Marching toward a healthier life on Anchorage’s Chester Creek Trail/Visit Anchorage photo

Better health is only steps away

With U.S. life expectancies steadily falling behind those of other Western nations and the U.S. medical community suggesting expensive GLP-1 drugs and vaccines for everything as the solution, some European and Australian researchers are pointing to a cheaper, more accessible and natural alternative:

Take a hike.

After conducting a systematic review and “dose-response meta-analysis,” of the benefits of walking, doctors from Australia, Spain, Norway and the United Kingdom concluded that getting your feet moving for 7,000 steps per day offered significant protection against most of  the diseases killing Westerners these days.

The findings:

•  A 47 percent lower risk of all-cause mortality
• A 25 percent lower risk of developing cardiovascular disease
• A 47 percent lower risk of dying from cardiovascular disease
• A 6 percent lower risk of contracting cancer
• A 37 percent lower risk of dying from cancer
• A 14 percent lower risk of type 2 diabetes.
• A 38 percent lower risk of dementia
• A 22 percent lower risk of depressive symptoms
• And a 28 percent lower risk of falls, “the leading cause of fatal and nonfatal injuries among older adults,” according to the U.S. Centers for Disease Control. 

The meta-analysis was published last month in The Lancet, a highly respected, peer-reviewed, UK medical journal that has been around since 1823.

After finding that “even a modest step count was associated with lower risk,” the authors of the study were led to conclude that “the message that every step counts for those who are able should be emphasised as a core public health message, regardless of the specific quantitative target.

“For example, 4000 steps per day compared with 2000 steps per day was associated with substantial risk reduction, such as a 36 percent lower risk in all-cause mortality.”

Four thousand steps is shy of two miles for the average American male and under a mile and three-quarters for the average female. Seven thousand steps is about three and half miles for a male and three miles for a female.

The study suggested 7,000 steps as the new goal for an today’s society of leisure heavy on people who believe some sort of motorized vehicle is needed to travel any distance beyond that from the couch to the refrigerator.

10,000 steps

Above 7,000 steps, the study reported,  “health risks generally continued to decrease with every 1,000 steps per day increment across most outcomes, up to the highest analysable category of 12,000 steps per day.

“Although 10,000 steps per day, an unofficial target for decades without a clear evidence base, was associated with substantially lower risks for all-cause mortality, cardiovascular disease incidence, cancer mortality, dementia, and depressive symptoms than 7,000 steps per day, the incremental improvement beyond 7000 steps per day was small.”

Plus, health improvements in some categories plateaued above 7,000 steps, which led to the recommendation that “7,000 steps per day might be a more realistic and achievable recommendation for some, but 10,000 steps per day can still be a viable target for those who are more active.”

Stanford University researchers who tracked smartphones to see how much people were walking in 2017 found the American average to be about 4,800 steps per day. The average appears to have only declined since then.

The National Institutes of Health (NIH) in 2023 reported that the step counts of the nearly 6,000 participants in its “All of Us Research Program” dropped during the pandemic and never recovered.  Participants in that program volunteer to let the NIH track their Fitbits and monitor their electronic health records.

The federal agency reported it tracked about 5,500 Fitbit wearers who were walking an average of 7,808 steps per day before the pandemic. Their step counts fell to 7,089 after. The agency noted its step count is likely biased high due to the “relatively stringent criteria for a valid tracking day” and the program’s recruitment of “more active individuals.”

In drive-everywhere America, it is highly unlikely that average step counts among the less active were going up as those among the more active were going down. And the lack of steps has an easily visible component that is noticeable in this country, according to the Stanford researchers.

The big difference “between people who walked a lot and those who walked very little coincided with much higher levels of obesity,” they told the Stanford Report.

“Considering that an estimated 5.3 million people die from causes associated with physical inactivity every year,” the Report added, “these researchers looked for a simple and convenient way to measure activity across millions of people to help figure out why obesity is a bigger problem in some countries than others.”

The researchers concluded the bigger problem of obesity in the U.S. than in other countries was linked to Americans spending so little time engaged in the easiest form of exercise – walking. Instead, they drive or rely on all sorts of new, battery-powered vehicles – throttle-controlled, “moto-inspired” e-bikes; e-scooters; Onewheels; electric unicycles; Jumbos; e-quads- cycleboards; and more.

The cost of the decline in walking and the shift from riding pedal-bicycles to motoring around on battery-powered vehicles was writ in the staggering U.S. death toll during the SARS-CoV-2 pandemic of the unhealthy and the old.

The data on fitness and Covid-19 mortality is still new enough that it didn’t make it into The Lancet’s study of walking studies, but some researchers have begun to examine what lack of fitness meant to Americans during the pandemic.

The best of those studies to date was published in the peer-reviewed American Journal of Preventive Medicine in April 2023 and later recognized as the journal’s “Article of the Year.”

After examining the health records of nearly half a million Southern California residents insured by Kaiser Permanente and diagnosed with Covid-19 between Jan. 1, 2020 and May 31, 2021, the study reported finding “substantially higher odds of hospitalization, deterioration events, and death with lower amounts of self-reported physical activity in a stepwise fashion….”

