Top News in Internal Medicine
Magic health numbers: Physicians analyze new research and offer advice
Newswise | October 08, 2019
We’ve all heard them—those popular “magic” numbers that serve as goals to help us manage our health and achieve optimal wellness. But is it really important to walk 10,000 steps and drink eight glasses of water each day? Will cutting 300 calories a day promote weight loss and improve overall health? And how much coffee is too much?
Three Western Connecticut Medical Group (WCMG) physicians—Dr. Maura Conway, Newtown Primary Care, Dr. Nick Florio, Ridgefield Primary Care, and Dr. Mojisola Ukabi,
Brookfield Primary Care—summarized research and the “why” behind
several popular health numbers. Here’s their analysis, as well as some
recommendations based on their extensive experience advising patients on
all aspects of health and wellness.
Is 10,000 steps a meaningful number?
For many years, walking 10,000 steps per day has been considered the
“magic” number for optimal health. The Journal of the American Medical
Association (JAMA) Internal Medicine recently published results
from an observational Women’s Health Study focused on whether increased
steps per day are associated with lower mortality rates among older
The study found that participants who walked as few as 4,400 steps
per day experienced lower mortality rates when compared to participants
who walked 2,700 steps per day. And, the more steps participants took
per day, the more their mortality rates dropped. However, the study
showed that mortality rates leveled off at 7,500 steps, meaning that
study participants who walked more did not have significantly lower
WCMG physicians agree that although the key takeaway point from the
research is accurate—being active during the day can have health
benefits—walking 10,000 steps is not a magic number for everybody,
especially because 10,000 steps is not a scientifically-derived number.
“10,000 steps was established because it’s almost five miles, and walking five miles a day is good,” said Dr. Conway.
According to WCMG physicians, finding the right type of activity for
your lifestyle and fitness/mobility level—as well as setting goals that
motivate you to gradually move more—are the best steps you can take
toward improving your health.
“Activity level needs to be patient-centered. For someone who is very
active, 10,000 steps won’t be impactful. And for someone who is not
very active, a goal of 10,000 steps a day might be discouraging and lead
them to give up,” said Dr. Conway.
“People shouldn’t be discouraged if they get a wearable tracker and
they don’t reach 10,000 steps per day. If a patient can’t walk or can’t
meet 10,000 steps, they should talk with their doctor about other
activities they can do,” said Dr. Florio.
Dr. Florio said that keeping track of the length and intensity of
your exercise sessions is also an effective alternative to counting
steps and can result in health gains.
“I follow the American Heart Association guidelines,
which state that most people should engage in at least 150 minutes of
moderate-intensity physical activity or 75 minutes of vigorous-intensity
physical activity spread throughout the week. In addition to physical
activity, people should add resistance or weight training at least two
days per week,” said Dr. Florio. “Examples of moderate-intensity
activity include a brisk walk, slow bicycling, gardening, dancing, or
Bottom line: Although popular fitness trackers and
health guidelines promote walking 10,000 steps, daily activity goals
should be personalized and reflect your fitness/mobility level,
lifestyle, preferences, and abilities.
Can you improve your overall health by cutting 300 calories a day?
Study results recently published in The Lancet Diabetes & Endocrinology
found that participants lost an average of 16 pounds during a two-year
period when they cut their daily calorie intake by about 300 calories.
In addition to weight loss, researchers also observed that participants
who restricted their daily calorie intake showed decreased inflammation
and improvements in cholesterol levels, blood pressure, and blood sugar
control (which reduces the risk of developing type 2 diabetes).
“The research results make sense because eating fewer calories will
help people lose weight over time. Maintaining a healthy weight
contributes to overall better health and improved mobility,” said Dr.
Conway. “Establishing a target number of calories to cut per day can
make it easier for some people who are working on losing weight.
However, weight loss should be patient-centered because the number of
daily calories each person needs to cut to lose weight will vary.”
Dr. Florio said that it is often difficult for people to
significantly reduce their caloric intake. In this study, for example,
researchers wanted participants to cut their caloric intake by 25%.
However, participants were only able to reduce the number of calories
they consumed by 12%.
Dr. Florio said that some people might also have trouble cutting a certain number of calories or following a specific diet.
“I talk to patients about not dieting, but instead making
sustainable, healthy, and long-term changes to their eating habits,”
said Dr. Florio.
Dr. Ukabi agrees that there is some truth to this research, but it’s
not specific to cutting 300 calories per day. She recommends an
“everything-in-moderation” approach to weight loss.
