A Step Up to Health: The Power of Stairs

By Anya Higashionna and Jonanne Talebloo

With the increasing automation of the world around us, Levi Frehlich MSc PhD ©,  emphasizes, “We are learning more and more that a sedentary behavior independent of your activity levels can have a profound influence on your health. The environment can be used to break up sedentary behavior and utilizing stairs can be a “great first step.”

How many times a week are you faced with the decision: stairs or elevator? What goes through your head and influences your decision? Maybe you are trying to weigh out the benefits of being healthy versus “saving time” with an elevator. One counter to think about is walking up an escalator – a third option that is both faster and healthier! The contents of this post may change the way you think during this practically daily decision we are expected to make.

Furthermore, it is essential to understand that this question may be more important than we initially perceived. With heart disease being the most expensive medical condition and the leading cause of death, and hypertension being the most prevalent chronic condition, we should look to prioritize ways to prevent them. Luckily, one action can lower the risk of all of these chronic conditions and many others. A recent paper published in 2023 titled “Daily stair climbing, disease susceptibility, and risk of atherosclerotic cardiovascular disease: a prospective cohort study,” Song et al. found climbing more than five flights of stairs daily was associated with a lower risk of atherosclerotic cardiovascular disease (ASCVD) independent of disease susceptibility. Overall, it is safe to say that the question: stairs or elevator, has the potential to have more of an impact in our lives than we may originally think. 

Song and colleague’s research was a prospective study using data from almost 500,000 (458,860 to be exact) adult participants in the United Kingdom. A prospective cohort means that the subjects are followed to observe future outcomes. Baseline data for stair climbing, sociodemographic (e.g., age, sex, ethnicity, education, average annual household income), and lifestyle (e.g., smoking status, physical activity, alcohol intake, and dietary pattern) factors were collected. Five years after baseline, this data was recollected with a median of 12.5 years of follow-up. Individuals were followed until the occurrence of the ASCVD incident, loss to follow-up, or death. The follow-up measured stair climbing and incidence of ASCVD, coronary artery disease, or ischemic stroke. ASCVD was considered to include coronary artery disease, ischemic stroke, or acute complications. To account for the role of individual disease susceptibility, the following were analyzed: levels of genetic risk score, 10-year risk of atherosclerotic cardiovascular disease, and self-reported family history of atherosclerotic cardiovascular disease.

What story did the data share? Among populations with varying susceptibilities, the cohort “demonstrated that climbing more than five flights of stairs daily was associated with over a 20% lower risk of ASCVD”. Participants who reported starting to stair climb at baseline but stopping stair climbing (meaning stair climbing less than 5 times a day) at the second examination had an observed higher risk of ASCVD. However, it is important to note that the behavior exhibited by these participants may actually be due to comorbidities or other risk factors that compelled them to reduce stair climbing. Therefore, interpretations of this data should factor in risk effect as a potential factor in the reduction in physical activity. Nonetheless, the data indicates that those who stopped stair climbing midway through actually showed worse results than those who hadn’t started stair climbing. This may show that consistently performing these smaller acts daily is more important than overexerting yourself for one day a week. 

There are certainly more ways to integrate more daily movement without the use of stairs. Researchers from Icahn School of Medicine at Mount Sinai, New York, recently published a paper titled, “New principles, the benefits, and practices for fostering a physically active lifestyle” where they elucidated how ‘every minute counts’ for lifestyle movements and ‘going from nothing to something is the biggest bang for your buck’ in reference to Albert Bandura’s findings published in a 1977 paper on “Self-Efficacy”. This is important to remember as the biggest threshold isn’t going from 5 minutes of exercise to 30 minutes, but rather 0 minutes to 5 minutes. An effective way to confront these challenges is to think of SMART (Specific, Measureable, Achievable, Relevant, and Time-bound) goals. SMART goals are related to the concept of self-efficacy (REF) which states that “individuals are more likely to pursue goals if they think they can accomplish them.” Since goals that are viewed as easily attainable are more likely to be accomplished, SMART goals can help guide one to create these ideal goals that will get the ball rolling. The moment you decide to increase physical activity in your life, think SMART. A SMART goal you can have for introducing stair climbing into your life would be, “I will climb at least 2 flights of stairs a day for 1 month to improve my cardiovascular health”. You can even practice this by creating a SMART goal for when you want to start implementing the exercise practices stated in this article!

Whether you decide to start today or in a couple weeks, with or without stairs, it is important to remember the research goals to emphasize the simplicity of the activity and time efficient nature of stair climbing detours. People at all stages of life benefit from less sedentary lifestyles, but implementing healthy habits early on further increases the benefits of non sedentary lifestyle practices. Some similar practical ways to increase the amount of steps taken in your life include activities from simply parking further away from your destination to even dancing whenever you hear music you enjoy. As a college student, I like to walk the longer scenic route between classes or even do smaller things like walk to the next bus stop instead of catching the one I am closest to. The first step (pun intended), no matter how small, can pave the way to a healthier, more active life. So, when you first encounter the decision of choosing the escalator or stairs, consider it not just a choice in the moment but as an investment in your long term well being.