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Reconnecting with Nature: The Enriching Power of Walking

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8 Surprising Benefits of Walking Every Day

Protects your heart health, strengthens bones and joints, boosts your immune system, promotes weight loss, improves brain health, improves mental health, helps build community.

Extends Lifespan
Starting a Walking Routine

Many medical professionals and health organizations advocate the importance of regular physical activity to promote health and well-being. Walking is an easy, accessible form of exercise that has many health benefits.

A daily walk can help your body stay healthy, boost mood and energy levels, burn calories , and even prolong your life.

This article explains why walking daily can help you live a long and healthy life, along with tips for getting started.

gpointstudio / Getty Images

The heart is a muscle, and like any form of exercise, walking strengthens the heart and helps it work more efficiently. A stronger heart boosts circulation, which can help lower blood pressure and improve your heart rate .

Walking is an effective way to decrease inactivity and increase physical activity, which are known to help prevent and manage heart disease . Walking can also help lower other risk factors for heart disease, such as having excess weight, high blood sugar and cholesterol , and chronic stress .

Walking can also help manage your symptoms and improve your quality of life if you have heart disease .

For every 500 steps walked per day, adults ages 70 and older reduced their risk for heart disease , stroke , and heart failure by 14%.

Walking helps increase flexibility and stability and strengthens major muscle groups that help support bones and joints. Taking a brisk walk for 30 minutes daily three or more times a week has been shown to help prevent bone loss in people in premenopausal women when people and may also help promote bone turnover (the resorption of minerals as old bone is broken down to form new bones).

Physical activity like walking is known to boost the immune system . A single 30-minute walk can temporarily increase the level of specific immune cells in the blood. Research shows that people who exercise regularly get fewer viral infections and have less severe symptoms when they get sick than those who don't exercise regularly.

Walking burns calories, which promotes weight loss . A 125-pound person burns an average of 107 calories walking for 30 minutes at 3.5 miles per hour (mph) (equivalent to 17 minutes to complete one mile). A 185-pound person will burn about 159 calories at the same distance and pace.

Walking 30 minutes a day, at least five days a week, can effectively promote weight and body fat loss. Walking combined with a low-fat diet was found to be more beneficial for losing weight than diet alone over the course of a 12-week weight loss program.

How many calories you burn from walking depends on how fast you walk, your body type , and how flat the surface you walk on is.

When done regularly, moderate-intensity exercise like walking may increase brain volume in regions responsible for processing information and cognitive skills like memory and learning. In older adults, frequent, leisurely walks have also been found to decrease the risk of developing Alzheimer's disease and other forms of dementia .

Walking naturally releases mood-boosting endorphins in the body, and research shows that the more steps you take, the more your mood improves. Those who get regular exercise such as walking have an up to 40% decrease in the number of days per month they experience poor mental health, including stress , depression , and emotional concerns.

Going for a walk with others is a healthy social activity and can help prevent feelings of loneliness and isolation. Walking with others can also promote a sense of camaraderie, along with accountability, encouragement, and motivation to stick with a walking routine.

Extends Your Lifespan

Research found that increasing the number of steps taken daily by 1,000 resulted in a 22% decrease in the risk of dying from all causes, with greater decreases coming with the more steps walked. Compared with those who walked almost 4,000 steps daily, the risk of death from any cause was reduced by 49% for those who walked 5,500 steps per day and 67% for those who walked 11,500 steps a day.

Brisk walking is mainly associated with extending life expectancy. Compared to slow walkers, those who take regular brisk walks have up to 20 years greater life expectancy .

How to Walk: Tips for Starting a Walking Routine

If you are ready to start a walking routine, start slowly and only do what you can to avoid injuries.

Always consult a healthcare provider before starting a walking program.

It's recommended that adults get 150 minutes per week of moderate-intensity physical activity like walking. The total minutes can be broken up into smaller increments throughout the week, and more than 150 minutes per week of physical activity is associated with increased health benefits.

Although 10,000 steps a day is popularly used as a walking goal, studies show you don't need to walk that much to reap benefits. Walking 2,200 steps or more daily has been found to reduce the risk of heart disease and death from any cause, with the greatest benefits coming for those who walk between 9,000 and 10,500 steps a day.

How much you need to walk to get benefits can vary by age. One study found that the benefits of walking to lower the risk of death plateaued after 6,000 to 8,000 steps per day for people over 60, and at 8,000 to 10,000 steps per day for those younger than 60. Walking just 500 steps per day is associated with a decreased risk of heart disease , heart failure , and stroke in people over 70.

When You May See Results

When you see results will vary by how much you walk and at what intensity, along with your fitness level. But any walking will be better for you than no walking, even if it's just for a few minutes a day.

Walking daily has a host of benefits for your body, mind, and emotions. Research has also shown regular walking can help extend your life. Some walking is better than not walking at all, and even shorter daily walks can boost your health. If you're new to walking, start slowly to avoid injury.

Omura JD, Ussery EN, Loustalot F, Fulton JE, Carlson SA. Walking as an opportunity for cardiovascular disease prevention . Prev Chronic Dis. 2019 May 30;16:E66. doi:10.5888/pcd16.180690

Johns Hopkins Medicine. Exercise and the heart .

American Heart Association. Start with a step and walk your way to better health .

American Heart Association. Walk this way-it's quite good for you .

American Heart Association. Older adults could lower the risk to their heart and brain 500 steps at a time .

Lan YS, Feng YJ. The volume of brisk walking is the key determinant of BMD improvement in premenopausal women . PLoS One. 2022 Mar 16;17(3):e0265250. doi:10.1371/journal.pone.0265250

Nieman, DC, Henson, DA, Austin, M. D., & Brown, VA. Immune response to a 30-minute walk . Medicine & Science in Sports & Exercise , 2005 Jan;37(1):57-62. doi:10.1249/01.mss.0000149808.38194.21

da Silveira MP, da Silva Fagundes KK, Bizuti MR,et al. Physical exercise as a tool to help the immune system against COVID-19: an integrative review of the current literature . Clin Exp Med . 2021 Feb;21(1):15-28. doi:10.1007/s10238-020-00650-3

Bond Brill J, Perry AC, Parker L, Robinson A, Burnett K. Dose-response effect of walking exercise on weight loss. How much is enough? . Int J Obes Relat Metab Disord . 2002 Nov;26(11):1484-93. doi:10.1038/sj.ijo.0802133

Raji CA, Meysami S, Hashemi S,et al. Exercise-related physical activity relates to brain volumes in 10,125 individuals . J Alzheimers Dis . 2024;97(2):829-839. doi:10.3233/JAD-230740

Kim J, Lee J, Kim YS, Park SH. Identifying the relationship between leisure walking and prevalence of Alzheimer's disease and other dementias . Int J Environ Res Public Health. 2022 Jun 30;19(13):8076. doi:10.3390/ijerph19138076

Arthritis Foundation. 12 benefits of walking .

Chekroud SR, Gueorguieva R, Zheutlin AB, et al. Association between physical exercise and mental health in 1·2 million individuals in the USA between 2011 and 2015: a cross-sectional study . The Lancet Psychiatry . 2018;5(9):739-746. doi:10.1016/S2215-0366(18)30227-X

Harvard Health. Better together: the many benefits of walking with friends .

Bytyci I, Surma S, Lewek J, Banach M. Abstract 15520: the relationships between daily step counts with all-cause and cardiovascular mortality: a meta-analysis . Circulation . 2022;146(Suppl_1). doi:10.1161/circ.146.suppl_1.15520

Centers for Disease Control and Prevention. Physical activity for adults: an overview .

Ahmadi MN, Rezende LFM, Ferrari G , et al. Do the associations of daily steps with mortality and incident cardiovascular disease differ by sedentary time levels? A device-based cohort study . British Journal of Sports Medicine 2024;58:261-268. doi:10.1136/bjsports-2023-107221

Paluch AE, Bajpai S, Bassett DR, et al. Daily steps and all-cause mortality: a meta-analysis of 15 international cohorts. The Lancet Public Health . 2022;7(3):e219-e228. doi:10.1016/S2468-2667(21)00302-9

American Heart Association. American Heart Association recommendation for physical activity in adults and kids .

By Cathy Nelson Nelson is a freelance writer specializing in health, wellness, and fitness for more than two decades.

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Health Capsule

The Benefits of Walking

Thinking about adding more physical activity to your day? Walking can be a great way to get more active.

Walking is the most popular physical activity among adults, and it’s easy to see why. It requires no special clothes or equipment, and it’s free.

Regular walking can have many health benefits. It may lower your risk of high blood pressure, heart disease, and diabetes. It can strengthen your bones and muscles. It may help you maintain a healthy weight. It might also help lift your mood.

Make walking fun by going to places you enjoy, like a shopping center or park. Bring along someone to chat with, or listen to some of your favorite music (but keep the volume low enough to hear the sounds around you).

Think about safety as you plan when and where to walk. Walk with others when possible, and take a phone and ID with you. Let someone know your walking time and route. If it’s dark outside, wear a reflective vest or brightly colored clothing. And always be aware of your surroundings.

Try these tips to help make walking a part of your daily routine.

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The Importance of Walking to Public Health

LEE, I-MIN 1,2 ; BUCHNER, DAVID M. 3

1 Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School; 2 Department of Epidemiology, Harvard School of Public Health, Boston, MA; and 3 Division of Nutrition and Physical Activity, Centers for Disease Control and Prevention, Atlanta, GA

Address for correspondence: I-Min Lee, M.D., Sc.D., Brigham and Women's Hospital, Harvard Medical School, 900 Commonwealth Ave East, Boston, MA 02215; E-mail: [email protected] .

Purpose:

There is clear evidence that physical activity, including walking, has substantial benefits for health. This article, prepared as part of the proceedings of a conference on walking and health, discusses the type of walking that produces substantial health benefits, considers several methodological issues pertinent to epidemiologic studies investigating the association of walking and health, and reviews some of the reasons for the large public health importance of walking.

Methods:

Review of the available literature. Due to space constraints, this is not intended to be a comprehensive review; instead, selected studies are cited to illustrate the points raised.

Results:

Walking as a healthful form of physical activity began to receive attention in the 1990s due to new recommendations that emphasized moderate-intensity physical activity. The main example of moderate-intensity activity in the 1995 Centers for Disease Control/American College of Sports Medicine recommendation was brisk walking at 3 to 4 mph. Evidence for the health benefits of walking comes largely from epidemiologic studies. When interpreting the data from such studies, it is necessary to consider several methodological issues, including the design of the study, confounding by other lifestyle behaviors, and confounding by other kinds of physical activity. Walking has the potential to have a large public health impact due to its accessibility, its documented health benefits, and the fact that effective programs to promote walking already exist.

Conclusions:

Walking is a simple health behavior that can reduce rates of chronic disease and ameliorate rising health care costs, with only a modest increase in the number of activity-related injuries.

Could something as mundane as walking be of large importance to public health? The answer is yes. Indeed, because most Americans do not attain recommended levels of physical activity, walking could have even greater public health impact if sedentary Americans began to walk so as to meet public health physical activity recommendations.

It is well known that unhealthy behaviors are the main preventable causes of chronic diseases that account for most morbidity and premature mortality in developed countries. The most important health behaviors relate to tobacco use, diet, physical inactivity, and alcohol use. As an example of their importance, the Nurses' Health Study reported that 82% of coronary events in a cohort of women were attributable to these four unhealthy behaviors ( 38 ). A surprisingly low percentage of Americans adopt healthy behaviors in all of these areas. An analysis of national survey data from 2000 reported that only 3% of American adults had all four indicators of a healthy lifestyle, in that they did not smoke, engaged in regular physical activity, ate five or more fruits and vegetables each day, and had a healthy body weight (defined as body mass index 18.5-25 kg·m −2 ) ( 31 ).

In this article, prepared as part of the proceedings of a conference on walking and health, we will discuss the type of walking that produces substantial health benefits, discuss several methodological considerations for epidemiologic studies investigating the association of walking and health, and review the reasons for the large public health importance of walking.

WHAT TYPE OF WALKING IS RECOMMENDED?

It is in the context of how lifestyle behaviors, such as those discussed previously, affect chronic diseases that walking assumes its import to public health. Interestingly, the significance of physical activity, including walking, as a predictor of lower rates of chronic diseases took a relatively long time to gain wide acceptance. For example, the first US Surgeon General's report on smoking and health was published in 1964. However, the first US Surgeon General's report on physical activity and health was not published until 1996 ( 41 ). Combining the findings of this 1996 report with other evidence reviews, there is now strong evidence that a lack of physical activity increases risk of premature mortality and many chronic diseases, including cardiovascular disease (CVD), thromboembolic stroke, hypertension, type 2 diabetes mellitus, osteoporosis, obesity, colon cancer, breast cancer, anxiety, and depression.

Moderate-intensity physical activity, including walking, as a healthful form of physical activity began to receive attention in the 1990s ( 41 ). Before the 1990s, public health recommendations emphasized the health benefits of increasing physical fitness by means of vigorous activities like running ( 19 ). The focus of these earlier recommendations was primarily on the benefits of exercise for physical fitness, which was considered separate from health. Then, in 1995, the Centers for Disease Control (CDC) and the American College of Sports Medicine (ACSM) published a physical activity recommendation based upon the scientific consensus that substantial health benefits can accrue from moderate-intensity physical activity (3-6 METs) of at least 30 min·d −1 ( 29 ). Therefore, an important feature of the more recent recommendations has been the shift in emphasis toward public health. The CDC/ACSM recommendation also stated that 30 or more minutes of activity could be accumulated from multiple bouts, as long as each bout was 10 min or more.

