Abstract
Walking regularly is an excellent way to improve both physical and mental health. In fact, it is estimated that nearly 60% of people in the United States walk for leisure. 1 While prior research has demonstrated the many health benefits of walking, recent findings have indeed confirmed that walking is a valuable form of exercise with interesting new research discoveries. One of the most recent findings is the significant benefits of walking in terms of longevity—the more one walks, the longer they may live.
Nationally recognized as an expert in muscular fitness and lifestyle-based research, Paul M. Gordon, PhD, is a professor in the Department of Health, Human Performance, and Recreation at Baylor University, Houston, Texas. In an interview, he commented on a few significant findings that researchers have discovered or confirmed in the past decade. He said, “It is well known that brisk walking for a minimum of 150 minutes per week has many health benefits that can improve a person’s quality of life. More recently, walking has been linked to longevity. Studies have shown that individuals who walk for longer periods of time may have a longer life span. It is clear that there is a strong dose-response relationship—the more one walks, the greater the health benefits. Intermittently increasing ones walking pace for short periods (30 minutes to 1 minute) during a walk can also provide additional cardiovascular (CV) benefits. Regular walking not only has physical health benefits, but it can also improve mental health, particularly if one walks outside.”
Walking Facts
Various types and durations of walking may have benefits for many different aspects of health. For example, walking can prevent and manage both psychological and physical health conditions, including promotion of weight loss or weight maintenance; prevention and control of CV disease, type 2 diabetes, cancer, and mood disorders; and improve overall physical fitness, such as muscle strengthening and endurance. A recent article looked at the health benefits of walking for healthy aging and found that “walking decreases the risk or severity of various health outcomes such as CV and cerebrovascular diseases, type 2 diabetes mellitus, cognitive impairment, and dementia, while also improving mental well-being, sleep, and longevity.” 2
A Harvard Health article noted some interesting new aspects of the benefits of walking including the fact that walking may: counteract the effects of weight promoting genes—for people who walk an hour a day the effects of those genes may be halved; reduce the risk of breast cancer—women who walk seven or more hours a week may have a 14 percent lower risk of breast cancer than those who walked three hours or less per week; ease joint pain and in fact, walking five–six miles per week may help prevent arthritis; improve immune function—the article referred to a study that found, compared with those who exercised once a week or less, those who walked at least 20 minutes a day, 5 days a week, had 43 percent fewer sick days. 3
Fortunately, walking is a popular form of exercise. According to a report from the 2022 National Health Interview Survey, 58.7 percent of adults had walked for leisure in the past 7 days. 1 The report stated that the “percentage of adults who walked for leisure decreased with increasing age, from 61.8% of adults ages 18–44 and 59.1% of adults ages 45–64 to 51.6% of adults age 65 and older. Women (60.5%) were more likely than men (56.9%) to walk for leisure.” 1 There was a higher prevalence of walking among Asian non-Hispanic adults than Black non-Hispanic, other and multiple-race non-Hispanic, and Hispanic adults, and walking for leisure increased with increasing family income and education level. About 16 percent of adults walked for transportation. Transportation by walking was highest among adults with family incomes below 100 percent of the federal poverty level (24.1%). The authors of the report stated that “Walking, either as a leisure activity or to get from place to place, has been shown to offer considerable health benefits.” They concluded, “For many people, walking is considered a relatively easy and accessible physical activity for achieving health benefits. While wellness advantages do not discriminate between motivations for walking behavior (that is, for enjoyment or transportation), variations by sociodemographic characteristics illustrate that walking may serve specific purposes for different groups.”
