Evidence behind 10000 steps walking
Mini-Review
241
EVIDENCE BEHIND 10,000 STEPS WALKING
Apichai Wattanapisit1, *, Sanhapan Thanamee2
1
2
School of Medicine, Walailak University, Nakhon Si Thammarat, 80161, Thailand
Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
ABSTRACT:
A recommendation to walk 10,000 steps/day is widely promoted among populations. This study aimed
to review scientific evidence of 10,000 steps walking. English language articles between years 20002016 were searched from online databases; MEDLINE, CINAHL, and Google Scholar. The search terms
were “10000 steps walking” AND “adults”. Seventeen primary studies were reviewed. The studies
supported benefits of 10,000 steps/day on body compositions, blood pressure and serum lipid levels. A
10,000 steps/day walking was considered as an alternative recommendation on physical activity for
public health which comparable with 150 minutes/week of moderate-intensity physical activity.
Various approaches included prize reinforcement, using a step counter (pedometer), family- and
community-based interventions could increase a number of steps. Applying any interventions to
achieve the recommendation should consider about accessibility, appropriate duration, and continuity
of those approaches.
Keywords: Health benefits; Walking; 10,000 steps walking
DOI: 10.14456/jhr.2017.30
INTRODUCTION
“Walking is man’s best medicine” is a quote
of Hippocrates [1]. It is also one of the effective
physical activities to reduce risks of noncommunicable diseases (NCDs) and to increase
health benefits [2, 3]. Globally, physical activity
guidelines recommend adults should participate in
regular physical activity (PA) which based on type,
intensity and duration of activities [4, 5]. Walking
can be a moderate-intensity PA which beneficial
to health [6]. Alternatively, step-based walking
recommendations from around the world are
emerging, and they are different in terms of amount
of steps per day or steps per week [7]. The numbers
of walking steps are translated as 1) ‘sedentary
lifestyle index’ (<5,000 steps/day); 2) ‘low active’
(5,000-7,499 steps/day); 3) ‘somewhat active’
(7,500-9,999 steps/day); 4) ‘active’ (≥10,000
steps/day); and 5) ‘highly active’ (>12,500 steps/day)
[8].
As a physically active level, a 10,000 steps/day
walking becomes a commonly-acknowledged
*
Correspondence to: Apichai Wattanapisit
E-mail: apichai.wa@wu.ac.th
Cite this article as:
Received: August 2016; Accepted: October 2016
goal for daily fitness across the world through media
[9, 10]. The target of achieving 10,000 steps/day
is widely recognised in Japan [8]. 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) [11].
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)
[12-14].
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 [4, 5]. The step-based walking is considered as
an appropriate approach to increase participation in
health-related PA [15]. However, the benefits of and
recommendations on a step-based walking approach
or 10,000 steps walking are still controversial.
This study reviewed the current evidence
toward benefits, recommendations on the step-based
walking and interventions to reach and maintain the
Wattanapisit A, Thanamee S. Evidence behind 10,000 steps walking. J Health Res. 2017; 31(3): 241-8.
DOI: 10.14456/jhr.2017.30
http://www.jhealthres.org
J Health Res  vol.31 no.3 June 2017
242
MEDLINE
CINAHL
Google Scholar
“10000 steps walking” AND
“adults”
49 articles were published
between 2000 and 2016
28 articles were excluded based
on titles and abstracts
4 articles were review articles
17 research articles were
reviewed
Figure 1 Searching results
daily goal of 10,000 steps per day. This review
consisted of both experimental and observational
studies to fulfil the gap of knowledge of the 10,000
steps walking. The findings of this study might be
the additional information and an alternative
recommendation on PA among adult populations.
METHODS
The online databases were searched from
MEDLINE, CINAHL, and Google Scholar on 20 th
April 2016. The keywords comprised “10000 steps
walking” AND “adults”. Only English language
articles between years 2000-2016 were reviewed.
Secondary studies, including systematic and
narrative reviews, were excluded.
The 49 articles were found from the online
databases. Twenty-eight articles were excluded
based on titles and abstracts. Four systematic
reviews and narrative reviews were excluded. A
total of 17 articles were assessed (Figure 1).
RESULTS
Relevant studies
The relevant studies were shown in Table 1.
Benefits of 10,000 steps walking
Many studies investigated benefits of 10,000
steps walking on body compositions. 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 [22]. A longer
J Health Res  vol.31 no.3 June 2017
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) [27].
Improvements of blood pressure were the
benefits which found in several studies. According
to a study among university students, a 6-week
10,000 steps/day walk could significantly reduce
systolic blood pressure (SBP) (120.00±15.62 mmHg
versus 111.75±9.80 mmHg; P=0.04) and diastolic
blood pressure (DBP) (79.00±8.23 mmHg versus
71.56±8.34 mmHg; P=0.04) [26]. Soroush et al. also
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 [21].
