Combinations of stepping intensity and daily step counts against all-cause and cardiovascular disease mortality: insights from a device-based prospective study
Prospective cohort study observes lower mortality risk with varied step counts and cadence combinations in adults, highlighting flexible physical activity targets.
Key Points
To examine the joint associations of stepping intensity and daily step counts with all-cause mortality and cardiovascular disease mortality.
Analyzed 64,743 UK Biobank participants (mean age 61.5 years; 37,497 female; 1,697 mortality events) who wore wrist-worn accelerometers.
Stepping intensity was defined by peak 30-minute cadence (PK30, steps/minute during the highest non-consecutive 30 minutes), and daily steps were stratified into <5,000, 5,000-7,500, 7,500-10,000, and >10,000 steps/day.
Assessed dose-response associations with all-cause and cardiovascular disease mortality using multivariable-adjusted Cox proportional hazards and Fine and Gray subdistribution hazard models.
Compared with the reference group (<5,000 steps/day and fifth PK30 percentile), higher intensity lowered all-cause mortality even with <5,000 steps/day (80 steps/min: HR 0.72, 95% CI 0.54-0.97) and with 5,000-7,500 steps/day at lower cadences (60 steps/min: HR 0.70, 95% CI 0.58-0.86).
The 7,500-10,000 steps/day category displayed the lowest all-cause mortality risk in a U-shaped pattern, bottoming out at approximately 100 steps/min (HR 0.57, 95% CI 0.47-0.69).
Achieving 90 steps/min showed consistent mortality reductions across volume strata, and cardiovascular disease mortality exhibited comparable dose-response patterns.