Step Up to Better Health: The Case for Taking the Stairs

7 min read

May 28, 2024 – Stair climbing has long been touted as a feasible, free way to increase physical activity. After all, it’s accessible for a wide range of abilities and ages, and you can reap the benefit without changing into gym clothes or even leaving your home – if your house or apartment building has stairs. The activity even gave rise to a fitness fad in the 1980s, when the StairMaster skyrocketed to popularity. (Leave it to humans to invent a machine to simulate what’s already in virtually every building.) 

But this isn’t rooted in common sense alone. Evidence is piling up that the simple act of climbing stairs – and not even that many stairs – can significantly improve your heart health and longevity. 

The latest is an analysis of nine studies that followed nearly half a million people and found that climbing stairs is linked to a 24% lower risk of early death from any cause, and a 39% lower likelihood of death from cardiovascular disease, which includes heart attacks, heart failure, and strokes. The findings, which have not been published yet, were presented at the European Society of Cardiology’s Preventive Cardiology 2024 conference in April. Other research has linked regular stair climbing with a lower risk of metabolic syndrome (a term referring to several conditions that raise your chance of heart disease, stroke, and diabetes), improved fitness of the heart and blood vessels, and lower body weight.

Stair climbing “targets both the cardiovascular and respiratory systems,” said Vasiliki Tsampasian, MD, PhD, co-author of the new study and a clinical research fellow at the University of East Anglia in the U.K. 

Of course, climbing stairs also burns calories – up to four times as many as walking, said another co-author of the study, Vassilios Vassiliou, MD, PhD, a clinical professor of cardiac medicine at the University of East Anglia. A 170-pound man could burn well over 500 calories in an hour, while a 140-pound woman might torch 450-plus, according to the Compendium of Physical Activities, a tool developed by researchers to create a standard way to show how exercise and other movement affect the body.

The best part: You don't have to do this for an hour. 

How Many Stairs Are We Talking About?

The researchers admit it was hard to quantify how much climbing is needed to see health benefits. Those nine studies varied in how many stairs people climbed, and how fast. “But what could be seen is that the more stair climbing that was done, the better, independently of other physical activity,” said Vassiliou.

Up to a point, that is. One of the studies suggested that when subjects climbed six flights of stairs daily (about 60 steps), the benefits plateaued. 

“So, for the purposes of exercise prescription,” said Vassiliou, “reaching six flights daily would reduce overall and cardiac mortality.” (That number aligns with findings from a large observational study published last year that linked five-plus flights of daily stair climbing with a lower risk of atherosclerosis, the buildup of fats, cholesterol, and other substances in and on the artery walls.) 

It might help to think of taking the stairs not as exercise but as a lifestyle tweak.

If you’re used to taking the elevator, Vassiliou said, start taking one to two flights of stairs every day. Build from there. “Any stair climbing is better than no stair climbing,” he said. At six flights, “it would seem that they will get all the benefit from stair climbing,” at least as far as disease prevention goes.

You don’t have to take all the flights at once. You don’t have to climb them at a certain pace. You don’t have to don a sweatsuit and make a boot camp out of it. Just climb.

It’s a convenient and practical way to help you reach the overall level of physical activity you should be getting. According to the CDC, adults need 150 minutes of moderate-intensity aerobic activity per week – anything that raises your heart rate and makes you sweat. Depending on your fitness level, climbing a flight or two – or six – of stairs may count as moderate aerobics. 

There’s a quiet bonus to this: Your body will start burning more calories when you’re not exercising. Exercise scientists call this NEAT, for non-exercise activity thermogenesis. It refers to the calories you burn just living your life, outside of sleeping, eating, and sports-like exercise. NEAT can have a powerful effect on your health.

NEAT accounts for most of the calories you burn via activity, even if you’re a hard-training athlete, according to a National Institutes of Health review. For people who don't get around much, it’s responsible for up to 10% of total energy expenditure and as much as 50% in more active folks. 

