Summary
This observational cohort study leveraged linked Fitbit wearable device data and electronic health records from 6,042 participants in the All of Us Research Program to examine associations between step counts and chronic disease risk. The analysis found inverse, linear relationships between step count and four conditions (obesity, sleep apnea, gastro-oesophageal reflux disease, and major depressive disorder), with daily step counts above 8,200 associated with disease protection, whilst the relationships with type 2 diabetes and hypertension were nonlinear with a plateau effect above 8,000–9,000 steps. The findings provide real-world evidence for activity-based clinical guidance, although the study population was predominantly female, white, and college-educated, limiting generalisability.
UK applicability
These findings offer potential evidence to inform UK clinical guidance on physical activity recommendations for chronic disease prevention. However, the study population's limited demographic diversity and reliance on self-selected Fitbit users in a US research programme means findings should be validated in more representative UK populations before wholesale adoption into NHS clinical practice or public health messaging.
Key measures
Daily step count (steps per day); incident disease diagnoses linked to electronic health records; monitoring period of median 4.0 years with 5.9 million person-days of observation
Outcomes reported
The study examined the association between daily step counts (measured via Fitbit devices) and incident chronic disease diagnoses across multiple disease categories. Outcomes included obesity, sleep apnea, gastro-oesophageal reflux disease, major depressive disorder, type 2 diabetes, and hypertension.
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