The main example of moderate-intensity activity in the CDC/ACSM recommendation was brisk walking at 3 to 4 mph for most adults. That is, the recommendation specified the type of walking necessary to produce substantial health benefits: a minimum frequency ("most days of the week," typically interpreted to be at least 5 d·wk −1 ), a minimum duration each day (30 min), a minimum time for each activity bout (10 min), and a minimum intensity (moderate intensity). Of course, lesser amounts of walking could be combined with other types of moderate- or vigorous-intensity activity to attain similar benefits (e.g., as seen in Ref. ( 27 )).

It has been a challenge to communicate the information in the recommendation to the public. For example, people commonly have regarded 30 min as the target, instead of the minimum, duration of activity. Walking can be performed at light intensity (e.g., strolling while window shopping), moderate intensity, or (less commonly) at vigorous intensity (e.g., fast walking on an incline). It is not always obvious to adults which walking is moderate to vigorous in intensity and therefore counts toward the recommendation, and it is also not obvious to them which walking is light in intensity and so does not count on the recommendation. Messages about how to use pedometers usually do not communicate the minimum requirements. For example, messages along the lines that "every step counts" are useful for encouraging more physical activity, but a complete message would also include "and some steps count more than others." Additionally, although pedometers can act as an external motivation to exercise ( 39 ), there can be large variations in the number of steps recorded by inexpensive pedometers ( 8 ), and pedometers also cannot assess the intensity of the walking.

METHODOLOGICAL CONSIDERATIONS IN EPIDEMIOLOGIC STUDIES OF WALKING AND HEALTH

The evidence for the health benefits of walking come largely from epidemiologic studies. Therefore, in this section, we discuss some important methodological issues to consider when interpreting the data from such studies. Specifically, we will discuss three issues: (i) influence of study design, (ii) confounding by other lifestyle behaviors, and (iii) confounding by other aspects (kinds) of physical activity. In discussing these issues, we will draw on examples from the CVD literature because heart disease represents the leading cause of death in the United States ( 15 ).

Impact of study design.

All studies that have investigated walking in the prevention of CVD (i.e., examining this clinical end point directly, as opposed to CVD risk factors) have been observational epidemiologic studies, either case-control or cohort studies; there have been no randomized clinical trials due to feasibility constraints. Because such studies-in particular, the cohort studies-typically enroll thousands or tens of thousands of participants, the most practical method of assessing walking has been by questionnaires. Often, the large cohort studies have conducted smaller validation studies to examine the reliability and the validity of the self-reported physical activity data that they have collected on questionnaires. Generally, moderate correlations have been obtained between self-reported data and data obtained using more objective methods, such as using accelerometers ( 18 ).

An important fact to consider is that a moderate, or even good, correlation coefficient does not mean that exact correspondence has occurred; it merely indicates that the rank order of subjects (i.e., ranking from lowest to highest level of physical activity), measured by self-report, correlates well with the rank order as assessed by the more objective method. For example, in the College Alumni Health Study (CAHS), walking as reported on questionnaires correlated well with walking as recorded in physical activity diaries ( r = 0.64) ( 1 ). However, in another study by Bassett et al. ( 3 ), walking as reported on questionnaires captured only about 35% of walking as measured by pedometers. The CAHS physical activity questionnaire clearly ranks subjects well, as indicated by the correlation of 0.64. It also has face validity in that the data from CAHS had shown expected inverse associations between walking and many chronic diseases, including all-cause mortality, heart disease, stroke, and diabetes. In fact, this questionnaire, developed by Professor Ralph Paffenbarger, has provided key data on much that we know about the associations of physical activity and health ( 12,21-23,27,36 ).

One possible explanation for the discrepancy between self-reported walking and walking as measured using pedometers is that the CAHS questionnaire was intended to measure purposeful walking only-such as walking for exercise or transport, whereas the pedometer measures all walking-including incidental walking in the course of daily living (e.g., walking around in the morning while getting ready for work). A biologically relevant question is, which kind of walking, as well as at what intensity, is important for health benefits? Only purposeful walking, which is more likely to last at least 10 min per episode or, all walking, regardless if the walking episode lasts only several seconds? This is important for investigators to consider. As discussed above, perhaps the answer may differ depending on the health outcome of interest. For example, for weight management, perhaps every bit of walking counts, whereas for other diseases (such as breast cancer) or other health benefits (such as cognitive function), perhaps more sustained and faster walking may be more relevant. As mentioned above, large variations in the number of steps recorded by some pedometers also may partly explain the discrepancy between self-reported walking and walking as measured using pedometers ( 8 ).

How can we better measure walking? This is beyond the scope of this article and is covered by another article from the conference.

Confounding by other lifestyle behaviors.

Men and women who walk regularly, whether for transportation or leisure, are likely to differ from those who do not walk. One way in which they differ may be concerning other lifestyle habits. Intuitively, it would seem that those who walk regularly for leisure are likely to have healthier habits. This correlation is important because if we observe that walking is associated with lower rates of CVD, we need to consider-is walking responsible for the lower rates? Or are the lower rates due to other associated healthy habits?

Some evidence for demographic differences between those who do and do not walk is provided by the 1818 randomly selected men and women throughout the United States in the US Physical Activity Study ( 9 ). When comparing the two groups, those who reported regular walking sufficient to meet current physical activity recommendations and those who reported never walking, the sex distribution is similar for the two groups. However, regular walkers were more likely than never walkers to be younger, college graduates, and employed.

The US Physical Activity Study did not provide data on other lifestyle behaviors, so to examine whether differences exist for these characteristics, let us consider an example from another study. In the Harvard Alumni Health Study, a prospective cohort study that was begun in the early 1960s, information on health habits has been updated periodically. In the 1988 cycle of data collection, men who reported any walking tended to be younger than nonwalkers (66.2 vs 68.6 yr, respectively; P < 0.05). The mean body mass index did not differ much between walkers and nonwalkers (24.8 vs 24.6 kg·m 2 ; P = 0.19). A very low proportion smoked cigarettes, somewhat lower for walkers than nonwalkers (8.1 vs 9.5%; P = 0.26), but the difference was not statistically significant. Walkers in the Harvard Alumni Health Study were more likely than nonwalkers to report alcohol consumption (74.1% vs 67.2%; P < 0.05), which is cardioprotective in moderate amounts. Their diet also was healthier than nonwalkers; walkers ate less meat (27.8% of walkers ate ≤3 servings of meat per month compared with 23.8% of nonwalkers; P = 0.02) and more vegetables (25.0% of walkers ate ≤1 serving of vegetables per day compared with 31.6% of nonwalkers; P = 0.0002).

Therefore, in studies of walking and chronic disease prevention, it is important to consider differences between walkers and nonwalkers to exclude the possibility that the lower rates of disease among walkers may be due not to the walking itself but to other factors coexisting with walking that predict lower risk of disease.

Confounding by other aspects of physical activity.

In addition to being different concerning other lifestyle behaviors, walkers also may differ from nonwalkers concerning other kinds of physical activity that are carried out. In particular, we would expect walkers to be more active overall, expending more energy in leisure-time physical activities as well as in transportation. Walkers also may be more likely to participate in vigorous activities. Therefore, in examining the association between walking and the risk of developing chronic diseases, it is important to consider this correlation between walking and participation in other kinds of activities.

In particular, the separation of the effects of walking and other associated vigorous activities is important. If we were to observe lower rates of chronic disease among persons who walk, is it the walking that is responsible? Or is it the associated vigorous activities because there are clear data showing that vigorous activities lower the risk of premature mortality and chronic diseases such as CVD ( 41 )? This distinction is not merely academic, but it has important public health implications. One reason it is important to make the differentiation is that if it is indeed the associated vigorous activity that is responsible for the lower risk-and not the walking-then the current CDC/ACSM recommendation for moderate-intensity physical activity will not be helpful for delaying mortality and preventing CVD.

Empirical data in men and women show that walkers are more active and more likely to participate in other activities, including vigorous activities, than nonwalkers. In the Harvard Alumni Health Study with male participants only, walkers of any amount clearly were more active than nonwalkers. In the 1988 data collection cycle, the median energy expended on leisure-time physical activity (including walking) in walkers was 1902 kcal·wk −1 , as contrasted with less than half this in nonwalkers, 700 kcal·wk −1 . Forty-eight percent of walkers reported participation in other leisure-time activities of moderate intensity compared with 34% of nonwalkers. The difference was not as great for participation in vigorous activities, 40% of walkers, compared with 34% of nonwalkers. All these differences between walkers and nonwalkers were statistically significant.

In the Women's Health Study, a completed randomized trial of aspirin and vitamin E in the primary prevention of CVD and cancer in about 40,000 women, data were collected on physical activity at baseline ( 7,20,33 ). As with men in the Harvard Alumni Health Study, the women walkers (i.e., women reporting any regular walking) in this study also were much more active than the nonwalkers. The median energy expenditure on leisure-time physical activity (including walking) in walkers was 727 kcal·wk −1 but only 60 kcal·wk −1 in nonwalkers. Walkers also were more likely to participate in vigorous leisure-time activities than nonwalkers. With regard to specific vigorous activities, 10% of walkers jogged as compared with 3% of nonwalkers. For tennis, the corresponding figures were 5% versus 2%; for swimming, 12% versus 7%.

How might we account for such differences in epidemiologic studies of walking and chronic disease prevention? Investigators have commonly used two methods to account for such differences. First, adjustment can be made in analyses for participation in other activities, so that any results obtained are independent of the other activities. Second, analyses can be restricted only to participants who do not participate in vigorous activities, thus preventing confounding by vigorous activities. This latter method is often used in studies of women because a sizeable proportion of women do not participate in vigorous activities, and walking (of any amount) is a common activity ( 24 ). As a result of this restriction of the study sample, there cannot be confounding by vigorous activities because no subjects are participating in any vigorous activity.

In the remaining section of this article, we will discuss data from several studies of walking and CVD prevention, taking into consideration the methodological issues detailed above.

Walking and CVD prevention-epidemiologic data viewed in the context of methodological considerations.

Although there have been numerous studies of physical activity in the prevention of CVD, there have been far fewer studies specifically addressing this particular activity, walking. Many of the studies that have specifically examined walking have been published after the 1995 CDC/ACSM recommendation that promoted walking. A comprehensive review of these studies is beyond the scope of this article. We will instead select several of these studies to illustrate the methodological issues discussed above.

One of the earliest studies of walking in CVD prevention was published in 1978 by the Harvard Alumni Health Study investigators ( 28 ). Paffenbarger et al. examined the physical activity habits, including walking, of 16,936 male Harvard alumni, aged 35 to 74 yr, in relation to their risk of a first heart attack. After taking into account differences in age, investigators found that alumni who walked <5 blocks a day (about 3 miles·wk −1 ) had a 26% higher risk ( P = 0.016) compared with men who walked more. These early observations were limited by the analytical tools available then. There was no adjustment for other potentially confounding factors, such as other lifestyle habits, or participation in other physical activities. Additionally, only two levels of walking were examined, so dose-response relations could not be assessed.

In updated analyses of the Harvard Alumni Health Study, Sesso et al. ( 36 ) categorized men into more categories of walking and adjusted for differences in smoking, alcohol intake, body weight, personal and family medical history, as well as participation in other light-, moderate-, and vigorous-intensity leisure-time activities. Men who walked 5 to less than 10 km·wk −1 (approximately 3 to <6 miles·wk −1 ) had a 13% lower risk of coronary heart disease, statistically significant, than men walking less. With greater distances walked (10 to <20 and ≥20 km·wk −1 ), no greater risk reduction was observed ( P for trend = 0.08) among these men; that is, the dose-response curve seemed to be L-shaped for this population.

The Harvard alumni comprised only men. However, several studies of women have also shown walking to be predictive of lower risk of coronary heart disease. For example in the Women's Health Study, which enrolled 39,876 women aged 45 yr or older, Lee et al. ( 24 ) observed an inverse relation between overall leisure-time physical activity and risk of developing coronary heart disease. Additionally, to examine the independent effects of walking, they separately analyzed women who did not carry out any vigorous activities. In this group, both the duration of walking and the usual pace of walking were inversely associated with coronary heart disease risk ( 24 ). Compared with women who did not walk regularly, those walking <1, 1.0-1.5, and ≥2 h·wk −1 had multivariate (including adjustment for smoking, alcohol, diet, use of postmenopausal hormones, and parental history) relative risks of 0.86 (95% CI, 0.57-1.29), 0.49 (0.28-0.86), and 0.48 (0.29-0.78), respectively; P for trend <0.001. Compared with women who did not walk regularly, those with usual walking paces of less than 2, 2-3, and or greater than 3 mph had multivariate relative risks of 0.56 (0.32-0.97), 0.71 (0.47-1.05), and 0.52 (0.30-0.90), respectively; P for trend = 0.02. Thus, even women walking a very modest amount-perhaps 1 to 2 h·wk −1 -had about half the rates of heart disease compared with women who did not walk, after considering several potential confounders.

Another study of women, which included a sizeable number of minorities (16.5%), is the Women's Health Initiative Observational Study, which included 73,743 women aged 50-79 yr ( 25 ). Women were divided into those who rarely or never walked and four groups of walkers according to their usual walking pace based on self-reports. In an age-adjusted analysis, the fastest walkers, walking at greater than 4 mph, had less than half the risk of coronary heart disease compared with nonwalkers. Further adjustment for other potential confounders (including race, education, income, smoking, body mass index, waist-hip ratio, reproductive variables, diet, and family history) attenuated the association, but the fastest walkers still had about a 40% lower risk.

