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.

中文翻译：

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每日步数和全因死亡率：前瞻性队列研究的剂量反应荟萃分析

背景

关于促进健康的最佳每日步数仍然存在不确定性。

客观的

我们旨在调查每天步数与全因死亡风险之间的关联。

方法

检索 PubMed、Scopus 和 ISI Web of Science 至 2021 年 1 月，以发现基于设备的每日步数与普通人群全因死亡风险之间关联的前瞻性队列研究。两名审查员一式两份地提取数据，并使用 GRADE 方法对证据的确定性进行评级。使用随机效应模型汇总研究特定风险比 (HR)。

结果

纳入 7 项前瞻性队列研究，175,370 人年和 2310 例全因死亡率。 在总体分析中，每天每 1000 步的 HR 为 0.88（95% CI 0.83–0.93；I ²  = 79%，n = 7），0.87（95% CI 0.78–0.97； I ²  = 59%，n  = 3) 在 70 岁以上的成年人中，0.92 (95% CI 0.89–0.95; I ²  = 37%, n = 2) 在控制步强度的研究中。剂量反应荟萃分析表明存在强烈的负相关，其中风险从每天 2700 步线性下降到 17,000 步。每天 10,000 步的 HR 为 0.44 (95% CI 0.31–0.63)。由于大效应量和剂量反应梯度的升级，证据的确定性被评为强。

结论

即使每天步数的适度增加也可能与较低的死亡风险相关。这些结果可用于开发简单、有效和易于理解的公共卫生信息。