Hippocrates (460 BC-370 BC) was a Greek physician who is considered by most to be the father of modern medicine. Long ago, he wisely observed that “walking is the best medicine” and prescribed peripatetic exercise as a panacea to help citizens of Ancient Greece maintain mens sana in corpore sano — a sound mind in a sound body — across their lifespans.
Today, a large prospective cohort study of almost 140,000 older U.S. adults, published in the American Journal of Preventive Medicine, corroborates what Hippocrates said. Surprisingly, the investigators found that even walking less than the currently recommended guideline of 150 minutes per week was enough to significantly improve public health and lower mortality risk compared to inactivity.
This research was led by Alpa Patel, a cancer epidemiologist and strategic director of the Cancer Prevention Study-3 (CPS-3) at the American Cancer Society.
Although previous research correlated moderate-to-vigorous physical activity (MVPA) with a reduced risk of death, this is the first study to identify a quantitative dose-response between specific amounts of walking and reduced mortality risk in a large prospective cohort.
This landmark study on the remarkable benefits of walking by Patel et al. is one of the largest studies of MVPA to date and included 62,178 men (mean age 70.7 years) and 77,077 women (mean age 68.9). After correcting for other risk factors, the researchers found that walking-only MVPA for a minimum of 17 minutes a day was associated with lower mortality.
More specifically, Patel and co-authors concluded, “In older adults, walking below minimum recommended levels (>150 minutes per week) is associated with lower all-cause mortality compared with inactivity. Walking at or above physical activity recommendations is associated with even greater decreased risk.”
Traditionally, public health guidelines have recommended that adults engage in 150 minutes of moderate-intensity exercise per week, or 75 minutes of vigorous-intensity physical activity. However, a groundswell of new research suggests that people can reap significant psychological and physical health benefits with much less exercise than previously recommended. For example, another October 2017 study suggests that just 60 minutes of exercise per week—at any intensity—helps prevent against future depression.
Although moderate-to-vigorous physical activity is associated with countless psychological and physical health benefits, including better cognitive functioning and a lower risk of various chronic diseases, fewer than half of older adults meet physical activity recommendations. In 2015, then-Surgeon General Vivek Murthy launched the Step It Up! campaign, which promotes walking and walkability in every zip code to combat the sedentarism epidemic plaguing America.
Walking is by far the most popular form of MVPA and is referred to as “the perfect exercise” by Patel and her colleagues, who write in their conclusion:
“With the near doubling of adults aged ≥65 years expected by 2030, clinicians should encourage patients to walk even if less than the recommended amount, especially as they age, for health and longevity. Walking has been described as the 'perfect exercise' because it is a simple action that is free, convenient, does not require any special equipment or training, and can be done at any age. This study shows that engaging in walking is associated with increased longevity and has the potential to improve the public’s health significantly.”
Patel, Alpa V., Janet S. Hildebrand, Corinne R. Leach, Peter T. Campbell, Colleen Doyle, Kerem Shuval, Ying Wang, Susan M. Gapstur. "Walking in Relation to Mortality in a Large Prospective Cohort of Older U.S. Adults." American Journal of Preventive Medicine (Published online: October 19, 2017) DOI: 10.1016/j.amepre.2017.08.019
Harvey, Samuel B., Simon Øverland, Stephani L. Hatch, Simon Wessely, Arnstein Mykletun, Matthew Hotopf. "Exercise and the Prevention of Depression: Results of the HUNT Cohort Study." The American Journal of Psychiatry. (Published online: October 3, 2017) DOI: 10.1176/appi.ajp.2017.16111223
Fielding, Roger A., Jack M. Guralnik, Abby C. King, Marco Pahor, Mary M. McDermott, Catrine Tudor-Locke, Todd M. Manini et al. "Dose of physical activity, physical functioning and disability risk in mobility-limited older adults: Results from the LIFE study randomized trial." PloS One (Published online: August 18, 2017) DOI: 10.1371/journal.pone.0182155
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