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Wie dagelijks 7000 stappen doet vermindert daarmee het risico op hart- en vaatziekten, kanker, dementie, diabetes en depressie. Alle Nederlandse media, zelfs het NOS journaal vermeldden deze uitkomsten van een grote meta-analyse van totaal 24 studies waarbij de nadruk lag op de 7000 stappen terwijl algemeen altijd is aangenomen dat 10.000 stappen nodig zouden zijn. Het verschil in totale sterfte tussen 2.000 en 7.000 stappen blijkt 47 procent te zijn gerekend over alles studies uit de meta-analyse.
"We hebben het idee dat we tienduizend stappen per dag moeten zetten, maar dat is niet gebaseerd op enig bewijs", zegt onderzoeksleider professor dr. Melody Ding. Bij de Olympische Spelen van 1964 werd een stappenteller uitgegeven die de tienduizendstappenteller werd genoemd. En vanaf toen zijn die 10.000 stappen een eigen leven gaan leiden. Maar aldus professor dr. Melody Ding: "Er zijn ook andere manieren om aan beweging te komen, zoals fietsen of zwemmen." Het belangrijkste is dat mensen bewust bezig zijn met beweging als onderdeel van een gezonde levensstijl.
Maar de studiepublicatie in the Lancet gaat over het aantal stappen dat dagelijks nodig zou zijn om het risico op hart- en vaatziekten, kanker, dementie, diabetes en depressie te verminderen.
Hier de vertaling van het abstract in het Nederlands wat de nadruk dus wel legt op het verschil tussen 7.000 en 10.000 stappen per dag met als basis een minimum van 2.000 stappen:
57 studies uit 35 deelnemersgroepen werden opgenomen in de systematische review en 31 studies uit 24 groepen werden opgenomen in meta-analyses.
Voor totale mortaliteit, incidentie van hart- en vaatziekten, dementie en vallen werd een omgekeerd niet-lineair dosis-responsverband gevonden, met omslagpunten rond de 5000-7000 stappen per dag.
Een omgekeerd lineair verband werd gevonden voor mortaliteit door hart- en vaatziekten, incidentie van kanker, kankersterfte, incidentie van diabetes type 2 en depressieve symptomen.
Op basis van onze meta-analyses werd het aantal stappen per dag dat 7000 stappen per dag zette, vergeleken met 2000 stappen per dag, geassocieerd met een 47% lager risico op totale sterfte (HR 0,53 [95% BI 0,46–0,60]; I2=36,3; 14 studies),
een 25% lager risico op incidentie van hart- en vaatziekten (HR 0,75 [0,67–0,85]; I2=38,3%; zes studies),
een 47% lager risico op sterfte door hart- en vaatziekten (HR 0,53 [0,37–0,77]; I2=78,2%; drie studies),
een niet-significant 6% lager risico op incidentie van kanker (HR 0,94 [0,87–1,01]; I2=73,7%; twee studies),
een 37% lager risico op sterfte door kanker (HR 0,63 [0,55–0,72]; I2=64,5%; drie studies),
een 14% lager risico op diabetes type 2 (HR 0,86 [0,74–0,99]; I2=48,5%; vier studies),
een 38% lager risico op dementie (HR 0,62 [0,53–0,73]; I2=0%; twee studies),
een 22% lager risico op depressieve symptomen (HR 0,78 [0,73–0,83]; I2=36,2%; drie studies), en
een 28% lager risico op vallen (HR 0,72 [0,65–0,81]; I2=47,5%; vier studies).
Studies over fysieke functie (niet gebaseerd op meta-analyse) rapporteerden soortgelijke omgekeerde verbanden.
De bewijszekerheid was matig voor alle uitkomsten, behalve voor sterfte door hart- en vaatziekten (laag), incidentie van kanker (laag), fysieke functie (laag) en vallen (zeer laag).
Het volledige studierapport is gratis in gte zien of te downloaden:
Despite the rapid increase in evidence from the past decade on daily steps and health-related outcomes, existing systematic reviews primarily focused on few outcomes, such as all-cause mortality. This study synthesised the prospective dose-response relationship between daily steps and health outcomes including all-cause mortality, cardiovascular disease, cancer, type 2 diabetes, cognitive outcomes, mental health outcomes, physical function, and falls.
Methods
For this systematic review and meta-analysis, we searched PubMed and EBSCO CINAHL for literature published between Jan 1, 2014, and Feb 14, 2025, supplemented by other search strategies. Eligible prospective studies examined the relationship between device-measured daily steps and health outcomes among adults without restrictions on language or publication type. Pairs of reviewers (BN, KO, ML, and TN) independently did the study selection, data extraction, and risk of bias assessment using the 9-point Newcastle-Ottawa Scale. Hazard ratios (HRs) from individual studies were synthesised using random-effects dose-response meta-analysis where possible. Certainty of evidence was assessed using GRADE. This trial is registered with PROSPERO (CRD42024529706).