Specific Research Findings
A recent study by Veerman and colleagues explored the effects of physical activity (PA) on life expectancy. Participants were 40 years of age with PA levels based on data from the 2003–2006 National Health and Nutritional Examination Survey. Results showed that “If all individuals were as active as the top 25% of the population, Americans over the age of 40 could live an extra 5.3 years on average.” 4 Specifically the authors stated, “To receive the health benefits of the most active 25% (total PA level equivalent to 160 daily minutes of walking at 4.8 km/hour), individuals in the lowest activity quartile require the equivalent of an extra 111.2 minutes/day of walking per person. This daily dose of PA would increase life expectancy by up to 10.9 years.” 4 This study demonstrates the dose-response relationship of walking. The authors concluded, “Our findings suggest that PA provides substantially larger health benefits than previously thought, which is due to the use of more precise means of measuring PA. Our model demonstrates this large effect on life expectancy by using more precise means of measuring PA. Adverse health outcomes due to low PA rival and may exceed the risk of death seen in hypertension and smoking; a single extra hour of walking above age 40 may increase life by as much as three hours, on average.” Finally, they emphasized, “There is a strong need to communicate these new estimates to decision-makers and clinicians. Our findings support national policies and global initiatives that aim to increase PA.” 4
A meta-analysis by Banach and colleagues explored the effects of walking on the risk of CV disease. 5 The analysis included 17 cohort studies with a total of 226,889 participants (generally healthy or patients at CV risk) with a median follow-up of about seven years. The authors observed a nonlinear dose-response association between step count and all-cause and CV mortality with a progressively lower risk of mortality, with an increased step count. The authors stated, “This meta-analysis demonstrates a significant inverse association between daily step count and all-cause mortality and CV mortality with the more the better over the cut-off point of 3867 steps/day for all-cause mortality and only 2337 steps for CV mortality.” 5 This is a significant new finding in regard to how beneficial walking may be for a person’s health and that the benefits of walking may occur well under the much-talked-about 10,000 steps per day.
Dr. Gordon, in an interview, also stated that “Short bouts of walking throughout the workday has significant health benefits and can improve cognitive function. Taking a few breaks throughout one’s workday for short 10-minute walks to offset the detrimental effects of long periods of sitting can be an easy way to integrate PA into one’s daily routine. It might also improve productivity.”
A study by Chen and colleagues found that, among 400,000 participants, higher usual walking pace is associated with a deceleration of the acceleration of four classical epigenetic clocks acceleration. 6 In this study, general walking speed was defined as follows: a slow pace was less than three miles per hour; a steady pace was three to four miles per hour, and a brisk pace was more than four miles per hour. The authors concluded, “Our results illuminate a consistent and significant casual association, indicating that increased walking speed correlates with the deceleration of epigenetic aging. Essentially, brisk walking appears to exert a beneficial influence on slowing down the aging process.” 6
Conclusion and Advice for Clinicians
For a long period of time, there has been a great emphasis on the importance of walking 10,000 steps a day for health benefits. While the benefits of that information remain true today, research has shown that various types and amounts of walking can still benefit health. These facts take a lot of burden off of people who are in no way prepared to take on 10,000 steps a day and yet can still take joy in the self-care and potential benefits of less walking. While recommendations are still to aim for the optimal and higher number of steps and minutes per week of PA, taking a patient from 0 to 60, so to speak, is probably not going to work for everyone. For patients who are not exercising, recommending 10 minutes of walking several days per week may be a good start. The clinician and patient can work on what has always been the case for change, and that is having a discussion about readiness, motivation, ability, and obstacles.
Veerman and colleagues commented, “Increasing PA at the population level is a complex task that requires a systems-based approach, considering the wider social determinants that impact on PA, sedentary behavior, and their unequal distribution across population groups. Infrastructure measures that encourage active transport and walkable neighborhoods as well as green spaces might be promising approaches to increase PA and resultant healthy life expectancy at the population level.” 4
Finally, Dr. Gordon concluded in an interview, “Physicians have a powerful voice that can support positive behavior change among their patients. As part of their Exercise is Medicine promotional program sponsored by the American College of Sports Medicine, we are encouraging the clinical community to actively promote regular exercise to their patients. Much like a medication can be prescribed, exercise can also be prescribed to patients. Walking is the most common form of PA, and it can easily be performed by most individuals. There is no need for equipment or gym memberships, just a comfortable pair of shoes and a safe place to walk.”▪