Not 10,000 steps anymore. According to a recent English study, published in the British Journal of Sports Medicine, even modest physical activity—just a few days of limited movement, 1 or 2 days a week, measured at about 4,000 steps—could be enough to reduce all-cause mortality and death from heart disease among older women.
The Evidence
The shift toward industrialized lifestyles, characterized by sedentary jobs, mechanized transportation, and technological conveniences, has led to a deep decline in daily physical activity, with steps dropping from roughly 15,000–20,000 to about 5,000, especially among the elderly.
Given that lack/low physical activity in this growing segment of the population can contribute to physiological decline and increased vulnerability to disease, research has “turned on” to evaluating how much movement, more or less, could impact health, both specifically and in general. Robust evidence shows that regular physical activity promotes better well-being and increases longevity.
In particular, numerous literature studies document a positive association between daily step counts and the risk of cardiovascular disease and mortality; therefore, in light of the increasing availability and usefulness of wearable devices, it would be essential that step metrics be integrated into future physical activity guidelines. For example, recent meta-analytic data published in The Lancet Public Health suggest that measurable health improvements begin around 7,000 steps per day, reinforcing the message of the current study that substantial protection occurs well below the popular but scientifically unfounded goal of 10,000 steps, redefining the concept and the measure of “sufficient movement” for daily health.
With this aim, and also considering longer life expectancy, the current study included a total of 13,547 women aged 45 years and older, primarily U.S. residents, older, white, with higher socioeconomic status, which, as the authors note, could limit the generalizability of the results to populations not described, and none had diagnosed cardiovascular disease or cancer. Participants were asked to wear a pedometer for 7 consecutive days, then followed for about 11 years to assess mortality and the incidence of cardiovascular disease. The study examined the impact of four threshold levels defined as 4,000, 5,000, 6,000, and 7,000 steps per day. For risk analysis, participants were categorized by how often they reached the thresholds: 0 days, 1–2 days, or 3 days or more per week.
Results
The study reported that 13% of participants died and 5.8% developed cardiovascular disease during the follow-up period of about 11 years. Risk analysis revealed that women who reached a daily threshold of 4,000 steps or more for 1–2 days per week had a 26% lower risk of death and a 27% lower risk of cardiovascular disease compared with those who never reached the specified threshold during the week.
Similarly, women who reached a daily threshold of 4,000 steps or more for 3 or more days per week had a 40% lower risk of death and a 27% lower risk of cardiovascular disease. Overall, the study observed an inverse association between the number of daily steps and mortality risk among older women.
Moreover, the analysis showed a further reduction in mortality risk with higher daily-step thresholds (5,000, 6,000, or 7,000 steps per day), with associations largely attenuated after adjustment for the average daily step count, indicating that total step volume—and not how often one hits daily thresholds—matters most for reducing risk. While this analysis highlighted the benefit linked to total step volume, a complementary study on hypertensive adults published in the European Journal of Preventive Cardiology found that walking faster and longer further reduces cardiovascular risk, suggesting that pace may still play a role in high-risk populations.
Further Evidence
The study thus appears to show that a very modest level of daily physical activity can be associated with substantially lower risks of death and cardiovascular disease in older women, and that the daily step count, rather than the precise pattern used to reach a specific step threshold, can be linked to better health outcomes, achievable with any stepping pattern preferred by the woman, for example a more variable or irregular daily stepping pattern (“clustered pattern”) versus a more constant (“slow and steady”) pattern.
Finally, regarding the “weekend warrior” exercise pattern—exercising only 1 or 2 days per week, preferably on weekends—it appears to reduce the risk of chronic disease and mortality. In light of the current study identifying 4,000 steps as the minimum useful threshold to cut disease and mortality risk (below which frailty rises, feeding a further drop in activity) and with benefits stabilizing around 7,000–7,500 steps per day, a parallel study from the University of Chicago shows that even a modest uptick in walking cadence, about 14 extra steps per minute over one’s usual pace, could significantly improve physical function and help older adults maintain independence, highlighting again the benefits of movement that extend beyond longevity.
In addition to cardiovascular and survival benefits, a higher daily step count has also been linked to better mental health; a recent meta-analysis published in JAMA Network Open seems to note that every 1,000 extra steps per day reduces the risk of depression by about 9%, underscoring walking as an accessible, scalable tool for psychological well-being. Complementary evidence from large-scale studies based on natural experiments published in Nature would show that moving to more walkable cities increases daily steps by roughly 1,100 steps, sustaining them for months, illustrating how urban design itself can improve physical activity and magnify benefits at the individual level.
Conclusion
As this is an observational study, the results show an association rather than causation. Overall, the findings highlight the importance of incorporating step-tracking metrics into future physical activity guidelines, in clinical practice, and in public health efforts dedicated to the health and well-being of the aging female population.
Source
Hamaya R, Evenson KR, Lieberman D et al. (2025). Association between frequency of meeting daily step thresholds and all-cause mortality and cardiovascular disease in older women. British Journal of Sports Medicine, 2025. https://bjsm.bmj.com/content/early/2025/10/13/bjsports-2025-110311
Ding D, Nguyen B, Nau T et al. Daily steps and health outcomes in adults: a systematic review and dose-response meta-analysis. The Lancet Public Health, Open Access, 2025 Vol. 10, Issue 8, e668-e681. https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(25)00164-1/fulltext
Cheng SWM, Biswas RK, Koemel NA et al. Prospective associations of daily step count and stepping intensity with overall and type-specific major adverse cardiovascular events in people with hypertension. European Journal of Preventive Cardiology, 2025, zwaf441, https://doi.org/10.1093/eurjpc/zwaf441
Bizzozero-Peroni B, Díaz-Goñi V, Jiménez-López E et al. Daily Step Count and Depression in AdultsA Systematic Review and Meta-Analysis. Jama Network Open. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2828073
Althoff T, Ivanovic B, King AC et al. Countrywide natural experiment links built environment to physical activity. Nature, 2025, 645, pages 407–413. https://www.nature.com/articles/s41586-025-09321-3
Abbonati a Karla Miller
