Every Little Bit Counts

I have some amazing news to share. A recent study published in the journal Diabetes Care observed a reduced risk of diabetes (type 2) in older women who walked just 1000 steps more every day. You can access those findings here. This week’s post might, at first glance, seem a little dry to you, but if you’ll stay with me for a couple of minutes, I think you’ll find an important observation here that may resonate deeply. It’s not about diabetes, or even walking for that matter. It’s about success.

For more on this topic, check out another post I wrote on this topic, which I called Baby Steps.

Of course, I applaud this research. But I would not say that the discovery that walking 1000 steps more than your previous baseline reduces your risk of diabetes by 6 percent is the amazing part. I would not even say that measuring this is the amazing part. I would say, instead, that the amazing part is that a few researchers figured out a way to quantify (finally) what common sense has told us all along: that every little bit counts.

I am going to see what we can learn from taking apart the titles of the original article [Associations of Daily Steps and Step Intensity With Incident Diabetes in a Prospective Cohort Study of Older Women: The OPACH Study] and an article I saw about the original article [In Older Women, Every 1,000 Extra Steps Taken Daily May Be Tied To 6% Reduction In Diabetes Risk, Research Suggests]. Mainly, I’m going to ask a lot of questions.

Question 1: Would you suspect that the reduced risk of diabetes from moving a little more will accrue only to older women? What about younger ones? Do you think it’s possible that one day there won’t be much if any benefit, and then the next day, say on your 65th birthday for example, you will see a benefit? What about teens? Does your common sense tell you that they will benefit only if they join the track team and run cross-country? Or might a short walk after dinner (maybe with a friend, maybe alone) also be good for their physical and mental health? I’m just asking questions here.

Question 2: What about men? Do you think it is likely that only women benefit from increasing their steps?, but men do not benefit, whether they are very active, a little active, or completely sedentary?

Question 3: Now I want to say something about diabetes. Diabetes happens when you no longer have enough insulin to meet your demand. Activity improves the sensitivity of your insulin so a little goes further. When insulin is more sensitive you don’t need as much, so your overall insulin levels drop. The more you need (due to insulin resistance), the higher your insulin levels go. You need insulin to live, but high insulin levels are not your friend. Besides diabetes, high insulin levels are associated with many other chronic diseases, including hypertension, high triglycerides and low HDL cholesterol, fatty liver, kidney disease, coronary artery disease, obesity, and more. So what do you think? Is it possible that there might be other benefits to walking more?

Question 4: What about the walking part? Does any part of you suspect that walking is the only kind of movement that will be beneficial? What about yoga, stretching, weightlifting, Pilates, rowing, jogging, swimming, spinning, or bicycling? Do you think these are probably going to be a waste of time? And what about indoors vs. outdoors? Again, I’m just asking questions.

Question 5: And what about the 1000 steps? Might 999 steps provide equivalent benefit? 990 steps? 900? What about 500 more steps a day than you used to walk? Do you suspect that that’s an absolutely useless endeavor? Or might it be associated with not a 6% reduction, but half of that, 3%, because you took half the steps associated with a 6% risk reduction? Okay, maybe that’s a little generous. What about a 2% reduction? What does 2% actually mean?

Let’s do some arithmetic: For every 100,000 elderly women who walk whatever the amount is that would theoretically reduce their risk of type 2 diabetes by 2 percent, and assuming that 20 percent (20,000 women) are at high risk of developing diabetes, which is just an assumption for purposes of doing the math, a 2% reduction would translate into 400 women. So instead of 20,000 new diabetics, there would be 19,600 new diabetes. Tripling that number (60,000 minus 1200 equals 58,800) would get us to the 6% whose 1000 additional steps were actually measured, along with attendant benefits to their blood sugars. Fifty-eight thousand fewer diabetics for a little bit more activity in 100,000 older women. The numbers go up quickly, especially considering that 332 million people reside in the United States, and that approximately one-third of these (100 million) have abnormal blood sugars in the form of diabetes or pre-diabetes. Yes, you read that right.

And, finally, Question 6: The original article observed a stronger connection between reduced incidence of new cases of diabetes in people who walked at a moderate to vigorous pace than a low intensity pace. So I ask, does this mean that there was probably no benefit to walking at a more leisurely pace?

What’s my point? I’m drawing solely and completely on common sense when I say how deeply I believe that every little bit helps. I also believe, just as deeply, that setting unrealistic goals and then failing to meet them has a strong negative effect on your overall health and wellness. The trick then becomes to figure out how to set yourself up for success. This is a frameshift in the way Americans think about a health lifestyle.

I’m thrilled to know that researchers have identified a way to quantify the concept that even small steps translate into significant benefits. I am grateful for the research, and look forward to seeing further confirmation. But I don’t think we need to wait for more research on this topic. I think you can begin to pat yourself on the back for every single additional step you take above your previous baseline.

When you focus your attention on the things you did not achieve, as opposed to the ones you did, you chip away at your self-respect and feelings of pride and agency. Focus on this: YOU ARE DOING THE BEST YOU CAN. And that will always be good enough for me.

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