Revisiting "how many steps are enough?".

With continued widespread acceptance of pedometers by both researchers and practitioners, evidence-based steps/day indices are needed to facilitate measurement and motivation applications of physical activity (PA) in public health. Therefore, the purpose of this article is to reprise, update, and extend the current understanding of dose-response relationships in terms of pedometer-determined PA. Any pedometer-based PA guideline presumes an accurate and standardized measure of steps; at this time, industry standards establishing quality control of instrumentation is limited to Japan where public health pedometer applications and the 10,000 steps.d slogan are traceable to the 1960s. Adult public health guidelines promote > or =30 min of at least moderate-intensity daily PA, and this translates to 3000-4000 steps if they are: 1) at least moderate intensity (i.e., > or =100 steps.min); 2) accumulated in at least 10-min bouts; and 3) taken over and above some minimal level of PA (i.e., number of daily steps) below which individuals might be classified as sedentary. A zone-based hierarchy is useful for both measurement and motivation purposes in adults: 1) <5000 steps.d (sedentary); 2) 5000-7499 steps.d (low active); 3) 7500-9999 steps.d (somewhat active); 4) > or =10,000-12,499 steps.d (active); and 5) > or =12,500 steps.d (highly active). Evidence to support youth-specific cutoff points is emerging. Criterion-referenced approaches based on selected health outcomes present the potential for advancing evidence-based steps/day standards in both adults and children from a measurement perspective. A tradeoff that needs to be acknowledged and considered is the impact on motivation when evidence-based cutoff points are interpreted by individuals as unattainable goals.