Findings
57 studies from 35 cohorts were included in the systematic review and 31 studies from 24 cohorts were included in meta-analyses. For all-cause mortality, cardiovascular disease incidence, dementia, and falls, an inverse non-linear dose-response association was found, with inflection points at around 5000–7000 steps per day. An inverse linear association was found for cardiovascular disease mortality, cancer incidence, cancer mortality, type 2 diabetes incidence, and depressive symptoms. Based on our meta-analyses, compared with 2000 steps per day, 7000 steps per day was associated with a 47% lower risk of all-cause mortality (HR 0·53 [95% CI 0·46–0·60]; I2=36·3; 14 studies), a 25% lower risk of cardiovascular disease incidence (HR 0·75 [0·67–0·85]; I2=38·3%; six studies), a 47% lower risk of cardiovascular disease mortality (HR 0·53 [0·37–0·77]; I2=78·2%; three studies), a non-significant 6% lower risk of cancer incidence (HR 0·94 [0·87–1·01]; I2=73·7%; two studies), a 37% lower risk of cancer mortality (HR 0·63 [0·55–0·72]; I2=64·5%; three studies), a 14% lower risk of type 2 diabetes (HR 0·86 [0·74–0·99]; I2=48·5%; four studies), a 38% lower risk of dementia (HR 0·62 [0·53–0·73]; I2=0%; two studies), a 22% lower risk of depressive symptoms (HR 0·78 [0·73–0·83]; I2=36·2%; three studies), and a 28% lower risk of falls (HR 0·72 [0·65–0·81]; I2=47·5%; four studies). Studies on physical function (not based on meta-analysis) reported similar inverse associations. The evidence certainty was moderate for all outcomes except for cardiovascular disease mortality (low), cancer incidence (low), physical function (low), and falls (very low).
Interpretation
Although 10 000 steps per day can still be a viable target for those who are more active, 7000 steps per day is associated with clinically meaningful improvements in health outcomes and might be a more realistic and achievable target for some. The findings of the study should be interpreted in light of limitations, such as the small number of studies available for most outcomes, a lack of age-specific analysis and biases at the individual study level, including residual confounding.
Funding
National Health and Medical Research Council, New South Wales Health, and Ian Potter Foundation.
Previous physical activity guidelines have considered step counts but found the evidence base insufficient for making recommendations. However, the past decade has seen a rapid advancement in the evidence surrounding step counts. In a systematic literature search done in December, 2024, without language restrictions across PubMed and EBSCO CINAHL, with search terms for step counts (eg, “daily steps” or “step counts”) in combination with specific terms for health outcomes (eg, “mortality” or “cancer”) and study type (eg, “meta-analysis” or “review”), complemented by Google Scholar and reference searches, we identified 13 systematic reviews addressing daily steps and health outcomes. All consistently found that higher daily step counts are associated with better health outcomes. However, most reviews focused on all-cause mortality and cardiovascular disease, leaving gaps in our understanding of the associations between step counts and other health outcomes, such as cancer and cognitive function.
Added value of this study
This study examines the prospective dose-response association between daily steps and a wide range of health outcomes, including all-cause mortality, cardiovascular disease incidence and mortality, type 2 diabetes incidence, cancer incidence and mortality, dementia, depressive symptoms, physical function, and falls. Our findings show consistent associations across all these outcomes despite variations in dose-response curves. Notably, a stepping volume of 7000 steps per day is associated with 6–47% lower risks compared with 2000 steps per day across all examined outcomes. However, the relationship between cadence (a proxy for stepping rate or intensity) and health outcomes remains less consistent.
Implications of all the available evidence
Daily steps should be considered a practical metric for physical activity guidelines and recommendations. The observed prospective dose-response relationship can inform step-based targets. Future research should account for potential dose-response variations by age, health outcome, device type, and measurement methods.
Contributors
DD, PC, and KO conceptualised the study. DD, BN, PCD, TN, ML, MEF, RD, UE, PC, and KO developed the review protocol. BN, TN, ML, and KO did the literature search and independently screened studies and extracted data. KO did all meta-analyses and PC provided advice on statistical analysis. DD drafted the paper. BdPC and BJJ did additional data analyses on primary studies and provided data or codes. ZM provided advice on certainty of evidence assessment. All authors provided critical input during the writing and revision of the paper, and all authors accept responsibility for the decision to submit the manuscript. DD attests that all listed authors meet authorship criteria and that no others meeting the criteria have been omitted. KO and PC have directly accessed and verified the data reported in the manuscript.
Data sharing
No additional data are available. Codes are available upon request.
Declaration of interests
We declare no competing interests.
Acknowledgments
We thank the following researchers for providing additional information or conducting additional analysis upon requests: Matthew Ahmadi (The University of Sydney); Jeffrey Annis (Vanderbilt University Medical Center); Marcel Ballin (Uppsala University); Lloyd Chan (University of New South Wales); Chutima Jalayondeja (Mahidol University); Aiden Doherty (University of Oxford); Kosuke Inoue (Kyoto University); Asier Mañas (the University of Castilla–La Mancha); Alaina Shreves (University of Oxford); and Scott Small (University of Oxford). We also thank Jessica Bellamy and Laura Smith from the University of Wollongong for their help with literature searches. This study was funded by an Investigator Grant from the Australian National Health and Medical Research Council (2009254 to DD; 2025541 to CS; 1142685 to PCD; 1176858 to AK), an Early-Mid Career Researcher Grant from the NSW Ministry of Health (DD), and a Public Health Grant from Ian Potter Foundation (DD). The funders had no role in any phase of the study. This work was part of an evidence review completed for an update of the Australian 24h movement guidelines for adults and older adults, funded by contract research awarded to the University of Wollongong by the Australian Government Department of Health and Aged Care.
National, regional, and global trends in insufficient physical activity among adults from 2000 to 2022: a pooled analysis of 507 population-based surveys with 5·7 million participants
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Sex-specific differences in the association between steps per day and all-cause mortality among a cohort of adult patients from the United States with congestive heart failure
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