Your Checkup: Health Conversations for Motivated Patients
Ever leave the doctor’s office more confused than when you walked in? Your Checkup: Health Conversations for Motivated Patients is your health ally in a world full of fast appointments and even faster Google searches. Each week, a board certified family medicine physician and a pediatric nurse sit down to answer the questions your doctor didn’t have time to.
From understanding diabetes and depression to navigating obesity, high blood pressure, and everyday wellness—we make complex health topics simple, human, and actually useful. Whether you’re managing a condition, supporting a loved one, or just curious about your body, this podcast helps you get smart about your health without needing a medical degree.
Because better understanding leads to better care—and you deserve both.
Your Checkup: Health Conversations for Motivated Patients
How Many Steps a Day Keep the Doctor Away? New Study Reveals the Answer
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We dive deep into recent research that challenges everything you think you know about daily step goals. The famous 10,000 steps target was actually a marketing gimmick from 1960s Japan with no scientific backing, while new evidence shows 7,000 steps delivers the most dramatic health benefits.
• The 10,000 steps goal originated from Japanese marketing, not science
• Meta-analysis followed 161,000 adults across 24 global cohorts for seven years
• 7,000 daily steps reduced death risk by 47% compared to 2,000 steps
• Walking 7,000 steps cut heart disease risk by 25% and cancer mortality by 37%
• Dementia risk dropped 38% and depression symptoms decreased 22%
• Fall risk in older adults reduced by 28% with optimal step counts
• Most benefits occur transitioning from low to moderate activity levels
• Cardiovascular benefits plateau around 7,000-8,000 steps
• Diabetes prevention shows continued benefits beyond 10,000 steps
• Adding 1,000-2,000 steps equals roughly 10 minutes of walking
• Simple strategies include parking farther and taking after-dinner walks
Production and Content: Edward Delesky, MD & Nicole Aruffo, RN
Artwork: Olivia Pawlowski
Hi, welcome to your Checkup. We are the patient education podcast, where we bring conversations from the doctor's office to your ears. On this podcast, we try to bring medicine closer to its patients. I'm Ed Dolesky, a family medicine doctor in the Philadelphia area, and I'm Nicola Rufo. I'm a nurse, and we are so excited you were able to join us here again today, so I made this. I wanted some sort of Mexican food to make this week, but I didn't want it to be an enchilada, because that's your territory and there's no way I can make an enchilada better than you do. And I thought about I mean, burrito was off the table, too complicated. I mean, burrito was off the table too complicated. Thought about fajita, but I ended up making this white chili, chicken-based, with poblano peppers.
Speaker 2:What did you think it was delicious? Oh wait, no, you have dinner planned for us tonight. I was going to say I might have some for dinner tonight. I brought some for lunch the other day and, yes, it's been like 100 degrees out and Eddie was making chili for dinner, and then I brought some to work and it was really good.
Speaker 1:What did you like about it?
Speaker 2:All of it, everything it tasted delicious.
Speaker 1:I had never cooked with the poblano pepper before and I guess when I've been finding these, you know I've been like making my own little recipe book of links in the notes section of my phone. But I feel, when I've been finding these, you know I've been like making my own little recipe book of links in the notes section of my phone. But I feel like I really should write these down in the book at some point yeah, we have a receipt book.
Speaker 1:We do have a receipt book. I also feel like I haven't made it through like one turn of the rotation of, like my special meals to where, like you won't remember them, like I don't remember what I made like five weeks ago, but there was something there that like I made and I was like, wow, that was good, you should make that again. But I don't remember what it was. So that's why I have to look back in my receipt book yeah, this should go in the receipt book I'm honored.
Speaker 1:it was, um, you know I the shredding the chicken was the piece that was like a little annoying. I did the two forks method. Seems like there's an attachment on some kitchen product that I can use to be able to shred the chicken easier. And yeah, poblano peppers weren't that hot. It was good. I would do it again and it made a good amount too.
Speaker 2:Any other thoughts about the the chili 10 out of 10.
Speaker 1:Yeah, and tonight, um, we're recording this not exactly on a sunday, but you know, tonight we're going to have salmon we're gonna salmon.
Speaker 2:I'm so excited for this.
