace; grocery shopping, window shopping in a shopping centre; going to an entertainment centre; and attending parties might be an effective approach to increase daily steps

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• For a community-based intervention, multiple strategies consisted of local media campaign, environmental approaches, pedometer sale and loan services, and local PA projects were implemented in Ghent, Belgium, and its results showed an 8% increase in the number of people reaching 10,000 steps/day after one year intervention

Conclusion

• Walking was considered as a popular, acceptable, and accessible PA among populations
• Many studies showed positive outcomes of 10,000-step/day walking in sedentary or physically inactive populations
• in general populations, many benefits on health were found
• walking is a low-risk PA (minor injury and low injury rates)
• The key to success of any 10,000 steps/day interventions might include an appropriate duration and continuity of interventions
• Increasing accessibility to interventions, such as building PA friendly environment, also was a supportive factor to achieve the goal

Intervention by KKM

“Komuniti Sihat, Perkasa Negara” (KOSPEN) is a non-communicable disease (NCD) intervention program aimed at reducing the level of behavioural and biological NCD risk factors.