Investigators also examined the combined associations of walking and participation in vigorous activities in relation to CVD risk. In age-adjusted analysis, there was a significant trend of declining CVD risk with increasing time spent walking. Additionally, within each category of energy expended on walking, women who also participated in vigorous activities experienced additional risk reduction compared with women who did not. An interesting comparison is a head to head one-how do equivalent amounts of energy expended in walking or vigorous activity relate to CVD risk? The data provided do not give a precise answer because the categories used for walking and vigorous activity were not identical with respect to the amount of energy expended. However, it appears-at least in this study-that a given amount of energy expended, whether on walking or vigorous activities, is associated with approximately the same risk reduction. The age-adjusted relative risk of CVD among women who walked less than 2.5 MET ·h·wk −1 and also participated in more than 100 min·wk −1 of vigorous activities (very roughly expending some 10-12 MET·h·wk −1 ) compared with women who walked less than 2.5 MET·h·wk −1 and participated in no vigorous activity was 0.71. Using the same referent group, women who walked more than 10 MET·h·wk −1 and participated in no vigorous activity had an age-adjusted relative risk of 0.67. Thus, the risk reductions (relative risks of 0.71 and 0.67) were similar for the two groups of women who expended some 10-12 MET·h·wk −1 , the first group primarily through vigorous activities, and the second group primarily through walking. There are two points we would like to note-these relative risks were adjusted for age only, and they may change when further adjusting for other potential confounders. The second is that although there appear to be similar risk reductions, women who only walk to expend 10-12 MET·h·wk −1 would likely take 2.5-3 h to expend this energy, whereas women participating in vigorous activities to expend the same amount of energy would likely take 1-2 h only.

REASONS FOR THE LARGE PUBLIC HEALTH IMPORTANCE OF WALKING

In view of the documented health benefits of walking, the importance of walking to public health is now widely recognized, as illustrated by public health surveillance systems and Healthy People 2010 objectives. The questions about physical activity on the Behavioral Risk Factor Surveillance System list "brisk walking" as an example in a question that assesses the percent of adults engaging in moderate-intensity physical activity ( 5 ). Additionally, there is also a separate question that measures total walking. Healthy People 2010 objective 22-14 is to increase the proportion of trips made by walking, that is, to increase use of walking as a means of transportation ( 40 ).

The characterization of the relevance of walking to public health starts with its popularity. Walking is the most commonly reported activity in adults who meet physical recommendations ( 37 ). Another factor responsible for the importance of walking derives from its accessibility. Walking is a universal form of physical activity that is appropriate to promote regardless of sex, ethnic group, age, education, or income level. Walking does not require expensive equipment, special skill, or special facilities. It can be done indoors (e.g., mall walking and treadmill walking) or outdoors. In this regard, walking is particularly important for its potential to reduce disparities in health related to lack of physical activity.

Walking is poised to increase in significance to public health as the population ages. In large part, this is because the risk of chronic disease increases with age, and physical activity is effective therapy for many age-related chronic conditions. For example, physical activity plays a substantial role in the management of coronary heart disease, hypertension, type 2 diabetes, obesity, elevated cholesterol, osteoporosis, osteoarthritis, claudication, and chronic obstructive pulmonary disease-diseases that generally increase in prevalence with age. Physical activity also plays a role in the management of several other chronic conditions, including depression and anxiety disorders, dementia, pain, congestive heart failure, syncope, stroke, prophylaxis of venous thromboembolism, back pain, and constipation. Because the preference for more moderate-intensity activities, such as walking, increases with age ( 9 ), walking emerges as a leading therapeutic modality. Additionally, because the costs of medical care are substantially lower in physically active adults ( 30 ), walking has the potential to reduce medical expenditures, particularly among older adults where the prevalence of chronic diseases is high.

A few examples illustrate the importance of walking for preventing and managing chronic disease in older adults. The role of walking in controlling blood glucose is illustrated by the Diabetes Prevention Project, a randomized, controlled trial with a lifestyle intervention arm that included 150 min·wk −1 of brisk walking. In this trial, intervention reduced the risk of advancing from glucose intolerance to diabetes by over 50% ( 17 ). Physical activity also is effective in preventing falls and fall injuries in older adults ( 2 ). For example, a meta-analysis of four studies using a similar intervention that included walking reported a 44% reduction in fall injuries in the intervention group ( 34 ).

Physical activity is being seriously proposed as a means to prevent dementia, reflecting the probability that all the health benefits of physical activity, including walking, are not yet known. The prevalence of cognitive impairment increases dramatically with age in adults over age 65, with moderate to severe dementia affecting over 30% of adults aged 85+ ( 11 ). Research now suggests that physical activity during middle age and older reduces risk of cognitive decline with age ( 26 ). In one cohort study, walking that corresponded approximately to the amount required to meet CDC/ACSM recommendation was associated with a 34% reduction in risk of cognitive impairment ( 44 ).

Walking is also of relevance in addressing the obesity epidemic. The most obvious role of walking is in producing increases in caloric expenditure. The US Dietary Guidelines recognize that some adults prefer to increase caloric expenditure to the equivalent of at least 1 h of walking a day as a means to attain a healthy body weight ( 42 ). Short bouts of walking may play a role in weight management as well. One approach to the obesity epidemic rests on the calculation that the daily caloric excess driving the epidemic is modest, in the range of 10-50 kcal·d −1 ( 13 ). Because all steps expend energy, increasing steps by a modest amount each day (e.g., 1000-2000 steps) theoretically could prevent obesity, provided caloric intake does not change. Research is needed on the role of walking in weight management, particularly community approaches to promoting short bouts of walking of less than 10 min per episode, which accumulate to some sizeable total duration. That is, the obesity epidemic may offer a rationale for promoting forms of walking that do not count toward CDC/ACSM recommendations but do help manage weight. Such short bouts also may be more feasible to promote compared with longer bouts.

Another factor favoring walking over other activities is injury risk. The ability to identify physical activities with the lowest injury risk is limited by insufficient data and research on injury risk ( 14 ). But one study reported that greater amounts of walking were not associated with a greater injury risk ( 14 ). In contrast, the study reported the expected dose-response relationship, where adults performing sports for more than 3.75 h each week had the greatest risk of exercise-related injury.

The public health benefits of promoting walking extend beyond its direct benefits, that is, benefits that derive from physiologic effects (e.g., improved blood pressure, glucose control, lipid profile, etc.) in individuals who are more physically active. As an example, promoting active transportation (e.g., walking to work) reduces automobile use and thereby road congestion and air pollution. Reducing air pollution should lower rates of asthma and cancer. Reducing automobile use theoretically reduces risk of injury from automobile collisions. Hiking increases contact with natural environments. There is increasing evidence that exposure to natural environments improves mental health ( 10 ). Walking is often a group activity that results in social interaction, which also has independent effects on health as indicated by evidence that low social interaction is associated with increased mortality ( 35 ).

Finally, walking is important to public health because effective interventions to promote walking already exist. The Guide to Community Preventive Services identifies interventions that are effective in promoting walking ( 16 ). These include community-wide campaigns, such as Wheeling Walks, targeting sedentary middle age and older adults, which reported a 23% increase in the number of walkers in the community ( 32 ). Promoting access to locations for walking also increases the amount of walking the community. A study of trail enhancement and promotion reported an increased level of physical activity in adults who used the trails ( 4 ). Further, many trail projects are not expensive. A study of six trails in a medium size Midwest city estimated a $1 investment in multiuse trails would save about $3 in medical costs ( 43 ). The Community Guide also recommends signs to increase stair use ( 16 ). Because a bout of stair use is surely almost always less than 10 min in duration, this recommendation has relevance for greater caloric expenditure in obesity (and also to maintaining muscular strength and endurance). In children, there is growing interest in programs that increase the percent of children and youth who walk or bike to school ( 6 ).

CONCLUSIONS

In summary, if everyone in the United States were to obtain 30-60 min of moderate-intensity physical activity each day, the benefits would be extensive. Although it is currently difficult to quantify all the effects, one predicts lower rates of chronic diseases (such as obesity and CVD) and a dramatic reduction in medical expenditures, with only a modest increase in number of activity-related injuries. Because walking is the most popular type of moderate-intensity physical activity, walking has substantial importance to public health. We reach the interesting conclusion that part of the solution to chronic disease and rising health care costs is as simple as walking everyday. Indeed, if everyone in the United States began walking 30-60 min each day, the benefits would be extensive. Although it is currently difficult to quantify all the effects, one predicts lower rates of chronic diseases (such as obesity and CVD) and a dramatic reduction in medical expenditures, with only a modest increase in number of activity-related injuries. The evidence of health benefits and effective interventions justifies research on policies that are effective in promoting physical activity including policies that improve access to enjoyable places for walking, policies that promote walking to school and policies that promote active transportation.

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EPIDEMIOLOGY; EXERCISE; INTERVENTION; PHYSICAL ACTIVITY; PUBLIC HEALTH; WALKING

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12 Unexpected Health Benefits of Walking and How to Make a Habit of It

Walk your way to better sleep, strength, mood, and more incredible wellness payoffs.

Walking for 30 minutes every day can improve your health in more ways than you might expect. Not only is walking a fantastic low-impact form of cardiovascular exercise, it can significantly improve your mental and emotional health, and help with a range of wellness goals from stress to sleep. We asked experts for the biggest benefits of walking, and here's what they had to say.

Michael Lam , MD, MPH, ABAAM, is a physician specializing in nutrition and healthy aging.
Allison Grupski , PhD, is a clinical psychologist and the vice president of behavior change strategies and coaching at WeightWatchers.
Brian Shinkle , DO, is the medical director at Pivot Onsite Innovations and Pivot Occupational Health, specializing in occupational medicine.

Benefits of Walking Daily

Increases energy levels.

"Not many people recognize walking as a real workout," says Michael Lam, MD, MPH, ABAAM, a physician specializing in nutrition and healthy aging. "Perhaps it's too easy, too common, too enjoyable, or too relaxing to be considered a serious form of exercise. [But] in fact, the best thing about this delightful activity is that it's one of the easiest exercises you can do on a consistent basis."

It sounds like a Catch-22 because you need energy to walk, but walking increases your energy levels. But it's the truth. Walking has been shown to boost your energy and increase your stamina. The more you do it, the more invigorated you may feel.

However, the challenge is making walking (or consistent movement in general) a regular part of your daily routine. "Many health coaches, doctors, and fitness trainers will tell you that the best form of exercise is one you'll actually maintain," Lam says.

Improves Heart Health

There's a reason walking is hailed as one of the best forms of exercise for heart health. The National Heart Foundation of Australia estimates that walking 30 minutes or more each day can actually lower the risk of heart disease, reducing the risk of stroke by a whopping 35 percent. Plus, daily walking can help you maintain a healthy weight, metabolism, blood pressure, and blood cholesterol, all of which help keep you in good cardiovascular shape.

Even if you can't commit to 30 minutes per day, evidence shows that even a small amount of walking is better than none when it comes to our hearts (yes, vigorous vacuuming, playing with the kids, walking the dog, and going on that long grocery run all count!).

According to a 2023 review published in The British Journal of Sports Medicine, walking might save your life. Researchers analyzed the results of 196 studies and determined that a brisk walk (even just 11 minutes a day) significantly lowered subjects' risk for heart disease, various kinds of cancer, and overall mortality. What better argument for lacing up your shoes and hitting the pavement?

Lowers Stress and Improves Mood

It's no secret that exercise is a well-researched and proven way to reduce stress. Walking releases endorphins, a feel-good chemical in the body that promotes a state of pleasure like laughter and love. "Endorphins interact with receptors in the brain and bring about feelings of well-being, increased self-esteem, increased pain tolerance, and even a sense of euphoria, often referred to as a 'runner's high,'" Lam explains.

A 2018 study also found that even single, brief 10-minute bouts of walking improved the mood state of participants. "Being active impacts the way our brain processes neurotransmitters like dopamine," explains clinical psychologist Allison Grupski. "It has an immediate impact."

Reduces Depression

Research shows that physical activity, including walking, can reduce depression. A study of 121 post-menopausal women, for example, found that those who walked three times per week for 40 minutes at a time had a significant decrease in depression.

A second study discovered that even walking at a brisk pace for just 2.5 hours per week was associated with a significantly lower risk of depression compared with adults who don't exercise.

"Depression affects millions of people globally and is a leading cause of disability worldwide," says Brian Shinkle, DO, the medical director at Pivot Onsite Innovations and Pivot Occupational Health. "Data has long shown the benefits of exercise on reducing depression."

Controls Blood Sugar

A meta-analysis of data from more than 300,000 participants made an important discovery: Those who walked regularly had a 30 percent lower risk of developing type 2 diabetes. This is because walking can help control or lower blood sugar.

Walking at a brisk pace, in particular (faster than 20 minutes per mile), was linked with a 41 percent lower risk of type 2 diabetes. A study of 201 people with type 2 diabetes, on the other hand, found that every additional 2,600 steps of daily walking was associated with a 0.2 percent lower A1c, or blood sugar level.

Boosts Immune Function

Another health benefit of walking every day: Researchers believe that exercise can significantly boost immune function, potentially causing a change in antibodies and white blood cells that help your body fight off illness.

The temporary rise in body temperature may also prevent bacteria from growing while slowing down the release of stress hormones (which can increase your chance of illness). Plus, walking may flush bacteria from the lungs and airways, reducing your chances of picking up cold and flu viruses.

Alleviates Lower Back Pain

An estimated 75 to 85 percent of Americans will experience lower back pain at some point in their lifetime. Fortunately, there's an inexpensive cure that requires no special equipment: walking.

In a study published in the journal Clinical Rehabilitation, researchers recruited participants with lower back pain, instructing half to follow a muscle-strengthening program in a rehab clinic and half to follow a program of regular aerobic walking (two to three times a week for 20 to 40 minutes). Both groups reported that their pain improved significantly.

According to the researchers, walking strengthens the abdominal and back muscles in ways similar to the rehab exercises—and it was the additional advantage of being free and available at any time. As another bonus, the walking subjects boosted their overall physical fitness: When given a short walking test, they went an average of 0.05 miles farther than they had before the study.

