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The Magic Pill

New research shows that walking 10,000 steps a day can significantly improve health and well-being.

black and white graphic of man in hat walking with trail of footsteps behind himWalking 10,000 steps a day for better health is not a new concept. The idea first surfaced in the 1960s in Japan by the maker of the first commercial pedometer. Now, walking and tracking 10,000 steps a day has become a global phenomenon.

The health benefits of walking are not lost on Kelly G. Loeb, who has been walking for exercise for nearly five years. The Los Angeles native is a social worker and a community engagement coordinator at the University of Kansas Alzheimer’s Disease Research Center. She has gradually increased her step total to the point that she now consistently walks 10,000 steps every day.

Loeb noted that her bloodwork now shows all of her numbers in the healthy range, and she has lost a significant amount of weight since she began walking regularly.

“Losing weight wasn’t my goal, but it was definitely one result of my walking routine,” she said.


New scientific research is backing up the health advantages that Loeb and millions of others experience by walking every day. Studies published last fall by the Journal of American Medical Association (JAMA) in JAMA Neurology and in JAMA Internal Medicine seem to indicate that walking is actually a prescription more people should be seeking. Walking around 10,000 steps a day has been linked to less dementia and less cardiovascular disease overall, including less heart disease, less heart failure and fewer strokes. It may significantly reduce the risk of 13 types of cancer while also lowering the risk of dementia by 50%.

“Exercise as medicine may be the most powerful treatment we have for a variety of health conditions,” said John M. Jakicic, Ph.D., a research professor in the Division of Physical Activity and Weight Management in the Department of Internal Medicine at KU School of Medicine.

The study in JAMA Neurology found that walking 9,800 steps per day was associated with steady declines in dementia risk, and even fewer steps than the 9,800 threshold were still associated with a decline. The study also found that greater walking intensity was related to significantly lower dementia risk. The companion study showed that for every 2,000 steps a day, you could lower your risk of premature death by 8% to 11%.

An article on the website WebMD summed it up nicely, “Turns out there IS something special about 10,000 steps a day.”

None of this surprised Russell Swerdlow, M.D., co-director of the KU Alzheimer’s Disease Research Center and professor of neurology at KU School of Medicine.

“If exercise were a pill, we’d all be clamoring for a prescription,” he said. “We don’t fully understand exactly how exercise works, but we understand enough to know that everyone should be doing it.”

Swerdlow said there are current exercise studies at the KU Alzheimer’s Disease Research Center looking to see what dose of exercise is optimal for the prevention of cognitive decline. He pointed out that the study in JAMA Neurology is one that associates steps with health, not one that tests different amounts of exercise in a randomized trial.

“This is certainly an area ripe for further study,” Swerdlow said. “Many researchers at KU Medical Center continue to explore exercise and its link to preventing or slowing a number of diseases.”


One of those scientists at KU Medical Center is Jakicic, who studies obesity and its relationship to chronic diseases, including cardiovascular disease, cancer and diabetes. He has published several studies on the association between better health and steps. He also was a member of the U.S. Department of Health and Human Services 2018 Physical Activity Guidelines Advisory Committee.

“Evidence suggests that accumulating up to 10,000 steps per day is helpful for reducing chronic conditions such as cardiovascular disease, type 2 diabetes and some forms of cancer,” Jakicic said. “And more recent evidence supports the benefits of reducing the risk of dementia.”

Jakicic also noted that there are benefits for people with pre-existing diseases as well as for those who are already healthy adults looking to prevent future illness and enhance their longevity, resulting in better quality of life.

A large contributor to many health problems is excess body weight, which suggests that weight loss will help to reduce health risks. However, weight loss can be challenging for many — but science is telling us that lacing up those sneakers and taking a walk may help.

“For patients interested in weight loss — when coupled with a modest reduction in calorie intake — progressing to 10,000 steps per day has been shown to enhance long-term weight loss and the prevention of weight regain following weight loss,” Jakicic said.

John M. Jakicic, Ph.D., Sandra Billinger, Ph.D., Russell Swerdlow, M.D. walking outdoors on the KU Medical Center Kansas City campus
John M. Jakicic, Ph.D., Sandra Billinger, Ph.D., Russell Swerdlow, M.D.


What exactly makes walking — especially vigorous walking — so good for our bodies? The answer is both simple and complex. Sandra Billinger, Ph.D., professor of neurology in KU School of Medicine, studies exercise, brain health and stroke recovery. She said that there are proven benefits to pumping blood through your system, which can happen when walking.

“Movement and physical activity in general confer benefits on the vascular system, the heart and delivering oxygen rich blood to the muscles and organs,” she said. “There are so many molecules released that have positive effects on our body for blood pressure, cholesterol, glucose regulation and more.”

