Upping step count could reduce T2D, hypertension risk

A study presented at the recent EPI Scientific Sessions showed that increasing step count could reduce the risk of developing type 2 diabetes (T2D) and hypertension.

“Among middle age adults, accumulating a higher volume of steps/day was associated with a lower risk of T2D and stage 2 hypertension,” said the authors led by Assistant Professor Amanda Paluch from the University of Massachusetts in Amherst, Massachusetts, US. Among women, an increase in daily step count also translated to a reduced risk of obesity, they added.

“The results of our study add to the growing evidence about the importance of regular physical activity for improving heart health, and that preventive efforts can be effective, even as middle-aged adults move into older adulthood … Encouraging the accumulation of steps/day may be an effective public health strategy to lower the burden of cardiovascular (CV) risk factors,” they said.

The researchers looked at data of 1,923 individuals (mean age 45.3 years, 58 percent female) enrolled in the CARDIA* study. The participants had worn an accelerometer for ≥10 hours/day for ≥4 days between the years 2005 and 2006 and had at least one follow-up visit at 5 or 10 years (mean follow-up 9.7 years). 

After adjusting for demographics and lifestyle (eg, healthy eating index, smoking status, alcohol consumption), every 1,000 step increase per day was associated with a 10 percent reduced risk of T2D (hazard ratio [HR], 0.90, 95 percent confidence interval [CI], 0.84–0.96) and a 5 percent reduced risk of stage 2 hypertension (HR, 0.95, 95 percent CI, 0.92–0.99). [EPI Lifestyle 2020, abstract P498]

Further adjustment for comorbidities led to results only remaining significant for T2D (HR, 0.93, 95 percent CI, 0.87–0.99).

When comparing step count by quartile, individuals in the highest quartile had a 43 percent reduced risk of T2D (HR, 0.57, 95 percent CI, 0.33–0.99; p_trend=0.02) compared with those in the lowest quartile, as well as a 31 percent reduced risk of stage 2 hypertension (HR, 0.69, 95 percent CI, 0.50–0.96; p_trend=0.03).

Women had a 13 percent reduced risk of obesity with every 1,000 step increase per day (HR, 0.87, 95 percent CI, 0.81–0.94). Women in the highest quartile had a 58 percent lower risk of obesity compared with those in the lowest quartile (HR, 0.42, 95 percent CI, 0.23–0.78; p_trend=0.01); this reduced risk was not observed in men (HR, 0.67, 95 percent CI, 0.37–1.16; p_trend=0.11).

“Diabetes and high blood pressure are not inevitable. Healthy lifestyle changes, such as attaining and maintaining a healthy body weight, improving diet, and increasing physical activity can help reduce diabetes risk. This study shows that walking is an effective therapy to decrease risk,” said Professor Robert Eckel from the University of Colorado, Aurora, Colorado, US, and former president of the American Heart Association, who was not affiliated with the study.

“For people who find the idea of a daily, extended exercise period and physical activity regimen daunting, shifting the focus to accumulating steps throughout the day may help them become more active … the more steps, the better,” suggested Paluch.

“[S]teps-per-day is an easy measurement and motivator that most people understand and can easily measure given the booming industry of wearable technologies or smartphones,” she added, noting that this research will be followed up with an investigation on the effect of walking speed on CV outcomes.