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Is Vigorous Exercise Better Than Walking?

Investigators addressed this question in a large, prospective study that included several understudied subgroups.

The CDC recommends moderate-intensity physical activity of at least 30 minutes on most, preferably all, days of the week. Is walking as beneficial as more vigorous exercise? The Women's Health Initiative Observational Study provided an opportunity to compare walking with vigorous exercise for preventing heart disease in a diverse cohort of 73,743 postmenopausal women (age range, 50-79) without histories of heart disease or cancer. Participants completed detailed physical-activity questionnaires and were followed for up to 5.9 years (mean, 3.2). Weekly energy expenditure was calculated in metabolic equivalents (METs).

The number of MET-hours per week was inversely associated with heart-disease risk. Walking and vigorous exercise yielded similar benefits: For example, at least 2.5 hours/week of either activity reduced risk by about 30%. Faster walking pace was associated with lower risk, prolonged daily sitting with higher risk. Findings were consistent among white and black women and across age and body-mass index categories.

Comment: This large, prospective study of postmenopausal women demonstrates the equal value of walking and vigorous exercise for reducing cardiovascular risk. Because faster walking was associated with lower risk, the findings support current CDC guidelines, which recommend moderate-intensity activity. The study is remarkable for its size and inclusion of previously understudied racial, ethnic, and age groups.

— Harlan M. Krumholz, MD, SM

Published in Journal Watch Cardiology October 11, 2002

Citation(s):

Manson JE et al. Walking compared with vigorous exercise for the prevention of cardiovascular events in women. N Engl J Med 2002 Sep 5; 347:716-25.

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