Walking is now widely endorsed as a great way to get daily exercise. And people seem to be listening: A recent AARP survey of 1,000 people age 18 and older found that the most popular form of exercise was walking (36 percent), followed by strength training (10 percent). Jogging and group sports (such as basketball or soccer) each tallied 8 percent.

But how effective is it? In this review, I will summarize the specific health and fitness benefits of walking.

HEALTH BENEFITS OF WALKING

Walking produces a wide variety of health benefits, including:

• reduced risk of cardiovascular events
• wt. loss / loss of body fat
• improved aerobic fitness (in some people)
• increased HDL-cholesterol (ie., the "good" cholesterol)
• improved glucose metabolism
• lower blood pressure
• enhanced mental function (memory, intelligence, decreased risk of dementia)
• improved mood (depression, stress)

Walking has proved its health benefits in numerous studies. You might be surprised to learn that plain old walking, if done regularly, can ward off some really serious diseases:

Walking Prevents Cancer:

A substantial amount of research shows that exercise can reduce the risk of several different types of cancer.  A comprehensive review, published in 2002, concluded that "convincing" evidence exists showing that exercise reduces the risk for breast and colon cancer, and exercise "probably" reduces the risk for prostate cancer (Friedenreich CM, et al. 2002).  At that time, nearly 170 studies had been published evaluating the impact of exercise on cancer.  The Nurses' Health Study showed that women who walked at a normal or brisk pace for one hour per day lowered their risk of colon cancer by a whopping 46 percent.

Walking Prevents Coronary Heart Disease:

Walking can reduce the risk for coronary heart disease. This has been demonstrated in both men and women: The Women's Health Observational Study provided data on nearly 74,000 postmenopausal women. The researchers found that women who walked 3 hrs/week at a brisk pace had a dramatic decrease in risk of coronary events. Also, walking was just as effective for preventing cardiovascular events in these women as "vigorous exercise." The benefits of exercise were evident even in women who were obese (BMI of 30 or higher) (Manson JE, et al. 1999).

A large Harvard study of male health care professionals showed how much various types of exercise can lower the risk of coronary heart disease. Walking 30 min/day reduced the risk of coronary artery disease by 18% (Tanasescu M, et al. 2002).

Walking Prevents Diabetes Mellitus:

Walking has been shown to reduce the risk for developing diabetes in a variety of age groups, including the elderly (Dziura J, et al. 2004).

Walking Prevents Hypertension:

Walking for only 20 min/day lowered the long-term risk of developing hypertension in Japanese men (Hayashi T, et al. 1999).

Walking Prevents Obesity:

Researchers at the University of Tennessee showed that body composition (eg., fatness) in women was directly related to how far women walked on a regular basis:

Similar trends were seen when body fat percentage, waist circumference, and waist-hip ratios were analyzed: ie., these values were all lower in the group that walked the most (Thompson DL, et al. 2004).

Walking Prevents Functional Decline During Aging:

• Physical disability: Research shows that an inverse relationship exists between exercise and physical disability (Keysor JJ. 2003).  In other words, people who exercise more have less disability, compared to people of the same age who don't exercise. But, what about walking? In one study, walking as little as 1 mile per week slowed the decline in functionality that occurs with advancing age (Miller ME, et al. 2000).

• Mental function (cognition, dementia): Improvements in memory and attention were demonstrated within 6 months when a twice-per-week walking program was instituted (van Uffelen JG, et al. 2008). In another study of women with documented coronary risk factors, walking 30 minutes per day at a brisk pace was equated to being "cognitively younger" by 5-7 years (Vercambre MN, et al. 2011).

Walking Reduces Premature Death:

And if that isn't enough proof that walking is good for your health, an eight-year study of 13,000 people found that those who walked 30 minutes a day had a significantly lower risk of premature death than those who rarely exercised. A 12-yr study of elderly, nonsmoking men enrolled in the Honolulu Heart Program showed that the mortality rate for men who walked less than 1 mile per day was nearly twice that compared to men who walked more than 2 miles per day (Hakim AA, et al. 1998.)

Thus, walking on a regular basis can literally save your life!