“It’s good to cut calories if you want to get to or maintain a
healthy weight, but don’t cut calories by depriving yourself of what you
enjoy,” said Dr. Ukabi. “Most people tend to ‘cheat’ when they deprive
themselves of certain foods. So if you love bacon, eat one piece instead
of the four pieces you might normally eat. That way, you still get the
taste, but with fewer calories.”
Bottom line: Reducing your calorie intake over time
may help you lose weight and improve your overall health, but the number
of calories each person needs to cut to achieve health gains will vary.
As an alternative to counting calories, you can also reduce your
calorie intake by making sustainable, long-term changes to your eating
habits and portion sizes.
How much coffee is really okay?
There is a lot of conflicting research out there about how much
coffee is too much, and whether coffee is good or bad for your health.
For example, a study conducted by researchers at Queen Mary University
of London, United Kingdom suggested that drinking up to 25 cups of
coffee per day is safe for heart health. However, another study in The American Journal of Clinical Nutrition
suggested that drinking more than six cups of coffee per day is
associated with a moderate increase in the risk of cardiovascular
“Coffee intake research is conflicting,” said Dr. Conway. “Although
some research suggests that too much coffee can be harmful, other
studies suggest that drinking coffee could lower the risk of developing
certain health conditions, such as heart disease.”
Drs. Conway, Florio, and Ukabi said that they advise most patients to
drink coffee in moderation. However, patients with certain health
conditions may need to be aware of how coffee affects their body.
For example, Dr. Ukabi said that if you experience heart palpitations
after drinking coffee, you should talk to your doctor—you may be
drinking too much.
“I usually only talk to patients about caffeine intake if it might be
related to another health condition, such as bladder irritation, heart
disease, or insomnia,” said Dr. Florio. “In general, two-to-four
eight-ounce cups of coffee per day are a normal, healthy amount for
people who do not have an underlying health condition.”
Also, Dr. Florio said it’s important to know what researchers consider to be a “cup” of coffee.
“What you buy in the store is usually much more than one cup. It’s
also important to know how much caffeine is in the coffee, as different
types of coffee have varying amounts of caffeine,” said Dr. Florio.
WCMG physicians also advise patients to be conscious of what they are
adding to their coffee and the effect it may have on calorie intake.
“Black coffee is best because you can avoid added calories and sugar from cream and sweeteners,” said Dr. Ukabi.
Bottom line: A few cups of coffee per day are safe
for most people who do not have other health conditions. However, you
should pay attention to the amount of caffeine the coffee contains and
the size of the coffee—as well as how drinking coffee affects your
body—to make sure you aren’t drinking too much. You should also be aware
of how added sweeteners or cream may impact your calorie intake.
Do you really need to drink eight glasses of water a day?
There are many different recommendations and formulas for figuring
out how much water you should drink each day. Although there’s no
question that your body needs adequate hydration to function at its
best, WCMG physicians agree that water intake needs vary from person to
person and should be based on diet, activity level, urine output, and
For example, if people are breathing heavily, sweating a lot, or are
dealing with diarrhea or another acute illness, they should increase
their water intake to make up for water loss.
“Eight glasses of water a day isn’t one-size-fits-all. One person may
need eight glasses of water per day, and another may need just two or
three,” said Dr. Florio.
Drs. Conway, Florio, and Ukabi said that monitoring water intake
becomes more important for people who have medical conditions such as
congestive heart failure or kidney disease because these conditions
cause problems with regulating fluid in the body.
Dr. Florio said that paying attention to your body’s thirst signals
is also an excellent way to make sure you stay adequately hydrated.
“The body is smart and does a good job regulating hydration in
healthy people. You feel thirsty when you need more water and feel
satisfied when you’ve had enough,” said Dr. Florio. “You don’t
necessarily need to drink a specific number of glasses, but you should
listen to your body.”
“In general, urinating every two-to-four hours means that your
hydration levels are good. If you haven’t urinated in two-to-four hours,
you may be dehydrated and should drink water,” said Dr. Ukabi.
Bottom line: Unless you have a health conditions
that affects your body’s ability to regulate fluids, drinking water when
you feel thirsty is usually enough to help you stay hydrated. Paying
attention to your urine output and activity level can also give you
clues about your hydration needs.
Although following these popular “magic” health numbers may help some
people achieve their health goals, they aren’t a “one-size-fits-all”
solution for everyone. The best way to achieve optimal wellness is
through a personalized diet and activity plan that reflects your unique