“The odds ratios are striking,” the authors of that study wrote. “In the full sample, those who were consistently inactive were 191 percent more likely to be hospitalized and 391 percent more likely to die than those who were consistently active.

“Higher odds of adverse Covid-19 outcomes among physically inactive patients were documented in all racial and ethnic categories, in most age categories, in all body-mass-index categories, and for patients with and without diagnoses of cardiovascular disease or hypertension.”

Even among those already suffering from a chronic disease, the authors reported, “the odds of hospitalization, inpatient deterioration event, and death were lowered” if they had “engaged in some physical activity before COVID-19 diagnosis, compared with those in the always inactive category.”

The findings led to the suggestion that increasing physical activity should be recommended “as an additional pandemic control strategy for all, regardless of demographics or chronic disease status.”

Not really ‘news’

Findings that exercise saves lives and prolongs life expectancy are by no means new. Dr. John Cantwell in Florida and Dr. Ken Cooper in Texas helped fuel a running boom in the U.S.  in the 1970s after they published books about the connection between daily exercise and good health.

Cooper founded The Cooper Institute in 1970 specifically to study the connection between physical fitness and chronic disease. His goal, he told the Dallas-based People Newspapers in January, was to “bridge the gap from fantasy to scientific legitimacy in the practice of medicine. We’ve jumped over that gap in proving exercise is medicine.”

Unfortunately, the now 93-year-old and still working doctor added, “preventive medicine has been an oxymoron as far as the medical profession is concerned. They say there’s no money in it.”

He now finds his legacy, the Kenneth T. Cooper Institute at Texas Tech, forced to push back at the idea that medications are the answer to everything.

“Fitness Still Matters to Reduce all-Cause and Heart Disease Deaths, Despite Advances in Modern Medicine and Lifestyle Changes,” it declared in 2021 in the wake of a joint research project with investigators from Harvard and Stanford universities who examined declining rates of heart attacks and strokes thanks to a national drop in smoking, the development of cholesterol lowering drugs, the creation of new medications for treating diabetes and high blood pressure, and more advanced cardiac catheterization and surgical techniques that save lives.

All of those medical treatments have been good, but when the researchers examined nearly 48,000 men who’d completed baseline examinations and maximal treadmill exercise tests at the Cooper Clinic over a 50-year time span, what they found was this:

• High fitness reduced mortality by 47 percent in the group seen between 1970 and 1991.
• And high fitness reduced mortality by 48 percent in the group seen between 1992 and 2014.

And then there is the quality of life issue.

Steve Farrell, the lead author on the story, said it illustrated that fitness “remains as important now as it did in the first study,” or maybe “more important than ever” given the health threat posed by SARS-CoV-2.

The findings of that 2021 study were echoed three years later in a study of “active travel” in the UK. Researchers reporting in the peer-reviewed journal BMJ Public Health wrote that an examination of 17 years of  health records for 82,297 Scots aged 16 to 74 years found that “active commuters (those who walked or cycled to work) were less likely to suffer from a range of negative physical and mental health outcomes than non-active commuters.”

“Compared with non-active commuting,” the study reported, bicycle commuters cut their risks of all-cause mortality by 53 percent, of hospitalization for any reason by 90 percent (despite the danger of being hit by motor vehicles while on a bicycle), of cardiovascular disease (CVD) by 76 percent, of being put on heart medicine by 70 percent,  of death from cancer by 49 percent, of hospitalization for cancer by 76 percent, and of being prescribed drugs due to mental health problems by 80 percent.

“Pedestrian commuting,” the study said “was associated with” a 91 percent lower risk of hospitalization, a 90 percent lower risk of CVD hospitalization or of having a CVD prescription, and a 93 percent lower chance of a mental health prescription.

The response from Americans to all this data showing that people need to exercise more has been to drive more instead. The Federal Reserve Bank reports U.S. drivers racked up 3.3 trillion miles on the country’s roads this July as motoring recovered from a pandemic low of 2.8 trillion in February 2021.

Vehicle miles driven in July 2015 were below 3.1 trillion, and in July 2005, they were below 3 trillion. The amount of American driving has increased so steadily and is continuing to increase so steadily that the U.S. Department of Transportation last year warned Congress that the belief that electric cars will solve the nation’s carbon-dioxide emission problem is a pipe dream.

Even if 80 percent of American vehicles are electric by 2050, DOT reported, the nation’s stated goal of “net zero” greenhouse gas emissions is beyond reach unless Americans drive less than they are driving today, and that is not expected.

DOT projects vehicle miles driven will increase by more than 20 percent between now and 2050 because most Americans would rather be moved by motor power than move under their own power, even if it costs the nation a fortune in health care spending and slowly kills them.

If it is doesn’t kill them quickly in collisions. According to the National Safety Council, “an estimated 44,680 people died in preventable traffic crashes in the United States during 2024.” This approached three times the 16,756 people The Trace calculates were killed in firearm homicides in the same year.