Steps to longevity: Association of daily total steps and bouted steps with all-cause mortality

Aims: This study aims to investigate whether bouted steps (walking of 10+ minutes) is associated with all-cause mortality, adjusting for total steps. Methods: In a cohort study, we analyzed data from 2764 participants (mean age = 49.4 years, 51.9% female) in the United States National Health and Nutrition Examination Survey 2005-2006 cycle. Total steps (<4000, 4000-7999, 8000-11999, ≥12000) and bouted steps (0, 86-599, ≥600) per day were assessed using validated accelerometer algorithms. A bout of 10-min walking entails ≥600 bouted steps. Results: During a mean follow-up of 13.0 years, 598 deaths were identified. Compared to those with <4000 total steps/day, the hazard ratios and 95% confidence intervals for taking 4000-7999, 8000-11999, and ≥12000 steps/day were 0.52 (0.44, 0.63), 0.41 (0.27, 0.61), and 0.44 (0.26, 0.74). Compared to those with zero bouted steps/day, the estimates for those taking 86-599 and ≥600 bouted steps/day were 0.83 (0.59, 1.16) and 0.56 (0.40, 0.78), adjusting for total steps/day. Conclusion: Both daily total steps and bouted steps are beneficially associated with all-cause mortality. Future studies are warranted to confirm the health benefits of promoting walking bouts of 10 minutes or longer for bouted steps, in addition to advocating for a sufficient total daily step count.