{"id":9031,"date":"2025-10-25T01:14:53","date_gmt":"2025-10-24T22:14:53","guid":{"rendered":"https:\/\/jordan-cardiac.org\/?p=9031"},"modified":"2025-10-25T01:14:53","modified_gmt":"2025-10-24T22:14:53","slug":"daily-step-count-should-be-the-fifth-vital-sign","status":"publish","type":"post","link":"https:\/\/jordan-cardiac.org\/en\/daily-step-count-should-be-the-fifth-vital-sign\/","title":{"rendered":"Daily Step Count Should Be the Fifth Vital Sign"},"content":{"rendered":"
Daily Step Count Should Be the Fifth Vital Sign<\/div>\n
<\/div>\n
Source: Adapted from Medscape Commentary, October 14, 2025.<\/div>\n
Author: Dr. George D. Lundberg, MD<\/div>\n
Former Editor-in-Chief of JAMA, with a regular commentary column under his name on Medscape Commentary.<\/div>\n
<\/div>\n
1. Background<\/div>\n
\u2022 Traditional vital signs: pulse, respiration, temperature, and blood pressure.<\/span><\/div>\n
\u2022 \u201cPain\u201d was once proposed as a fifth vital sign but failed because it\u2019s subjective.<\/span><\/div>\n
\u2022 Dr. Lundberg proposes step count (daily steps) as a new, objective fifth vital sign.<\/span><\/div>\n
<\/div>\n
2. Rationale<\/div>\n
\u2022 \u201cVital\u201d means essential and significant \u2014 daily steps meet that definition.<\/span><\/div>\n
\u2022 With modern wearables (Fitbit, smartwatches), step count is accurate, measurable, and continuous.<\/span><\/div>\n
\u2022 A decline in daily steps can indicate early disease or loss of function.<\/span><\/div>\n
<\/div>\n
3. Physiologic Basis<\/div>\n
Daily steps integrate multiple body systems:<\/div>\n
\u2022 Nervous system (spinal cord, peripheral nerves)<\/span><\/div>\n
\u2022 Musculoskeletal system (bones, joints, tendons, ligaments)<\/span><\/div>\n
\u2022 Cardiovascular system (cardiac output, vessel patency)<\/span><\/div>\n
\u2022 Balance and proprioception (vestibular function)<\/span><\/div>\n
<\/div>\n
Low daily steps can serve as an early warning that something may be wrong.<\/div>\n
<\/div>\n
4. Addressing Objections<\/div>\n
\u2022 Critics say daily steps are voluntary and subjective.<\/span><\/div>\n
\u2022 The author argues this is a strength \u2014 they reflect motivation, stamina, and mental wellbeing.<\/span><\/div>\n
\u2022 Like pulse or blood pressure, step count varies with conditions but remains clinically useful.<\/span><\/div>\n
<\/div>\n
5. A Question to Reflect On<\/div>\n
Before fully adopting daily steps as the \u201cfifth vital sign,\u201d one might pause and ask:<\/div>\n
Could there be a better or complementary alternative?<\/div>\n
<\/div>\n
Some experts point to cardiorespiratory fitness (VO\u2082 max), resting heart rate variability, or even sleep quality metrics as potentially stronger, more comprehensive indicators of physiologic resilience.<\/div>\n
<\/div>\n
This question remains open for debate \u2014 and may inspire clinicians and researchers to rethink what truly defines a \u201cvital sign\u201d in modern medicine.<\/div>\n
Every new idea in medicine begins with a question \u2014 what\u2019s yours?<\/div>\n
<\/div>\n
6. Practical Value<\/div>\n
\u2022 Reference ranges can be set easily from global wearable data.<\/span><\/div>\n
\u2022 Step count provides an integrated indicator of both physical and psychological health.<\/span><\/div>\n
<\/div>\n
7. Personal Insight<\/div>\n
\u2022 Dr. Lundberg (age 92) tracked his daily steps via Fitbit since 2018.<\/span><\/div>\n
\u2022 Fluctuations in his step count closely matched real health changes \u2014 as reliably as other vital signs.<\/span><\/div>\n
<\/div>\n
8. Conclusion<\/div>\n
\u201cStep aside, four vital signs \u2014 make room for number five: step count (daily steps).\u201d<\/div>\n
Simple, inexpensive, and powerful \u2014 a universal marker of vitality and function.<\/div>\n
<\/div>\n
Walking is medicine \u2014 count your steps, protect your life.<\/div>\n
<\/div>\n
https:\/\/www.medscape.com\/viewarticle\/daily-step-count-should-be-fifth-vital-sign-2025a1000r63<\/a><\/div>\n
<\/div>\n","protected":false},"excerpt":{"rendered":"

Daily Step Count Should Be the Fifth Vital Sign Source: Adapted from Medscape Commentary, October 14, 2025. Author: Dr. George D. Lundberg, MD Former Editor-in-Chief of JAMA, with a regular commentary column under his name on Medscape Commentary. 1. Background \u2022 Traditional vital signs: pulse, respiration, temperature, and blood pressure. \u2022 \u201cPain\u201d was once proposed […]<\/p>\n","protected":false},"author":145,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-9031","post","type-post","status-publish","format-standard","hentry","category-uncategorized"],"_links":{"self":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts\/9031","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/users\/145"}],"replies":[{"embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/comments?post=9031"}],"version-history":[{"count":1,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts\/9031\/revisions"}],"predecessor-version":[{"id":9032,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts\/9031\/revisions\/9032"}],"wp:attachment":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/media?parent=9031"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/categories?post=9031"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/tags?post=9031"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}