Walking has a lot of benefits, we already know that. However, how much should one walk? a recent study among older people revealed that if seniors could achieve a 4,000 steps goal in one to two days in a week, they would lower their risk of early deaths by a quarter.

This study was led by Harvard University, and published in the British Journal of Sports Medicine.

What Did the Study Find About Older People's Health And Walking?

We all know that staying active brings great health benefits. In fact, Health and Me also covered how walking and staying active could lower the risk of dementia. Until now, however, it was unclear how much should one walk.

With this recent study, researchers found that achieving 4,000 steps per day on one or two days a week could lower risk of death and lower risk of cardiovascular disease, (CVD), as compared to not reaching this level on any day.

How Was The Study That Analyzed Older People's Walking And Its Impact On Health Conducted?

The study analyzed 13,547 American women, who were over the age of 62, with the average being 72. All of them were given trackers for seven consecutive days, between 2011 and 2015. These people were followed for over a decade. None of them had heart disease or cancer at the beginning of the study.

While they were being monitored in the end of 2024, 1,756 women died and 781 developed heart disease.

The study found that those who clocked up at least 4,000 steps a day on one or two days of the week had 26% lower risk of death from all causes, and a 27% lower risk of dying from heart diseases. This was as compared to those who did not reach this threshold on any day of the week. The study further saw that those who achieved the step count for three days of the week, their lower risk of death from any cause increased by 40%, however for CVD related deaths, it remained at 27%.

Takeaways And Limitations

The researchers said that while the most important take away was that people would now have an amount to walk. However, it is important to note that the study was observational, with no firm conclusion, and was done only on women, and assessed for only one week.

The researchers agreed that there is no "best" way to take your steps. The key is to just ensure that you are getting your steps in. "A greater number of steps, regardless of daily patterns, is associated with better health outcomes." The study saw that on an average, women took 5,615 steps a day.

While there were limitations, but the researchers still added, "An important translational implication of these findings is that since step volume is the important driver of the inverse associations, there is no ‘better’ or ‘best’ pattern to take steps; individuals can undertake [physical activity] in any preferred pattern (eg ‘slow and steady’ v ‘bunched patterns’) for lower mortality and CVD risk, at least among older women. These findings provide additional evidence for considering including step metrics in the next [physical activity] guidelines, and that ‘bunching’ steps is a viable option for health.”

A person's body mass index (BMI) may seem normal while they may already be at a significant metabolic risk. According to experts at the first AIIMS Obesity Summit in New Delhi, which is themed “Decoding Obesity: Biology to Remedy,” this is particularly observed frequently among South Asians.

Addressing the summit on Saturday, AIIMS Director Dr Nikhil Tandon said obesity cannot be understood simply through numbers. He argued that doctors need to look beyond weight and BMI to understand where fat is distributed in the body and how the individual's overall health is affected due to the additional fat.

“People will say, you know, subcutaneous is all right, visceral is bad,” Tandon said, referring to the difference between fat stored under the skin and fat accumulated around internal organs. He said that while measures like waist circumference remain essential, they do not fully capture the complete complexity of obesity.

South Asians Face Higher Metabolic Risk Even At Lower BMI

Tandon spoke about how South Asians can develop metabolic issues at lower BMI levels because of differences in fat distribution in the body. “A lot of people of South Asian descent may not qualify as people who are obese, but because of central disposition of fat, they can have metabolic, maybe metabolically unhealthy at very, very low BMIs,” he said.

He compared the body types and prevalence of lifestyle disorders in South Asians and Pima Indians, mentioning that South Asians showed a substantially higher incidence of diabetes at lower BMI levels. He said that obesity should not be assessed solely by what we see on the weighing scale.

“If at similar numbers, two people have very different health outcomes, then you have to understand the reason for the difference in health outcomes rather than be fixated in the number,” Tandon said.

Also read: Thin Outside, Fat Inside: Why A Slim Body May Still Hide Metabolic Health Risks?

Obesity Does Not Occur Due To Willpower Issue

The summit's discussions also challenged the idea that obesity can be managed by just eating less and exercising more.

Prof Naveet Wig, patron of the summit, shared his own experience of repeatedly gaining and losing weight, explaining that his experience had reinforced the complexity of obesity.

“It is a relapsing disease. It is a relapsing problem. It is a chronic problem,” he said, adding that obesity involves multiple factors including genetics, environment, behaviour, sleep, muscle, adipose tissue, the gut and the brain.

He also cautioned against using medication like GLP-1 as many may turn it into a substitute for comprehensive obesity care. “We can't let drug become a doctor,” Wig said, stressing the importance of nutrition, exercise, sleep and preservation of muscle mass.

He noted that modern obesity care now includes GLP-1 therapies, including oral options, as well as surgical treatments. He questioned whether enough attention is being paid to nutrition, muscle preservation and sleep when these treatments are used.

Also read: Can You Really Lose 5 Kg In A Week With Just 4 Minutes Of Exercise? Japan's Viral Workout Explained

Prevention May Need To Start Much Earlier

Tandon also stressed that obesity prevention cannot begin late in adulthood. He explained that body weight, blood pressure, cholesterol and glucose tend to follow patterns established early in life. Major changes in these trajectories could be due to underlying influences that need to be addressed.

“You don't go to sleep at night with a BMI of 23 and wake up with a BMI of 30,” he said, explaining that obesity as a process that develops over time.

