People talk about its discovery all over the world. Prof. Banach to scientists: Don’t let your wings be clipped

Aleksandra Zalewska-Stankiewicz, “Wprost”: Professor, do you still spend half the day in front of the computer, answering questions from journalists from all over the world?

Prof. Maciej Banach*: The media frenzy calmed down a bit, but in fact the interest in our study exceeded the expectations of the entire team that worked on this project. It was my first time doing a live interview on the BBC. I am very happy that the work of scientists from Poland has been noticed and is still commented on so widely.

Did you not expect that your discovery would be considered “sensational”?

We presented the results of our analysis last year in Chicago at the American Heart Association (AHA) Congress, which is one of the most important meetings of the cardiology community in the world. The results were already being commented on in the medical community, so we hoped to reach as many patients as possible. However, when our work was published in the “European Journal of Preventive Cardiology” in June this year, a real avalanche started. They wrote about us, among others: “The Washington Post” or “The Guardian”.

Your analysis has shown that 4,000 steps a day is the minimum number of steps a person can use to maintain good health and avoid premature death from any cause. Previously, people talked about 10,000 steps.

Indeed, previously patients often asked us how many steps they should take every day to improve their health. Based on the data we had at the time, we said the minimum number was 6,000 to 10,000 steps. For many people, this information was so discouraging that they did not even take any action. They assumed in advance that they would not find time for it. When they heard that there might be fewer of them, their motivation to move increased.

How many steps do you take a day?

Today I did 9600 of them, but I had a very intense day. However, there are days when my activity is limited to about 6,000 steps, but I make up for it on weekends – then I sometimes walk up to 18-20,000 steps. I would like to emphasize that the results of our study are in no way intended to discourage movement.

So what message should this study send to people around the world?

We say: “Patient, start with 4,000 steps, because thanks to this you reduce the risk of death from cardiovascular diseases by 16 percent, which includes, among others, atherosclerosis, hypertension, coronary heart disease, stroke or heart failure. But be consistent and more and more active. Each increase in steps by 500-1,000 steps per day reduces the risk of death by 7 to 15 percent, as the more the better. And if you take more steps, between 6-13 thousand, that’s even better, because then we can observe the greatest health benefits. So the original, earlier message about about 10,000 steps a day was not incorrect, it is simply the optimal value, not the minimum.

Why did your team take up this topic?

Three factors determined this. I have already mentioned the first one. We were often unable to explain to patients exactly how long their training should last and properly encourage them to do it. Additionally, there was a lot of confusion about how many of these steps were needed to achieve a health-relevant effect. There was talk of 10,000 steps, but this number was related to a marketing gimmick referring to the Japanese marketing campaign from the 1960s, when one of the companies designed the world’s first pedometer for the Olympic Games in Tokyo. In addition, we have noticed that most people use smartwatches or other tools to monitor their activity and health, which can measure our physical activity results in a very simple but accurate way.

It is said that you have made the world’s largest analysis in this area. How did it go?

We used the method of meta-analysis and systematic review, based on 17 cohort, i.e. observational, studies. The material was extensive and concerned almost 230,000 patients. We were aware that previous analyzes had certain limitations, were much smaller, and even those published in The Lancet were based on results from unpublished studies. Additionally, what distinguished our analysis was that it was based on a relatively homogeneous population of healthy people.

Are there healthy people?

There aren’t. Therefore, we allowed for the element of risk in the form of overweight or obesity, but eliminated other risk factors that could potentially shorten life. Therefore, we did not take into account, among others: patients with diagnosed cardiovascular disease, hypertension, cancer, or struggling with chronic liver disease and other chronic diseases.

Why do you think this topic has attracted so much interest around the world?

For several years, there has been a certain fashion for physical exercise. And I’m very happy about it, especially since the diet we currently use is worse than the one from 30 or 40 years ago. As a consequence, 60-70 percent of people in Poland are bold or obese. Fortunately, more and more patients realize that it is dangerous and are starting to be active. When I was the director of the Institute of the Polish Mother’s Health Center in Łódź, we organized runs that attracted great interest. People who have certain physical limitations also exercise, and walking can be a great alternative for them.

How large a group of scientists worked with you on this project?

11 people were directly involved and worked hard for a year and a half – experts from some of the largest research groups in the world in preventive cardiology. I founded the first one, dealing with the preparation of meta-analyses, in 2012, and the second one, the International Panel of Lipid Experts, three years later. Both employ almost 200 people from all over the world.

Is it difficult to convince doctors to do research today?

Today, young doctors are thinking about specializing as soon as possible after graduation and finding a good job. And there’s nothing strange about it. They often undertake professional activities in several places to earn money for themselves and their families. The result is that scientific work in Poland is now carried out either by people pursuing PhDs and post-doctoral degrees, or by enthusiasts. And we must always identify such people and motivate them to do scientific work as part of good mentoring, which is still too rare in Poland. I am an example of a person for whom science is a great passion. This was the case even when I was deputy minister of science and higher education or when I headed the Polish Mother’s Health Center. I believe that if you catch the science bug, it stays with you for life. Although some situations can discourage you from taking action.

For example, what kind?

An obstacle is certainly the fact that in Poland there is no established career path for people who want to pursue scientific work. They are not offered benefits. Moreover, scientific work involves many disappointments that we must prepare for. Grants are sometimes applied for 4-5 times. The publication of our work was also not easy. We sent it to the best medical journals in the world and unfortunately some of them rejected it. But that’s what success is all about – you have to constantly try, fail many times, to finally know how to use it properly and achieve your goals.

What advice do you have for young scientists and their older colleagues?

To the latter, not to miss people with the science bug and help them develop, not be afraid that they can be better and learn from them. I believe that mentoring schools should be established in Poland – they function very well in other countries. Young people should be supported by scientific centers and societies. We would certainly benefit from more government support for grant implementation. And I will tell doctors whose wings are being clipped to do their job, draw conclusions and move forward. Not everyone will wish them well, on the contrary – I have experienced it many times as one of the youngest professors in Poland. But such is life, one might say “unfortunately”. But if it had discouraged me, we wouldn’t be talking about our breakthrough discovery today.

* Prof. Maciej Banach – he served as Undersecretary of State at the Ministry of Science and Higher Education in 2010-2012, and in 2014-2021 he was the director of the Institute of the Polish Mother’s Health Center in Łódź. He is the head of the Department of Preventive Cardiology and Lipidology of the Medical University of Lodz and the Head of the Heart and Vascular Research Center at the University of Zielona Góra and an adjunct professor at the Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore USA – 3rd best hospital in the world according to the Newsweek ranking 2023. He is the secretary general of the European Atherosclerosis Society and the president of the Polish Lipidological Society. He also serves as chairman of the Lipid and Blood Pressure Meta-analysis Collaboration Group, as well as the International Lipid Expert Panel. He is the founder and president of the foundation – Think-Tank “Innovation for health”. Winner of many awards, including: 5 Honorary Doctorates: University of Zagreb (2022), University of Kosice (2020), University of Bucharest (2019), Victor Babes University of Medicine and Pharmacy in Timisoara (2017) and Institute of Cardiology in Kiev ( 2018).