Speaker 1:I love salmon so much you know, we, growing up, there was, um, I tried to, like you know, scoot outside a little bit of what I know, which is like, uh, you know, a dry rub lemon pepper seasoning. So tonight is a little different. We are doing a soy sauce with minced garlic marinade and the good people have read it seem to think that an orange zest with orange juice was the way to go. So that's been sitting, you know, the salmon has been sitting in that marinade for the better part of the day. Um, it does. I do have to look up, like, how long to cook salmon for, which is like I, you know you can look at it and you're like, oh, just like you know when it's right, but, uh, do you have any off the dome thoughts about how long to cook salmon for?
Speaker 2:What is it Like? Two little pieces. Yeah maybe like an inch, maybe a little less than an inch thick, Like I feel like salmon cooks pretty quick, like 12 to 15 minutes maybe.
Speaker 1:I think that's what the AI ai generated answers online really, yeah, at 400 degrees I'm just going vibes, you know I know, yeah, the vibes is okay, but you know like my vibes brought me to a broiled salmon last time yeah, no, we're not, which is fine. You know, that's how I used to do it. I think I'm gonna try baking it really yeah, growing up that's what we did.
Speaker 1:So you said well, I think, unless because the broiler and the bake is in the same area, so I'm not sure. If it was like it's all in the oven Bake, then hit a button, then broil, I didn't pay attention that much. This is all a much more recent occurrence that I'm like really actively participating in the kitchen.
Speaker 2:I know I love it, especially since, like you, have like a break from work, so you're just my little stay at home house husband and you know I got to say something actually.
Speaker 1:Oh boy.
Speaker 2:I do have something to say here in the pre-show banter. Okay, I don't know if you're going to cut this.
Speaker 1:Time will tell.
Speaker 2:No, I just okay. Like I go to work, I come home, I can just like hang out, chill, take a shower, do my skincare work out if I didn't before work and then I come down and dinner's either ready or being made, the house is clean and it's lovely. And, you know, I feel like men aren't as stupid as we've been saying that they are, because this is what men have been doing for years. Like they go to work, they come home, dinner's ready, the house is clean. Da da, da da. It's a great way to live good.
Speaker 1:I'm glad that this is what's came, what came out, because I was waiting for the shoe to drop, because and I've been trying to be more intentional about this, about leaving a mess afterwards and like I'm I really try to like clean up as I'm going now, especially in the last like week or two, because I realize it, it's so much easier that it does, and like having an empty dishwasher.
Speaker 1:I mean, there was a time when I didn't have a dishwasher not growing up, but, like you know, early 20s and didn't have a dishwasher, and that was like tough, what was me? No dishwasher. But you know, you sink into the corner of the couch and time flies and you're rotting watching your shows and then all of a sudden, like the second, third, helping that I was going to go get or continue to be in the kitchen and then all of a sudden it's like time to go to bed. We're a little embarrassed about when that bedtime is, so I'm not going to say it out loud. Yeah, it's 830. It varies, it varies, and then it's still like messy out there, and so I'm trying to be better about that. No, you're right, I think. I mean this is like the easiest thing.
Speaker 2:Like I actually had that thought. I was like, wow, this is what men had been doing for years. Obviously, women go to work. Blah, blah, blah. We know.
Speaker 1:Yeah, yeah, yeah.
Speaker 2:But like back in the day, this whole time we've been clouding on men saying they're stupid. They cracked the code years ago.
Speaker 1:Maybe they did Um, you know, 2025.
Speaker 2:I'm here unveiling their secrets.
Speaker 1:No, I'm glad you like it. I um, it makes me feel you know, in this time that's a little uh, nebulous about what I do during the day. It makes me feel nice to be able to have one less thing for you to worry about.
Speaker 2:Yeah, I should bring you home he has his like you should bring me home a sandwich. You went to the beach again. Came home without a sandwich.
Speaker 1:They don't keep well if I don't get it and bring it immediately back. So that's it doesn't keep well. This one didn't keep well. I think they like skimped on the blue cheese a little bit, which was a part of the issue. The like roasted turkey long hot one is great. I just wish there was more blue cheese on this buffalo chicken one yeah, I should order extra blue cheese next time.
Speaker 1:I'm not gonna be that guy why, can I have extra blue cheese? Yeah, I don't know what were you gonna say before I said something about the sandwiches.
Speaker 2:What was I gonna say? Oh, you have back to your house, husband oh yeah day you have your, your um ladies at wegmans that you see every monday, oh what gems?
Speaker 1:oh my god. Yeah, I don't think I've talked about this before.
Speaker 2:She wasn't there on monday and I was upset about it, um, so she took a long weekend so there's two different women who I've um interacted with one twice now one I dumped, like they work there they work there.