WALKING AS A "TREATMENT" OF DISEASE

Walking on a regular basis can also be beneficial if these diseases are already present. Here is a brief summary of some of the research:

Walking and Coronary Heart Disease:

Walking at least 40 minutes/day on a regular basis was associated with a significant reduction in cardiovascular mortality in elderly British men with a history of coronary heart disease (Wannamethee SG, et al. 2000).

Walking and Diabetes Mellitus:

Brisk walking improved not only blood sugar control, but, also, a variety of additional medical parameters in type-2 diabetics. And, those who exercised the most obtained the most benefit (Di Loreto C, et al. 2005).

Walking and Obesity:

Researchers at Duke University compared running with brisk walking. Patients were instructed not to diet during the 8-month study. Overweight adults (average BMI of 29.7 kg/m2) who walked an average of 30 minutes per day at 40-55% of maximum oxygen uptake avoided gaining additional weight. Subjects in all 3 groups who exercised lost body weight and fat mass, with the group who ran 20 miles/week losing the most. However, when running 12 miles/week was compared with walking 12 miles/week, both groups lost weight and fat mass. Subjects who did not exercise gained about 2.5 lbs (Slentz CA, et al. 2004). Thus, it appears that brisk walking is as effective as running when it comes to losing weight.

In a separate study, sedentary, post-menopausal women who walked 150 minutes per week decreased their body fat by 4% over a period of 24 weeks. The walking program was roughly 60 minutes per session at a pace that was approximately 60% VO2max (Ready AE, et al. 1996).

The table below provides a rough guide to how many calories you burn while walking:

Use our unique Exercise Calorie Converter to determine how long you have to walk to burn-off the calorie amounts in specific fast-food menu items.

Walking and Osteoarthritis:

An 8-week supervised walking program produced an improvement in walking ability and functional status, a decrease in arthritis pain, and a decrease in medication use in patients with osteoarthritis of the knee (Kovar PA, et al. 1992).

Walking and Depression:

A 4-month program of walking or jogging for 30 minutes per day, 3 days per week, was found to be just as effective in alleviating depression as a traditional antidepressant drug (Blumenthal JA, et al. 2007).

WHAT WALKING WON'T DO

It is important to also summarize what walking won't do:

• Walking and Aerobic Capacity: For some people, walking doesn't challenge the cardiovascular system enough to improve aerobic capacity (what most people refer to as their fitness level) (Leon AS, et al. 1996).

Whether or not walking will improve your aerobic capacity comes down to 2 variables: (a) what your current fitness level is and (b) how hard the effort is. The most important factor in improving your aerobic fitness is exercise "intensity," not the type of exercise you do, or, how long you exercise (Wenger HA, et al. 1986).

When middle-aged subjects marched at a pace of 4-5 km/hr, for 40 minutes per day, 4 days per week, after 20 weeks their aerobic capacity improved by an impressive 28% (Pollack ML, et al. 1971).

In another study where young males marched while wearing a weighted back pack, the following results were seen (all subjects marched at a pace of 5 km/hour, for 30 min/day, 5 days per week) (Shoenfeld Y, et al. 1980):

In other words, to improve your aerobic fitness by walking, the key is to push your heart rate up. You can do that by either (a) walking faster, (b) walking uphill, or (c) adding some resistance (eg., wearing a weighted vest or a back-pack).

• Walking and Cancer: Despite all the evidence showing that regular exercise reduces the risk of developing various types of cancers, some research suggests that exercise must be fairly vigorous to obtain any benefit, ie., walking may not be as effective as vigorous exercise. At least one study showed that walking did not reduce the risk of breast cancer in pre- and postmenopausal women (Dorn J, et al. 2003).

• Walking and Osteoporosis: Walking isn't very effective for preventing the decline in bone density that occurs with advancing age. In one study, postmenopausal women walked 15-40 minutes/day at a fairly brisk pace 3 times per week. After one year, the walkers demonstrated the same decline in bone density as women who didn't walk (Cavanaugh DJ, et al. 1988). Walking on a level surface doesn't "stress" the skeleton enough to stimulate bone growth.

