Want to Live Longer? Take the Stairs
Climbing stairs lowers risk of death, according to new study
People who want to improve their heart health — and maybe even live longer — should make a habit of taking the stairs, rather than the elevator or escalator, according to a new report from the United Kingdom.
People who reported regularly climbing stairs had a 39 percent lower risk of death from heart disease and a 24 percent lower risk of dying from any cause, according to the analysis, which pooled the results of nine studies involving more than 480,000 patients. Regular stair-climbing was also associated with a lower risk of heart attack, stroke and heart failure.
“We would encourage people to take the stairs when they can,” said study author Sophie Paddock, a clinical fellow in cardiology at the University of East Anglia and Norfolk and Norwich University Hospital Foundation Trust. “Studies have shown that brief bursts of exercise throughout the day can still have beneficial health impacts.”
A short version of the analysis was presented April 26 at ESC Preventive Cardiology 2024, a medical conference in Athens, Greece, organized by the European Society of Cardiology. Paddock and her coauthors have not yet published the full report in a peer-reviewed journal.
Experts say the study’s findings are consistent with earlier studies that suggested stair-climbing was associated with lower cholesterol and a lower risk of type 2 diabetes. Research also suggests that short bursts of moderate exercise, such as stair-climbing, are linked to a longer life. One study found that climbing more than five flights of stairs, or approximately 50 steps, daily was associated with a lower risk of hardening of the arteries. Health benefits from regularly heading up the stairs happen relatively quickly. An analysis of stair-climbing studies earlier this year found improvements in heart disease risk happen in as little as four weeks.
Another study presented at an American Heart Association conference in 2021 found that taking more steps per day, either all at once or in shorter spurts, may help people live longer.
Building muscle, improving balance
Climbing stairs forces both the heart and muscles to work harder, said Tamara Horwich, a cardiologist and health sciences clinical professor of medicine and cardiology at the David Geffen School of Medicine at UCLA. Climbing stairs can help build muscle mass, reduce fat mass, lower the risk of osteoporosis and improve balance, said Horwich, who was not involved in the new analysis.
Continuous stair-climbing is considered moderate to strenuous exercise, Paddock said, and burns up to 10 times as many calories as sitting. “This improves your cardiorespiratory fitness just like any other form of high intensity exercise,” Paddock said.
“I love this study because it provides medical insights to what we instinctively know is true: Movement, all kinds of movement, at all times of the day, is good for heart health,” said Suzanne Steinbaum, a cardiologist and spokeswoman for the American Heart Association. “Stairs challenge us physically, so just by using them more often, we increase our stamina and strength for other focused exercise.”
Although the studies in the new review focused on people using the stairs at home or work, Paddock said that using stair-climbing equipment at the gym would likely provide the same benefit.
Even a little stair-climbing is better than nothing. Those who can’t climb all the stairs in a building could try taking the elevator part of the way, then climbing the rest, Paddock said.
Another easy way to get the benefits of stair-climbing is to incorporate a low, stable bench, such as those used in step aerobics classes, into your workout routine, said Randal Thomas, a preventive cardiologist at Mayo Clinic in Rochester, Minnesota, who was not involved in the new report. Stepping on and off a low bench provides a greater workout than walking on a flat surface.
Researchers don’t know how many stairs a person needs to climb for optimal heart health, Paddock said.
Recommended exercise
The American Heart Association recommends at least 150 minutes per week of moderate-intensity aerobic activity or 75 minutes per week of vigorous aerobic activity, or a combination of both, preferably spread throughout the week, Steinbaum said. Only about 1 in 5 adults gets this much exercise. Even fewer perimenopausal or menopausal women work out this much, even though exercise is one of the best remedies for hot flashes and other menopausal symptoms, Steinbaum said.
“When my patients start to move more, in any fashion, I can see the improvements in cardiovascular fitness and endurance within four months,” Steinbaum said. “This is one of the more powerful markers of improved heart health and decreasing mortality risk.”
Experts have key questions about the study and its limitations.
The design of the analysis doesn’t prove cause and effect, or that stair-climbing definitely extends life, Thomas said. That’s because some of the studies included in the analysis were more rigorous than others.
The only way to prove that stair-climbing reduces the risk of a heart attack would be to randomly assign similar groups of people to either climb stairs regularly or do something else, then calculate the percentage in each group who experience a heart attack, Thomas said. This type of study, called a randomized controlled trial, is considered the gold standard of medical evidence. However, such trials are expensive and take a long time.
Possible limitations
There are lots of alternative explanations for the report’s results, said Keith C. Ferdinand, a professor of medicine at the Tulane University School of Medicine. For example, it’s possible that the regular stair-climbers in this analysis followed other heart-healthy habits, such as eating lots of vegetables and avoiding tobacco. In that case, those other healthy habits may deserve as much or more credit as stair-climbing, said Ferdinand, who was not involved in the new analysis.
It’s also possible that people who regularly took the stairs — perhaps because they read news articles about the benefits — were more educated than people who chose to take the elevator, Horwich said. People with more education tend to live longer than those with little education.
Lastly, the people who chose to take the stairs may have been healthier from the beginning. People who smoke two packs of cigarettes a day may not be fit enough to take the stairs. But in that case, the major cause of a person’s heart attack could be tobacco, rather than whether they climb stairs, Thomas said.
Some patients in Paddock’s analysis were healthier than others. Some had survived a heart attack; others had peripheral vascular disease, a condition in which narrowed blood vessels reduce blood flow to the arms or legs; and 13 percent were current or former smokers, she said. Participants in the studies ranged from 35 to 84 years old. Just over half were women.
The studies in Paddock’s review asked people to fill out questionnaires about their exercise habits. It’s possible that the participants didn’t accurately remember how often they took the stairs, Paddock said. People also have been known to exaggerate to make themselves look better on questionnaires.
Climbing for your heart
In spite of those limitations, Horwich said there’s abundant evidence from other studies suggesting that climbing stairs — and exercise in general — is good for the heart.
“We already know that walking is good for the heart,” Horwich said. “If you can’t climb steps, take steps on flat ground.”
Not everyone should take the stairs, however. People who are very frail, or who have poor balance, are probably better off taking the elevator, Horwich said.
But Steinbaum said people shouldn’t assume they can’t climb stairs just because they’ve reached a certain age. “Don’t rule people out for being ‘old,’” Steinbaum said. “My parents are in their 80s, and my dad still competes in barefoot waterskiing, and my mom walks miles every day. The more we move, the longer we can move in life.”
By: Liz Szabo, AARP
Liz Szabo is an award-winning health writer based in Washington and previously worked at USA TODAY and KFF Health News.