How fast is fast enough? Walking cadence (steps/min) as a practical estimate of intensity in adults: a narrative review

<jats:sec><jats:title>Background</jats:title><jats:p>Cadence (steps/min) may be a reasonable proxy-indicator of ambulatory intensity. A summary of current evidence is needed for cadence-based metrics supporting benchmark (standard or point of reference) and threshold (minimums associated with desired outcomes) values that are informed by a systematic process.</jats:p></jats:sec><jats:sec><jats:title>Objective</jats:title><jats:p>To review how fast, in terms of cadence, is enough, with reference to crafting public health recommendations in adults.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>A comprehensive search strategy was conducted to identify relevant studies focused on walking cadence and intensity for adults. Identified studies (n=38) included controlled (n=11), free-living observational (n=18) and intervention (n=9) designs.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>There was a strong relationship between cadence (as measured by direct observation and objective assessments) and intensity (indirect calorimetry). Despite acknowledged interindividual variability, ≥100 steps/min is a consistent heuristic (e.g, evidence-based, rounded) value associated with absolutely defined moderate intensity (3 metabolic equivalents (METs)). Epidemiological studies report notably low mean daily cadences (ie, 7.7 steps/min), shaped primarily by the very large proportion of time (13.5 hours/day) spent between zero and purposeful cadences (<60 steps/min) at the population level. Published values for peak 1-min and 30-min cadences in healthy free-living adults are >100 and >70 steps/min, respectively. Peak cadence indicators are negatively associated with increased age and body mass index. Identified intervention studies used cadence to either prescribe and/or quantify ambulatory intensity but the evidence is best described as preliminary.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>A cadence value of ≥100 steps/min in adults appears to be a consistent and reasonable heuristic answer to ’How fast is fast enough?' during sustained and rhythmic ambulatory behaviour.</jats:p></jats:sec><jats:sec><jats:title>Trial registration number</jats:title><jats:p><jats:ext-link xmlns:xlink="http://www.w3.org/1999/xlink" xlink:href="NCT02650258" ext-link-type="clintrialgov">NCT02650258</jats:ext-link></jats:p></jats:sec>