WALKING FOR HEALTH: "30 MINUTES" vs. "10,000 STEPS"?

Hopefully, by now, you should be convinced that walking is good for your health. But how much should we walk?

The 1996 Surgeon General's Report recommended that everyone obtain "a minimum of 30 minutes of physical activity of moderate intensity (eg., brisk walking) on most, if not all, days of the week" (CDC, 1996). However, you may have also heard the recommendation to "walk 10,000 steps per day." So, which one is correct?

Quite honestly, for some people, just getting off the couch and doing any exercise would go a long way towards improving their health and fitness.

To provide a specific answer: 30 minutes of exercise is not equivalent to 10,000 steps. 10,000 steps is roughly 5 miles for most adults. It's not possible to walk 10,000 steps in 30 minutes...unless you can maintain a pace of more than 5 steps per second!

Here is a another way to compare "steps" with "minutes of exercise":

• One study of the effects of exercise on obesity showed that, to "prevent weight gain," subjects would need to walk a minimum of 6-7 miles per week (Slentz CA, et al. 2004.) That's the equivalent of roughly 2000 steps per day. But, higher amounts may be necessary to achieve weight loss.
• In a study of diabetics, researchers defined a "minimally-effective" amount of exercise as 77 minutes of walking per day. This is equivalent to about 6400 steps per day (Di Loreto C, et al. 2005). At an average of 2000 steps per mile, that works out to 3.2 miles (Hill JO. 2005).

The "10,000 steps per day" recommendation began getting attention around 1998. In 2001, the President's Council on Physical Fitness suggested 11,000 - 13,000 steps per day for adults. However, newer research suggests you don't need to walk that much...

So, how much you should walk each day depends on what benefit you are trying to achieve. If the goal is to improve health parameters and lower the risk of diseases such as diabetes and heart disease, then 4400 to 7500 steps per day will accomplish that. However, to produce weight loss, many people will have to walk even farther.

CONTINUOUS vs. INTERMITTENT EXERCISE

Considering that the average American walks only an average of 1.4 miles/week (that's about 400 steps per day!), meeting these exercise goals is a very tall order.

While this may be discouraging for those who are planning to start walking to lose weight, keep the following in mind: breaking each day's exercise up into smaller, multiple sessions may be just as effective as one, long, continuous exercise session.

Intermittent Exercise and Weight Loss:

One study compared 30 minutes of continuous walking (single session) to 3 separate 10-minute sessions (multiple sessions) in middle-aged women who were not overweight or obese. The average daily calorie expenditure in the group that exercised for 3 separate 10-minute sessions was only slightly less than in the 30-min continuous session (Fulton JE, et al. 2001):

Thus, people who wish to lose weight should realize that the calories they burn throughout the day add up, whether they occur all at one time, or intermittently throughout the day. This is why wearing a pedometer can be so helpful (see below).

Intermittent Exercise and Fitness Level:

In one study, fitness levels improved similarly whether walking consisted of a single 30-min session, or, three separate 10-minute sessions. The increase in VO2max was similar in both groups, although it was only a modest improvement. The subjects were sedentary women and the walking program was somewhat aggressive (3.5 - 4 mph) for their fitness level (Murphy MH, et al. 1998).

Another example showing that intermittent exercise can be beneficial is a study from Finland of sedentary men who were asked to play a round of golf 2-3 times per week.  Instead of riding in a cart, they were told to walk the course (ie., "intermittent" exercise).  After 20 weeks, noticeable improvements were seen in health (lipid profile), fitness (muscular strength) and body composition (Parkkari J, et al. 2000).

GETTING READY TO WALK

A walking program is simple. All you need are comfortable shoes and a pedometer (see below). Shoes specifically designed for walking are best. Wear loose clothing, keeping in mind that exercise elevates the body's temperature. And don't forget the sunblock and bottle of water!

NOTE: If you are 50 years or older, and have not exercised regularly, you should see your personal physician before beginning a new exercise program.

