Throughout history, few things have inspired as much quackery as the pills, potions and promises to slow ageing, boost vitality, or extend life. Yet, amid the hype and hollow claims, a few golden truths remain. As far back as 400 BC, Hippocrates, widely considered the father of modern medicine, famously said, "Walking is man's best medicine." More than two millennia later, science is finally catching up with that wisdom.
Author
- Thomas E. Yates
Professor of Physical Activity, Sedentary Behaviour and Health, Diabetes Research Centre, University of Leicester
People who walk more than 8,000 steps a day reduce their risk of premature death by half, compared to those who walk fewer than 5,000 steps - the threshold for a sedentary lifestyle. But beyond 8,000 steps, the benefits tend to plateau, which challenges the long-held belief in the magic of 10,000 steps a day.
In fact, that benchmark wasn't born of science, but of marketing . The 10,000-step goal originated from a 1960s Japanese advertising campaign for the world's first commercial pedometer called the manpo-kei, which literally translates to "10,000 steps meter".
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Lately, researchers have been exploring a simple but important question: does every step count the same, or can walking faster - at a brisk pace of more than 100 steps a minute, or around three to four miles per hour - actually give you more health benefits?
For ageing and heart health there is mounting evidence that pace really matters. Simply converting a 14-minute daily stroll into a seven-minute brisk walk has been associated with a 14% reduction in heart disease .
An analysis of more than 450,000 adults in the UK used a genetic marker of biological age to reveal that by middle age, a lifetime of brisk walking reduces biological age by up to 16 years compared to a lifetime of slow walking.
A follow-up study suggested it is never to late to benefit from brisk walking. An inactive 60-year woman or man was modelled to gain around an additional year of life expectancy through simply introducing a ten minute brisk walk into their daily routine.
The power of brisk walking can also be seen in its ability to predict future health outcomes. It has been shown to be a stronger predictor of the risk of dying from heart disease than traditional predictors such as blood pressure and cholesterol, while also being a more powerful predictor than many other measures of lifestyle - including diet, obesity levels, and total physical activity.
In fact, perhaps the single most informative question a doctor could ask their patient is: "How fast is your walking pace in comparison to other people?"
Halo of benefits
But brisk walking may not provide additional benefits for all outcomes or in all contexts. For example, the benefit of brisk walking over light-intensity walking in lowering cancer risk is less certain.
A recent study suggested that although total walking was associated with reduction in 13 different types of cancers , there was no added value from brisk walking. Breaking prolonged sitting with light-intensity pottering around has also been shown to have profound impacts on metabolic effects.
Importantly, walking has a halo of benefits beyond physical health. It can help with brain activity, doubling creative idea production . Indeed, the systems in the brain that support memory and imagination are also the same as those activated during whole body movement.
Many of us already harness this very phenomenon, using walking to mull over problems and arrive at solutions or insights that would otherwise remain elusive. Context is also important here, with the mental health and cognitive benefits of walking thought to be enhanced when walking through nature.
So called "nature prescriptions" for clinical populations have harnessed these principles to increase walking activity and improving both mental and physical health.
Physical inactivity is a major driver of the modern epidemic of long-term conditions, such as diabetes and heart disease, that are now observed in industrialised and developing economies alike. It has been estimated that 3.9 million premature deaths could be averted annually through targeting physical inactivity.
However, instead of prevention, medical systems are largely based on management - people get ill and are then prescribed medicines to treat the illness. On average it takes $1 billion to bring a new drug to market which, despite these research and development costs, still go on to generate sizeable profits for shareholders showing the scale of the health economy.
If just a fraction of these costs were diverted into public health initiatives aimed at increasing walking and physical activity opportunities for all, the need for an ever more sophisticated medical management ecosphere may retreat.
In short, when searching for the elixir of life, you could do worse than looking down at your feet.
Prof Yates receives funding from the The National Institute for Health and Care Research (NIHR) Leicester Biomedical Research Centre
