Walking to health – twenty-one years on

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Those of you who’ve been reading my blogs for a while know that I frequently write about the latest research and public policy documents on walking and health.  There have been two biggies this week.  The first is a whole BJSM* issue of editorials, articles and reviews dedicated to the benefits of walking.  The second is the publication of the WHO* Global Action Plan on Physical Activity 2018-2030 – which in large part is advocating walking as a solution to the global inactivity crisis. 

BJSM Special issue on walking for health
The motivation behind the BJSM’s special issue of walking for health is the 21st anniversary of Morris and Hardman’s seminal review Walking to health.  The publication turned heads, not only in the health and fitness world but those of policy makers too.  It offered walking as the health solution for individuals, communities, the environment and nationally.  It integrated exercise science, the field of preventative medicine and public policy recommendations; triggered a shift in perception towards walking for health; and spawned two decades of further research into the benefits of walking and other moderate intensity physical activities.  Ironic really that it took over two thousand years to validate Hippocrates’ maxim that Walking is man’s best medicine.  Here’s some snippets of what was known and intimated at back in 1997:

  1. Walking is the most natural activity and the only sustained dynamic aerobic exercise common to everyone.
  2. Walking faster than customary (in a ‘training zone’ of 70% of maximal heart rate) develops and sustains physical fitness.
  3. Walking strengthens and preserves the muscles and joints of the lower body.
  4. Posture and carriage may improve.
  5. Walking has potential, long term, for weight and diabetes control.
  6. Walking is the most common weight-bearing activity, with indications at all ages of an increase in related bone strength.
  7. The pleasurable and therapeutic, psychological and social dimensions of walking are evident but need further study.
  8. No special skills or equipment are required.
  9. Walking is convenient and may be accommodated into occupational and domestic routines.
  10. Walking is self-regulatory in intensity, duration and frequency and is inherently safe.
  11. Unlike so much physical activity, there is little, if any, decline in middle age.
  12. It is a year-round, readily repeatable, self-reinforcing, habit-forming activity and the main option for increasing physical activity in sedentary populations.
  13. An economic assessment of the benefits and costs of walking should be made.

The WHO Global Action Plan on Physical Activity Plan (GAPPA)
GAPPA can in many ways be seen as the culmination of Morris and Hardman’s 1997 paper.  Its global strategy has pulled on the best available scientific evidence and consulted at a government, non-state, academic and research level with over 120 countries contributing.  It’s an important document setting a global strategy for reducing inactivity worldwide:

  • 10% by 2025
  • 15% by 2030. 

Current global figures are that 1 in 4 adults, and 3 in 4 adolescents (aged 11-17), do not get the recommended two and a half hours a week of moderate exercise.  In more developed countries like the UK levels of inactivity are far worse. 

Roughly a third of all Britons don’t meet the recommended physical activity levels and in Wales it’s two-thirds of the population. There’s huge gender and cultural disparities so for many demographics the statistics are even worse.  Something needs to be done and this something has been initiated by the WHO.  Here’s some of the key statements from the document:

 

  1. Regular physical activity is proven to help prevent and treat noncommunicable diseases (NCDs) such as heart disease, stroke, diabetes and breast and colon cancer.  It also helps prevent hypertension, overweight and obesity and can improve mental health, quality of life and well-being.  Yet much of the world is becoming less active.

  2. The global cost of physical inactivity is estimated to be INT$ 54 billion per year in direct health care, in 2013, with an additional INT$ 14 billion attributable to lost productivity.

  3. The four strategic objectives are to create an active society, active environments, active people and active systems.

  4. Sustained campaigns at a national and local level need to be initiated to increase the understanding of and positive attitudes towards physical activity and promote the ways everyone can increase physical activity and reduce sedentary behaviour.

  5. Mass participation initiatives in public spaces need to be implemented, engaging whole communities, providing free access to physical activity.

The relevance for you and me is first, it’s yet another endorsement of the benefits of walking.  On a health, social and environmental level walking offers a solution.  Nordic walking of course takes this several steps further, especially when done within a group setting like ours at Bristol Nordic Walking.  It utilises the upper as well as the lower body; places an increased demand on our heart and lungs making these vital organs more efficient and burning more calories; it’s outdoors and sociable; works our key postural muscles; and  – oh my goodness – it’s actually fun!

Secondly, this document is a call to action.  What can we do as individuals and as a club to promote walking and physical activity?  I don’t know the answer – maybe you do.

Vicky

 *British Journal of Sports Medicine

* World Health Organisation