Walking Shoes

The type of shoe you choose depends on the way your feet strike the ground. A simple way to determine this is to moisten the bottom of your bare foot and stand on a flattened brown paper grocery bag. The imprint your foot leaves will determine the type of shoe you need. (For a thorough explanation of this, see our review: "Running Shoes".)

A good walking shoe should last 500 miles - or about one million steps. But, if you plan serious walking, you should buy running shoes. They're more flexible, and usually made out of mesh instead of leather, which keeps your feet from sweating. And there is more of a variety of support and cushioning.

GENERAL GUIDELINES FOR WALKERS

Every workout should begin with a brief warm-up followed by a few simple stretches. Walk around the house or in place for a few minutes to get the blood flowing to the muscles before you attempt to stretch them. Although walking primarily works the major muscles of the legs, don't forget to stretch your back, shoulders and arms. This will help to loosen up any tension you may be carrying and make your walk more enjoyable as well as more effective.

Beginning walkers can make their workouts less strenuous by limiting how fast and far they walk. Here are some practical tips:

Walking: Practical Tips

"Brisk" walking is generally described as walking at 3-4 mph. It might be easier to think of the speed as "1 mile in 15-20 minutes." Note that walking at 4 mph is pretty fast; most people don't walk that fast.

More important than how long you walk or how fast you walk is what your heart rate is while you are doing it. For example, let's say you take the dog out for a short walk every morning. If you stop every minute or 2 to let it explore, this kind of walk won't be very effective.

Keep in mind that "brisk" walking is not always synonymous with "vigorous" exercise. Walking at 3-4 mph would be "vigorous" for an 80-yr old but "light" exercise for a 20-yr old.....even though both are walking at exactly the same speed. In other words, whether an exercise is defined as light, moderate, or vigorous is determined by your heart rate response, not the speed or effort (Thompson PD, et al. 2003).

Here are some practical tips for your walking program:

Getting Ready:

• If necessary, get clearance from your physician first!
• Get some properly-fitted running shoes, a hat, and some sun-block
• Get a heart rate monitor
• Use your car to locate a landmark that is 1-mile from your house

During Your Walk:

• Walk fast and swing your arms
• Initially, shoot for a pace where you can still talk in short sentences
• Check your HR while you are walking; adjust your pace so that your HR is 70% of your calculated maximum
• Gradually increase the distance until you can walk continuously for 30 minutes
• If you get short of breath, stop and recover
• If you develop chest pain, stop immediately and seek medical attention

After Your Walk:

• Within 30-60 minutes, consume some protein and drink plenty of fluids
• Mark your calendar that you exercised today!

MONITORING YOUR DISTANCE: Pedometers

Couch potatoes may rack up only 3,500 steps per day during general activity. Wearing a pedometer has been shown to increase the distance walked per day (Wyatt HR, et al. 2004).

But before you start planning your walking schedule, you must determine your baseline, or how many steps you take on a daily basis. This is where the pedometer comes in.

In general, pedometers are most accurate for counting steps, less accurate for calculating distance and least accurate for counting calories. No matter what the brand, pedometers tend to lose their accuracy at very slow walking speeds, as the instrument lacks the "sensitivity" to detect steps during a slow pace (Schneider PL, et al. 2003). (see our review: "Pedometers").

Tips for Increasing Your Step Count

Did you know that walking up a flight of stairs in an office building adds about 100 steps? And if you park your car in the farthest corner of the parking lot, you could tack on a couple hundred more? Here are some more tips:

• Return your grocery cart inside the store.

• Avoid drive-throughs.

• Take the stairs instead of the elevator or escalator.

• Listen to books on tape or music while you walk. Listening to lively music while you walk is a great way to energize your workout. But if you wear headphones, keep the volume down and watch out for traffic that you may not hear.

• Find a walking partner, or join a walking club.

• Walking a round of golf represents a distance of about 7 km.

• People who own dogs walk an average of 300 minutes per week compared to 168 min/wk for people who don't (Brown SG. 2006), so that's another option.

MONITORING YOUR WALKING PACE

The table below shows how "steps per minute" equates to walking pace:

Walking usually will not push your heart rate as high as jogging. A "brisk" walk is considered "moderate-intensity" exercise by scientists.  However, if you really get into it by pumping your arms and walking fast, your target heart rate can be achieved.