Billinger points to a 2020 study published in The New York Times that showed 9,815 molecular changes caused by exercise. That is a significant change, and scientists are doing more studies to understand why. Much of this research is taking place at KU Medical Center, including a number being conducted in Swerdlow’s lab, which studies exercise metabolism. Swerdlow looks closely at mitochondria, an organelle some call the “powerhouse of the cell” because it produces the chemical energy that powers the cell. Failure of the mitochondria is connected to Alzheimer’s disease and cognitive decline. Swerdlow and some of his fellow scientists are trying to figure out the link between mitochondria and the brain and how to boost mitochondria production.

“There’s little doubt that mitochondria and exercise are intertwined,” Swerdlow said. “When you exercise, you create oxidative stress in the muscle and that boosts mitochondria production, in the muscle and elsewhere in other tissues in your body.”

And that lactic acid, which naturally builds up with vigorous exercise and contributes to the fatigue felt when exercising? It’s boosting mitochondria in your muscles. It’s also boosting mitochondria all over the body, including the brain.

“We often think of oxidation as bad,” Swerdlow said. “But in this case, it might be very good indeed.”


Maintaining an active lifestyle is important for preventing and surviving cancer, said Christie Befort, Ph.D., professor in the Department of Population Health in KU School of Medicine and associate director for Cancer Prevention and Control at The University of Kansas Cancer Center. Befort conducts community-based research in behavioral weight-loss intervention and cancer prevention and survivorship.

“Studies are beginning to confirm the benefits of the popular goal of 10,000 steps per day as the optimal number of steps for health and longevity, including for cancer prevention,” she said. “But some is much better than none. There are significant benefits seen with increasing steps at different increments, up to this optimal goal.”

Achieving 10,000 steps throughout your day is about the same as walking four or five miles, depending on your stride. Five miles a day may seem like a lot, but it might not be that much more than many people already walk.

“The average adult in the U.S. gets between 2,000 to 4,000 steps per day doing their normal lifestyle activities and through their occupation,” Jakicic said. “Your steps can really start to add up by seeking opportunities to move more whenever possible.”

That is not possible for everyone, particularly those who are already suffering from a chronic disease or those with mobility issues. The good news is that studies show some exercise is better than none. The benefits do increase the higher the step count — up to about 10,000 steps — where those benefits either level off or stop. Billinger pointed out that smaller step counts can still provide incredible benefits.

“For people who reached 3,800 steps per day, dementia onset was reduced by 25%, which has significant public health benefits,” she said of the JAMA Neurology study, noting that more research is needed.

When it comes to maximizing the benefit of steps, think in terms of the number 10. Research indicates that 10-minute bursts of exercise several times a day may have their own special benefit, including physiological changes that are seen after a 10-minute period of brief exercise.

Jakicic encourages people to think of them as “exercise snacks.” These 10-minute snacks can come all throughout the day, and at any time.

“There’s still some magic in three 10-minute exercise snacks,” he said. “They can come in many different forms. Whatever you enjoy doing is the best place to start.”


Years from now, there may be an actual pill to simulate some of the changes of exercise. Swerdlow’s lab has been working toward a synthetic way to boost mitochondria and mitochondrial function. But he said the pill is still several years out from clinical trials in humans.

“We are developing a pill that we believe can simulate many of the beneficial effects of exercise, and are pleased with our progress,” Swerdlow said. “In the meantime, we understand enough about what exercise does for our bodies, including our mitochondria, that we do know everyone should be doing it.”

While researchers are working on that miracle exercise pill, Kelly Loeb said she will keep on walking and trying to get her 10,000 steps in every day.

“My primary goal is to move more, sleep better and feel stronger.”

Working up to 10,000 steps a day

John M. Jakicic, Ph.D., a research professor in the Division of Physical Activity and Weight Management, said most people — even couch potatoes — can work their way up to 10,000 steps. Here are his tips:


Look at tracking features built into your cell phone, watch or fitness tracker and see how many steps you get over the course of a week.


This first goal will involve moving about 10-15 minutes more per day than usual. For example, if you find that your typical day averages 3,000 steps per day, try for at least 4,000 steps per day.


Increase your goal every few weeks until you are able to work up to 10,000 steps per day. Keep in mind that every 2,000 additional steps equals approximately one mile. These extra 2,000 steps represent an additional 20-30 minutes of movement throughout the day.


As you increase your step count, remember there are additional benefits to steps at a brisk pace — and even more benefits if that pace is held for about 10 minutes.


If you can’t get in 10,000 steps every day, walk as many steps as you can.

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