Speaker 1:Yeah, yeah, they're um cashiers, um. The second one, the one in the middle, is a quicker story. I was making mussels that day and like they didn't have plastic bags, so I just have the mussels sitting in the mesh, sitting in a cooler bag, and I I plop the muscles on there as I'm just like unloading a conveyor belt of food. And then she's like, oh, no, now my entire conveyor belt is going to smell like muscles all day. I felt bad about that. Now I'm more aware.
Speaker 1:Second lady I had the same interaction twice on the first and third trip of the month, and she was like, oh, so do you have the day off or something? And I was like, oh, you know, I'm actually uh, I'm actually uh, well, I'm like, oh, transitioning roles now. So I'm like, no, I'm actually like a family medicine doctor, primary care doctor. It's like, oh, oh. And I'm like, yeah, I'm heading over here in september, so I have some time off trying trying new things in the kitchen. You know, take it for a spin and they're great, she's great. And then she thought of me when she read a paper in the inquirer saying that more people should go into family medicine instead of like neurosurgery, which I stand behind.
Speaker 1:I mean we need more neurosurgeons, of course, but I think we desperately need more people in primary care, so you know.
Speaker 2:Definitely wouldn't have to go to work if you were a neurosurgeon. No you also wouldn't see me Also wouldn't see me.
Speaker 1:There was one time in med school I was a quick, quick little anecdote here I was in the operating room with a neurosurgeon Really really great guy and he was like please do anything other than this. And I was like why he told me this sad story and I don't know if there are any neurosurgeons listening. But he got home from work at like two in the morning and he had two young kids at home and he walked into the kid's room and the kids start screaming, thinking that there's a stranger in the building. And that's when he knew that he spent a lot of time at work. And then he went to sleep for three hours and got up at five and went back yikes now being a neurosurgeon wasn't ever on the list of things for me to do.
Speaker 1:Have a ton of respect for them, but people should do primary care because we need more of that oh, can I have a sip here of Poppy? Yeah, go ahead, go nuts, Not a paid advertisement.
Speaker 2:Oh my God, you almost. Why don't you just have?
Speaker 1:the whole thing. When did you open this? I opened it around like 2 pm.
Speaker 2:Oh, you did. Yeah, I thought you just opened it now. No, no, go nuts.
Speaker 1:All right. So what are we going to talk about today, Nick?
Speaker 2:Today we're talking about step counting, and how many steps do you really need in a day?
Speaker 1:So there's a recent study that came out in the Lancet Public Health July 2025, that discusses readjusting maybe the step goal, and I see a lot of headlines on social media about like, oh, 10,000 steps might not be the goal anymore, and one thing that left me frustrated was like the articles are all very superficial and I wanted to take the time to actually read the study and then break down for you all what this actually may mean. So we're talking about something that's really easy to overlook but has a huge importance in your daily steps.
Speaker 2:Yeah, so we've heard, like you said, that everyone's heard that you should have 10,000 steps a day. At least it's everywhere. On every fitness app, fitness tracker. Yeah, the fitness girl is on TikTok.
Speaker 1:Love to talk about their steps.
Speaker 2:Yep, but that act, that number, was actually um kind of essentially pulled out of thin air as a marketing um tactic from a pedometer company in Japan in the 1960s which is fascinating. Yeah, I know, it's kind of like there was no science behind that number at the time, just kind of picked a number.
Speaker 1:It's like a nice round number. Yeah, it's like, why not?
Speaker 2:And here we are in 2025, still going along with this marketing campaign, basically.
Speaker 1:Yeah, and it really up until now. I mean, a lot of different studies have looked into this individually, but this one is a big conglomeration of a lot of other studies, but up until now there wasn't a whole lot of science behind it at the time. So the question we're trying to answer today for you by reviewing this paper is how many steps do you actually need for better health? Is it 10,000, or could it be something way less? The answer might surprise you and it might change how you think about health, fitness and, like in quotes, what counts when it comes to movement.
Speaker 2:Okay, so before we talk about the number, we'll talk about the study first, and the study was actually um followed a large group of people over the course of seven years. It followed 161,000 adults across 24 global cohorts. Um just people wearing a step tracker living their lives. So really they just measure the steps. They watched what happens with these people in their everyday lives and then they watched what happened and they were tracking outcomes such as death, heart disease, cancer, diabetes, dementia, depression and even things like falls.