For bone health, a 10,000-step daily walk was
sufficient to maintain bone mineral density (BMD)
in 49 to 64 years old adults [29]. Several studies
found significant improvements in blood tests [24,
27, 30]. High-density lipoprotein (HDL) increased
significantly (3 mg/dl) after a 36-week-10,000
steps/day walking [27]. This finding, an increase in
HDL, was similarly found in older Australians, aged
55 to 85 years [30]. 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) [24].
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Table 1 Relevant studies
Titles
Author(s)
1.
A pilot randomised controlled trial evaluating motivationally
matched pedometer feedback to increase physical activity
behaviour in older adults [16]
Strath et al.
Year of
publication
2011
2.
Short-term effects of using pedometers to increase daily physical
activity in smokers: a randomised trial [17]
Kovelis et al.
3.
A randomised study of reinforcing ambulatory exercise in older
adults [18]
4.
5.
6.
8.
9.
Sample size
Summary
Randomised
controlled trial
81
2012
Randomised
controlled trial
76
Petry et al.
2013
Randomised
controlled trial
45
A randomised controlled trial of continuous activity, short bouts,
and a 10,000 step guideline in inactive adults [19]
Samuels et al.
2011
Randomised
controlled trial
43
Effects of "10,000 steps Ghent": a whole-community intervention
[20]
Effects of a 6-month walking study on blood pressure and
cardiorespiratory fitness in U.S. and Swedish adults: ASUKI Step
Study [21]
U.S. cohort differences in body composition outcomes of a
6-month pedometer-based physical activity intervention: the
ASUKI Step Study [22]
Maintaining high activity levels in sedentary adults with a
reinforcement-thinning schedule [23]
De Cocker et al.
2007
1,682
Soroush et al.
2013
Non-randomised
controlled
Non-randomised
controlled
Walker et al.
2014
Non-randomised
controlled
142
A pedometer feedback intervention with
individually matched motivational messaging
was an effective intervention strategy to
increase PA behaviour.
Physically inactive smokers improved their
daily physical activity level by using a
pedometer.
The participants in the reinforcement
condition walked an average of about 2,000
more steps/day than participants in the
control condition.
A 10,000 steps/day recommendation could
increase the largest step counts compared to
a continuous 30 minutes/day and an
accumulating the total of 30 minutes/day
recommendation.
Multiple strategies using a central theme of
10,000 steps/day could increase PA levels.
Walking more than 10,000 steps/day
approached a significance for changes in
systolic blood pressure.
A 10,000 steps/day walking programme
changed the body composition measures.
Andrade et al.
2014
Non-randomised
controlled
61
Low-intensity exercise exerts beneficial effects on plasma lipids
via PPARγ [24]
Butcher et al.
2008
Non-randomised
controlled
34
355
Monitoring plus reinforcement-thinning
schedule could increase the number of
walking steps.
The exercise programme (walking) could
significantly decrease total cholesterol and
increase high-density lipoprotein (HDL).
243
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7.
Study design
244
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Table 1 Relevant studies (cont.)
Pal et al.
Year of
publication
2011
Tully et al.
2011
Non-randomised
controlled
31
Schneider et al.
2006
Before-and-after
interventional
56
13. Walking to meet physical activity guidelines in knee
osteoarthritis: is 10,000 steps enough? [28]
White et al.
2013
Cohort
1,788
14. Maintaining femoral bone density in adults: how many steps per
day are enough? [29]
Bowyer et al.
2011
Cohort
105
15. How many steps are enough? Dose-response curves for
pedometer steps and multiple health markers in a communitybased sample of older Australians [30]
16. Steps per day required for meeting physical activity guidelines in
Japanese adults [31]
17. Achieving the daily step goal of 10,000 steps: the experience of a
Canadian family attached to pedometers [32]
Ewald et al.
2014
Cross-sectional
2,458
Cao et al.
2014
Cross-sectional
940
Choi et al.
2007
Cross-sectional
4
Titles
10. The effect of two different health messages on physical activity
levels and health in sedentary overweight, middle-aged women
[25]
11. UNISTEP (university students exercise and physical activity)
study: a pilot study of the effects of accumulating 10,000 steps on
health and fitness among university students [26]
12. Effects of a 10,000 steps per day goal in overweight adults [27]
Author(s)
Study design
Sample size
Summary
Non-randomised
controlled
32
A 10,000 steps/day guideline was more
effective than a 30 minutes/day walking for
increasing the number of steps.
A 10,000 steps/day walking might be an
appropriate intervention in sedentary
university students to increase PA.
A 10,000 steps/day walking resulted in
weight loss over 36 weeks in previously
sedentary, overweight/obese adults.
The analysis supported 7,910 steps/day (for
men) and 9,040 steps/day (for women) as
optimal steps/day cut-points, and 100
steps/minute was considered as a moderateintensity PA.
A walking speed greater than 1.32 m/s for
10,000 steps/day was sufficient to maintain
a healthy bone mineral density.
Most of the health benefit was achieved by
8,000 steps/day.
