January 2025 Issue
Focus on Fitness: Promoting 10k Steps a Day
By Dina Aronson, MS, RDN
Today’s Dietitian
Vol. 27 No. 1 P. 40
Is It Good Practice?
Encouraging a goal of 10,000 steps a day has become a popular message for promoting physical activity, reducing chronic disease risk, and managing weight. It’s simple and effective, achievable for much of the population, and a powerful tool to help clients and patients manage their health over the long term. In this article, Today’s Dietitian explores the history and supporting evidence for the 10k step recommendation, whether it’s the right goal for everyone, and advice for RDs counseling clients looking to increase activity.
History and Evidence
The origin of the 10,000 steps per day concept is unclear, but it likely derives from the trade name of a pedometer sold in 1965 by Yamasa Clock and Instrument Company in Japan called Manpo-kei, which translates to “10,000 steps meter.”1 Although “10k a day” has become a universally accepted benchmark, actual step counts and associated benefits are more nuanced, particularly when comparing different age groups.
Achieving 10,000 steps per day can be perceived not as a guideline per se, but as a way people may choose to meet key guidelines set forth by the US Department of Health and Human Services.2 One of the guidelines for adults, for example, is getting 150 to 300 minutes of moderately intense activity a week. Translating this into a daily, easy-to-remember, easy-to-track goal—like 10k steps a day—is a strategy to help people stick to the guideline.
Nonetheless, there’s evidence specific to step advice. Most studies on steps have examined mortality risk to understand the impact of both the volume (number) and cadence (intensity) of walking. A 2020 JAMA study assessed cardiovascular disease, cancer, and all-cause mortality in 4,840 adults from an NHANES cohort.3 Researchers found, over the 12-year observational period, that the greater the number of daily steps taken, the lower the rates of all-cause mortality. For example, taking 8,000 steps per day was associated with significantly lower mortality than taking 4,000, while 12,000 showed further improvements over 8,000 steps.
A large cohort study in 2021 followed 2,110 adults for about 10 years and found that those taking at least 7,000 steps per day, compared with those taking fewer than 7,000, had a 50% to 70% lower risk of mortality.4 Both studies reported no differences in outcomes related to step intensity. A UK study of 78,500 adults showed that both the number of steps and intensity improve all-cause mortality as well as mortality from cancer and cardiovascular disease.5
A 2019 study published in JAMA Internal Medicine examined the impact of daily steps on mortality among a cohort of nearly 17,000 older women (average age of 72) from the Women’s Health Study. It found that walking as few as 4,400 steps per day was significantly associated with lower mortality rates compared to walking around 2,700 steps per day. Furthermore, as the number of daily steps increased, mortality rates continued to decline until leveling off at about 7,500 steps per day. The intensity of the steps didn’t show a clear correlation with lower mortality rates when the total number of steps per day was taken into account.1 In addition, a 2022 meta-analysis of 15 studies involving nearly 50,000 people concluded that for adults aged 60 and older, the risk of premature death leveled off at about 6,000 to 8,000 steps per day, while adults younger than 60 saw the risk of premature death stabilize at about 8,000 to 10,000 steps per day.6
This, of course, doesn’t mean that there’s no value in setting a high step goal. Beyond chronic disease risk reduction and longevity benefits, health experts know that higher levels of physical activity are associated with numerous advantages such as stress reduction, better mood, enhanced cardiovascular fitness, improved strength and flexibility, blood pressure control, alleviation of depression and anxiety, and even reduced risk of dementia. A 2022 study published in JAMA Neurology even settled on a number—it found that walking 9,800 steps per day is associated with a consistent reduction in dementia risk.7
Is 10k the Right Goal?
For able-bodied individuals, why count steps, rather than track distance or time? Step counting isn’t inherently superior; any measurement tool that supports an individual and helps them stick to their physical activity goals is the best method to use. The main advantage of step counting is that it’s simple: a pedometer, either standalone or built into the fitness tracking device on a phone or watch, is all that’s needed. Pedometers are relatively accurate and affordable, and step counter apps are free for those with a smartphone. The main drawback is that the tool only tracks exercises involving steps (walking, running, elliptical training, dancing) while underestimating contribution from other activities such as cycling, swimming, gardening, yoga, and calisthenics.
Counting steps is a strategy—a means to an end. Dana Angelo White, MS, RDN, ATC, certified athletic trainer and sports dietitian nutritionist for Quinnipiac University, says, “10k steps reminds me of the eight glasses of water a day recommendation—we don’t really have science to back it up, but it really isn’t a bad recommendation for most people to meet hydration goals, and clearly, it resonates!”
Psychology of 10k a Day
For many people, there’s something especially appealing about a step goal in and of itself, perhaps because it stimulates the reward center of the brain on a daily basis. As Leanne Mauriello, PhD, Founder & CEO of Evolve Health Advisors LLC, explains: “So many principles of effective behavioral science strategies are wrapped within the concept of 10,000 steps per day. It lends itself to becoming a daily habit and a lifelong healthful behavior. How many times do you check your smartwatch, smartphone, or app to see if you reached 10k steps? It’s a sticky goal that so many of us strive to reach.”
