Wellness
4 Core factors to avoid a heart health syndrome
To avoid CKM syndrome, health experts suggest paying close attention to four of the American Heart Association’s Life’s Essential 8 – blood pressure, lipids, body weight and blood sugar level – which are core health factors that impact your metabolic health.

In the U.S., 1 in 3 adults is at risk for a newly recognized syndrome that comes from a combination of heart disease, kidney disease, type 2 diabetes and excess body weight. This cluster of conditions, called cardiovascular-kidney-metabolic (CKM) syndrome, is an example of how problems in one part of your body can affect other parts.
To avoid CKM syndrome, health experts suggest paying close attention to four of the American Heart Association’s Life’s Essential 8 – blood pressure, lipids, body weight and blood sugar level – which are core health factors that impact your metabolic health.
Good metabolic health means your body uses energy well and keeps these factors in a normal range. However, when numbers are off in one area, it can affect others, raising your risk for heart disease, stroke, kidney disease and diabetes.
Consider these tips from the American Heart Association to help keep your core health factors under control.
Blood Pressure
High blood pressure, also known as hypertension, happens when the force of your blood pushing against the walls of your blood vessels is too high. High blood pressure is a leading cause of heart disease, stroke and kidney disease.
Because high blood pressure doesn’t have symptoms, the only way to know you have it is to get your blood pressure checked. Healthy blood pressure is below 120/80. If your blood pressure is 130/80 or higher, talk to your doctor about checking your other core health factors.
Lifestyle changes can help reduce high blood pressure. One example is a Dietary Approaches to Stop Hypertension (DASH) eating pattern that’s low in fat and rich in fruits, vegetables, whole grains and low-fat dairy products. Losing 10 pounds and reducing alcohol consumption can also reduce blood pressure.
Cholesterol
Cholesterol is a waxy substance your liver makes then circulates in the blood where your body uses it to build cells and make vitamins and hormones. You may also get cholesterol from eating animal products. If there’s too much cholesterol circulating, your risk of type 2 diabetes, heart disease and stroke may increase.
For optimal CKM health, your LDL cholesterol should be below 100 and triglycerides below 150. Triglycerides are the most common type of fat in the body. If your triglyceride level is 135 or higher, talk to your doctor about decreasing your risk.
Losing body weight and increasing physical activity decrease triglyceride levels. In addition, DASH and Mediterranean (plant-based, high-fiber, low-fat) eating patterns support healthy LDL and triglyceride levels.
Body Weight
Healthy weight may be determined by body mass index (BMI), a number that represents your weight in relation to your height. Extra body fat can mean a higher risk for many health problems, including heart disease, stroke, high blood pressure, high cholesterol and diabetes.
CKM syndrome starts when BMI is 25 or higher and waist circumference is 88 centimeters or higher for women and 102 centimeters or higher for men. Aim for a BMI between 18.5-25.
To lose weight and keep it off, start by setting realistic goals. Understand how much and why you eat, manage portion sizes, make smart snack substitutions and be physically active.
Blood Sugar
High blood sugar can slowly damage the kidneys. In fact, diabetes is the leading cause of kidney disease, and it increases the risk of heart attack and stroke.
Blood sugar is measured in two ways: a fasting blood glucose test (short term blood sugar) and an A1C test (long term blood sugar control). A normal fasting blood glucose level is 70-99 and a normal A1C level is below 5.7%. Fasting blood glucose above 125 and A1C of 6.5% or higher means you have diabetes.
Habits that help you avoid high blood pressure, weight gain and high cholesterol also keep your blood sugar in check. These are especially important if you have a family history of diabetes.
Learn more about CKM syndrome and how to manage your risk at heart.org/CKMhealth.
Wellness
Walking further and faster linked to reduced risk of heart attacks, heart failure, stroke in people with high blood pressure
Compared to a daily step count of 2,300 steps, every extra 1,000 steps was linked to a 17% reduction in the risk of developing a major adverse cardiovascular event (MACE), up to 10,000 steps. Additional steps above 10,000 were associated with a lower risk of stroke.

Analysis of over 36,000 people with high blood pressure has shown that taking more steps, even below the recommended daily target of 10,000 steps, and walking faster, is associated with a significant reduction in the risk of major problems of the heart and blood vessels.
The study, published in the European Journal of Preventive Cardiology, found that compared to a daily step count of 2,300 steps, every extra 1,000 steps was linked to a 17% reduction in the risk of developing a major adverse cardiovascular event (MACE), up to 10,000 steps. Additional steps above 10,000 were associated with a lower risk of stroke.