Speaker 1:Yeah, and it's one of the. This type of study is called a meta-analysis, when they take a bunch of different studies and they put them together and take all of that data and then do some statistical magic on it to try to draw some conclusion based off of all of that. And so basically they measured the steps and then they watched what happened over time. A key piece that happens in here is like a lot of times in these reported studies about physical movement, people are reporting what they do. Like they're saying, oh yeah, I moved for half an hour today of moderate intensity exercise. But something we've done in prior episodes is try to like quantify that and it's kind of challenging because it's very personal, right. Like it's breathlessness when you are talking to a neighbor.
Speaker 1:Steps are much more black and white. There's no guessing, there's no diary about what you do, it's just movement from real people in the real world. And so, getting into the headline stats that they did, you know, for anyone really interested you can go look at the method section. But we kind of tried to explain it in that last segment there. What they did is they compared people to other folks walking 2000 steps a day. They called that the lowest amount that people would normally do on average so not completely sedentary, but just 2000 steps a day was the comparison group. Then they took people who had 7,000 steps a day and that's where they found the most remarkable results. So people walking 7,000 steps a day, compared to 2,000 steps a day, had the following a 47% lower risk of dying from any reason, a 25% lower risk of developing heart disease, 37% lower risk of dying from cancer, 38% lower risk of dementia, 22% lower risk of depressive symptoms and they were 28% less likely to fall.
Speaker 2:Those statistics are all not insignificant.
Speaker 1:Not at all. The coolest part of it is that most of the benefit came from going from a very low step count to more moderate ones, count to more moderate ones. So I'm talking like 2,000 or 4,000 steps to even 6,000, which makes it much more attainable. You may not necessarily need 10,000 steps is one of the big takeaways from this paper but I do think it would be important for us to spend a little time and break down each outcome a little bit more. So first up would be cardiovascular disease. More steps led to fewer heart problems. That was simple, and especially when it got to about 7,000 to 8,000 steps, more steps. After that the curve of benefit flattened, so there wasn't as much benefit afterwards, but it didn't reverse and there was still continued benefit, but not as dramatic after that 7,000 to 8,000 mark. What about cancer mortality?
Speaker 2:Cancer mortality, or dying from cancer, was about a 37% lower risk when people were taking 7,000 steps a day. Um, so that's not to say that your risk of getting cancer is lowered by 37%. It's that death risk. If you have cancer, it goes down.
Speaker 1:Yep Key thing Um which a little bit of a bummer, you know, it would be nice if you can like avoid that, um, but it makes it.
Speaker 1:You know, it gives people more longevity when they carry these diagnoses and not something we've spent a lot of time talking about on the podcast here, but you know, having there are a lot of people living with cancer, especially now with advanced therapies chemotherapy, immunotherapy so it's nice to know that there's something out there that someone can do to lengthen their life.
Speaker 1:So then there's type 2 diabetes, which they looked at Obviously a huge public health issue that we've spent a lot of time talking about. What they found is that people walking 7,000 steps a day had a 14% lower risk of developing diabetes. This makes a lot of sense to me, keeping in line with how we've discussed physical activity and a healthy diet as ways to prevent it. But now we have some figures that say about 7,000 steps has a bit of reduction, and what they found in this paper is that the benefits kept increasing even past 10,000 steps. This was a little bit more of a linear association in comparison to that cardiovascular risk, where it was kind of like the end of a slope where things flattened out. You still got benefit, but not a ton after 7,000, not the case for the diabetes. That was more linear relationship. The more, the better. Nikki. What did they say about this was a really interesting one, pretty significant benefit there. There were a couple studies that they included that looked at this dementia.
Speaker 2:Yeah, the dementia one was um. Like you said earlier was the risk had dropped by 38% with higher steps. So this one um was a little bit higher than 7,000. It was about 8,800 steps, but still not 10,000.
Speaker 1:Right.
Speaker 2:And decreasing your risk of dementia by 38% just by walking is kind of crazy.
Speaker 1:It is great, and you know we shouldn't overlook mental health. People who had more steps had a 22% lower risk of depression and that again, like diabetes, was a straight line. So more steps, better mood. We incorporate, we try to incorporate exercise into all of our treatment plans for people, for people with depression, and so this makes a lot of sense to me.
Speaker 2:Endorphins make you happy, and happy people don't kill their husbands, and happy people don't kill their husbands, I hope you're happy.