Strengthens Joints

Shinkle says walking can play a huge role in reducing the development and progression of osteoarthritis, a form of arthritis that affects the joints. "Exercise has long shown benefits in treating and preventing osteoarthritis: A recent study shows that walking may improve pain and slow the progression of the disease," Shinkle says.

Researchers found that people who walked for exercise had a 40 percent reduction in the development of new frequent knee pain when compared to a group that didn't walk. "Exercise [like walking] has numerous health benefits and should always be a first-line prevention and treatment approach to degenerative joint disease," Shinkle adds.

Boosts Creativity

In a series of four experiments conducted at Stanford University, researchers compared subjects' creativity levels while they walked versus while they sat. When the researchers administered a test that involved imagining new uses for ordinary objects (like a brick or a shoe), the walking subjects' creative output increased by an average of 60 percent, whether they took outdoor strolls or walked inside with a treadmill .

As the study authors wrote, “Walking opens up the free flow of ideas, and it is a simple and robust solution to the goals of increasing creativity and increasing physical activity.”

Improves Posture

Walking every day can significantly improve posture because it encourages an upright stance and strengthens the muscles that support your spine. This includes your core, pelvic muscles, and back. Walking also promotes better balance and coordination, both of which you need to maintain good posture.

The more you walk over time, the less muscle imbalances and joint tension you'll have, which can take a toll on your posture. It'll get easier and become more natural to stand upright, both during movement and at rest. Better posture not only improves physical appearance; it's also important for preventing chronic pain and discomfort that's associated with poor alignment—especially as you age.

Increases Lung Capacity

Walking regularly can also enhance lung capacity because, the more you do it, the more you gradually increase the efficiency and strength of your respiratory muscles. It works like this: As you walk, your body needs more oxygen. This causes your lungs to work harder and expand bigger to deliver that oxygen to your bloodstream. Over time, this increased respiratory effort strengthens your diaphragm and the other muscles that you need to breathe properly. This is important because improved lung capacity can help you breathe more easily during physical activity, so you feel less breathless and have better endurance.

Improves Sleep

Walking also improves the quality of your sleep. One study—a four-week intervention that increased participants’ daily steps—found that those who were more active throughout the entire month had better sleep (particularly amongst women). The research also found that, on active days, the participants reported better and longer sleeps than they had on less-active days.

Ultimately, walking helps to regulate your body’s natural circadian rhythm, which is the internal clock that controls your sleep-wake cycles. It increases the production of sleep-promoting hormones (like melatonin), which makes it easier for you to fall asleep and stay asleep. And the reduced anxiety and stress from walking can also help you sleep sounder at night.

How to Make Walking an Everyday Habit

Grupski and Lam agree that walking is one of the best places to start when it comes to making movement a daily priority . "You don't need fancy equipment, you don't need to learn complicated moves, and you don't need special attire," Lam says. "You can just put on some good sneakers, comfortable clothes, and maybe listen to a good playlist . It's often gentle enough that even if your health is compromised, you can still get many of the benefits from 30 minutes a day of walking at a brisk pace."

Grupski says the first step to making walking a habit is to forget about keeping score. "We tend to get caught up in numbers," Grupski says. "Those numbers can feel really daunting and actually get in the way of taking the first step." Instead, Grupski encourages people to do what they can in the moment, whether that's three minutes of walking a few times a day or 30 minutes all at once.

These are some simple tricks Grupski recommends to sneak in extra steps. It's a process called piggybacking, or habit stacking —tying new behaviors to familiar ones we already do.

Take the stairs instead of the elevator.
Park further away when running errands.
Walk around the house while your coffee brews.
Take a "walking meeting" instead of sitting at your desk.
Walk around the field during the kids' sports practice.

Whether you walk in segments or all at once, making walking a regular habit will help it become second-nature. "The more we do something regularly, the more likely we are to keep it up," Grupski says. "Repetition is key when it comes to habit development."

Frequently Asked Questions

As with most exercises, you should pay less attention to the numbers and more attention to how you feel. How much you need to walk to see the health benefits will depend on various factors like your starting fitness level, your weight, your pace, and more. If you don't notice any health benefits from walking, try taking longer walks or picking up the pace to exert more energy. Research suggests that walking at a brisk pace for at least 150 minutes per week is good for you.

Yes, walking backward on a treadmill does provide health benefits. You can burn calories by walking backward on a treadmill. Walking backward can also help you work different muscle groups in your legs than forward walking, which can help to improve overall balance, coordination, and strength.

Walking gets your heart pumping just like running and cycling. However, how many calories you burn depends on a few factors. Walking uphill, for example, will require more energy and burn more calories than walking on flat ground. Walking at a faster speed may also burn more calories than cycling at a slow speed. Generally, running and cycling will burn more calories because they require more physical exertion.

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Pilozzi A, Carro C, Huang X. Roles of β-Endorphin in stress, behavior, neuroinflammation, and brain energy metabolism . Int J Mol Sci . 2021;22(1):338. doi:10.3390/ijms22010338

Chaudhry, S. et al. " Biochemistry, Endorphin ." StatPearls . April 2023.

" Physical Activity Reduces Stress ." Anxiety and Depression Association of America.

Edwards MK, Loprinzi PD. Experimental effects of brief, single bouts of walking and meditation on mood profile in young adults . Health Promot Perspect . 2018;8(3):171-178. doi:10.15171/hpp.2018.23

Asikainen, T-M & Miilunpalo, S & Oja, P & Rinne, Marjo & Pasanen, M & Uusi-Rasi, Kirsti & Vuori, Ilkka. (2002). Randomised, controlled walking trials in postmenopausal women. British journal of sports medicine. 36. 189-94.

Pearce M, Garcia L, Abbas A, et al. Association between physical activity and risk of depression: A systematic review and meta-analysis . JAMA Psychiatry. 2022;79(6):550–559. doi:10.1001/jamapsychiatry.2022.0609

Jeon CY, Lokken RP, Hu FB, van Dam RM. Physical activity of moderate intensity and risk of Type 2 diabetes: a systematic review . Diabetes Care . 2007;30(3):744–752. doi:10.2337/dc06-1842

Manjoo P, Joseph L, Dasgupta K. Abdominal adiposity and daily step counts as determinants of glycemic control in a cohort of patients with type 2 diabetes mellitus . Nutr Diabetes . 2012;2(1):e25. doi:10.1038/nutd.2011.22

V. Linda, et al. " Exercise and immunity ." MedlinePlus. Feb. 2024.

American Association of Neurological Surgeons. " Low Back Pain ." Accessed May 23, 2024.

Shnayderman I, Katz-Leurer M. An aerobic walking programme versus muscle strengthening programme for chronic low back pain: a randomized controlled trial . Clinical Rehabilitation . 2013;27(3):207-214.

Lo GH, Vinod S, Richard MJ, et al. Association between walking for exercise and symptomatic and structural progression in individuals with knee osteoarthritis: data from the osteoarthritis initiative cohort . Arthritis Rheum. 2022;74(10):1660-1667. doi:10.1002/art.42241

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Morning Walk Essay for Students and Children

500+ words essay on morning walk.

The modern-day world is full of psychological disorders, poor health, mental tension , and many more problems. Likewise, the life of some people is like a mad rush from one work to another without any break.

Besides, there are very few people in the world that care about their health more than their work or daily tasks. But, there are ways by which we can restore our healthfully and morning walk is one of them. Additionally, it is so effective that it can reduce the amount of health disorder from the world.

The Best Time for a Walk

Most people believe that rising up early as 4 am and going on a walk at that time is more healthy . But, the best time of marooning walk is as soon as one gets up. Also, it is very important that you do not drink or eat anything before going for a morning walk.

Moreover, the place of the walk should be an open ground with a lot of fresh air and greenery. But, the best place for a walk in a garden, green belts, and parks, etc. are the most brilliant places. Bides, the pace of the walk should neither be too fast nor too slow. Conversation during walk should be avoided as it distracts the person from the walk.

It is helpful in vitalizing the health of the vital organs of the body. Additionally, it improves the functionality of the different system of the body. It is so because during sleep most of the organs of the body are at rest and a morning walk helps to revitalize them. In addition, it removes tiredness and the feeling of fullness from the body. The fresh air of the open area refreshers our body and mind.

That’s why many doctors advise their patients to start morning walk because of their incredible result.

Get the huge list of more than 500 Essay Topics and Ideas

Importance of Morning walk

From childhood, we have heard that “early to bed and early to rise makes a man healthy, wealthy and wise.” This is not just a saying because morning walks make a man healthy and wise.

Moreover, it improves the physical shape and state of the body which protects us from many diseases. Besides, all this morning walks create a sense of equality among the people.

Above all, morning walk gives you energy, motivates you to avoid laziness, creates a positive mindset, it is good for your organs especially heart, and it gives you time to plan your schedule. According to research, the best time for a morning walk is in the latter part of the afternoon between 3 pm to 7 pm.

To sum it up, we can say that, Morning walk is very important for the body. Also, it helps to keep the body and mind healthy. Besides, everyone whether kids or elders should try to make a morning walk a part of their daily routine. As it is seen that the life span of people who walk daily is more in comparison to those who do not do morning walk.

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Walking for Exercise

three women, older in age, walking up a grassy hill with blue sky behind them

Walking is one of the most popular forms of exercise worldwide. It doesn’t require expensive equipment or special skills, and it provides a wide range of health benefits. Whether you choose an outdoor solitary path in nature, a busy route on city sidewalks, a treadmill workout, or a few rounds around your office building, walking is a relatively accessible way to stay active .

Walking is a type of cardiovascular physical activity, which increases your heart rate. This improves blood flow and can lower blood pressure. It helps to boost energy levels by releasing certain hormones like endorphins and delivering oxygen throughout the body. Brisk walking is considered a moderate-intensity, low-impact workout that does not exert excess strain on joints (hip, knee, ankles) that are susceptible to injury with higher-impact workouts.

People may think that walking is not as effective as higher-impact workouts. Yet a large cohort study of runners and walkers found that after 6 years of follow-up, when expending an equal amount of energy, moderate-intensity offered similar benefits as higher-intensity running in reducing the risk of high blood pressure, high cholesterol, and diabetes. [1] The faster the walking pace, the greater the risk reduction observed.

Walking and Health

The 2018 Physical Activity Guidelines for Americans recommends that adults with chronic conditions do at least 150-300 minutes of moderate-intensity aerobic physical activity weekly, if able. [2] Walking is an exercise that meets this aerobic component and is associated with improving high blood pressure and body mass index, and lowering the risk of diabetes, stroke, and cardiovascular disease, and early death. [3-6] Walking speed, duration, and frequency can be adjusted depending on one’s starting fitness level, so that almost everyone can participate in walking as exercise.

Walking is often recommended to people with cardiovascular disease (CVD) by their doctors because it is a relatively safe way for them to be more active. A meta-analysis of 32 randomized controlled trials found that walking increased aerobic capacity of the heart, lowered blood pressure, and reduced body mass index and body fat. [7] However, a survey of more than 29,000 adults found that the prevalence of walking (for exercise or leisure) was lower in those with more CVD risk factors. [3] This may be partly due to people believing they need to walk long distances to see a heart-health benefit. Yet a randomized controlled trial of 40 adults with uncontrolled hypertension who were placed on a DASH diet and walking regimen were able to lower their systolic blood pressure by 15 points as compared with controls by increasing their steps by only 33%, or about 2000 extra steps a day. [8]

Physical activity affects various metabolic responses that control blood glucose. Exercise immediately uses glucose for energy and improves the body’s response to insulin. It can prevent or delay the development of type 2 diabetes and improve insulin sensitivity in those with type 1 diabetes . [9] Exercise activates the muscles, which has receptors for insulin to promote the storage of glucose in muscle tissue both during and after exercise, thereby lowering the amount of glucose in the blood. To achieve greater improvements in blood glucose control, longer durations of walking as well as higher intensity brisk walking or walking up stairs are more effective than a casual stroll. [9,10] However, even interrupting long periods of sitting with 3-5 minutes of light walking every 30 minutes can improve blood glucose control in overweight and obese individuals. [9] Spacing out exercise sessions throughout the week, rather than exercising for longer durations only 1-2 days a week, appears to most benefit insulin sensitivity.

The American Diabetes Association recommends a minimum of 150 minutes weekly of aerobic exercise of moderate-to-vigorous exercise like brisk walking, spread over at least 3 days a week with no more than 2 consecutive days without activity. [9] Further improvements in diabetes control are seen when adding 2-3 sessions weekly of resistance (strength) exercises on nonconsecutive days, using elastic resistance bands, free weights, weight machines, or body weight exercises.

Brisk walking is a popular activity for adults trying to control their weight. A meta-analysis of 22 randomized controlled trials found that brisk walking for about 3 hours a week caused significant reductions in body weight, body mass index, waist circumference, and fat mass in men and women with obesity under the age of 50. [11] Women over 50 showed more modest changes in total weight loss due to increases in fat-free mass (internal organs, cells, water, muscles), and there was insufficient data in men over 50.

A walking intervention was conducted in 490 healthy adults, half of whom had been exercising regularly, and the other half who did not exercise. Both groups participated in the intervention of walking 10,000 steps for 4 weeks and used a self-reported sleep quality questionnaire. The study found that in the non-exercise group, significant improvements were reported in perceived sleep quality, sleep duration, and sleep latency (time to fall asleep), whereas the regular exercise group reported only improved perceived sleep quality. [12] The authors noted this may have been due to the regular-exercisers already sleeping well prior to the intervention, so that additional improvements in duration and latency would be limited. Other controlled trials have found that walking is more effective than yoga in helping to improve sleep quality in cancer patients. [13]

Walking appears to have a positive effect on mental health, with the most evidence for depression. [14] Some research also shows benefit for anxiety, stress , and loneliness. There may be positive effects on mental health related to the walking setting, such as in forests, parks, and other outdoor and natural environments. However, research in this area is still limited and few studies have compared different types of walking on mental health (e.g., commuter walking versus dog walking, or walking by choice versus for necessity).

