Clocking up at least 4000 daily steps on just 1 or 2 days per week is linked to a lower risk of death and cardiovascular disease (CVD) among older women, a recent study suggests. The large prospective study examined not only how many steps the women took but how often they reached their step targets across the week, addressing a key gap in current physical activity guidelines.

Researchers followed 13,547 women (average age 71) from the US Women’s Health Study who wore accelerometers for 7 consecutive days between 2011–2015 and were tracked for nearly 11 years. The women were free of cardiovascular disease or cancer at the start of the study.

During the monitoring period -- up to the end of 2024 -- 1765 women (13%) died and 781 (5%) developed CVD.

Achieving at least 4000 steps/day on 1–2 days of the week was associated with a 26% lower risk of death from all causes and a 27% lower risk of a CVD death compared with not reaching this threshold on any day of the week.

For those achieving this step count on at least 3 days of the week, the lower risk of death from any cause increased to 40%, but remained at 27% for the risk of cardiovascular death.

While higher daily step counts of 5000 to 7000 on 3 or more days of the week were associated with a further fall in the risk of death from any cause—32%---they were associated with a levelling out in the risk of a CVD death—16%.

When the findings were adjusted to take into account average daily steps, previously observed associations weakened, suggesting that the average number of steps is the key driver of the protective effect, suggest the researchers.

This is an observational study, and as such, no firm conclusions can be drawn about cause and effect, the authors acknowledged. Nevertheless, they said, the findings suggest that frequency of meeting daily step thresholds is not critical (even 1–2 days/week of ≥4000 steps/day was related to lower mortality and CVD), and that step volume is more important than the frequency of meeting daily step thresholds in the older population.

To read the abstract of the study, published in the British Journal of Sports Medicine, click here