Experimental walking trials discussed in the next section can help to address these issues.įourteen intervention studies published in 2009 or early 2010 were identified in which walking was used as an intervention for one or more CVD-related health outcomes measured before and after intervention. Walking- and active-transit research is limited by potential bias due to pre-existing or subclinical illness and residual confounding by unmeasured CVD-related health behaviors, which are of critical concern in observational studies. Most studies examine any (versus no) active transportation, which prohibits assessment of dose response and may contribute to inconsistencies across countries (e.g., Scandinavian populations typically exhibit more frequent active transportation relative to U.S. Recent cross-sectional investigations support beneficial relationships between active commuting and dyslipidemia, triglycerides, HDL, diastolic blood pressure, and fasting insulin levels, although such findings are variable across studies and population subgroups. A case-control study suggests that the association between active commuting and incident myocardial infarction is partially mediated by changes in traditional CVD and inflammatory markers. In a meta-analysis of prospective or case control studies examining CVD endpoints, walking and cycling for transportation was associated with an 11% reduction in CVD risk. Walking or cycling for transportation is one way to accumulate PA as part of a daily routine and has become the focus of an emerging body of research. Increased walking volume is associated with reduced CVD mortality and events among those diagnosed with diabetes, with some evidence that the cardioprotective effects of walking may be stronger in diabetics than those with normal glucose tolerance. Walking may be particularly appropriate, and accessible to Type 2 diabetics who may be less able to perform vigorous PA than healthy individuals. Recently, Hamer and Stamatakis found that walking was associated with reduced risk of CVD mortality in Scottish men and women with diagnosed CVD this finding was consistent with a prior study in a larger study population. Walking as a component of secondary prevention for patients diagnosed with CVD is supported by the existing recommendations to incorporate exercise into cardiac rehabilitation and to promote gradual progression of exercise intensity to prevent acute cardiovascular events in individuals with low fitness. The favorable relationships between walking and CVD risk observed among adults who did not report undertaking previous vigorous PA suggest that walking is a promising strategy for yielding cardiovascular health benefit in the obese, who are less likely to perform vigorous PA, as well as for general, sedentary patient populations. Section 2 reviews strategies to promote walking and provides evidence regarding the optimal manner by which walking might be encouraged in various settings. Section 1 summarizes the evidence that walking improves cardiovascular health. īuilding on several previous reviews, this paper reviews recent evidence of the health benefits of walking and promotion of walking behavior, with a particular focus on studies published since 2008. Walking has been described as the nearest activity to perfect exercise. ), and can be used as a means of active commuting, which may be more likely to be adopted and sustained than traditional exercise programs.

It is often the activity of choice when adults are counseled to incorporate additional PA into their lives (for e.g. Walking is the most commonly reported PA among adults and is frequently cited as an example of moderate intensity exercise that adults can accumulate throughout the day in order to reach the goal of 150 minutes per week. It may more easily circumvent frequently cited barriers to exercise, such as “lack of time” and the belief that one is “not the sporty type”, than other forms of activity it has been found to promote better adherence than more intense exercise. Walking is eminently suited to PA prescription as it requires no special skills or facilities and is achievable by virtually all age groups with little risk of injury. Health professionals are faced with the challenge of prescribing PA that will be sustained by the sedentary majority. Despite the documented benefits of physical activity (PA) and published activity guidelines, a large proportion of the population does not perform sufficient exercise to maintain optimal health.

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