Wednesday, October 20, 2021

Walk To Your Heart's Desire ... And Stroll To Good Health

"Walking is the exercise that needs no gym. It is the prescription without medicine, the weight control without diet, the cosmetic that is sold in no drugstore. It is the tranquilizer without a pill, the therapy without a psychoanalyst, the fountain of youth that is no legend. A walk is the vacation that does not cost a cent."

Aaron Sussman & Ruth Goode, The Magic of Walking (1967)

After heart bypass surgery this summer, I was faced with the absolute need for exercising to maintain good health. It's something I have known forever; however, there is nothing like open heart surgery to make this charge a necessary, life-saving reality. A near-death experience humbles the soul and makes one appreciative of a second chance to improve the odds of survival and the quality of life.

My new exercise program is largely based on walking – both lifestyle walking and fitness walking. I accomplish the exercise by using a treadmill, an indoor track, or a suitable outdoor path. For someone 70-years-old, walking represents the most convenient and inexpensive means of exercising.

In fact, walking is the suggested workout over running for many people. For example, those with knee, ankle and back problems and also for people who are overweight to obese. I fit all of those aliments, so in my case, walking is a lower impact exercise and can be done for longer periods of time.

The truth is, the more you walk, the better for all sorts of health reasons: weight loss, lower blood pressure and blood sugar, a better cholesterol profile, stress reduction, improvements in mood, memory, and brainpower, and longevity.

Walking can help you live healthier and longer, and it may also help you shed excess pounds? Still, a common misconception is that working out in and of itself can help someone lose weight. Diet is a far more important piece of the weight-loss equation, research suggests.

Losing a pound a week requires a calorie deficit of 3,500 calories, or 500 calories per day. You can accomplish this through diet, exercise or a combination of both approaches. But it seems that diet and exercise aren't equally effective.

"The reason dieting may be more effective than just exercise is because exercising would take a ton more activity and effort to create a 500- to 700-calorie deficit,” says Yasi Ansari, a registered dietitian and spokesperson for the Academy of Nutrition and Dietetics.

To put this in perspective, a 155-pound person would burn roughly 500 calories from an hour of high-impact aerobics or by walking for 90 minutes at a rate of 4.5 mph. That's a pretty long time for an old codger like me.

So, in other words, I can't expect a huge weight loss from those quick trips to the gym. Someone who started exercising 30 minutes almost every day would probably lose about a pound over the course of a month. For most people trying to lose weight, that would be downright disappointing. (It’s no wonder that half of all new gym customers drop off by the end of January.)

While walking itself can help you lose weight, it’s much more effective when combined with a calorie-restricted diet. And, that's a topic for another blog post.

Suffice it to say, diet and exercise go hand-in-hand for weight loss. In a 12-week study, people with obesity restricted calories by 500–800 per day. One group walked 3 hours per week at 3.7 mph (6 kph), while the other group didn’t walk.

While both groups lost a significant amount of body weight, those in the walking group lost about 4 pounds (1.8 kg) more, on average, than those who didn’t walk.

(Bernadette Kleist, Ursel Wahrburg et al. “Moderate Walking Enhances the Effects of an Energy-Restricted Diet on Fat Mass Loss and Serum Insulin in Overweight and Obese Adults in a 12-Week Randomized Controlled Trial.” J Nutr. 2017.)

How many calories are you actually burning when walking and how can you get the most out of those steps? Many people today use different wearables and online calculators to assess how many calories are burned walking. However, research has shown these devices are not entirely accurate.

In fact, one study in the Journal of Applied Physiology found most people are actually burning more than generally reported by fitness monitoring tools. In 97% of cases examined, too few calories burned were reported, researchers revealed.

You burn more calories in a shorter amount of time with higher-intensity exercise that pushes you into a higher heart rate. Walking, however, is a moderate-intensity form of exercise, not a high-intensity style of exercise that you do in short bursts, such as boxing or high-intensity interval training (HIIT).

(Dana Santas. “How to best burn calories while walking.” CNN. October 18, 2021.)


Walk Smarter?

I am dedicated to walking and trying to control my diet. This entry is to give some pointers on the best way to maximize walking. Allow me to share some science behind the practical exercise. Caution: Consult with your doctor before planning your own program.

The National Institutes of Health reports getting in your steps is actually more important than the overall intensity with which you achieve them when it comes to using walking to increase your life span and overall health.

Doctors often recommend walking as an easy way for inactive people to ease into better health. Taking 4,000 or fewer steps a day is considered a low level of physical activity. A goal of 10,000 steps a day is commonly cited, but recent studies have shown that health benefits accrue even if fewer than 10,000 steps are taken daily.

To investigate how many steps are needed to gain health benefits, a team led by Dr. I-Min Lee at Brigham and Women’s Hospital and Harvard Medical School analyzed the daily activity of almost 17,000 women with an average age of 72 years. They then tracked deaths among the women from any cause for more than four years.

(I-Min Lee, M.B.B.S., Sc.D.; Traci Marquis-Eydman, M.D.; Frank H. Netter M.D.; School of Medicine, Quinnipiac University, North Haven, Conn.; JAMA Internal Medicine. May 29, 2019.)