To calculate your target exercise heart rate, take 60 to 80 percent of your maximum HR (To determine your maximum heart rate, see our review: "Heart Rate, Exercise Intensity, and Training"). Try to push your exercise heart rate up to that range for 20 minutes at least four times a week. Be sure you can talk while walking. If you can't converse, you are exercising too hard.

Walking is one fitness activity that allows you numerous options. Once you have reached a point where you can walk a few miles with relative ease, you can start to vary the intensity. Progress to a faster walk and then into a slow jog. To increase your cardiovascular endurance, concentrate on lengthening your stride or increasing your speed. You can also carry hand weights, or, if you're really motivated, you can even wear a "weight vest".

CROSS-TRAINING

Finally, don't limit your exercise to only walking. Muscular strength decreases by 30 percent between the ages of 30 and 70. Two-thirds of women and 25 percent of men in their 70's say they don't have the strength to lift their grandchildren. Walking isn't going to improve your upper body strength. That's why walking and weight training are both recommended for older adults.

Other exercises recommended for older adults are swimming, cycling, and yoga. These are all low-impact exercises that are a good compliment to walking.  (Note, however, that while these activities are helpful for improving cardiovascular fitness, flexibility, and balance, other forms of exercise are necessary for bone strength.  See our review:  "Exercise and Osteoporosis".)

QUESTIONS

Q: What is a typical walking pace?

ANSWER: The textbook value for walking speed by healthy adults is 84 meters/minute. In a study of pedometers, the following statement was noted: "...at more typical walking speeds between 67 and 107 meters/minute..." (LeMasurier GC, et al. 2003). In another study, the walking pace of 10 male and 10 female subjects, ages 22-69 yrs, averaged about 96 meters/minute (range: 77-115 meters/minute) (Schneider PL, et al. 2003).

"Moderate" walking is defined as 3.0 mph (equivalent to 20 minutes per mile). "Brisk" walking is defined as a pace of 3.5 mph or faster (equivalent to 17 minutes per mile) (Ainsworth BE, et al. 2000). For most people, that's pretty fast.

Here is a table. These values apply if your stride length is 2.5 feet:

For boys and girls ages 5-11 years, the average self-determined walking pace in one study was 77 meters/minute (Beets MW, et al. 2005).

SUMMARY

Daily physical activity helps to lower blood pressure and cholesterol, and helps reduce obesity, symptoms of anxiety and depression, and symptoms of arthritis. But, to acquire many of these health benefits, exercise does not have to be strenuous. Moderate daily physical activity can substantially reduce the risk of developing or dying from type 2 diabetes, and a variety of cardiovascular diseases, such as heart disease, hypertension, and stroke.

Walking on a regular basis is a great way to get your daily dose of physical activity. In addition to the fact that it can be done by almost everyone, walking is an excellent way to maintain your health.

FOR MORE INFORMATION

A great web site for those in need of a pedometer is: www.New-Lifestyles.com.

Readers may also be interested in the following stories:

• Exercise and Coronary Artery Disease
• Exercise For Older Adults
• Exercise Guidelines for Health: Official Recommendations
• Health and Fitness Targets
• Hiking
• Pedometers
• Running Shoes

EXPERT HEALTH and FITNESS COACHING

Stan Reents, PharmD, is available to speak on this and many other exercise-related topics. (Here is a downloadable recording of one of his Health Talks.) He also provides a one-on-one Health Coaching Service. Contact him through the Contact Us page.

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ABOUT THE AUTHOR

Stan Reents, PharmD, is a former healthcare professional. He has been a member of the American College of Lifestyle Medicine (ACLM) and the American College of Sports Medicine (ACSM). In the past, he has been certified as a Health Fitness Specialist by ACSM, as a Certified Health Coach by ACE, as a Personal Trainer by ACE, and as a tennis coach by USTA. He is the author of Sport and Exercise Pharmacology (published by Human Kinetics) and has written for Runner's World magazine, Senior Softball USA, Training and Conditioning and other fitness publications.