Climbing Stairs

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AtmasvasthBhavin Jankharia

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Earlier this month, Andrea Raisi and colleagues [1] published an article on stairs climbing and the risk of major chronic diseases, using data from the UK Biobank. Of the 442,027 people with data on stairs climbing, they found that those who climbed 15 flights of stairs (10 steps per stair) per day or more had a significant reduction in all-cause mortality as well as the incidence of multiple diseases such as heart failure, dementia and type 2 diabetes, compared to those who did not climb stairs. 

Another study also mined the UK Biobank data to show that stairs climbing reduced the risk of type 2 diabetes in people with both low and high genetic risk of diabetes [2].

Yet another prospective study using data from the Harvard Alumni Health Study [3] found that climbing between 10-19 floors per week (1 1/2 to 2 3/4 floors per day) (1 floor = 2 flights or around 20 steps) reduced all-cause mortality, compared to those who didn’t. 

Hence, the popular adage, “take the stairs instead of the lift”.

Which is all very well…the challenge of course is finding the stairs to climb and/or finding the motivation to climb stairs, if they exist. 

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In Matunga where I live, most buildings are still ground plus 2 or 3 floors and many of us who live on the 2^nd or 3^rd floor (3^rd or 4^th floor American) have no choice but to climb up 2-3 floors, i.e. 4-6 flights at least 2-3 times a day. (I climb up at least 3 times a day, if not more, which means I am meeting the lower limit of 6 flights per day mentioned in Andrea Raisi’s study as well as the lower limit of 10 floors per week, mentioned in the Harvard Alumni Study, by compulsion). My 87-years old father also climbs half this number every day. However, slowly and surely, all these buildings are disappearing, replaced by high-rises with lifts, which means that unless you are specifically motivated to climb stairs, there is no compulsion to do so anymore. The advantage of living on the 3^rd floor of a non-lift building is that whether you like it or not, you get a certain amount of exercise each day, an advantage that disappears once you no longer live in buildings that necessitate climbing stairs. 

This was beautifully brought out in a study by Morris and colleagues [4] way back in 1953, 70 years ago, who showed a 90% less incidence of early mortality from coronary artery disease in bus conductors as compared to bus drivers. Since London had double decker buses, conductors had to keep climbing up and down multiple times a day out of compulsion, as part of their job, compared to the bus drivers, who were sedentary. This study could have been replicated in Mumbai, but then we are like that only…little and poor research if at all. 

Earlier this year, in the piece titled “Every Move Counts”, I wrote,

The last and most interesting paper of this piece is the one by Emmanuel Stamatakis and colleagues [5] on vigorous intermittent lifestyle physical activity (VILPA), research made possible because of the availability of activity trackers/accelerometers. VILPA was measured in non-exercisers - these are activities that involve a sudden vigorous burst of walking or running or climbing stairs for up to 2 minutes as part of daily activities and not as part of a structured exercise or PA program. They found that a median of 4.4 minutes of VILPA was associated with a 26-30% reduction in all-cause and cancer mortality and a 32-34% reduction in cardiovascular disease mortality. 

I ended with a set of instructions, the 4^th one being,

4. Add bursts of vigorous physical activity to your daily routine, perhaps the easiest being a brisk walk wherever you are walking to go somewhere or climbing stairs, for at least 2 minutes, twice a day.

The postulate is that these short bursts of increased activity when climbing stairs (slowly or quickly), improve multiple health parameters that both, reduce the incidence of disease and improve lifespan. 

So what does this mean for you and I?

If you are already running or cycling and/or strength training or walking more than 45 minutes a day briskly, it is unlikely that stairs climbing will make any significant additional difference. However, if you are not particularly physically active or lack the time but do indulge in bouts of short MVPA or VPA, then taking the stairs a few times a day or week will make a difference. 

The saying, “take the stairs instead of the lift”, is true. The question is to find the stairs and if you do, then the motivation to climb them.

Footnotes

1. Raisi A et al. Association of stair use with risk of major chronic diseases. Am J Prev Med. 2023 Oct 7:S0749-3797(23)00405-1. 

2. Wu Y et al. Stair climbing, genetic predisposition, and the risk of incident type 2 diabetes: A large population-based prospective cohort study. J Sport Health Sci. 2023 Mar;12(2):158-166. 

3. Rey-Lopez JP et al. Associations of self-reported stair climbing with all-cause and cardiovascular mortality: The Harvard Alumni Health Study. Prev Med Rep. 2019 Jun 28;15:100938. 

4. Morris JN et al. Coronary heart-disease and physical activity of work. Lancet. 1953 Nov 28;262(6796):1111-20

5. Stamatakis E et al. Association of wearable device-measured vigorous intermittent lifestyle physical activity with mortality. Nat Med. 2022 Dec;28(12):2521-2529.