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As I sat writing my most recent book (last year’s The Menopause Manifesto), I became aware of how little I was moving.
Of course, this was during the first wave of the pandemic — before we knew there would be waves (insert a very sad face emoji), and everyone was terrified to go out.
I worked from home for at least four weeks, and all my little trips to the store vanished. I felt as if I were turning into veal.
Or at least I was. I had curtailed many activities due to the fear of catching COVID, and the time that I wasn’t writing seemed occupied by monitoring the news. Sure, I went for a run or a hike on the weekends, but during the week I would be surprised if I moved more than 1,500 steps a day.
I worked from home for at least four weeks, and all my little trips to the store vanished. Whatever was in the pantry had to last until the next time I felt like braving the grocery store. Basically, I felt as if I were turning into veal.
At the same time, though, I was reading article upon article about the health benefits of exercise for my book — not just aerobic exercise but simply moving more. And not just for osteoporosis prevention, but for heart disease, mental health, maintaining muscle mass, and so on.
It took me quite a while to get out of my minimal moving mindset. But eventually I began working with a trainer (the wonderful Kim Schlag). She set me a goal of 5,500 steps a day, which I thought would be a cinch, but of course it’s not.
So many things in the US feel designed to keep us from moving. I park at a garage across the street from work (about one block from my car to my office), climb six flights of stairs, and I am in and out of exam rooms all day, but of course I am sitting when I’m listening to my patients and when calling them on the phone. On a busy day, that doesn’t get me past 4,250 steps. The only way I can crack 5,500 steps is if I add in a walk at lunch or after work, and so it takes a lot of planning.
But lately I’ve been wondering how many steps are ideal, healthwise, and should I be aiming for more? We’ve all heard “10,000 steps,” but is that based in science?
10,000 steps a day didn’t come from science — and no one is exactly sure where it comes from.
I’m always skeptical about quasi-medical truisms like this. After all, drinking to stay ahead of your thirst is a Gatorade marketing slogan that found its way into our everyday lexicon, and it’s now taken by many people as gospel! (Find out about more about that here.)
I did some reading, and it’s a shocker, I know, but 10,000 steps a day didn’t come from science. While no one is exactly sure where it comes from, most people in the movement space think it is from the name of a pedometer that was sold in Japan in 1965, which was called Manpo-kei and translates to “10,000 steps meter” in English — never underestimate the power of marketing.
So what does science tell us?
Getting 13,000 to 14,000 steps per day would be a challenge. The only time I consistently get that amount is when I am visiting a big city.
I had the good fortune to get some great information from an interview with Dr. Herman Pontzer, an expert in metabolism, for the new season of my podcast Body Stuff. He’s spent a lot of time studying the Hadza, a hunter-gatherer community in Tanzania. (Note: Data from the Hadza also helped inform the grandmother hypothesis, which I wrote about in The Menopause Manifesto. Plus, you can also listen to this episode of Body Stuff on menopause and hear me interview one of the experts behind that hypothesis, Dr. Kristen Hawkes).
Dr. Pontzer told me that Hadza women average about 13,000 steps a day, and interestingly, women in an Old Order Amish community in Canada, where no motorized vehicles are used, walk about 14,000 steps a day.
If you think back to ancestral humans — before farming was done — we were all hunter-gatherers, and getting food took effort. If hunting and gathering had been too taxing physically for our ancestors, well, we’d have evolved differently. Being able to move a lot also means being capable of moving to places with better food when needed. If this kind of movement also keeps us healthy, it’s an evolutionary win.
But are 13,000 to 14,000 steps a day for women really what we need? I was hoping not, since that would be a challenge. The only time I consistently get that amount of steps a day in is when I am visiting a big city — like New York, London or Paris — and I’m also not working full time while I’m there but hustling to see the city.
Among adults younger than 60, the more steps taken, the lower the mortality rate until reaching 8,000 to 10,000 steps per day.
Fortunately, the Women’s Health Study followed a cohort of women who wore pedometers and then compared the outcomes of several health metrics with the number of steps taken. Data from this study was published in 2019, and what it shows is this: Among women ages 45 and older, those women who took 4,400 steps per day had significantly lower mortality than those with 2,700 steps per day. In fact, the more steps the women took, the lower the mortality rate until they reached 7,500 steps per day where the benefits leveled off. Interestingly, the speed of the steps didn’t matter, just the number of steps.
Recently, a meta-analysis was published this year, looking at 15 studies and arriving at very similar results. Among adults younger than 60, the more steps taken, the lower the mortality rate until reaching 8,000 to 10,000 steps per day. For those aged 60 and older, the health benefit plateaued around 6,000 to 8,000 steps per day.
Women in the US seem to average a little less than 5,000 steps a day, so many people are starting from a good place. However, that data is also pre-COVID and I wonder how many people were like me and curtailed their activities a lot to limit their risk of exposure and then never returned back to that baseline.
I am also reminding myself that even if I don’t hit that number, I need to think of exercise more like finding a bill on the street.
So now I’ve got a new goal in mind — I’m aiming for 7,500 steps a day!
But I am also reminding myself that even if I don’t hit that number, I need to think of exercise more like finding a bill on the street.
Here’s what I mean — some of us, and my hand is definitely raised here, are binary when it comes to exercise. We either hit our exercise goal and we are amazing people, or we don’t and we are bad.
But imagine if you used that binary thinking with money. If you found $5 on the street, would you say to yourself, “No thanks, I was aiming for $50,” and just leave it on the ground? Um, no. You would be thrilled that you found $5!
That is how I now think of exercise. Because even some exercise is always good for me … just like found money.
This post was adapted from Dr. Jen’s newsletter “The Vajenda”; to sign up for it, go here. And to learn more about the lies that people have been told — and sold — about their health, listen to her TED podcast Body Stuff.
Watch Dr. Jen Gunter’s TED Talk about periods here:
