Worth a Stroll

Researchers found hitting 4,000 steps benefits older groups

Rick Sobey
Boston Herald

Are you constantly looking at your watch or phone to check your step count as you strive to hit 10,000 steps a day? Well, a Mass General Brigham study released in November shows that only 4,000 steps one or two days a week can lead to health benefits for a senior population.

Older women who took 4,000 steps on just one or two days per week had a 27% lower risk of cardiovascular disease and a 26% lower risk of death compared to those who got fewer steps, according to the researchers.

And with more steps came even greater benefits.

“In countries like the United States, advances in technology have made it such that we don’t really move very much, and older individuals are among those least active,” said senior author I-Min Lee, an epidemiologist in the Mass General Brigham Department of Medicine and the Division of Preventive Medicine at Brigham and Women’s Hospital.

“Because of today’s low step counts, it’s increasingly important to determine the minimum amount of physical activity required to improve health outcomes, so that we can off er realistic and feasible goals for the public,” Lee added.

How the study was conducted

In this federally funded study, Mass General Brigham researchers conducted a prospective cohort study of 13,574 older women — who were about 72 years old on average — without cardiovascular disease or cancer from BWH’s Women’s Health Study.

The women wore ActiGraph GT3X+ accelerometers to track their steps over seven days between 2011 and 2015. For the next 10 years, the researchers monitored mortality and cardiovascular disease incidence.

Participants were sorted by how many days per week they achieved steps of 4,000; 5,000; 6,000 or 7,000.

Those who got 4,000 steps one or two days per week had 26% lower mortality risk and 27% lower cardiovascular disease risk compared to those who never hit 4,000 on any day.

What’s more, reaching 4,000 steps three or more days in a week decreased mortality risk further to 40%.

As for women who reached the higher step thresholds, cardiovascular disease risk leveled out.

Interpreting the findings

The health benefits seem to be associated with the total volume of steps taken, rather than how many days per week a particular threshold was achieved.

This suggests that there isn’t a “better” way to get steps — women with similar total volume of steps, either achieved by consistent steps throughout the week or sporadic steps in just a few days, had similar health benefits.

Future research will need to explore whether these effects hold in populations beyond older, American, mostly white women. Also, the researchers want to analyze even lower step count thresholds to determine whether less than 4,000 steps can produce similar health benefits.

“I hope our findings encourage the addition of step count metrics to physical activity guidelines, including the upcoming 2028 U.S. Physical Activity Guidelines,” said lead and corresponding author Rikuta Hamaya of Mass General Brigham’s Department of Medicine and the Division of Preventive Medicine at BWH. “If we can promote taking at least 4,000 steps once per week in older women, we could reduce mortality and cardiovascular disease risk across the country.”

As more embrace anxiety drugs, MAHA derides meds

Phillip Reese
KFF Health News

After a grueling year of chemotherapy, surgery and radiation to treat breast cancer, Sadia Zapp was anxious — not the manageable hum that had long been part of her life, but something deeper, more distracting.

So Zapp, a 40-year-old communications director in New York, became one of millions of Americans to start taking an anxiety medication in recent years. For her, it was the serotonin-boosting drug Lexapro.

“I love it. It’s been great,” she said. “It’s really helped me manage.”

The proportion of American adults who took anxiety medications jumped from 11.7% in 2019 to 14.3% in 2024, with most of the increase occurring during the COVID pandemic, according to survey data from the Centers for Disease Control and Prevention. That’s 8 million more people, bringing the total to roughly 38 million, with sharp increases among young adults, people with a college degree and adults who identify as LGBTQ+.

Even as psychiatric medications gain public acceptance and become easier to access through telehealth appointments, the rise of a class of antidepressants called selective serotonin reuptake inhibitors, known as SSRIs, has triggered a backlash from supporters of the “Make America Healthy Again” movement who argue they are harmful. Doctors and researchers say medications such as Prozac, Zoloft and Lexapro are front-line treatments for many anxiety disorders and are being misrepresented as addictive.

Health and Human Services Secretary Robert F. Kennedy Jr. decried broadening SSRI use. During his Jan. 29 confirmation hearing, he said he knows people who had a tougher time quitting SSRIs than people have quitting heroin.

Food and Drug Administration Commissioner Marty Makary has also suggested that SSRI use among pregnant women could lead to poor birth outcomes.

SSRIs’ common side effects include upset stomach, brain fog and fatigue.

For many people, however, the side effects are mild, and the benefits of treating chronic anxiety are worth it, said Patrick Kelly, president of the Southern California Psychiatric Society. “The statements about SSRIs were just not grounded in any sort of evidence or fact,” Kelly said of Kennedy’s comments.

A recent comprehensive study showed that over half of people with generalized anxiety disorder taking an SSRI saw their anxiety symptoms reduced by at least 50%.

“When it’s being done right and when you’re also using appropriate therapy techniques, SSRIs can be really, really helpful,” said Emily Wood, a psychiatrist who practices in Los Angeles.

MAHA blames anxiety on poor diet, lack of exercise

MAHA supporters partly blame poor dietary choices and the increase in sedentary lifestyles for the rising number of health problems, including anxiety, depression and other mental health disorders. As a remedy, they called for measures such as reducing consumption of ultra-processed foods, which studies in recent years have connected to depression and anxiety, and cutting back on screen time in favor of exercise.

Psychiatrists often encourage a healthy diet and exercise as an adjunctive therapy for anxiety and depression. Wood said those who can manage anxiety without medication should also consider talk therapy.

But medication can help.

Studies show the risks of taking SSRIs during pregnancy are low for mother and child. By contrast, “depression increases your risk for every complication for a mother and a baby,” Wood said.

Some people who stop taking antidepressant medication will experience nausea, insomnia or other symptoms, especially if they quit suddenly. But “the concept of addiction simply does not apply to these chemicals,” Kelly said, a statement backed up by studies.

Addiction, though, is a possibility with benzodiazepines such as Xanax that are often a second line of treatment for anxiety. These controlled substances can also increase the risk of opioid overdose in patients taking both types of drugs. During congressional hearings last year, Kennedy also decried benzodiazepine overuse as a problem.

While benzodiazepines are effective for short-term use, they require monitoring and care, Wood said.

“Those are really great meds for acute anxiety and not great as longterm anxiety medications, because they are habit-forming over time,” Wood said.

Social shifts drive increased use of anxiety meds

A number of leading theories could explain why so many more people are taking anxiety medication, including increased social media use and more isolation, physicians and researchers say.

Plus, the medicines are relatively easy to get. Many people obtain SSRI and benzodiazepine prescriptions from their primary care physician or after a brief teletherapy appointment.

Southwest Montana Health Care Directory