Approximately 1.28 billion people worldwide are living with high blood pressure, and it places them at increased risk of heart disease (49% increase), stroke (62% increase) and heart failure (77-89% increase). Until now, it has been unclear how much people with high blood pressure need to increase their physical activity in order to see a reduction in their risk of MACE.
Professor Emmanuel Stamatakis, Director of the Mackenzie Wearables Research Hub at the University of Sydney, Australia, who supervised the study, said: “This study is one of the first to demonstrate a dose-response relationship between daily step count and major problems of the heart and blood vessels. In a nutshell, we found that, if you live with high blood pressure, the more you walk with greater intensity, the lower your risk for future serious cardiovascular events.
“These findings support the message that any amount of physical activity is beneficial, even below the widely recommended daily target of 10,000 steps.”
The study analysed data obtained from 32,192 people who had enrolled in a sub-study of the UK Biobank study. They had been diagnosed with high blood pressure and agreed to wear an accelerometer on their wrist for seven consecutive days to measure how far and how fast they walked. Data from the accelerometers was collected between 2013 and 2015. The average age was 64 and the participants were followed up for nearly eight years, providing the researchers with data for 283,001 person-years. During this time 1,935 cases of heart problems or stroke occurred.
In addition to a 17% reduction in overall risk for every extra 1,000 steps a day, the researchers found a 22% reduction in heart failure, 9% reduction in risk of heart attack, and 24% reduction in risk of stroke. This means that every increase of 1,000 steps a day was associated with:
- an average reduction in the absolute risk of MACE of 31.5 events per 10,000 person-years
- an average reduction in the absolute risk of 7.2 heart failure events per 10,000 person-years
- an average reduction in the absolute risk of 9.9 myocardial infarctions (heart attacks) per 10,000 person-years
- an average reduction in the absolute risk of 10.4 strokes per 10,000 person-years.
The average (mean) intensity of the 30 minutes of fastest walking per day was 80 steps a minute and this was associated with a 30% reduced risk of MACE. There was no evidence of harm in people whose 30 minutes of fastest walking or running was over 130 steps a minute.
The researchers found similar results when they looked at 37,350 people without high blood pressure. Every 1,000-step increase in daily step count led to an average lower risk of MACE, heart failure, myocardial infarctions and stroke of 20.2%, 23.2%, 17.9%, and 24.6%, respectively.
Prof. Stamatakis said: “Our findings offer patients accessible and measurable targets for heart health, even below 10,000 steps daily. Clinicians should promote physical activity as standard care, especially in patients with high blood pressure. Our results can inform new, tailored public health recommendations for these patients. Future recommendations on walking in people with high blood pressure could consider promoting higher stepping intensity.”
Strengths of the study include the large number of patients, the use of accelerometers to provide detailed information on numbers of steps and speed, and the use of data from national records in England, Wales and Scotland on deaths and causes of death.
Limitations include the fact that physical activity was measured only when people first joined the study and did not include any subsequent changes in behaviour. In addition, the researchers point out that their findings can show only that there is an association between walking further and faster and better health outcomes, not that it causes these better outcomes. However, they conducted extensive analyses to minimise the risk of what is called ‘reverse causation’ (in which, in this case, health problems could be causing both a reduction in physical activity and an increase in heart disease events). Most UK Biobank participants are White, are less likely to be obese, to smoke or drink alcohol, and to be better educated, and so they may not be representative of the general UK population.
Wellness
Rethink the 10,000 a day step goal, study suggests
For those who cannot yet achieve 7000 steps a day, even small increases in step counts, such as increasing from 2000 to 4000 steps a day, are associated with significant health gain.

A major new study led by the University of Sydney suggests that walking 7000 steps a day offers similar health benefits across several outcomes as walking 10,000.
Led by Professor Melody Ding from the School of Public Health, the study was published in The Lancet Public Healthand analysed data from 57 studies from 2014 to 2025 that were conducted in more than ten countries including Australia, USA, UK and Japan.
The largest and most comprehensive review to date, the researchers examined the impact that different daily step counts have on the chance of dying from cardiovascular disease and cancer, and developing diseases such as cancer, type 2 diabetes, dementia and depression. Professor Melody Ding says the findings offer a more achievable benchmark for people who struggle to meet traditional exercise guidelines.
“Aiming for 7000 steps is a realistic goal based on our findings, which assessed health outcomes in a range of areas that hadn’t been looked at before,” said Professor Ding. “However, for those who cannot yet achieve 7000 steps a day, even small increases in step counts, such as increasing from 2000 to 4000 steps a day, are associated with significant health gain.”