So NEAT can keep your weight under control, which reduces the risk of nearly every disease and life-threatening medical condition. Alas, 36% of Americans don't get around much, and 48% get only low levels of activity. A mere 16% meet the recommended guidelines for activity, according to the National Health and Nutrition Examination Survey.

Why Only 2% of Us Take the Stairs

Michael Easter said humankind’s “trudge toward inactivity” began with the Industrial Revolution, as machinery reduced our physical labor. He’s a fitness journalist and author of The Comfort Crisis, a book that argues for embracing discomfort to grow mentally and improve physically.

“Hunter-gatherer tribes are the best model for how humans lived in the past, and they get 14 times more physical activity than we do in a day,” Easter said. But most of us “live in a world where we don’t have to do anywhere near that much work, and that’s why we see health problems associated with inactivity.”

So start with stairs, he suggested. Easter cites a study from the American Journal of Public Health that followed people in two shopping malls that both had staircases with escalators nearby. In one mall, researchers put up a poster reading “Stay healthy, use the stairs,” and in the other, they posted multiple banners with similar messages.

Only 2% of shoppers in mall A chose the stairs over the escalator before the poster was placed there, and that number climbed to only 4.8% with the poster intervention. (It declined again before the study was over.) In mall B, with the banners, stair use rose to 6.7%, not a huge improvement.

“People will look at stairs next to an escalator and know the stairs are better for them,” said Easter, “but they rationalize it by thinking ‘How much better? It’s just one staircase.’ So they don’t take it.”

But little things add up. “If you take the stairs, and carry your groceries in a basket rather than push them in a cart, and then carry your grocery bags further to your car because you parked further away than normal … you start adding all that up and it makes a significant difference in health,” he said.

Exercise was invented to offset our increasingly sedentary lifestyle. But exercise wouldn’t be so essential if we got more activity naturally. “People don’t understand how powerful incidental physical activity is. How powerful NEAT is,” said Easter. 

Stair-Taking Advice from the Stair-Taking Champion (Literally)

The easiest way is to just take the darn stairs every chance you get. But if you want to turn stair climbing into a workout, listen to Wai Ching Soh of Kuala Lumpur, Malaysia. He’s a 29-year-old professional tower-running athlete who’s won the Empire State Building Run-Up the last 3 years in a row, climbing the building’s 1,576 stairs in 10 minutes and 36 seconds in 2023. 

He said the technique for stair climbing is pretty straightforward—whether you’re doing it as part of your NEAT in a day, or as a workout for your heart and blood vessels.

  • Plant your foot perpendicularly on the stair. For speed, place it on the innermost part of the step to turn corners faster. 
  • Use handrails if needed for stability, Vassiliou said. According to Soh, tower runners use them “to pull ourselves upward and reduce the loss of momentum during turns.” (Vassiliou said the science isn’t clear if using handrails lessens the exercise effect.) 
  • Lean forward with each step, Soh said, which moves your center of gravity in the direction you’re going and makes the climb easier.
  • Don’t worry about footwear. There’s little impact and no need for extra cushioning. Tower runners generally wear thin-soled shoes, or minimalist footwear – what Soh calls a sock shoe

If you want to get serious: “A good beginner workout would be to walk up the stairs nonstop for about 20 floors using the handrail,” said Soh. “When you get used to that, you can start taking two steps at a time.” From there, add speed and volume.

Here’s what stair-climbing has done for Soh’s health: A good VO2 max (a measure of aerobic fitness) for a male Soh’s age is 45.4 mL/kg/min, and his is 76. His resting heart rate is 40 beats per minute, which puts him in the same class as a marathon runner.

Don’t tell yourself you’re choosing the escalator or elevator to save time. 

“Unless you’re going up to very high floors, like in a New York City building, I find that you won’t get there any faster taking an elevator or escalator than you will using the stairs,” said Easter.

And you’ll add years to your life.