He argued that eating habits, physical activity and other behavioural patterns become established early, making childhood and early-life interventions particularly important.

Ultimately, Tandon said, preventing weight gain in the first place may be easier than trying to reverse obesity later.

“Once you become obese, it's incredibly difficult to lose weight. And once you lose weight, it's incredibly difficult to sustain that weight loss,” he said.

The experts say that obesity treatment should focus not simply on making patients lighter, but on making them healthier by paying attention to metabolic health, fitness, nutrition, muscle mass, sleep and long-term sustainability.

For years, the weighing scale has been one of the simplest ways to assess health. A person with a “normal” Body Mass Index (BMI) is often considered healthy, while being overweight or obese is viewed as the primary warning sign. But what if someone looks slim on the outside and still carries a significant metabolic risk on the inside?

This is where the concept of TOFI—“Thin Outside, Fat Inside” becomes important. TOFI describes individuals who may have a normal BMI or appear lean but carry a higher proportion of visceral fat—fat stored deep inside the abdomen around vital organs. Unlike the visible fat under the skin, visceral fat is metabolically active and can contribute to inflammation, insulin resistance and other metabolic abnormalities.

Research has shown that Asian Indians tend to develop abdominal and visceral fat at lower BMI levels compared with several other ethnic groups. They may also have relatively lower muscle mass. As a result, a person can appear slim, have a seemingly reassuring weight, and yet have an increased risk of metabolic disease.

Why does this matter?

Also read: From Insulin Resistance to Fertility: Understanding the Metabolic Side of PCOS

The important message is that BMI alone does not tell the complete story. BMI measures weight in relation to height, but it does not distinguish between muscle and fat or indicate where fat is stored. That is why measurements such as waist circumference can provide valuable additional information. A larger waist can indicate increased abdominal fat and may signal higher cardiometabolic risk even when BMI falls within the normal range.

Being normal weight does not automatically mean being TOFI. However, people with a sedentary lifestyle, low muscle mass, increasing waist circumference, family history of diabetes, unhealthy dietary patterns, poor sleep or metabolic abnormalities may warrant closer assessment.

Simple health checks such as blood pressure, fasting glucose or HbA1c and lipid profile can provide important clues. Depending on the individual and clinical situation, doctors may also recommend assessment of liver health or body composition.

What can we do?

The solution is not simply to focus on losing kilograms. For a normal-weight person carrying excess visceral fat, the goal should be to improve body composition and metabolic health. Regular physical activity—particularly strength training combined with aerobic exercise—can help build or preserve muscle and improve insulin sensitivity.

A balanced diet rich in vegetables, whole grains, pulses, adequate protein and fibre, while limiting excess refined carbohydrates, sugary foods and ultra-processed foods, is equally important. Adequate sleep, stress management and avoiding prolonged sedentary periods are also essential components of metabolic health.

By Dr Farah Ingale, Director - Internal Medicine & Consultant – Diabetologist, Fortis Hiranandani Hospital, Navi Mumbai

We have always been told that truly sustainable weight loss is a long-term process made up of daily physical activity, healthy eating, and regular sleep. However, a four-minute workout from Japan, which has taken social media by storm, has confidently challenged this idea.

Making an ambitious promise, the makers of the workout claim that one can lose around 5 kg in just one week with the 4-minute workout.

The video, which was reshared on social media, has crossed 3 million views on X, with nearly 60,000 likes, has sparked a debate whether the short routine could really replace a longer gym session.

The virality of the video makes sense. Most of us argue with ourselves everyday, trying to talk ourselves out of going to the gym and spending hours toiling away. But do we realistically need just a few minutes to get in shape?

You don't need dumbbells, gym membership, or any special equipment to do this workout routine. You can apparently do it almost anywhere.

Can You Actually Lose 5 Kg In 7 Days?

Also read: Novak Djokovic’s Health Struggles At US Open: Are The Demands Of Elite Tennis Becoming Too Much?

There is no evidence that four minutes of exercise a day can make someone lose 5 kg of body weight in seven days. The viral claim comes from the makers of the video, rather than a clinical study showing that people following the routine lost 5 kg in a week.

Experts also say that such a drastic amount of weight loss in seven days is not realistically achievable for most people.

Additionally, what appears on the weighing scale can also move up or down because of water retention, food in the digestive system, and other short-term changes. A sudden drop in weight therefore does not necessarily mean that 5 kg of body fat has disappeared.

Losing considerable body fat needs more than just a 'very short workout'. Along with at least 30 minutes of physical activity, one needs a sustained calorie deficit.

The Four Minutes Of Exercise Is Not Completely Useless

Also read: What Is Zone 2 Cardio? The Workout Everyone Is Talking About

Now as the facts are clear, we would be remiss to not appreciate the routine's biggest potential, which is getting inactive people to move, not weight loss.

Four minutes of activity is certainly better than spending those four minutes sitting still. If a short routine like this Japanese workout feels manageable enough to turn it into a daily habit, it can give you a starting point for physical activity, which you can gradually increase.

But one needs to be careful. A short workout routine usually makes your heart work harder. If you experience pain, dizziness, chest discomfort, or an irregular heartbeat, you must stop immediately.

People who are new to exercise or have existing health concerns should speak with a doctor before starting a new routine.

How To Lose Weight Safely?

Rather than trying to take a shortcut and achieve a drastic weight loss in less days, opt for a more sustainable approach is to gradually increase daily movement and combine it with a balanced diet.