Every step counts, but a few minutes of intense exercise a day can save lives

The evidence accumulated over the past decades on the health benefits of physical activity and exercise is overwhelming, with consistent findings from large prospective cohorts, meta-analyses and international guideline documents demonstrating robust reductions in all-cause mortality and major non-communicable diseases.

More recently, the availability of device-measured physical activity data — the type of data we can get from smartwatches and pedometers, for example — has refined these associations, confirming nonlinear dose-response relationships and demonstrating that even small increases in moderate-to-vigorous physical activity (MVPA) among the least active individuals are associated with meaningful health impact and reductions in mortality risk.

A recent study published in The Lancet contributes importantly to this direction by estimating the population-level mortality benefits of modest increases in MVPA and reductions in sedentary time. Its headline message — that even a five-minute-per-day increase in physical activity could prevent a meaningful proportion of deaths — has clear public health appeal. However, careful interpretation is needed so we don’t oversimplify the mechanisms — both physiological and behavioural — that drive them.

The study is robust, methodologically sound and highly relevant for public health policy. Yet, its findings must be read with appropriate nuance. Specifically, three elements require particular attention:

A correct understanding of these factors allows for a balanced message: every step counts, especially for sedentary individuals, but structured exercise remains the most effective strategy for reducing mortality risk and improving long-term health outcomes.

A key element in interpreting these findings concerns the intensity and quality of physical activity. The evidence underlying mortality reduction is primarily linked to MVPA, rather than low-intensity or incidental movement. Activities such as brisk walking, cycling or jogging generate sufficient physiological stimulus to activate central mechanisms, including developing new mitochondria (the cells’ engines), improving cardiorespiratory fitness, enhancing fat oxidation, and improving blood sugar regulation.

This distinction is essential to avoid misinterpretation: not all movement produces the same biological effects, health benefits or reductions in mortality risk. Reducing sedentary time and increasing light activity is beneficial, but the greatest health gains are linked to activity performed at sufficient intensity and accumulated progressively over time. For individuals starting from very low baseline levels, even small increases in MVPA can yield disproportionate benefits. However, these relative gains should not be taken to mean that minimal activity is sufficient in absolute terms. Rather, they underscore the importance of progressing from inactivity towards more structured and sustained exercise habits.

Exercise differs from general physical activity in that it is planned, structured and goal-oriented, specifically designed to improve physical function and health. This distinction is not semantic but physiological. Aerobic exercise improves cardiovascular and metabolic efficiency, while resistance training preserves and enhances muscle mass, metabolic health and functional capacity. Their combination is consistently linked to the most robust and lasting health outcomes, including improved body composition, metabolic control and resilience to age-related decline. These adaptations are difficult to achieve through low-intensity activity alone.

Importantly, recent data-driven approaches to health promotion are helping translate these principles into practice. Integrated ecosystems that combine assessment, personalization and continuous engagement can support tailored exercise programmes based on individual profiles, helping people progress from generic activity to more precise and effective interventions.

One example of this is the AI-driven assessment station Technogym Checkup, which evaluates physical and functional parameters, and translate them into individualized exercise prescriptions. By combining connected equipment, data tracking and tailored profiling, these capabilities can be extended beyond initial assessment, enabling continuous monitoring feedback, and adaptation of exercise programmes. In this way, individualized prescriptions are not static, but evolve dynamically with the user’s progress, supporting long-term behaviour change and more effective health outcomes.

A population-level example is the Wellness Valley in Emilia-Romagna, where a multi-stakeholder approach involving institutions, healthcare systems and private sector actors has promoted physical exercise as a cultural and preventive health lever. This initiative shows how structured, community-based strategies can increase activity levels, reduce sedentary behaviour, and contribute to measurable improvements in population health outcomes.

Interventions aimed at the least active segments of the population are likely to yield the greatest absolute benefits. For these individuals, small, achievable increases in MVPA represent a realistic and impactful first step. However, this also means that the magnitude of effect observed in this population cannot be directly extrapolated to already active or athletic populations.

For sedentary individuals, five additional minutes of MVPA may represent a realistic and powerful starting point — a first step towards healthier behaviour patterns. For clinicians and policy-makers, this supports incremental, inclusive messaging that meets people where they are. But we have a responsibility to communicate clearly that small steps are a beginning, not the endpoint. The ultimate goal should remain the promotion of structured, progressive exercise programmes capable of delivering maximal health benefits.

A practical illustration of how these principles can be translated into population-level action is provided by the Wellness Foundation, the non-profit organization founded in 2003 by Nerio Alessandri – Founder and CEO of Technogym – with the aim of promoting a wellness-oriented culture grounded in healthy and active lifestyles.

The Wellness Valley is designed to foster not only higher levels of physical activity, but also a broader cultural shift towards structured exercise, ultimately enhancing the health and quality of life at the population level. Complementing this experience, the Wellness Foundation also develops and supports a range of interventions – including community-based programmes, school and workplace initiatives, and urban planning strategies – aimed at facilitating access to progressively structured and higher-quality physical activity across population groups. This illustrates how effective public health strategies can not only lower the threshold for entry into physical activity but also create enabling environments that support progression towards more structured and health-enhancing exercise behaviours.

The Lancet study compellingly demonstrates that small increases in moderate-to-vigorous physical activity can meaningfully reduce mortality risk, particularly among the least active individuals. Not a drug, not a supplement, not a treatment requiring a highly skilled healthcare professional – just five minutes of moderate-to-vigorous physical activity a day.

Every step does indeed count, and even modest changes can have population-wide implications. However, correct interpretation requires acknowledging that the benefits observed are linked to moderate-to-vigorous intensity, non-zero baseline activity levels, and high-risk populations. Importantly, translating this evidence into sustained population impact requires coordinated, multi-setting strategies that create supportive environments and enable individuals to progressively engage in structured, higher-quality physical activity.

The final message, therefore, should be both inclusive and aspirational: start by moving more — every step matters — but aim to exercise better. To achieve the greatest improvements in longevity and health, individuals should be encouraged to progress towards precision exercise programmes that combine aerobic and resistance training, transforming small behavioural changes into lifelong health investments.