Research showed …

  • Adults who took 8,000 or more steps a day had a reduced risk of death over the following decade than those who only walked 4,000 steps a day.

  • Step intensity (number of steps per minute) didn’t influence the risk of death, suggesting that the total number of steps per day is more important than intensity.

During the decade of follow-up, 1,165 out of the 4,840 participants died from any cause. Of these, 406 died from heart disease and 283 died of cancer.

Compared with people who took 4,000 steps a day, those who took 8,000 steps a day at the start of the study had a 50% lower risk of dying from any cause during follow-up. People who took 12,000 steps a day had a 65% lower risk of dying than those who took only 4,000.

Higher step counts were also associated with lower rates of death from heart disease and cancer. These benefits were consistent across age, sex, and race groups.

Step intensity did not seem to impact the risk of mortality once the total number of steps per day was considered. Only an increased number of steps per day was associated with a reduced risk of death.

Using a fitness tracker to help you recognize when you reach your target heart rate zones can help you maximize the calorie-burning and health-boosting benefits of your walk. It is believed using a fitness tracker could get you to walk an extra mile a day.

The American College of Sports Medicine puts your target heart rate for moderate-intensity physical activity at 64% to 76% of your maximum heart rate. Because walking is not a high-intensity exercise, you are going to achieve the biggest caloric burn doing it at moderate intensity, which means a brisk but sustainable pace for you.

The 64% and 76% levels would be:

  • 64% level: 170 x 0.64 = 109 bpm, and

  • 76% level: 170 x 0.76 = 129 bpm

This shows that moderate-intensity physical activity for a 50-year-old person will require that the heart rate remains between 109 and 129 bpm during physical activity.

(“Target Heart Rate and Estimated Maximum Heart Rate. CDC.)

(Deborah Riebe, Jonathan K Ehrman, Gary Liguori, Meir Magal. Chapter 6 “General Principles of Exercise Prescription.” In: ACSM’s Guidelines for Exercise Testing and Prescription. 2018, 143-179.)

If you're not fit or you're just beginning an exercise program, it is recommended you aim for the lower end of your target heart rate zone. Then, gradually build up the intensity. If you're healthy and want to exercise at a vigorous intensity, opt for the higher end of the zone.

It's important to note that maximum heart rate is only a guide. You may have a higher or lower maximum heart rate, sometimes by as much as 15 to 20 beats per minute. If you want a more specific range, consider discussing your target heart rate zone with an exercise physiologist or a personal trainer.

Also note that several types of medications, including some medications to lower blood pressure, can lower your maximum heart rate, and then lower your target heart rate zone. Ask your doctor if you need to use a lower target heart rate zone because of any of your medications or medical conditions.

(Mayo Clinic Staff. “Exercise intensity: How to measure it.”)

According to the Centers for Disease Control and Prevention, to estimate your maximum age-related heart rate, subtract your age from 220. For example, if you're 48 years old, your estimated maximum heart rate is calculated as 220 - 48 = 172 beats per minute.

Keeping with our example of a 48-year-old person, a moderate-intensity heart rate would be between about 110 and 131 beats per minute. During this type of exercise, you will feel your breathing rate increase but should still be able to speak in complete sentences. 


Getting the Most Out of Walking

The quicker you walk the more efficient and effective your effort will likely be. To get the health benefits, try to walk for at least 30 minutes as briskly as you can on most days of the week. 'Brisk' means that you can still talk but not sing, and you may be puffing slightly. Harvard Health says walking for 2.5 hours a week – that’s just 21 minutes a day – can cut your risk of heart disease by 30%.

"The big mistake most walkers make is taking too long of a stride," says Michele Stanten, walking and author of Walk Off Weight: Burn 3 Times More Fat with This Proven Program to Trim Your Belly, Butt and Back Fat. "When your foot lands straight out in front of you it acts almost like a brake and slows you down. By shortening your stride you'll walk faster and burn more calories."

So, I see many experts on walking touting the benefits of shortening your stride and using interval walking.

Here is some research to back up those claims …

It would seem that walking at a consistently brisk pace that keeps your heart pumping would make the most sense. Yet, there is considerable research showing that changing your pace to vary your intensity, and, consequently, your heart rate, throughout your walk can increase your metabolic rate by 6% to 20% more than remaining at a steady pace throughout the duration of your walk.

In a study published in 2015 in the journal Biology Letters, Ohio State University researchers found that walking at varying speeds can burn up to 20% more calories compared to maintaining a steady pace. The researchers put participants on a treadmill set at a steady speed and asked them to walk quickly to the front of the treadmill or slowly moving to the back of the treadmill belt while they monitored their respiration.

Their analysis showed that the very act of changing speeds burns more energy because the legs must do more work to move from a slow to a fast pace and vice versa. The researchers estimated that up to eight percent of the energy we use in normal daily walking could be due to the energy needed to speed up and slow down.

