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

Abstract

Objective 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. Methods 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. Results 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 Conclusions Premature ACM/CVD mortality might be prevented through different combinations of stepping intensity and step counts.