Physical activity guidelines worldwide typically use frequency, duration, and intensity parameters. Step-based recommendations using pedometers and accelerometers are emerging, but there is wide variation in recommended step counts. Normative data show healthy adults take 4,000-18,000 steps/day, with 10,000 steps/day as a reasonable target. However, "low active populations" exist. Interventions show incremental increases of 2,000-2,500 steps/day. Controlled studies show a strong relationship between cadence and intensity, with 100 steps/minute representing moderate intensity walking. Multiplying this by 30 minutes gives 3,000 steps, a heuristic value. Computed translations of MVPA recommendations equate to 7,100-11,000 steps/day. Direct estimates of minimal MVPA are 7,000-8,000 steps/day. A graduated step index categorizes activity levels, with 10,000 steps/day as 'active' and 7,000-8,000 steps/day as minimal MVPA. Studies show that 7,000-8,000 steps/day meet public health guidelines. Health outcomes suggest that even small increases in steps/day can improve health, especially for sedentary individuals. However, there is a need for a more flexible step-based scale that incorporates MVPA recommendations. Pedometers are more practical and cost-effective than accelerometers, but they may undercount steps for certain activities. The concept of a graduated step index is useful for research, clinical practice, and public health. It allows for tracking and communication of physical activity levels. The review highlights the importance of considering both habitual activity and MVPA when determining step-based recommendations. The findings suggest that 7,000-8,000 steps/day is a reasonable target for minimal MVPA, while 10,000 steps/day is a more active level. The review also emphasizes the need for a more comprehensive step-based scale that incorporates MVPA recommendations and allows for flexibility in step accumulation. The study concludes that step-based recommendations should be harmonized with existing public health guidelines and that a graduated step index is a useful tool for communicating physical activity levels.Physical activity guidelines worldwide typically use frequency, duration, and intensity parameters. Step-based recommendations using pedometers and accelerometers are emerging, but there is wide variation in recommended step counts. Normative data show healthy adults take 4,000-18,000 steps/day, with 10,000 steps/day as a reasonable target. However, "low active populations" exist. Interventions show incremental increases of 2,000-2,500 steps/day. Controlled studies show a strong relationship between cadence and intensity, with 100 steps/minute representing moderate intensity walking. Multiplying this by 30 minutes gives 3,000 steps, a heuristic value. Computed translations of MVPA recommendations equate to 7,100-11,000 steps/day. Direct estimates of minimal MVPA are 7,000-8,000 steps/day. A graduated step index categorizes activity levels, with 10,000 steps/day as 'active' and 7,000-8,000 steps/day as minimal MVPA. Studies show that 7,000-8,000 steps/day meet public health guidelines. Health outcomes suggest that even small increases in steps/day can improve health, especially for sedentary individuals. However, there is a need for a more flexible step-based scale that incorporates MVPA recommendations. Pedometers are more practical and cost-effective than accelerometers, but they may undercount steps for certain activities. The concept of a graduated step index is useful for research, clinical practice, and public health. It allows for tracking and communication of physical activity levels. The review highlights the importance of considering both habitual activity and MVPA when determining step-based recommendations. The findings suggest that 7,000-8,000 steps/day is a reasonable target for minimal MVPA, while 10,000 steps/day is a more active level. The review also emphasizes the need for a more comprehensive step-based scale that incorporates MVPA recommendations and allows for flexibility in step accumulation. The study concludes that step-based recommendations should be harmonized with existing public health guidelines and that a graduated step index is a useful tool for communicating physical activity levels.