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Harvard Commentaries
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Harvard Commentaries
Reviewed by the Faculty of Harvard Medical School


Man to Man Man to Man
 

Walking -- Getting the Respect it Deserves


January 24, 2013

By Harvey B. Simon M.D.

Harvard Medical School

Walking is a simple, normal human function. In fact, the two-footed upright gait is one of the things that separates us from all other animals. Strange as it seems, though, modern man seems determined to walk as little as possible.

It's understandable that few men would walk five miles to work. But remarkably few choose to walk even a half-mile to a friend's house or neighborhood store. And it's not just a question of walking in the 'hood.' Moving walkways whisk us through airports; elevators and escalators lure us away from stairways; and carts haul us around the links.

Walking doesn't get the respect it deserves.

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"But It's Not Aerobic"

Running is the poster-boy for aerobic exercise. Perhaps because they've seen so many hard-breathing, sweat-drenched runners counting their pulse rates, ordinary guys often assume that less intense exercise is a waste of time.

Ever since the 1970s, the aerobic doctrine has dominated the discussion of exercise and health. The doctrine holds that the benefits of exercise depend on working hard enough to boost your heart rate to 70% to 85% of its maximum, keeping it there for 20 to 60 minutes, and repeating the workout at least three times a week.

Aerobic exercise training is indeed the best way to score well on a treadmill test of your aerobic capacity. It is excellent preparation for athletic competition. And it's great for health. But intense workouts carry a risk for injury, and aerobic exercise is hard work. Although the aerobic doctrine inspired the few, it discouraged the many.

In fact, moderate exercise is excellent for health — and walking is the poster-boy for moderate exercise.

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Walking as Medicine?

More than 2,400 years ago, Hippocrates said, "Walking is a man's best medicine." To find out if he was right, two scientists from University College London analyzed the research published between 1970 and 2007.

After sifting through 4,295 articles, they indentified 18 studies that met their high standards for quality. In all, these studies evaluated 459,833 participants who were free of cardiovascular disease when the investigations began. Each of the studies collected information about the participants' walking along with other cardiovascular risk factors, which included age, smoking, and alcohol in every case plus additional data in most. The subjects were tracked for an average of 11.3 years, during which cardiovascular events (angina, heart attack, heart failure, coronary artery bypass surgery, angioplasty, and stroke) and deaths were recorded.

The results make a strong case for walking. In all, walking reduced the risk of cardiovascular events by 31% and it cut the risk of dying during the study period by 32%. These benefits were equally robust in men and women. Protection was evident even at distances as low as about 4 ½ miles per week and at a pace as casual as about 1 ½ miles per hour. The people who walked longer distances and/or at a faster pace enjoyed the greatest protection.

Like other forms of regular moderate exercise, walking improves cardiac risk factors, such as:

  • Cholesterol
  • Blood pressure
  • Diabetes
  • Obesity
  • Vascular stiffness and inflammation
  • Mental stress

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Walking for Good Health

If cardiac protection and a lower death rate are not enough to get you moving, consider that walking and other moderate exercise programs also help protect against:

  • Dementia
  • Peripheral artery disease
  • Obesity
  • Diabetes
  • Depression
  • Colon cancer
  • Erectile dysfunction

Whether you walk in a business suit or a sweat suit, on city streets or country roads, every walk you take is a step towards good health.

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Walking for Transportation

Does walking for transportation pay off? And how! A recent study found that people who live in cities have a lower risk of being overweight and obese than people who live in the suburbs. The explanation: driving vs. walking. Walking for transportation is a good way to start any exercise program. Here's how:

  • Walk to work and to the store.
  • Walk to the train instead of driving there.
  • Get off the bus or subway a few stops before your destination.
  • Instead of competing for the closest parking space or paying extra for a nearby lot, park further away and walk to your destination.
  • Go for a walk at lunchtime instead of spending all your time in the cafeteria.

Supportive street shoes are adequate. But you can change into walking shoes for your commute or lunchtime stroll. And because you don't need to push yourself enough to sweat, you don't need special clothing. Just stay warm in the winter, cool in the summer, and dry in the rain. But when the weather is really harsh or the street slippery, put safety first and walk down long hallways, in a mall or on the stairs.

