One of the first landmark studies that recognized this fact was conducted more than 70 years ago. In the 1950s, epidemiologist Jeremy Morris studied more than 30,000 employees of the London transportation system. He observed that bus drivers who sat all day behind the wheel had a higher risk of developing coronary heart disease than conductors who walked up and down the aisles and stairs collecting fares. This natural experiment fundamentally changed how we think about activity for the prevention of heart disease.
Despite the accumulation of decades of evidence, physical inactivity remains one of our greatest public-health challenges. According to the American Heart Association’s 2026 Heart Disease and Stroke Statistics report, which my colleagues and I recently published in Circulation, fewer than half of U.S. adults achieve the recommended amount of aerobic activity, and only one in five achieve recommended targets for combining aerobic and muscle-strength training activities.
So why don’t we, as clinicians, approach physical inactivity the way we do other major cardiovascular risk factors?
The value of structured exercise extends well beyond heart disease. A recent randomized trial published in the New England Journal of Medicine found that patients with colon cancer who participated in a three-year structured exercise program were 30% more likely to live longer and without cancer compared with the group that only received advice to exercise.
Today, we have the opportunity to change our collective approach to physical inactivity. Millions of people now have smartphones, watches, and digital tools to track daily movement. These wearable devices have the potential to help us measure, modify, and monitor our movement behaviors. But as health monitors have gotten more popular, the sheer volume of health advice for how to use them has increased exponentially. As a result, it can sometimes be overwhelming to know where to start.
So, what’s a good goal for daily steps? Most people may think that 10,000 steps a day is the right target. But this number originated from a marketing campaign—not from science—because it was easy to remember. Ten thousand steps per day was never based on hard evidence. In fact, when researchers examined daily step counts in large population studies, the health benefits for walking begin well before 10,000 steps.
To address the 10,000 steps misperception, we should retire that arbitrary target as a one-size-fits-all prescription and replace it with a message grounded in evidence: start where you are, and do a little more. If you're currently taking 3,000 steps a day, aim for 4,000. If you're at 5,000, try for 6,000.
At the same time, we cannot ignore that the choice to exercise is not solely an individual one. It is also shaped by a person’s surroundings. In order to be able to make walking an exercise habit, there need to be safe sidewalks, neighborhood parks, and green spaces in the communities in which we live and work. We must prioritize policies that enable and support a healthy environment and healthy activity choices.
The science is remarkably reassuring: you don’t need to become an athlete to improve your health. Spending more minutes walking today can improve the health of your heart and your brain for years to come. The goal is not to reach an arbitrary number. It is to keep moving.
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