Walk or run? Think distance, not speed, for health benefits

Physicians can assure patients that lacing up their sneakers and taking a brisk, two-mile walk earns them the same health benefits as a runner who goes that distance.

Although a runner may cover the distance in about half the time, the runner and the walker would end up with similar reductions in the risk for hypertension, high cholesterol, diabetes and possibly coronary heart disease, according to a study in the May issue of Arteriosclerosis, Thrombosis and Vascular Biology, a journal of the American Heart Assn.

“If you take a Calvinistic approach — the harder you work, the better the results — you would think there would be more benefit from running,” said cardiologist Paul D. Thompson, MD, a study author and medical director of cardiology and the Athletes' Heart Program at Hartford Hospital in Connecticut. “In this case, though, the faster you are, the faster the results. But slow and steady gets you to the same point.”

The study group was particularly large, and the “results probably provide among the best available answers to the important public health question as to what intensity of exercise is required to reduce [cardiovascular heart disease] risk,” the report said.

Researchers evaluated 33,060 runners in the National Runners' Health Study and 15,045 walkers in the National Walkers' Health Study. Dr. Thompson said there will be more results coming from the data. The study found:

• Running reduced the risk for first-time hypertension 4.2%, and walking reduced it by 7.2%.
• Running cut the risk for first-time high cholesterol 4.3%, and walking reduced it by 7.0%.
• Running cut the risk for first-time diabetes 12.1%, and walking decreased it by 12.3%.
• Running reduced coronary heart disease 4.5% compared with 9.3% for walking.

“People frequently evaluate the total time of exercise rather than the distance covered,” Dr. Thompson said. “This shows you don't need to push yourself very hard with the speed of the exercise for those cardiovascular event risks to go down.”

The results show that patients just need to get up and exercise; they don't need to go out and run a marathon to see benefits, said cardiologist Gerald Fletcher, MD, American Heart Assn. spokesman and professor of medicine in the cardiovascular diseases department at Mayo Clinic College of Medicine in Jacksonville, Fla.

“It is not as easy as taking a pill, but that is unrealistic,” he said. “Walking is very beneficial. Exercise helps people feel better, take less medication and stay out of the hospital.”

Prescription for a healthy lifestyle

The AHA recommends that adults get 30 minutes of moderate-intensity aerobic activity at least five days a week or at least 25 minutes of vigorous aerobic activity a minimum of three days a week. That should be coupled with moderate- to high-intensity muscle-strengthening activity at least two days a week for additional health benefits, the association said.

“Physicians need to spend 20 or 30 seconds telling their patients 'Don't forget to exercise,' ” Dr. Fletcher said. “It needs to come face-to-face, not just in writing.”

Although the study showed the result was the same for runners and walkers who went the same distance, runners tended to exercise twice as much as walkers.

“This is probably because [runners] can do twice as much in an hour,” Paul T. Williams, PhD, the study's principal author and a staff scientist at Lawrence Berkeley National Laboratory, Life Sciences Division, in Berkeley, Calif., said in a statement. “The more the runners ran and the walkers walked, the better off they were in health benefits.”

But too much exercise can pose problems. A study in Mayo Clinic Proceedings in 2012 showed that there is a point where too much exercise can result in cardiovascular problems. It said extreme endurance exercise, such as an ultramarathon, where participants run 100 miles, can lead to atrial and ventricular arrhythmias, coronary artery calcification and diastolic dysfunction.