Pulse Brain · Growing Health Evidence Index
Tier 3 — Observational / field trialPeer-reviewed

Association of step counts over time with the risk of chronic disease in the All of Us Research Program

Hiral Master, Jeffrey Annis, Shi Huang, Joshua A. Beckman, Francis Ratsimbazafy, Kayla Marginean, Robert J. Carroll, Karthik Natarajan, Frank E. Harrell, Dan M. Roden, Paul A. Harris, Evan L. Brittain

Nature Medicine · 2022

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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.

Theme
Nutrition & health
Subject
Dietary patterns & chronic disease
Study type
Research
Study design
Observational cohort
Source type
Peer-reviewed study
Status
Published
Geography
United States
System type
Human clinical
DOI
10.1038/s41591-022-02012-w
Catalogue ID
BFmoso8xrl-pagb23

Topic tags

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