A 7,700-8,000 steps/day walking was
comparable with 150 minutes/week MVPA.
‘Get off the chair’ was emphasised to meet
the daily step goals.
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245
Recommendations on 10,000 steps walking
among adult population
As the global recommendations on PA, adults
should have at least 150 minutes/week of MVPA [5].
To compare with the time-based recommendations,
Cao et al. investigated the optimal steps per day
needed to meet the current PA recommendations by
using accelerometer-based monitoring [31]. 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 [31]. Men needed a slightly
lower number of steps per day to meet the
recommendation compared with women (7,523
steps/day versus 7,905 steps/day) [31]. According to
the study of Cao et al., 10,000 steps/day walking
extended beyond the recommended number of steps.
To meet the PA recommendations, in terms of
quality, walking at greater than 100 steps/minute
was considered as a moderate-intensity PA [28]. For
quantity, although both step-based and time-based
goals could elevate the number of walking steps, a
step-based achievement was more effective than a
time-based achievement to reach a 10,000 steps/day
goal. The studies showed that a 10,000 steps/day
goal could increase more walking steps compared to
30 minutes/day recommendations [19, 25].
Interventions to reach and maintain 10,000 steps
walking
Meeting a 10,000-step per day goal in public
health needed specific interventions. 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 [18, 23]. 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 [23]. 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 [18].
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
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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 (P<0.001) [17].
To increase effectiveness of using a pedometer,
individualised motivational feedback and
motivational feedback plus telephone feedback
could increase on average 1,684 steps/day (P<0.001)
and 2,013 steps/day (P<0.001), respectively,
compared to using only a pedometer after a 12-week
intervention [16].
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 [32]. 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 [20].
DISCUSSION
The recent studies found a wide range of 10,000
steps/day walking benefits. Body compositions,
blood pressure, and lipid profiles were commonly
positive findings in those studies. Benefits of
interventions were found in various age groups
from young to older adults. Moreover, a 10,000
steps/day walking at greater than 100 steps/minute
could be an appropriate level to achieve the current
PA recommendations. Recommendations regarding
10,000 steps goal should specify the exact number
of steps rather than the amount of time. The evidence
supported interventions included prize reinforcement,
using a pedometer with or without individualised
feedback, encouraging to increase steps/day
in family, and multistrategy community-based
intervention were effective schemes to reach and
maintain 10,000 steps walking.
Walking was considered as a popular,
acceptable, and accessible PA among populations
[15, 33]. Many studies showed positive outcomes of
10,000-step/day walking in sedentary or physically
inactive populations [24, 26]. Additionally, in
general populations, many benefits on health were
found [21, 22, 34]. On the other hand, increasing PA
raised musculoskeletal injury risks [35], however,
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246
walking was a low-risk PA (minor injury and low
injury rates) [36].
Reaching the step-based recommendation
might need an instrument such as pedometer to
measure the objective data [37]. Using a pedometer,
especially a traditional pedometer, was limited by
several factors [38, 39]. Presently, smartphone
pedometer applications could be substitutions of
traditional pedometers in the free-living setting [40].
Nevertheless, accuracy among different smartphone
pedometer applications was still controversial [41].
The key to success of any 10,000 steps/day
interventions might include an appropriate duration
and continuity of interventions. The previous studies
showed that the number of steps per day decreased
by time after interventions [18, 23]. Increasing
accessibility to interventions, such as building PA
friendly environment, also was a supportive factor
to achieve the goal [20].
Barriers to achieving 10,000 steps per day
included several layers based on the social
ecological model [42]. Functional limitations and
low self-efficacy were individual barriers. For
environmental issues, lack of perceive and actual
environmental supports for walking were also
obstacles. In addition, unsupportive regional and
community policies could be considered as barriers
to achieve the 10,000 steps walking [43].
The strengths of this study were the coverage of
recently primary evidence and comparison between
a 10,000 steps/day approach and time-based PA
recommendations. However, this study was a
narrative review which not summarised statistics of
all studies. Another weakness was using the
expansive search terms which leading to nonspecific
and missing data.
In summary, a 10,000 steps/day walk should be
promoted to populations, especially in physically
inactive populations. Beyond the scope of this study,
any health promotion campaigns in the future should
consider behavioural and motivational aspects to
meet this step-based goal [44].
CONCLUSIONS
The recent studies support benefits of 10,000
steps/day on body compositions, blood pressure and
serum lipid levels. A 10,000 steps/day walking is
considered as an alternative recommendation on PA
for public health. Various approaches included prize
reinforcement, using a pedometer, family- and
community-based interventions can increase a
number of steps to meet the step-based goal.
J Health Res  vol.31 no.3 June 2017
Applying any interventions to achieve the
recommendation
should
consider
about
accessibility, appropriate duration, and continuity of
those approaches.
CONFLICT OF INTERESTS
The authors declare that there is no conflict of
interests regarding the publication of this article.
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