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Daily Step Count and All-Cause Mortality: A Dose–Response Meta-analysis of Prospective Cohort Studies

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Abstract

Background

Uncertainty remains about the optimum step count per day for health promotion.

Objective

We aimed to investigate the association between step count per day and all-cause mortality risk.

Methods

PubMed, Scopus, and ISI Web of Science were searched to January 2021 to find prospective cohort studies of the association between device-based step count per day and all-cause mortality risk in the general population. Two reviewers extracted data in duplicate and rated the certainty of evidence using the GRADE approach. Study-specific hazard ratios (HRs) were pooled using a random-effects model.

Results

Seven prospective cohort studies with 175,370 person-years and 2310 cases of all-cause mortality were included. The HR for each 1000 steps per day was 0.88 (95% CI 0.83–0.93; I2 = 79%, n = 7) in the overall analysis, 0.87 (95% CI 0.78–0.97; I2 = 59%, n = 3) in adults older than 70 years, and 0.92 (95% CI 0.89–0.95; I2 = 37%, n = 2) in studies controlled for step intensity. Dose–response meta-analysis indicated a strong inverse association, wherein the risk decreased linearly from 2700 to17,000 steps per day. The HR for 10,000 steps per day was 0.44 (95% CI 0.31–0.63). The certainty of evidence was rated strong due to upgrades for large effect size and dose–response gradient.

Conclusions

Even a modest increase in steps per day may be associated with a lower risk of death. These results can be used to develop simple, efficient and easy-to-understand public health messages.

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Correspondence to Sakineh Shab-Bidar.

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Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Ahmad Jayedi, Ali Gohari, and Sakineh Shab-bidar declare that they have no conflict of interest.

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The authors’ responsibilities were as follows—AJ and SS-B: designed research; AJ and SS-B: performed the literature search, screened articles, extracted data, and wrote the paper; AJ: analyzed data and interpreted the results; SS-B and AG: revised the subsequent draft for important intellectual content; SS-B is the guarantor; and all authors have read and approved the final manuscript.

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Jayedi, A., Gohari, A. & Shab-Bidar, S. Daily Step Count and All-Cause Mortality: A Dose–Response Meta-analysis of Prospective Cohort Studies. Sports Med 52, 89–99 (2022). https://doi.org/10.1007/s40279-021-01536-4

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