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Daily Step Counts in America Still Haven’t Returned to Pre-Pandemic Levels

ReachMD Healthcare Image
07/18/2023
everydayhealth.com

The COVID-19 pandemic has reshaped our lives in ways that most of us could never have imagined. In response to stay-at-home mandates, we embraced technologies — hello two-hour grocery delivery! — that enabled us to check off most of our to-do list without ever moving from the couch.

Unfortunately, it seems Americans may have gotten a little too good at taking shortcuts, and our activity levels haven’t returned to pre-pandemic levels, according to a new nationwide study.

On average, the nearly 5,500 participants took about 600 fewer steps per day compared with how much they walked before the pandemic began, says lead author Evan Brittain, MD, associate professor of cardiovascular medicine at Vanderbilt University Medical Center in Nashville, Tennessee.

“Taking fewer steps started during the pandemic and continued. Even through 2021, the gap didn’t seem to be closing. It seems to be a behavioral change that has stuck in many individuals, unfortunately,” says Dr. Brittain.

It's too early to know if the decline is here to stay, says Brittain. “If it continues, there could be health consequences, and so it’s important for the public and medical practitioners to be aware of the trend,” he says.

Even ‘Post-COVID,’ Participants Continued to Take 600 Fewer Steps a Day

The participants in this study are part of the larger All of Us Research Program, an ongoing population study run by the National Institutes of Health that has more than 329,000 participants so far, with the goal to recruit over one million. People in the study agree to share their health information, including metrics like blood pressure and cholesterol, along with blood and urine samples.

This study included people who enrolled in the Fitbit Bring-Your-Own-Device project. “If you already owned a Fitbit and consented to link your account to electronic medical records, you could enroll in this part of the study,” says Brittain.

Related: How to Get Started With Walking Workouts: An Absolute Beginner’s Guide

Step counts collected between January 1, 2018, and January 31, 2020, were considered pre-COVID. Steps tracked after that date until the end of 2021, when the study ended, were considered post-COVID.

Pre-pandemic, the median number of daily steps was around 7,800. That number dropped by about 600 steps in the post-COVID phase.

Although the study wasn’t designed to uncover the reason behind the decline, Brittain speculates that it may be related to changes to work and socializing habits that never quite returned to pre-COVID levels.

Younger People Saw the Biggest Decline in Steps

Investigators further analyzed the data to see what could be influencing the decline. Sex, obesity, diabetes, and other illnesses or conditions such as coronary artery disease, hypertension, or cancer didn’t factor into the number of daily steps.

“One of the biggest differences was age. People who were 60 and older had virtually no change in their activity levels. We saw the biggest reduction of activity in people between the ages of 18 and 30 years old,” says Brittain. Every 10-year decrease in age was associated with a 243 step reduction per day, he notes.

“These findings are fascinating, and one additional demonstration of how the pandemic has completely disrupted people’s lifestyle habits and behaviors,” says Silvia Saccardo, PhD, an associate professor in social and decision sciences at Carnegie Mellon University in Pittsburgh, who was not involved in the study.

The trends observed here are consistent with what Dr. Saccardo uncovered in her own research involving college students. “We also saw that steps went down during the pandemic, and they haven’t resumed their pre-pandemic level of activity,” she says.

In the early weeks and months of the pandemic, lockdown orders forced people to stay home, and that led to a change in habits, says Saccardo. “Psychological theories suggest that the more you repeat a behavior, the more used to it you get, and you can build habits that way,” she says.

Geography, Income, Education, and Vaccination Status Associated with Step Reductions

Geography made a difference, too. “We saw the biggest reductions in activity in people who live in the Northeast. That could be due to a higher concentration of urban areas in that region. Maybe people tended to walk more as part of their daily life [before the pandemic] and that stopped happening as much,” says Brittain.

Researchers also found that people with a lower income, less education, and who weren’t vaccinated also logged fewer steps.

Mental health surveys were also included in the research, and higher stress levels and more symptoms of depression were associated with taking fewer steps.

“Were people taking fewer steps because they were depressed, or were they depressed because they were taking fewer steps? We can’t tease that out from this data,” says Brittain.

Are Fitbit Wearers Representative of the Larger U.S. Population?

“This is an interesting study. I am not sure I find the results alarming because it is unclear whether the findings can be generalized to the whole U.S. population,” says I-Min Lee, MD, ScD, professor of medicine at Harvard Medical School and professor of epidemiology at Harvard T.H. Chan School of Public Health in Boston. Dr. Lee is a researcher and expert in step counts, but she was not involved in this study.

It's worth noting that this group was made up entirely of volunteers who already owned the tracking device. Participants were 72 percent female and 86 percent white, and close to 70 percent had a college degree, she points out. “The prevalence of obesity in the study was 12 percent compared to a national level of 42 percent — which is also not representative of the general population,” says Lee.

Previous research suggests that people who buy and wear activity trackers are healthier in general in pretty much every dimension of health, Brittain confirms. “But that may mean the effects we’re seeing in this cohort of generally healthier people are an underestimate of the trend,” he says.

Need to Get Back to Your Pre-Pandemic Step Count? Here Are a Few Tips to Get You Started

The average American walks between 3,000 to 4,000 steps a day, or about 1.5 to 2 miles, according to Mayo Clinic.

Taking more steps each day is associated with a host of health benefits, including dementia prevention and reducing the risk of heart attack and stroke. There’s also evidence that upping your step count can reduce the risk of premature death from all causes, according to the Centers for Disease Control and Prevention. The benefits level off between 6,000 and 10,000 steps per day, depending on your age.

Wondering if your step count has taken a dive? If you wear a tracker, you could go back and compare your pre-COVID averages with what you’re currently logging.

If it’s lower, don’t get too discouraged, says Brittain. “Keep in mind that the thinking on moving and exercise has changed. We know you don’t have to get big chunks of exercise for it to have health benefits. There’s a lot of evidence that small periods of activity can add up,” he says.

With just a few tweaks, you could start to chip away at the deficit, says Brittain.

The Mayo Clinic offers a few tips on elevating your step game.

  • Walk while waiting. Early for an appointment? Take a walk instead of sitting when you're early for an appointment or school pick up.
  • Schedule workday walks. Put reminders in your calendar for short walking breaks (even if you work at home). Have a one-on-one meeting? Plan to walk and talk.
  • Park farther away. Choose parking spots farther away from the entrance to the grocery store or office.
  • Take the stairs. Taking the stairs can get your heart rate up a little, even if you are going down.

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