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Getting Started

One of the nice things about walking is that you don't need special skill, much less lessons. It will get you away from the demanding routines of daily life, which is a nice plus for mental health. Here are a few tips to get you started and give walking the priority it deserves.

Shoes: By wearing walking shoes you'll be able to build up to a pace that's difficult to achieve walking on the way to work. Most major athletic brands offer shoes especially designed for walking. Fit and comfort are more important than style; your shoes should feel supportive but not snug or constricting. Look for a padded tongue and Achilles counter. The uppers should be light, breathable, and flexible, the insole moisture resistant, and the sole shock-absorbent. The heel wedge should be raised, so the sole at the back of the shoe is two times thicker than at the front. Finally, the toe box should be roomy, even when you're wearing athletic socks.

Tips

Time: To make walking a part of your daily life, set aside dedicated time to do it. Walk for 30 to 45 minutes nearly every day. Do it all at once or in chunks as short as 5 to 10 minutes.

Distance: Aim for two to four miles a day. As a rule of thumb, urban walkers can count 12 average city blocks as one mile. Another way to keep track of your distance is to buckle a pedometer to your belt. Some just keep track of your steps, while others have bells and whistles such as timers, clocks, alarms, and bells — or, at least, chimes that ring out little tunes. You can get a decent pedometer for under $40, but even the best models can sometimes mistake a jiggle for a step. Still, a pedometer can help you keep track and can motivate you to take extra steps whenever you can. If you have an average stride length, count 2,000 steps as about a mile of walking.

Intensity: Aim for a brisk pace of 3 to 4 miles per hour. But you'll get plenty of benefit from strolling at a slower pace as long as you stick with it. If you're counting steps, 80 steps a minute indicates a leisurely pace, 100 steps a minute a moderate to brisk pace, and 120 steps a minute a fast pace. Even without counting, you'll do well simply by reminding yourself to walk briskly.

Clothing: A T-shirt and shorts are fine in warm weather. An ordinary sweat suit will do nicely when it's cool, but a nylon athletic suit may be more comfortable. Add layers as the temperature drops; gloves and a hat are particularly important. If you really get into it, a water-repellant suit of Gore-Tex or a similar synthetic fabric will keep you warm without getting soggy with sweat.

For safety's sake, pick brightly-colored outer garments, and always wear a reflector on country roads if it's dark.

Safety: Walk facing cars if you don't have a sidewalk underfoot, and avoid high-speed and congested traffic. Beware of dogs and, for that matter, people; be sure unfamiliar locations are safe, and even then try to walk with a companion.

Warm-up/cool down: Before you take a serious walk, stretch to warm-up and again to cool down afterwards. Start out at a slow pace, and slow down towards the end of your walk as well. Begin with routes that are well within your range, and then extend your distances as you improve. The same is true of your pace: Begin modestly, then pick up your speed as you get into shape. Intersperse a brisk clip with a less strenuous stride, and then gradually extend these speedier intervals. Add hills for variety and additional intensity.

Form: Try to keep your posture erect with your chin up, your eyes forward, and your shoulders square. Keep your back straight, belly flat, and butt tucked in. Keep your arms close to your torso, bent at the elbow. Take a natural stride, but try to lengthen your stride as you improve. Land on your heels, and then roll forward to push off with your toes. Swing your arms with each stride, and keep up a steady rhythmic cadence.

To stay motivated, walk with a friend or listen to a radio or MP3 player. And for some guys, the best motivation is a dog.

Always listen to your body. If you are ill or injured, back off. Stay well-hydrated, and avoid hazardous conditions. Consider walking in a mall if it's too hot, cold, wet, or slippery outdoors. You can also consider using a treadmill at home or at a health club.

One way or another, walk.

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Harvey B. Simon, M.D. is an Associate Professor of Medicine at Harvard Medical School and a member of the Health Sciences Technology Faculty at Massachusetts Institute of Technology. He is the founding editor of the Harvard Men's Health Watch newsletter and author of six consumer health books, including The Harvard Medical School Guide to Men's Health (Simon and Schuster, 2002) and The No Sweat Exercise Plan, Lose Weight, Get Healthy and Live Longer (McGraw-Hill, 2006). Dr. Simon practices at the Massachusetts General Hospital; he received the London Prize for Excellence in Teaching from Harvard and MIT.

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