A meta-analysis of 196 prospective cohort studies involving more than 30 million adults looked at the effects of differing amounts of exercise on the risk of early death. [15] They found that participants who reported meeting minimum exercise guidelines of 150 minutes weekly of moderate exercise had a 31% lower risk of dying early compared with those who did not exercise at all. But even those who exercised half that amount at 75 minutes weekly benefitted with a 23% lower risk of death (this translates to 11 minutes daily of a brisk walk, dancing to three favorite high-energy songs, or parking in the furthest spot from a building and taking a roundabout path to the entrance). Part of the reason for greater longevity was a decreased risk of chronic diseases like heart disease and certain cancers. The authors noted that if everyone met even half the recommended exercise guidelines, 1 in 10 premature deaths could be prevented.

A note on walking pace: Moderate intensity activity is defined as having a metabolic equivalent (MET) of 3.0-6.0, or a pace of about 2.5 to 4.2 mph. A growing body of research has shown that the faster the walking pace, the greater the health benefits. [16] A Physicians’ Health Study found that participants who walked regularly had a reduced risk of CVD and early death from CVD compared with those who didn’t walk regularly. [17] The greatest benefits were in those who walked 3 mph or faster (“brisk” or “very brisk” pace), but those walking 2.0-2.9 mph (“normal” pace) also saw a protective benefit compared with those not walking regularly. Some studies have found that walking at a self-rated fast pace was associated with a reduced risk of early deaths from all causes compared with reported walking at a slow pace. [18-20] Yet one study following 4840 participants found that total steps taken was an important factor in reducing mortality: the more steps taken, the lower the risk of death from all causes. The association of walking intensity (speed) and lower mortality was not as strong when adjusting for total steps taken (meaning that a slower walk may also be protective against early death the more steps that are taken). [21]

Do I really need to take 10,000 steps a day?

So is there any science to support stepping it up? Generally, research finds that more steps are better but even a lower amount can achieve health benefits. A study following 4,840 men and women 40 years of age and older for about 10 years found that those taking at least 8,000 steps daily had a 51% lower death rate from all causes compared with those taking 4,000 steps or fewer. [21] A large cohort of more than 16,000 older American women (mean age 72 years) from the Women’s Health Study followed for 4 years found that those taking 4,400 steps a day had a 41% lower death rate compared with those taking about 2,700 steps a day. [22] Death rates continued to drop in relation to taking more steps up to 7,500 daily, but steps beyond that did not show additional benefit.

Although these studies confirm that taking more steps is good, the exact amount to see a health benefit will vary among individuals. The guideline from the Centers for Disease Control and Prevention to “move more and sit less throughout the day; some physical activity is better than none” remains an appropriate goal for everyone. [23] There’s nothing wrong with aiming for 10,000 steps or even higher, except when it becomes so daunting that you lose motivation, or you feel discouraged that a lesser amount is not good enough. Rather than feeling chained to a specific step count, listen to your body, challenge it, and feel good about what it can accomplish.

Planning Your Walking Routine

Now that you’re ready to begin walking for exercise, there are several details to consider. Where will you walk? Will you need special clothes? Are there any precautions to take?

Where to walk

There are various options, and having different choices available can prevent boredom, accommodate poor weather, and change up the intensity.

School track. If you have injuries or are new to walking, you might start with a school track during off-hours that provides a generally flat and often cushioned surface.
Sidewalks. If walking in the city or high-traffic areas, sidewalks are the safest choice. Keep your eyes on the path before you, and be aware of people who may be moving quickly around you.
Indoor mall. This is a popular choice during off-shopping hours as it provides a temperature-controlled environment with a flat predictable surface and stairwells to increase the intensity. There are usually benches or seating throughout the mall for resting. Studies have found that mall-walking is a safe, accessible, and affordable exercise environment for older adults. [24,25]
Home exercise videos. There are safe, free walking videos available online or for purchase in which you would follow an instructor, set to music. Preview the video before following it, to ensure it is the right tempo and intensity for your needs.
Look forward, not at your feet. Looking down can cause you to lose your balance.
Try not to hold onto the rails with both hands. If you feel unsteady, slow the walking pace. Walking with the arms moving at the sides is a natural action and will better engage the core muscles and develop balance. If balance is initially poor, try holding onto just one rail.
Start at a slower speed to allow your body to adjust to the movement. Gradually increase the speed or incline every few minutes if desired to increase intensity. There are also fitness benefits in varying the speed and/or intensity throughout the workout, increasing and decreasing the pace or incline. Most treadmills have built-in “interval training” workouts that follow this pattern.
Allow a 5-minute cool-down, walking at a slower pace. This can prevent dizziness that occurs if suddenly stopping the treadmill.

Clothes for walking should be comfortable and not too tight, to allow you to move freely. Some athletic clothes are made with special polyester or nylon sweat-wicking fabric, which helps to keep moisture away from your skin. It is designed to move sweat to the fabric’s outer surface to be evaporated quickly. Cotton absorbs sweat, adding weight and dampness to clothing, and does not dry out easily. It may be helpful to wear layers as your body temperature may change throughout the walk.

Shoes should have flexible soles and good arch support. Generally, running or any fitness shoe is appropriate for walking. Allow extra room in the toe bed as your foot may swell during exercise because of extra blood flow (up to a full shoe size!). This can lead to blisters if your feet rub against the shoe or the toes rub against each other. Choose a shoe at least a half size larger than your usual shoe. However, also be careful of too-large shoes that cause your foot to slide back and forth, which can create blisters. Replace the shoe when it becomes worn down, feels less supportive, or you notice new foot or leg pain after walking.

Accessories like sunglasses and hats may be needed when walking at peak sun hours to protect against UV exposure to skin and eyes.

Walk safely

Pedestrian fatalities related to traffic accidents, risk of falls or other injuries, and environmental hazards including assailants are all important considerations before stepping out:

Choose a well-lit area or walk during daylight hours.
Wear reflective gear if you walk towards dusk (try inexpensive reflective bracelets if you don’t have reflective clothing).
Choose a path that is not too isolated. It may be worth traveling further out to a park or area that has sidewalks or paths designed for walkers.
Walk with someone if possible.
Keep a mobile phone within easy reach at all times in case you need to call for help.
Don’t listen to music or podcasts too loudly, talk on the phone, or text while walking, which can distract you from being able to hear and see cars, people, and other surroundings. Not surprisingly, studies find that texting while walking decreases speed and stride length and may negatively affect balance, increasing the risk of trips and falls. [26]
Stay hydrated. Drink water before you start walking and carry extra water with you especially in warm weather.
If walking during peak sun strength from about 10am to 3pm, apply sunscreen to exposed areas even if the sun does not feel strong or it is cloudy.

Transitioning into a walking routine

Walking and mindfulness.

If walking is your exercise of choice, a typical routine may start with this: athletic shoes on, earbuds in, upbeat music playing, walking path determined. Your main goal is to complete a certain number of steps or length of time.

The fitness benefits are clear, but what you may not realize is that walking also offers psychological perks that we may miss. These come from increasing our awareness of the sights and sounds that are beyond our pedometer and music playlist. An example might be looking at nature (trees, flowers, clouds) or paying attention to people or events happening as we walk past. Buddhist monks practice walking meditations, which concentrates on the movement or position of the arms or legs while walking, which leads to increased relaxation. Some studies have shown that this form of mindful walking can reduce blood pressure and depression. [27]

One randomized controlled trial lasting 12 weeks observed adults with type 2 diabetes performing a Buddhist walking meditation (walking on a treadmill while concentrating on footsteps by stating “Budd” and “Dha” with each step) or a traditional walking regimen. [27] Both groups walked at the same moderate intensity with a duration and frequency of 30 minutes 3 times a week. The walking meditation group resulted in lower fasting blood glucose levels, blood pressure, and cortisol levels than in participants doing a traditional walking regimen.

Other studies have found that walking in nature, such as in a forest or alongside a river, can decrease negative moods like depression, anxiety, anger, fatigue, and confusion. [28,29]

Staying Active
HIIT (High Intensity Interval Training)
Yoga for Exercise
Zumba Fitness
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Colberg SR, Sigal RJ, Yardley JE, Riddell MC, Dunstan DW, Dempsey PC, Horton ES, Castorino K, Tate DF. Physical activity/exercise and diabetes: a position statement of the American Diabetes Association. Diabetes care . 2016 Nov 1;39(11):2065-79.
Mendes R, Sousa N, Themudo-Barata JL, Reis VM. High-Intensity Interval Training Versus Moderate-Intensity Continuous Training in Middle-Aged and Older Patients with Type 2 Diabetes: A Randomized Controlled Crossover Trial of the Acute Effects of Treadmill Walking on Glycemic Control. International journal of environmental research and public health . 2019 Jan;16(21):4163.
Mabire L, Mani R, Liu L, Mulligan H, Baxter D. The influence of age, sex and body mass index on the effectiveness of brisk walking for obesity management in adults: a systematic review and meta-analysis. Journal of Physical Activity and Health . 2017 May 1;14(5):389-407.
Hori H, Ikenouchi-Sugita A, Yoshimura R, Nakamura J. Does subjective sleep quality improve by a walking intervention? A real-world study in a Japanese workplace. BMJ open . 2016 Oct 1;6(10).
Tang MF, Chiu HY, Xu X, Kwok JY, Cheung DS, Chen CY, Lin CC. Walking is more effective than yoga at reducing sleep disturbance in cancer patients: a systematic review and meta-analysis of randomized controlled trials. Sleep medicine reviews . 2019 Oct 1;47:1-8.
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Garcia L, Pearce M, Abbas A, Mok A, Strain T, Ali S, Crippa A, Dempsey PC, Golubic R, Kelly P, Laird Y. Non-occupational physical activity and risk of cardiovascular disease, cancer and mortality outcomes: a dose–response meta-analysis of large prospective studies. British Journal of Sports Medicine . 2023 Jan 24.
Masuki S, Morikawa M, Nose H. High-intensity walking time is a key determinant to increase physical fitness and improve health outcomes after interval walking training in middle-aged and older people. InMayo Clinic Proceedings 2019 Dec 1 (Vol. 94, No. 12, pp. 2415-2426). Elsevier.
Imran TF, Orkaby A, Chen J, Selvaraj S, Driver JA, Gaziano JM, Djoussé L. Walking pace is inversely associated with risk of death and cardiovascular disease: The Physicians’ Health Study. Atherosclerosis . 2019 Oct 1;289:51-6.
Stamatakis E, Kelly P, Strain T, Murtagh EM, Ding D, Murphy MH. Self-rated walking pace and all-cause, cardiovascular disease and cancer mortality: individual participant pooled analysis of 50 225 walkers from 11 population British cohorts. British journal of sports medicine . 2018 Jun 1;52(12):761-8.
Celis-Morales CA, Gray S, Petermann F, Iliodromiti S, Welsh P, Lyall DM, Anderson J, Pellicori P, Mackay DF, Pell JP, Sattar N. Walking pace is associated with lower risk of all-cause and cause-specific mortality. Medicine and science in sports and exercise . 2019;51(3):472-80.
Grøntved A, Hu FB. Walking pace and handgrip strength: simple measures of fitness and mortality risk? Eur Heart J . 2017 Nov 14;38(43):3241-3243.
Saint-Maurice PF, Troiano RP, Bassett DR, Graubard BI, Carlson SA, Shiroma EJ, Fulton JE, Matthews CE. Association of daily step count and step intensity with mortality among US adults. JAMA . 2020 Mar 24;323(12):1151-60.
Lee IM, Shiroma EJ, Kamada M, Bassett DR, Matthews CE, Buring JE. Association of step volume and intensity with all-cause mortality in older women. JAMA internal medicine . 2019 Aug 1;179(8):1105-12. *Disclosure: DR Bassett reports receiving personal and travel fees from ActiGraph outside of the submitted work and is a member of its Scientific Advisory Board; the device used in this study was selected in 2009, prior to his involvement in the study.
Centers for Disease Control and Prevention. How much physical activity do adults need? https://www.cdc.gov/physicalactivity/basics/adults/index.htm Accessed 11/13/2020.
Farren L, Belza B, Allen P, Brolliar S, Brown DR, Cormier ML, Janicek S, Jones DL, King DK, Marquez DX, Rosenberg DE. Peer Reviewed: Mall Walking Program Environments, Features, and Participants: A Scoping Review. Preventing chronic disease . 2015;12.
King DK, Allen P, Jones DL, Marquez DX, Brown DR, Rosenberg D, Janicek S, Allen L, Belza B. Safe, affordable, convenient: environmental features of malls and other public spaces used by older adults for walking. Journal of physical activity and health . 2016 Mar 1;13(3):289-95.
Crowley P, Madeleine P, Vuillerme N. The effects of mobile phone use on walking: a dual task study. BMC research notes . 2019 Dec;12(1):352.
Gainey A, Himathongkam T, Tanaka H, Suksom D. Effects of Buddhist walking meditation on glycemic control and vascular function in patients with type 2 diabetes. Complementary therapies in medicine . 2016 Jun 1;26:92-7.
Song C, Ikei H, Park BJ, Lee J, Kagawa T, Miyazaki Y. Psychological benefits of walking through forest areas. International journal of environmental research and public health . 2018 Dec;15(12):2804.
Gotink RA, Hermans KS, Geschwind N, De Nooij R, De Groot WT, Speckens AE. Mindfulness and mood stimulate each other in an upward spiral: a mindful walking intervention using experience sampling. Mindfulness . 2016 Oct 1;7(5):1114-22.