Speaker 1:And then there's falls, especially falls in older adults, and this deserves a little bit more of a discussion. So those older adults walking around 8,800 steps a day had a 28% lower fall risk. Now, if you're someone who's young and listening to this and you haven't considered falls, they can be devastating. For someone who's elderly, they can. Someone being isolated at home, they can fall, and they can be in danger just by laying on the ground. If they can't get up, they can break bones. It could be really just devastating altogether.
Speaker 1:What they did find, though, is that for some folks who are over 75, there was a little hint in the data that says that maybe too many steps might increase the risk if they have balance or frailty issues, and that was more of a postulation from their discussion about why they thought that might happen. But there was a little inflection point where, at some point, too many steps turn things in a different direction and maybe increased falls. So I don't think there's anything huge to say here. I think people should be. If you're at 2,000 steps a day and you aren't walking as much, I think you have a lot of room to improve, but maybe don't go overboard, is my takeaway, Do you agree?
Speaker 1:Mm-hmm takeaway, Do you agree? So those were. We tried to the itemized list there of all the different outcomes that they looked at. What is the big takeaway? What is the ideal number per se?
Speaker 2:I'd say the sweet spots around seven to 8,000 steps a day.
Speaker 1:Yeah, and that at that spot there's a whole lot of health benefits and they either plateau or max out right around there. It seems that for a lot of them going higher isn't bad, but the biggest return goes from going low to moderate.
Speaker 2:Yeah, and most people can work their way to 7,000 steps really just in your everyday life. You don't need to get a new gym membership or buy a treadmill or anything crazy like that.
Speaker 1:Yeah, and so you know, in this next part, really we want to motivate you. So what can you do this week? So let's make it real. Say you take out your phone or maybe you have a watch. Say you're averaging about 3,000 steps a day. Set a goal to hit 4,000 or 5,000 steps this week, and I mean realistically, it looks like about an extra 10 minutes of walking.
Speaker 2:Yeah, and an extra 10 minutes of walking. If we kind of bring like a number like 4,000 or 5,000 down to something, that's 10 minutes, it's pretty easy to do. To do. You can walk around your neighborhood, go for a walk after dinner, park your car farther when you're at the grocery store I love a far parked car you do love a far parked car, which I don't, depending on the situation.
Speaker 2:I do love an after dinner walk we don't do that here, but I love an after dinner walk yeah, maybe in the suburbs I do love the only okay we're not city people I do love, we can like because we live in such a walkable city, if we are walking to dinner I it really makes such a difference Like, even if it's like a 10 minute walk back home, you just feel so much better, Like there is nothing bad like, or I'm sorry, there's like nothing worse. I feel like then going to a really big dinner, probably eating way more than you would otherwise be comfortable with, and then sitting in a car.
Speaker 2:Oh yeah way more than you would otherwise be comfortable with. And then sitting in a car. Oh yeah, it's like like walking home.
Speaker 1:You like stretch out things, get moving oh yeah things start working unless it's from tom's dim sum, and I'm like struggling, oh yeah, you were yeah I shouldn't have had a diet coke. No, no, that shouldn't have happened.
Speaker 2:That was my can't mix bubbles with MSG.
Speaker 1:No, there's gotta be something in there. Maybe there's an episode brewing Like there was stuff brewing in me and MSG X bubbles episode, but who knows. But it really does all add up. And if you do walk a lot already, that's great. Um, if not, you can think about this that even a small increase can really make a difference. I think this is an open access study, so if anyone's really curious to look into it, they can. But they even showed benefit, like adding a thousand steps at each interval and see what benefit that gets you. It was really cool.
Speaker 1:There's a lot of complicated health topics that we cover on this show. We try to distill them and make them simple. Eat this, this medicine does this, this side effect. This is all complicated. This one's simple Move more and you can take one step at a time, literally. Literally one step at a time and truly, your brain, your heart, your mood, your future self will be so proud of you, and with that I thank you for coming back to another episode of your Checkup. Hopefully you were able to learn something for yourself, a loved one or a neighbor.
Speaker 1:If you like this, send it to someone who you think might like it. Share it with a family member or friend, and you can check us out on our social media. We're most active on Threads, the text-based Instagram app. If you did like anything from here, rate and review. If you don't mind, you just leave a little message on our Apple podcast or wherever you're listening, and I'm done rambling at this point. So, most importantly, stay healthy, my friends, until next time. I'm Ed Dolesky. I'm Nicole Ruffo. Thank you and goodbye, bye, no-transcript for a complete information tailored to you. In short, I'm not your doctor, I am not your nurse, and make sure you go get your own checkup with your own personal doctor.