Due to its specificity yet flexibility, the 10,000-step goal minimizes opportunities for excuses not to exercise. It’s easy to find reasons to skip a fitness class, a gym visit, or a bike ride, but there are numerous occasions throughout the day to add more steps. Moreover, the appeal of seeing the step counter flip to five digits can be motivating, even prompting an extra nighttime walk. Achieving the 10,000 steps goal on consecutive days may also create a streak that people strive to maintain, turning the activity into a self-sustaining habit.
Furthermore, once established, the 10,000-step goal acts as a powerful trigger for habit stacking, also known as habit coupling. This involves linking a new habit to an existing one, making it easier to adopt. For example, if a client has mastered her step goal but is trying to reduce her intake of sweets, she might set a goal to have her first and only sweet of the day after reaching 10,000 steps. This strategy could help her succeed in curbing her intake.
Getting 10,000 steps is also a great way to optimize mental health. “There are benefits that extend beyond the physical activity,” Angelo White says. “The routine of getting steps in during your lunch break with a friend or the commitment to spending more time with your pet by taking them for extra walks—10k steps may be the initial goal, but the benefits branch out from there.”
Recommendations for RDs
As with any lifestyle change, dietitians should assess each patient’s health status and limitations when recommending exercise. Regular follow-ups will ensure that adjustments can be made to accommodate progress or regression. Not all individuals will benefit equally from—or be able to achieve—the 10,000-step goal. But given that the average adult in the US gets around 3,000 to 4,000 steps per day,8 there’s often room for improvement. By helping clients and patients seek opportunities to move more as appropriate, those extra steps can add up to big benefits.
Dietitians should keep in mind that a universal step standard isn’t practical because of individual differences. A 10,000 daily step target is not realistic for some groups, such as those with physical disabilities/limitations, older adults, and those living with chronic diseases, for whom overexertion may pose serious health risks. On the flip side, 10,000 steps is too low for most healthy children.9
It’s important to take a personalized approach by setting individualized, realistic, and achievable goals to prevent injury and promote sustainability. It may be helpful to encourage consistency over intensity, helping make getting in those extra steps a regular habit. Integrating natural movement into daily routines, like walking meetings, parking farther away, taking the stairs, and walking the dog, are tried and true strategies that really do make a difference. It’s also important for RDs to assess the nutritional status of clients and patients looking to up their exercise to ensure proper fueling. Under-fueling or inappropriate fueling for activity can result in increased likelihood for exercise intolerance and other health risks, including endocrine dysregulation.10
Finally, it’s essential for dietitians to adhere to their scope of practice and expertise. While providing general exercise recommendations is appropriate, dietitians without specialized training in exercise physiology should collaborate with a multidisciplinary team for specific exercise prescriptions, especially when dealing with at-risk populations. This collaborative approach ensures comprehensive and safe care for all patients.
— Dina Aronson, MS, RDN, is the director of nutrition content for Tangelo, working remotely in Bloomfield, New Jersey.
References
1. Lee I, Shiroma EJ, Kamada M, et al. Association of step volume and intensity with all-cause mortality in older women. JAMA Intern Med. 2019;179(8):1105–1112.
2. US Department of Health and Human Services. Physical Activity Guidelines for Americans, 2nd edition. Washington, DC: US Department of Health and Human Services; 2018.
3. Saint-Maurice PF, Troiano RP, Bassett DR Jr, et al. Association of daily step count and step intensity with mortality among US adults. JAMA. 2020;323(12):1151-1160.
4. Paluch AE, Gabriel KP, Fulton JE, et al. Steps per day and all-cause mortality in middle-aged adults in the coronary artery risk development in young adults study. JAMA Netw Open. 2021;4(9):e2124516.
5. del Pozo Cruz B, Ahmadi MN, Lee I, Stamatakis E. Prospective associations of daily step counts and intensity with cancer and cardiovascular disease incidence and mortality and all-cause mortality. JAMA Intern Med. 2022;182(11):1139–1148.
6. Paluch AE, Bajpai S, Bassett DR, et al. Steps for health collaborative. Daily steps and all-cause mortality: a meta-analysis of 15 international cohorts. Lancet Public Health. 2022;7(3):e219-e228.
7. del Pozo Cruz B, Ahmadi M, Naismith SL, Stamatakis E. Association of daily step count and intensity with incident dementia in 78 430 adults living in the UK. JAMA Neurol. 2022;79(10):1059–1063.
8. 10,000 steps a day: Too low? Too high? Mayo Clinic website. https://www.mayoclinic.org/healthy-lifestyle/fitness/in-depth/10000-steps/art-20317391. Published March 23, 2020. Accessed June 3, 2024.
9. Tudor-Locke C, Bassett DR. How many steps/day are enough?. Sports Med. 34, 1–8 (2004).
10. Areta JL, Taylor HL, Koehler K. Low energy availability: history, definition and evidence of its endocrine, metabolic and physiological effects in prospective studies in females and males. Eur J Appl Physiol. 2021; 121: 1–21.
Integrating Technology and Tools
• Pedometers and Smartwatches: These tools can help patients track their steps and monitor progress.
• Mobile Apps: Apps can provide motivation and track activity, helping patients stay committed to their goals.
• Gamification: Incorporating game-like elements can make physical activity more engaging, enjoyable, and rewarding.
• Incentives: Many health plans and employee programs offer rewards for achieving step goals.