Combinations of stepping intensity and daily step counts against all-cause and cardiovascular disease mortality: insights from a device-based prospective study.

Authors

Le Wei, Matthew N Ahmadi, Nicholas A Koemel, Raaj Kishore Biswas, Borja Del Pozo Cruz, Emmanuel Stamatakis

Published in

British journal of sports medicine. Sep 08, 2026. Epub Sep 08, 2026.

Abstract

Understanding the joint role of stepping intensity and step counts could inform pragmatic step-based physical activity strategies for premature mortality prevention. We examined the joint association of stepping intensity and daily step counts with all-cause mortality (ACM) and cardiovascular disease (CVD) mortality.
This prospective cohort study included the UK Biobank wrist-worn accelerometers subsample. We used peak 30-min cadence (PK30), the average steps/minute during the highest but not necessarily consecutive 30 minutes of the day, as a stepping intensity metric. We categorised daily steps into less than 5000, 5000-7500, 7500-10 000, above 10 000 steps/day group. We examined the multivariable-adjusted dose-response associations of PK30 and step counts with ACM/CVD mortality using Cox proportional and Fine and Gray subdistribution hazard models, respectively.
ACM analyses included 64 743 participants (mean age 61.5 (SD 7.8) years; female 37 497; 1697 events). Compared with the reference (fifth PK30 percentile and <5000 steps/day), both the <5000 and 5000-7500 steps/day groups showed a beneficial linear PK30-ACM risk association. Substantially lower ACM risk was observed at higher PK30 in the <5000 steps/day group (eg, 80 steps/min: HR 0.72 (95% CI 0.54 to 0.97)) and lower PK30 in the 5000-7500 group (eg, 60 steps/min: HR 0.70 (0.58 to 0.86)). Among all groups, 7500-10 000 steps/day had the lowest ACM risk, with a U-shaped pattern and the lowest risk was observed at approximately 100 steps/min (0.57 (0.47 to 0.69)). Higher PK30 was associated with lower ACM at 90 steps/min across all step-groups (eg, <5000 steps/day, 0.64 (0.32 to 1.32); above 10 000, 0.71 (0.59 to 0.87)). The CVD mortality results demonstrated similar dose-response patterns to those of ACM.
Premature ACM/CVD mortality might be prevented through different combinations of stepping intensity and step counts.

PMID:
42711120
Bibliographic data and abstract were imported from PubMed on 09 Sep 2026.

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