The research concludes …

The metabolic rate for oscillating-speed walking was significantly higher than that for constant-speed walking (6–20% cost increase for ±0.13–0.27 m s−1 speed fluctuations). The metabolic rate increase was correlated with two models: a model based on kinetic energy fluctuations and an inverted pendulum walking model, optimized for oscillating-speed constraints. The cost of changing speeds may have behavioral implications: we predicted that the energy-optimal walking speed is lower for shorter distances. We measured preferred human walking speeds for different walking distances and found people preferred lower walking speeds for shorter distances as predicted.

Further, analysing published daily walking-bout distributions, we estimate that the cost of changing speeds is 4–8% of daily walking energy budget.”

(N. Seethapathi and M. Srinivasan. “The metabolic cost of changing walking speeds is significant, implies lower optimal speeds for shorter distances, and increases daily energy estimates.” Biol. Lett. 11: August 21, 2015.)

Danish research presented in Diabetes Care studied people with type 2 diabetes who were randomly assigned to either a continuous-pace walking group that walked at a steady moderate speed or an interval walking group that alternated 3-minute repetitions at low and high intensity. After four months, researchers found that only the interval walkers improved their blood-sugar levels, reduced their BMI (Body Mass Index), and lost dangerous visceral belly fat. Interval walking is superior to energy expenditure–matched continuous walking for improving physical fitness, body composition, and glycemic control.

(Kristian Karstoft, MD; Kamilla Winding, MSC; et al. “The Effects of Free-Living Interval-Walking Training on Glycemic Control, Body Composition, and Physical Fitness in Type 2 Diabetic Patients.” Diabetes Care. February 2013.)

Based on the research noted above, showing an even bigger metabolic boost with varied intensities, you should break up your pace to also include short durations of light intensity.

(Jeff Csatari. “One Way to Make Your Daily Walk Way More Effective, Says Science.” Galvanized Media. April 1, 2021.)

To walk most effectively, researchers conclude …

  1. Keep your chin up.

  2. Bend your arms.

  3. Take shorter steps.

  4. Speed up, slow down according to the following:

Warm up – Walk at an easy pace for 10 minutes.

Do power intervals – For 30 seconds, do a hard power walk—walking for as fast as you can. Immediately afterward, slow back down to an easy walk for recovery. Repeat this cycle 9 more times.

Cool down – Walk at an easy pace for 10 minutes.

  1. Hit the hills if you're looking for even more fat burn

Follow the same routine as above, but perform your power intervals on a hill. Walk 30 seconds powerfully up the hill, and then 30 seconds back down at an easy pace.

Get walking with this 12-week walking schedule – Mayo Clinic Staff

Just beginning? Are you looking to ease into getting in shape? Mayo Clinic offers this 12-week walking schedule from the National Heart, Lung, and Blood Institute to start you on the path to better health. But before starting this walking plan, talk with your doctor if you have serious health issues, or if you're older than age 40 and you've been inactive recently.

The plan says …

Aim to walk at least five days a week. Start out warming up with a five-minute, slower paced walk. Slow your pace to cool down during the last five minutes of your walk.

Start at a pace that's comfortable for you. Then gradually pick up speed until you're walking briskly – generally about 3 to 4 miles an hour. You should be breathing hard, but you should still be able to carry on a conversation. Each week add about two minutes to your walking time. After you've tried the walking schedule for 12 weeks, aim to increase the time you're walking briskly even more, from 30 to 60 minutes a day.

In addition to walking, add strength training exercises – such as pushups, planks and squats – to your routine.

This walking schedule can also help you meet recommended guidelines for physical activity. For most healthy adults, the Department of Health and Human Services recommends these exercise guidelines:

  • Aerobic activity. Get at least 150 minutes of moderate aerobic activity or 75 minutes of vigorous aerobic activity a week, or a combination of moderate and vigorous activity. The guidelines suggest that you spread out this exercise during the course of a week. Greater amounts of exercise will provide even greater health benefits. But even small amounts of physical activity are helpful. Being active for short periods of time throughout the day can add up to provide health benefits.

  • Strength training. Do strength training exercises for all major muscle groups at least two times a week. Aim to do a single set of each exercise, using a weight or resistance level heavy enough to tire your muscles after about 12 to 15 repetitions.

Week

Warmup

Brisk walking

Cool-down

1

5 minutes

5 minutes

5 minutes

2

5 minutes

7 minutes

5 minutes

3

5 minutes

9 minutes

5 minutes

4

5 minutes

11 minutes

5 minutes

5

5 minutes

13 minutes

5 minutes

6

5 minutes

15 minutes

5 minutes

7

5 minutes

18 minutes

5 minutes

8

5 minutes

20 minutes

5 minutes

9

5 minutes

23 minutes

5 minutes

10

5 minutes

26 minutes

5 minutes

11

5 minutes

28 minutes

5 minutes

12

5 minutes

30 minutes

5 minutes

(Based on National Heart, Lung, and Blood Institute – access at https://www.mayoclinic.org/healthy-lifestyle/fitness/in-depth/walking/art-20050972?_ga=2.235348993.1282641308.1634746135-1945205748.1634746135)


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