Last reviewed April 2023

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Essay on Benefits of Morning Walk

Students are often asked to write an essay on Benefits of Morning Walk in their schools and colleges. And if you’re also looking for the same, we have created 100-word, 250-word, and 500-word essays on the topic.

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100 Words Essay on Benefits of Morning Walk

Introduction.

Morning walk is a healthy habit that offers numerous benefits. It is a simple exercise, suitable for people of all ages.

Boosts Physical Health

Morning walk helps to maintain a healthy body. It strengthens our heart, controls weight, and improves digestion.

Enhances Mental Well-being

Walking in the morning boosts mood and reduces stress. It provides a peaceful start to the day, enhancing mental clarity.

Promotes Social Interaction

Morning walks offer a chance to interact with neighbors, fostering a sense of community.

250 Words Essay on Benefits of Morning Walk

Morning walks, a simple yet potent activity, have been lauded for centuries for their multitude of benefits. The practice of starting the day with a brisk walk not only invigorates the body but also refreshes the mind.

Physical Health Advantages

The first and most apparent benefit of a morning walk is its positive impact on physical health. Walking increases cardiovascular fitness, strengthens bones, and improves muscle power. It also aids in weight management by boosting metabolic rate and burning calories. Moreover, the early morning sunlight provides a healthy dose of Vitamin D, crucial for bone health and immune system function.

Mental Health Benefits

Beyond the physical, morning walks also offer significant mental health benefits. The tranquility of the morning, combined with the rhythmic exercise, helps to clear the mind, reduce stress, and improve mood. The release of endorphins, often referred to as ‘feel-good’ hormones, during a walk can create a sense of happiness and euphoria.

Enhancement of Creativity and Productivity

Morning walks can also stimulate creativity and productivity. Fresh air and nature can spark new ideas and foster a problem-solving mindset. Starting the day with a walk sets a proactive tone for the day, leading to increased productivity.

In conclusion, morning walks are a simple, accessible way to improve both physical and mental health, and enhance creativity and productivity. Incorporating this practice into daily routines can lead to significant improvements in overall well-being and quality of life.

500 Words Essay on Benefits of Morning Walk

Morning walks are a great way to kickstart your day. They increase heart rate, improve circulation, and aid in burning calories, contributing to weight management. Walking in the morning exposes the body to natural sunlight, which helps produce vitamin D, essential for bone health and immune system function.

Additionally, morning walks can help regulate blood pressure and lower the risk of chronic diseases such as diabetes, heart disease, and certain types of cancer. They also improve digestion, helping to maintain a healthy gastrointestinal tract and promote better metabolic function.

Moreover, walking in the morning can enhance cognitive function. It increases blood flow to the brain, which can improve concentration, memory, and creative thinking. This is particularly beneficial for students, as it can enhance academic performance.

Connection with Nature

Morning walks also provide an opportunity to connect with nature. Walking in a park or along a trail allows one to appreciate the beauty of the natural world, which can be a powerful antidote to the stresses of modern life. This connection with nature can foster a sense of peace and well-being, and even inspire creativity.

Social Benefits

In conclusion, morning walks offer a wide range of benefits, from improving physical and mental health to fostering social connections and a deeper appreciation of nature. Incorporating a morning walk into one’s daily routine is a simple, cost-effective way to enhance overall well-being. Given these benefits, it is not surprising that morning walks are recommended by health professionals as part of a healthy lifestyle. Therefore, college students and people of all ages should consider adopting this practice to promote their health and well-being.

That’s it! I hope the essay helped you.

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The value of walking: a systematic review on mobility and healthcare costs

Martin wohlrab.

1 Dr. Margarete Fischer-Bosch-Institute of Clinical Pharmacology, Auerbachstrasse 112, 70376 Stuttgart, Germany

2 University of Tuebingen, Tuebingen, Germany

Jochen Klenk

3 Robert-Bosch Gesellschaft Für Medizinische Forschung, Stuttgart, Germany

4 Institute of Epidemiology and Medical Biometry, Ulm University, 89081 Ulm, Germany

5 IB University of Health and Social Sciences, Study Center Stuttgart, 70178 Stuttgart, Germany

Laura Delgado-Ortiz

6 ISGlobal, Barcelona, Spain

7 Universitat Pompeu Fabra, Barcelona, Spain

8 CIBER Epidemiología Y Salud Pública, Barcelona, Spain

Michael Chambers

9 MC Healthcare Evaluation, London, UK

Lynn Rochester

10 Translational and Clinical Research Institute, Newcastle Unviersity, Newcastle, UK

Matthias Zuchowski

11 Robert-Bosch-Hospital, Stuttgart, Germany

Matthias Schwab

12 Depts. of Clinical Pharmacology, and of Biochemistry and Pharmacy, University of Tuebingen, Tuebingen, Germany

Clemens Becker

13 Unit Digital Geriatric Medicine, University Clinic Heidelberg, Heidelberg, Germany

Simon U. Jaeger

14 Department of Clinical Pharmacology, University Hospital, University of Tuebingen, Tuebingen, Germany

Associated Data

For all inquiries regarding data access, please contact the corresponding author.

The ability to walk is an important indicator of general health and mobility deficits have wide-ranging economic implications. We undertook a systematic review to elucidate the impact of walking parameters on health care costs.

Publications reporting on associations between health care costs and walking parameters were identified by a systematic literature search in MEDLINE, Embase, and manual reference screening, following the PRISMA reporting guidelines. First, titles and abstracts were screened by two independent reviewers followed by a review of the full articles if they met the inclusion criteria. Costs were converted to US-Dollars with inflation adjustment for 2021. A narrative synthesis was performed.

Ten studies conducted between 2001 and 2021 fulfilled the inclusion criteria. Assessment of walking ability was carried out via patient reported outcomes, performance tests, or using wearable digital devices. Walking more than one hour per day, a faster walking speed and the ability to walk without impairments are associated with significant lower health care costs. A higher number of steps per day is associated with significant lower costs in two simulation studies, while in the study using a digital device, taking more than 10,000 steps per day is not significantly associated with lower direct costs. The heterogeneity of mobility assessments and of economic analyses both precluded a quantitative synthesis.

Cross-sectional and observational studies from this systematic review suggest a significant association of better walking performance with lower health care costs. Future health economic research and health technology assessments should use quantifiable mobility outcomes when evaluating new drugs or non-pharmacological interventions.

Introduction

Walking ability has emerged as important indicator of general health and has even been proposed to be a ‘vital sign’ [ 1 , 2 ]. Significant correlations between walking parameters (e. g. gait speed or sedentary time) and health outcomes such as mortality, morbidity, and quality of life have been established in recent years [ 3 – 5 ]. For example, taking more steps per day is associated with progressively lower all-cause mortality for young-middle age adults as well as for older adults [ 6 ]. In hip fracture patients, the ability to walk is a strong indicator of long-term survivorship [ 7 ], and Parkinson's disease patients with disturbed movement and physical impairments more likely experience falls [ 8 ]. Walking related adverse events (e.g. falls, admissions to care homes and hospitalisation), are recognized as crucial drivers of the costs of patient management [ 9 , 10 ].

Walking ability covers a meaningful aspect of health and reflects how a patient functions in daily life. As such, it represents an important outcome for studies on health-prevention and on effects of rehabilitation or surgery. Nonetheless, in the area of pivotal clinical trials, which are essential stages in drug development and marketing authorisation of new medicines, we have shown that assessments of walking parameters are not routinely included [ 11 ]. This is regrettable, since improvement in walking performance, in addition to disease-specific clinical efficacy and safety, represents a patient-relevant benefit. A positive effect of a new drug on the patients’ walking performance could also strengthen the manufacturer position in health technology assessments (HTA) or reimbursement negotiations. The constrained budgets of most national health systems mandate a careful allocation of health resources, and improvement or worsening in walking ability as a consequence of treatment could be an interesting additional variable in economic models for cost-effectiveness and cost utility analyses. Yet, a better understanding is still needed of how walking ability and costs are linked at the patient level and which parameters are the best estimators for costs.

At present, clinical trials assess walking most often as a part of generic quality of life questionnaire scores (e. g. EQ-5D, SF-36) which include some components/questions concerning mobility [ 11 ]. Tangible information on actual walking status is difficult to derive from the summary scores. Conventional performance outcomes measuring walking-related mobility (e. g. the 6-min walking distance) may suffer from other limitations, e.g. a moderate external validity [ 12 ]. Developments in digital technology have opened up the way for comprehensive real-world measurements of mobility including walking volume, pace, variability, asymmetry and phases [ 13 ]. Although the first steps have already been taken to establish walking performance as endpoints in clinical trials (for example using stride velocity as a secondary endpoint in Duchenne Muscular Dystrophy [ 14 ]), validation of these novel digital mobility outcomes (DMOs) is an important prerequisite. Mobilise-D ( https://www.mobilise-d.eu ) [ 15 ] , an EU-funded collaborative project of academia and industry, is dedicated to promote the acceptance of DMOs by regulatory authorities as endpoints in clinical trials, and by implication its use in labelling and marketing of new medicines.

The role of assessing walking ability for the analysis or prediction of health care expenditure is currently not well understood, as is its potential contribution to economic evaluations of new interventions. The present study aims to identify and synthesize the available primary literature investigating the specific association of walking parameters (conventional and digital) and health care costs.

This systematic review was conducted according to the Centre for Reviews and Dissemination’s Guidance for undertaking reviews in healthcare, with adherence to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guidelines [ 16 ]. The review has been registered in PROSPERO, the international database of prospectively registered systematic reviews (CRD42021261443).

Eligibility criteria

Eligibility criteria were defined using the PICO scheme (see appendix ). The population was not restricted to specific indications, ages, gender or geographic location. This review only includes studies assessing the economic consequences of mobility in terms of health care costs. We specifically focused on walking-related mobility parameters including gait speed, walking speed, or the number of steps, among others. Vector magnitude units per minute (VMU) or energy expenditure which are not necessarily derived from walking and questionnaires evaluating additional activity parameters at the same time were excluded. Studies that examined relationships between mobility and quality of life or further clinical factors (e. g. falls or mortality, which could have implications on health care costs), but did not assess economic consequences directly, were excluded. A PRISMA flow chart shows the study selection process, also giving reasons for exclusion (Fig. 1 ).

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Object name is 11556_2022_310_Fig1_HTML.jpg

Flow chart of search results (adapted from PRISMA Flow Diagram)

Information sources and search strategy

MEDLINE and EMBASE were searched for relevant primary research publications published from database inception until November 2022. The search was supplemented by manual reference screening and cross-referencing. The search strategy comprised two main constructs that refer to walking-related mobility outcomes and the economic implications. The main keywords “mobility”, “walking speed”, and “cost” were searched without restriction, thus not limiting the search strategy to the type of (cost) analysis. Additional search terms included in the search strategy were confined to the title. The search was restricted to studies of human subjects, written in the English language. Editorials, letters, historical articles, abstracts, and reviews were excluded. The full search strategy is presented in the Appendix .

Study selection

Two reviewers (MW, SJ) independently screened titles of all identified studies. If either reviewer considered a study to meet the inclusion criteria, its abstract was then screened independently. Upon agreement on inclusion, full texts were retrieved and reviewed independently. Disagreements were resolved in discussions with a third reviewer (MZ). Data merging, deduplication and screening was performed with the open source R package revtools [ 17 ].

Data extraction

Data were extracted from selected studies for the following study characteristics: author and year, title of publication, country of investigation, study perspective and comparators, study population and disease area, study design, database and sample size, type of medication, and cost results distributed across sectors (e. g. inpatient, outpatient, emergency, prescriptions, total costs) where reported. To facilitate comparison across studies, all costs from different country sources were inflated to corresponding values for the year 2021, using local inflation rates. These were converted to US dollars (USD) values based on 2021 end of year exchange rates published by the US Federal Reserve [ 18 ].

Quality of reporting assessment

We assessed the reporting quality of studies following on the basis of the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) guideline [ 19 ] Given that studies are very heterogeneous and do not completely meet type of studies for which CHEERS was initially implemented (cost evaluations of health interventions), individual items from the checklist were adopted based on the notation by Rothfuss et al. [ 20 ] (Table (Table1 1 ).

Assessment of quality

Study	Background and aims	Perspective	Population	Time horizon	Comparison	Economic outcomes	Discounting	Incremental costs	Sensitivity analysis	Findings and limitations	Funding	Conflict of interest
[ ]	+	[ +]	+	+	+	+	N/A	+	0	+	+	0
[ ]	+	[ +]	+	+	+	+	+	+	0	+	0	0
[ ]	+	[ +]	+	+	+	+	N/A	+	+	+	+	0
[ ]	+	0	+	+	+	[ +]	0	+	[ +]	+	+	+
[ ]	+	[ +]	+	+	+	[ +]	+	+	0	+	0	0
[ ]	+	[ +]	+	+	+	[ +]	0	+	+	+		+
[ ]	+	[ +]	+	+	+	+	+	+	0	+	+	+
[ ]	+	[ +]	+	+	+	+	0	+	0	+	+	+
[ ]	+	[ +]	+	+	+	+	0	+	0	+	+	+
[ ]	+	[ +]	+	+	+	+	0	+	+	+	+	+

Legend: + , present; [ +], partly fulfilled; 0, absent; N/A, non-applicable; notation based on Rothfuss et al

Search results

Results are presented as statistically significant differences of costs in individual studies. Due to heterogeneity in types of cost outcomes, settings, and disease areas, it was not appropriate to synthesize the results or conduct a meta-analysis of the economic findings. The initial search strategy yielded 2,771 titles after the elimination of duplicates. For the final qualitative synthesis, ten studies were included. These studies were conducted in Japan ( n = 4), United States ( n = 3), Brazil ( n = 1), Italy ( n = 1), and Germany ( n = 1).