“We know daily step count is linked to living longer, but we now also have evidence that walking at least 7000 steps a day can significantly improve eight major health outcomes – including reducing risk of cardiovascular disease, dementia and depressive symptoms.”
Health benefits at different step counts
The researchers looked at studies in which participants wore step counting devices, such as pedometers, accelerometers and fitness trackers, to track their daily step counts. Starting at 2000 steps, experts compared the health outcomes of people walking more steps a day at 1000 step increments to see whether there was any difference in the risk of early death or other major diseases.
When compared with 2000 steps a day, researchers found that:
- Walking 7000 steps a day reduced the risk of death by 47 percent, which was almost identical to the benefit seen at walking 10,000 steps per day.
- Dementia risk dropped by 38 percent from walking 7000 steps a day, with only a 7 percent extra reduction at 10,000 steps.
- Risk of type 2 diabetes fell by 22 percent from walking 10,000 steps a day and reduced to 27 percent at 12,000 steps.
- Significant health improvements were seen when people increased their average daily steps from 2000 to between 5000 and 7000 steps.
“For people who are already active, 10,000 steps a day is great,” said Dr Katherine Owen, co-author and chief analyst of the study from the School of Public Health. “But beyond 7000 steps, the extra benefits for most of the health outcomes we looked at were modest.”
“Our research helps to shift the focus from perfection to progress. Even small increases in daily movement can lead to meaningful health improvements,” said Professor Ding.
Experts are calling for future studies to explore how step goals should vary based on age, health status and region, and to include diverse populations and longer-term data to strengthen the evidence. Professor Ding says this kind of detail is rare and will be useful for health practitioners when tailoring advice for patients.
Wellness
Exercise eases depression and anxiety in kids
When children took part in structured exercise programs, their symptoms of depression and anxiety improved.

With more than three-quarters of children and teens experiencing depression or anxiety, parents are desperate for effective solutions. Now, new research from the University of South Australia shows that something as simple as regular exercise could be a powerful intervention to support young people’s mental health.
In the largest meta-meta-analysis of 375 clinical trials involving more than 38,000 young people, UniSA researchers found that when children took part in structured exercise programs, their symptoms of depression and anxiety improved. Specifically, the study found that:
- Anxiety improved most through low-intensity, resistance exercises, such as light weights or gentle circuit activities.
- Depression improved most through moderate-intensity, mixed-mode and resistance training, including circuits that combine aerobic and strength programs, particularly in programs lasting less than three months.
The biggest improvements in depression symptoms occurred in programs lasting fewer than 12 weeks, suggesting that benefits can emerge relatively quickly – especially for children aged 12 and over.
No significant differences were seen among the frequency of exercise sessions per week.
Children with depression and ADHD also showed the greatest improvements from exercise.
Lead researcher, UniSA’s Dr Ben Singh says the findings present parents with a non-invasive, low-cost solution to combat poor mental health in kids.
“Depression and anxiety are among the most prevalent mental health issues affecting children and
teenagers worldwide,” Dr Ben Singh says.
“Evidence-based treatment guidelines often recommend cognitive behaviour therapy and antidepressants as first-line interventions, yet 40-60% of children don’t receive treatment or fail to gain sufficient benefits, so we clearly need alternatives.
“Exercise is a low-cost, widely accessible strategy that could make a real difference to children’s mental health. And while people know that exercise is generally good for your health and wellbeing, there is little evidence that shows how exercise works for kids nor the types of exercise that might work better than others.
“Our study draws together global evidence to show that gentle, light-intensity exercise is highly effective in reducing anxiety in children and teens, while medium-intensity programs that combine resistance and aerobic training – like circuits with weights – can counteract depression.
“Importantly, it demonstrates how exercise is an effective, accessible, lifestyle intervention that can immediately improve mental health issues in children, without first defaulting to medicines.”
Senior researcher, UniSA’s Prof Carol Maher says the findings reiterate the importance of exercise for mental health.
“Exercise should be a core part of mental health care for children and teens, whether at school, in the community, or clinical settings,” Prof Maher says.
“Short, structured programs that include strength training or a mix of activities seem especially promising, but simply exercising, even for short amounts of time will deliver benefits.
“And for parents, rest assured – you certainly don’t need to fork out money for a gym membership or training program; play-based activities, games, and sport are all valuable forms of movement that can support mental wellbeing.
“The key message is simple: get active and keep active. Even short bursts of movement can make a real difference to a child’s mental health and wellbeing – especially for those who are struggling”.
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