Study characteristics

Studies were conducted between 2001 and 2021. Detailed information on the individual studies is shown in Table Table2. 2 . Six studies were observational cohort studies [ 21 – 23 , 28 , 29 ], two were cross-sectional studies [ 25 , 27 ], one was a decision analysis using a Markov Model [ 24 ], and one was a microsimulation [ 26 ]. All studies ( n = 10) examined the economic impact of mobility in middle-aged to aged populations. All studies focused on direct healthcare costs (including total costs but also costs by individual health sector).

Publication	Title	Country	Database and sample size	Study design	Study population and setting	Method & Comparison	Outcome measures	Cost data

Perkins et al. 2001 [ ]	Assessing the Association of Walking with Health Services Use and Costs among Socioeconomically Disadvantaged Older Adults	USA	= 1,088 Regenstrief Physical activity and Health Survey (RPAHS)	Cohort study	Community dwelling patients > 55 years	Multivariate models assessing the association between walking and health services use and costs (adjusting for sociodemographic characteristics, chronic disease, health status, and previous utilisation)	Health services use, and total costs	Health services use and cost data obtained from the RPAHS for the 12 months following interviews (Primary care, emergency, hospital costs as charges calculated on an annual basis)
Tsuji et al. 2003 [ ]	Impact of walking upon medical care expenditure in Japan	Japan	= 27,431 NHI claims history files	Prospective cohort study	Japanese men and women, aged 40–79 years. National Health Insurance (NHI) beneficiaries in rural Japan	Logistic regression model and multivariate models to adjust for the effect of potential socio economic confounders. Persons walked for < 30 min, 30 min – 1 h, > 1 h (per day)	Medical care Expenditure	Insurance claims history; uniform national fee schedule determines prize for each service prospectively collected for 4 years (charges for outpatient and inpatient care)
Hirai et al. 2021 [ ]	Physical Activity and Cumulative Long-Term Care Cost among Older Japanese Adults: A Prospective Study in JAGES	Japan	= 34,797 Japan Gerontological Evaluation Study (JAGES)	Prospective cohort study	Community-dwelling people aged 65 years or older, with no physical or cognitive disabilities	Generalized linear model with Tweedie distribution and log-link function, adjusted for socio economic confounders. Comparison of individuals by 3 categories (< 30 min, 30–59 min, 60 min) of time spent walking	Cost of long-term care insurance services	The outcome variable was the cumulative cost of LTCI services during the follow-up period. Documented in the Japan Gerontological Evaluation Study (JAGES)

Turi et al. 2015 [ ]	Walking and health care expenditures among adult users of the Brazilian public healthcare system: retrospective cross-sectional study	Brazil	= 963 Basic Health Units	Retrospective cross-sectional study	Patients aged ≥ 50 years	Logistic regression model and multivariate models to adjust for the effect of potential socio economic confounders. Walking (never, seldom, sometimes, often, always) during leisure-time and healthcare expenditure in primary care	Total medical expenditures	Expenditure on consultations, laboratory tests and medical consultations transformed into currency by standard table (provided by Brazilian government)

Purser et al. 2005 [ ]	Walking speed predicts health status and hospital costs for frail elderly male veterans	USA	= 1,388 Department of Veterans Affairs (VA) multicenter clinical trial	Cohort study	Medical or surgical patients > 65 years. Geriatric Evaluation and Management (GEM) program	Multivariate models to adjust for the effect of potential socio economic confounders, assessing baseline in gait speed and absolute change over 1 year	Inpatient health services use, and total costs	Data on length of stay, number, and charges of inpatient consultations, rehabilitation and social work visits as available from Veterans Affairs databases
Bonnini et al. 2020 [ ]	Improving walking speed reduces hospitalization costs in outpatients with cardiovascular disease. An analysis based on a multistrata non-parametric test	Italy	= 649 Exercise-based secondary prevention program	Prospective cohort study	Patients participating in an exercise-based secondary prevention program (average age 63)	Multi-strata permutation test after propensity score matching. Patients divided at baseline into two groups characterized by low and high WS (based on the average WS maintained during a moderate 1-km treadmill-walking test)	All-cause hospitalization and related costs	Hospitalization related costs (Process of transformation of hospitalization rates to costs is not described.)
Okayama et al. 2021 [ ]	Clinical impact of walking capacity on the risk of disability and hospitalizations among elderly patients with advanced lung cancer	Japan	= 60 Shizuoka Cancer Center	Prospective cohort study	Patients aged ≥ 70 years with advanced non-small-cell lung cancer (NSCLC)	Recurrent event analysis comparing (not adjusted for socioeconomic confounders) comparing Mobile group vs less mobile group	Length of hospital stay, inpatient medical costs	Inpatient medical costs. Electronic health records of hospitals, actual revenue that the hospital was paid from the health insurance funds for a given inpatient stay

Kato et al. 2013 [ ]	Effects of walking on medical cost: A quantitative evaluation by simulation focusing on diabetes	Japan	= 1,000 hypothetical subjects	10 year- Markov model	Hypothetical subjects representing middle aged Japanese people	Markov Model (rates of events were determined on papers and statistical data published in Japan) Patients after 10 years with 0 steps, + 3,000 steps, and + 5,000 steps	Total number of events during 10 years, Medical costs during 10 years	Medical costs for diabetes (inpatient and outpatient costs) associated with each health status events estimated from public statistical data in Japan
Karl et al. 2018 [ ]	Direct healthcare costs associated with Device-based assessment, and self-reported physical activity: results from a cross-sectional population-based study	Germany	= 477 KORA FF4 study	Retrospective cross-sectional study	Patients aged between 48 and 68 years	Two-part gamma regression model adjusted for potential socioeconomic confounders comparing inactive participants to active subjects (very low moderate-vigorous physical activity (MVPA) vs. very high MVPA)	Total healthcare costs	Direct medical costs (based on physician visits, ambulatory hospital visits, and drugs) calculated using national unit costs, as recommended by the Working Group Methods in Health Economic Evaluation (AG MEG)
Kabiri et al. 2018 [ ]	The Long-Term Health and Economic Value of Improved Mobility among Older Adults in the United States	USA	n = 12.6 million Medical Expenditure Panel Survey (MEPS 2012)	Micro Simulation	Patients ≥ 51 years with osteoarthritis	Six-step process to model the effect of improved mobility though improvements in quality of life measures on health economic outcomes. Comparing “status quo” population (pre-treatment mobility levels) with the “mobility improvement” population	Medical expenditures, Nursing home utilisation	THEMIS microsimulation tracked individuals to translate changes in quality of life to health economic outcomes derived from MEPS data base (included costs were not described)

The description of the source of cost data and the calculation of costs varied considerably across studies. A detailed description was absent in one study [ 28 ] but it can be assumed that estimates of hospitalization rates were based on a regional Health Service Registry. Outpatient/emergency room visits or inpatient hospital stays were gathered from institutional electronic health records [ 21 , 25 , 29 ], or insurance databases [ 22 , 23 ]. Karl et al. [ 27 ] directly questioned patients. Hirai et al. [ 30 ] used data from the Japan Gerontological Evaluation Study (JAGES), which collected information about the costs from the municipalities that also act as insurers. Kato et al. estimated costs from public statistical data in Japan [ 24 ] and the microsimulation study by Kabiri et al. used THEMIS (The Health Economic Medical Innovation Simulation) to estimate how mobility improvements affect medical expenditures through monetized quality adjusted life years including data from MEDICARE, and MEDICAID [ 26 ].

Quality of reporting

The assessed quality of reporting is shown in Table Table1. 1 . All publications outlined the background adequately to understand the research need and the research question. All studies reported cost differences due to a change in walking parameters. Costs that should be included in an analysis depend on the study perspective (refers to the point of view one takes when assessing costs), so failing to state the perspective meant that some of these studies lacked a clear rationale for the types of cost included. Five studies [ 24 , 26 , 28 , 29 ] did not adjust costs that occurred at different points in time, and two studies [ 23 , 26 ] conducted a sensitivity analysis to address a certain variety of their assumptions.

Reported results

Cost results are shown in Table Table3. Perkins 3 . Perkins A, Tsuji I, Purser JL, Kato M, Turi B, Kabiri M. [ 21 – 26 , 28 , 29 ] reported that lower levels of walking ability were associated with higher health care expenditure, and one study [ 27 ] reported no statistically significant association between mobility and health care costs. Six studies reported additional associations between walking parameters and health care utilisation [ 21 – 23 , 26 , 28 , 29 ].

Cost results

Publication	Walking outcomes	Utilization results	Direct Costs results (adjusted to 2021 USD)
Perkins et al. 2001 [ ]	PRO: Walking Time (average minutes of walking per week by newly developed questionnaire)	Walking 120 or more minutes was associated with a lower risk of emergency room visit (OR = 0.5) and hospital stay (OR = 0.6) in the subsequent year	Total annual costs for those walking 0 min per week (8,123 $) vs. those walking more than 120 min per week (2,844 $) Inpatient costs for those walking 0 min per week (6,018 $) vs. those walking more than 120 min per week (1,814 $) Emergency room for those walking 0 min per week (1,109 $) vs. those walking more than 120 min per week (388 $)
Tsuji et al. 2003 [ ]	PRO: Walking Time (self-reported walking duration per day (3 factor levels))	Compared with those walking > = 1 h/day, per capita per month cost for inpatient care in those walking > = 30 min was 16% higher. For outpatient care, both the number of visits and the medical cost also significantly increased with shorter walking time	Medical costs significantly reduced with longer time spent walking. Per capita medical cost was 173 $ per month in those who walked for 30 min/day, 168 $ in those who walked for 30 min–1 h, and 115 $ in those who walked for more than 1 h
Purser et al. 2005 [ ]	PerfO: Walking Speed (timed 50 feet walking trial as part of the ‘Reuben’s Physical Performance Test’)	Each 0.10 m/s reduction in baseline walking speed was associated with additional rehabilitation visits (1.4 to 2.5), increased medical-surgical visits (1.9 to 3.7), and longer hospital stays (1.4 to 2.9) Each 0.10 m/s/yr increase in walking speed resulted in fewer hospitalization days (2.3 [1.3 to 3.3])	Each 0.10 m/s reduction in baseline walking speed was associated with higher costs (1,854 $ [1,207 $ to 2,499 $]) Each 0.10 m/s/yr increase in walking speed resulted in 1-year cost reductions of 1,651 $ [–90 $ to 3,394 $]
Kato et al. 2013 [ ]	No direct mobility measures (derived from literature) calculated steps	Not reported	In 10 years, the total medical costs were 5.2 and 8.4% lower for 3,000 and 5,000 steps increase, respectively. The cost reduction associated with a daily increase of 3,000 steps walked was calculated as 0,000,014 $ for each step
Turi et al. 2015 [ ]	PRO: Activity of daily living (walking during leisure time as self-reported in retrospective questionnaire ‘Baecke Questionnaire’)	Not reported	Participants inserted in the category of higher involvement in walking were 41% less likely to be inserted into the group with higher total expenditure (r = 0.59; 95% CI 0.39–0.89)
Kabiri et al. 2018 [ ]	Step Count No direct mobility measure (derived from MARCHE trial)	The model predicted that a 554-step-per-day increase in mobility would reduce nursing home utilization by 2.8%	The model predicted an increase of 554-step per day increase would reduce total medical expenditures by 0.9%
Karl et al. 2018 [ ]	DMO: Step Count (Self-reported hours of exercise per week. Accelerometer (worn during waking hours for 7 days) for uniaxial counts (counts/min) on the vertical axis for the deduction of activity levels and step counts)	Not reported	No significant results (Inactive participants (less than 10,000 steps per day), had higher direct healthcare costs as compared to active subjects)
Bonnini et al. 2020 [ ]	PerfO: Walking speed (maintained during a moderate 1-km treadmill-walking test)	Every 1 km/hour increase in walking speed was associated with a 21% reduction in risk of hospitalization (HR 0.79)	Hospitalization costs in the first, second and third propensity score tertile per patient were reduced from 1,281 to 341 $, from 904 to 383 $, and from 1,197 to 334 $ among low and high improvers in walking speed
Okayama et al. 2021 [ ]	PerfO: Walking speed (distance covered by walking up and down a 10 m course at a different dictated velocities, termed “incremental shuttle walking distance” (ISWD))	The mobile group had shorter cumulative lengths of hospital stay (41.3 vs. 72.9 days/person) than the less mobile group	The mobile group had lower inpatient medical costs (16,680 $ vs. 25,458 $ /person) than the less mobile group
Hirai et al. 2021 [ ]	PRO: Walking Time (categorized average minutes of walking per week by questionnaire)	Not reported	Cumulative LTCI costs were USD 3200 for those who walked for less than 30 min, USD 2400 for those who walked for 30 to 60 min, and USD 2100 for those who walked for more than 60 min

Abbreviations: PRO patient reported outcome, PerfO performance outcome, DMO digital mobility outcome

Methods used to assess walking ability

The majority of walking assessments consisted of patient-reported outcomes (PROs) collected via questionnaires. These assessments included the following parameters: walking time [ 21 , 22 ], and walking during leisure time as part of activities of daily life [ 25 ]. Specifically, Perkins et al. examined walking time by documenting the minutes of walking per week, using a newly developed questionnaire [ 21 ]. Tsuji et al. obtained mobility data from a survey conducted in 1994, which included a question on walking time asking how long on average patients walk a day [ 22 ]. Hirai et al. assessed walking time per day with a single question (“How long do you walk a day, on average?”). The time spent walking was categorized as > 60 min, 30–60 min, and less than 30 min per day. Turi et al. assessed walking during leisure time by using the section ‘physical activity during leisure-time’ of the ‘Baecke12’ questionnaire [ 25 ]. Walking ability was also assessed by determining walking speed using performance tests. Purser et al. used the Reubens Physical Performance Test, a supervised performance test [ 23 ]. Walking speed was examined by Bonnini et al. using a 1-km treadmill-walking test [ 28 ], and by Okayama et al. using the Endurance shuttle walk test [ 29 ]. Simulation studies did not assess walking directly. They furthermore examined quantitative risk reduction by walking derived from published studies to calculate the steps taken in their cost simulations [ 24 , 26 ]. The study by Karl et al. measured the number of steps with a portable accelerometer device (Actigraph GT3X) [ 27 ].

Association with health care costs

Walking time and leisure-time walking.

In a cohort of community-dwelling adults older than 55 years, Perkins et al. found an association between self-reported walking time of 120 min a week or more, and a significant decrease in emergency room visits and hospital stays in the following year. Annual total ($1,856 vs $6,266 $), inpatient ( $1,184 vs $4,872), and emergency room costs ($253 vs $762) were less for those reporting 60 or more minutes of walking per week compared to those reporting less than 60 min of walking per week [ 21 ]. In a four-year-long prospective cohort study in Japanese men and women, aged 40–79 years, Tsuji et al. found that medical costs ($86 vs. $97) were 12% significantly lower per capita and month, for subjects walking for more than one hour/day than for those walking less than one hour/day [ 22 ]. Hirai et al. reported that time spent walking was negatively associated with the cumulative costs of long-term care insurance. These cumulative costs were significantly higher in those who walked for less than 30 min than in those who walked for more than 60 min. Turi et al. reported the association of self-reported walking during leisure time with total healthcare expenditure during one year prior to the date of the interview in Brazilian patients (randomly selected users of the Brazilian National Health System) aged ≥ 50 years. Individuals who ‘always walked’ were 41% less likely to be in the highest 25% quantile (an indicator of high expenditure) of incurred health-care cost when compared to individuals who ‘never walked ‘ [ 25 ] (Table (Table2 2 ).

Walking speed

In a frail population of hospitalised medical or surgical patients older than 65 years, Purser et al. found that when the baseline walking speed was 0.10 m/s higher, this was associated with $1,334 lower 1-year costs during the index hospitalization [ 23 ]. Bonnini et al. conducted an intervention study to evaluate the effects of an unsupervised home program in patients with cardiovascular disease, consisting of 30–60 min of brisk walking at least 3–4 days per week over 3 years, on rates of hospitalization. Between four and six years after baseline, a significant lower hospitalization rate was observed in patients that had highly improved their walking speed compared to those who had only improved their walking speed to a low extent. This resulted in an average cost reduction per patient between high and low improvers in walking between $489 and $882 [ 28 ]. Okayama et al. prospectively enrolled patients aged ≥ 70 years with advanced non-small-cell lung cancer to investigate the association of pre-treatment walking capacity with hospitalization rates and medical costs. During the first year of initial therapy, medical costs (the actual revenue the hospital was paid from the health insurance funds) did not differ between less and more mobile groups, but significantly higher additional inpatients costs ($8,076 per person) were reported for the less mobile group [ 29 ].

Number of steps

Karl et al. investigated direct medical costs of patients aged between 48 to 68 years. They used cross-sectional data of the population in the German KORA FF4 study. In a subsample of patients for whom daily step count was reported there was no statistically significant difference in costs between those who walked more than 10,000 steps per day and those who did not [ 27 ]. Kato et al. 2013 used a Markov model to simulate costs over 10 years for middle-aged Japanese patients with diabetes. They estimated that total medical costs could be 5.2% and 8.4% lower for daily step count increases of 3,000 and 5,000, respectively [ 24 ]. Kabiri et al. conducted a microsimulation study of patients aged ≥ 51 years with osteoarthritis, and reported that 554 steps more per day would be associated with a 0.9% reduction in total medical expenditure [ 26 ].

Loss of walking-related mobility has an impact on the risk of mortality (most recently Maurice et al. [ 31 ]), morbidity, and quality of life, especially in older people, and the association of mobility with readmissions and falls is well reported [ 3 – 5 , 32 ]. The costs of impaired walking ability is a major burden for national health systems. Despite this, the observation from Macera nearly 20 years ago, that ‘quantitative data to make the case that medical care costs are lower among individuals who walk than those who do not is scarce’ [ 33 ], still holds in 2022.

In this systematic review, we identified ten studies, most of them recent, that reported a relationship between walking ability and health care costs. With one exception, all studies indicated that better walking performance is associated with significantly lower health care costs. Although it is difficult to derive causal relationships from retrospective studies, the results show that maintaining walking ability can be economically beneficial. It also implies that the accurate measurement and assessment of walking ability could be important. In this regard, this review showed clearly that the calculation and reporting of costs varied considerably between studies. Greater standardisation of cost outcomes would have been needed to allow for a comparison of results in a quantitative synthesis (meta-analysis). In addition, methodically different approaches were used to associate walking ability with monetary values. Further heterogeneity was introduced by the use of different sources of cost data: there was a mix of information from institutional electronic health records, insurance databases, direct questionnaires, and other sources.

In our analysis, we focused on quantitative walking measures, e.g. walking speed, walking distance or the number of steps to enable consistency in decisions regarding the inclusion of studies. Yet, the quantification of walking performance using retrospective questionnaires, as employed in a sizeable part of the included studies, suffers from recall bias and may impact the reported associations with health care costs. For some time now, walking outcomes can be recorded by devices such as mobile phones and wristbands or watches, but in this review, we could include only one study which used such a digital mobility outcome [ 27 ]. DMOs can record how a patient functions in the real world, and thus cover a meaningful aspect of health. Assuming that they can be shown to meet necessary requirements in terms of reliability, consistency, sensitivity to change and accuracy [ 34 ], they are increasingly recognized as having the potential to contribute important endpoints in clinical trials [ 14 ].

Not only clinical but also health economic studies would benefit from the availability of DMOs. Due to their high reliability, accuracy, and simple acquisition, DMOs could be used as a tool for HTA and economic evaluation where cost models could relate a change in the walking ability (e. g. walking speed or number of steps taken) to a monetary value. HTA reports could include the value of the expected cost reduction through improved mobility in cost-effectiveness or cost-utility analyses of new interventions. In such analyses, the willingness to pay threshold is used as an economic decision criterion but the ratios set are often not based on scientific evidence [ 35 ]. Future research approaches could address the question of the individual or societal willingness to pay for maintaining certain walking-related mobility levels. Some existing limitations of cost–benefit analysis could be addressed with precise and validated correlations of monetary values and health outcomes such as walking performance and clinically predicted manifestations. Taken together, the use of the association of costs and walking outcomes could become more relevant for health policy research, HTA, budget impact calculations for health insurance companies and the negotiation of reimbursement prices. DMOs may also be of value in the context of generating real-world evidence for monitoring actual costs of therapy.

Some limitations to our review apply. Our systemic literature search includes the most relevant databases (PUBMED and EMBASE) for primary research publications in the field of health economic studies, but did not include reviews by HTA bodies or governmental reports. A search in NHSEED and DARE database was not included as these have been discontinued. The search strategy used the main keywords “mobility”, “walking speed”, and “cost” without restriction, while including additional search terms with a title search only. We acknowledge that publications might have been missed that did not include either of those elements in the title. Yet, the framework of the CHEERS checklist clearly recommends that cost analyses should already be identifiable as such in the title. It should also be mentioned that several studies could not be included in the results although they reported cost effects related to general physical activity. In these cases, it was not possible to explicitly extract walking-related mobility outcomes. Moreover, the reported cost effects are based on direct health care costs, originating from different sectors and payers. This means that the studies are very heterogeneous and our review provides no information about the relationship of walking ability to costs beyond this perspective (e.g., indirect costs due to the loss of productivity). Although cost values were converted to USD and inflated to 2021 equivalent values, data were collected in different countries, at various points in time, and against a background of different health care settings. The presence/absence of chronic conditions varied between studies and most of the studies included enrolled middle-aged to older populations. As a consequence, this review cannot inform about the association of walking ability and health care cost in young individuals.

Our systematic review demonstrates the specific relevance of walking-related mobility for health care costs. Regardless of the type of assessment of walking ability (walking time, leisure-time walking, walking speed, number of steps), the studies show that better walking ability was significantly associated with lower health care costs. Future health economic research and health technology assessments should use quantifiable mobility outcomes when evaluating new drugs or non-pharmacological interventions. Walking parameters such as number of steps or walking speed appear to be particularly well suited for use in economic cost evaluations due to their scalability. They might help to quantify the monetary value of a new therapy in terms of improvement in walking performance as an additional source of information. Further studies are needed, starting with a clear prospective definition of the mobility outcome and greater standardisation of the costing perspective, study design, and analyses. In the future, digital mobility outcomes can provide objective measures of walking ability to inform health technology assessments and payer’s decisions more reliably.

Acknowledgements

Not applicable.

Tables Tables4, 4 , ,5 5 and and6 6 .

PICO scheme

Population	Studies of participants with no restriction to specific indications, ages, or gender
Comparison	Studies that include health care utilization and/or healthcare costs of patients comparing between patients with different levels of mobility outcome parameters
Outcome	Healthcare utilization and/or health care costs
Region	Any
Language of publication	Abstract available in English
Language of publication	Full-text available in English or German
Type of study	Health economic studies
Time frame	No restriction

Medline search terms

Concept	Terms	Hits
Walking Outcomes / Mobility	Walking speed [Mesh] OR mobility [Mesh] OR physical activity [ti] OR walking* [ti] OR gait* [ti] OR gait speed [ti] OR Step? [ti] OR stride speed [ti]	167,436
Economics	Socio economic [ti] OR economic [ti] OR health care [ti] OR costs OR health service use [ti]	900,150
Connection	# AND	3,409
Connection	# NOT editorial OR letter OR historical article OR review.pt	2,216

Embase search term

An external file that holds a picture, illustration, etc.
Object name is 11556_2022_310_Tab6_HTML.jpg

Authors’ contributions

MW, SJ and CB conceived the paper. MW was responsible for data management and coordinated the review process. MW and SJ screen titles, abstracts and full texts. MW and SJ drafted the manuscript. JK contributed to development of search strategy and provided access to Embase. LD, JK, MZ, MS, MC, LR and CB critically revised the manuscript and all authors gave their final approval of the version to be published.

This work was supported by the Mobilise-D project, which has received funding from the Innovative Medicines Initiative 2 Joint Undertaking (JU) under grant agreement No. 820820. This JU receives support from the European Union's Horizon 2020 research and innovation program and the European Federation of Pharmaceutical Industries and Associations (EFPIA). The content of this study reflects the authors’ views. Neither IMI nor the European Union, EFPIA, nor any Associated Partners are responsible for any use that may be made of the information contained herein. ISGlobal acknowledges support from the Spanish Ministry of Science, Innovation, and Universities through the “Centro de Excelencia Severo Ochoa 2019–2023” Program (CEX2018- 000806-S), and support from the Generalitat de Catalunya through the CERCA Program. LR acknowledges support from the National Institute for Health Research (NIHR) Newcastle Biomedical Research Centre and the Clinical Ageing Research Unit based at Newcastle upon Tyne Hospitals NHS Foundation Trust.

Availability of data and materials

Declarations.

MW reports grants from HORIZON 2020 IMI No. 820820, during the conduct of the study. SJ is partly supported by the Robert Bosch Stiftung Stuttgart. J.K. reports grants from HORIZON2020 IMI No.820820, during the conduct of the study. M.C. reports personal fees from Takeda Pharmaceuticals, during the conduct of the study; personal fees from Takeda Pharmaceuticals, outside the submitted work. MS is supported by the Robert Bosch Stiftung Stuttgart and reports grants from HORIZON 2020 IMI 2 Mobilise-D, during the conduct of the study, and grants and non-financial support from Green Cross WellBeing Co. Ltd., Gilead Sciences Inc., Robert Bosch GmbH, and CORAT Therapeutics GmbH, as well as other from Agena Bioscience GmbH, outside the submitted work. CB disclosed consultation fees from E. Lilly and speaker fees from Amgen, Nutricia and Pfizer, and reports grants from HORIZON 2020 IMI No. 820820, during the conduct of the study. LR reports grants from HORIZON2020 IMI 2 Mobilise-D and IDEA-FAST, National Institute for Health Research, Medical Research Council, Dunhill Medical Trust, Parkinson’s UK, and Cure Parkinson’s Trust.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Contributor Information

Matthias Schwab, Email: [email protected] .

Simon U. Jaeger, Email: [email protected] .

IELTS Essay: Walking

by Dave | EBooks | 5 Comments

This is an IELTS writing task 2 sample answer essay that is only available on my Patreon based on a real question from IELTS related to walking.

Here is the questions itself:

Despite the benefits for health, fewer people today than ever before exercise by walking.

Why is this?

What can be done to encourage more walking?

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Despite the benefits for health, fewer people today than ever before exercise by walking. Why is this? What can be done to encourage more walking?

In the ancient time a large portion of individuals were engaged with physical exercises and its hardly seen today. Strolling is the vital component for physical exercise which keeps fit and strong. It is well said that health is wealth. When wealth is lost something is lost but when health is lost everything is lost. This essay will discuss various why people have less interest in walking and also proposes some useful approaches to encourage walking.

Despite of the various benefits of walking still individuals have lost interest in walking. Firstly, due to the advent of the latest technologies, people prefer to utilize them. Secondly lack of awareness. Thirdly life style also has changed in recent times and preference of Gyms is on higher demand. Another factor is younger children too much into their studies to compete, adults are occupied with their responsibilities to accomplish targets and promotions, therefore walking is a wastage of time for them. Moreover, poor infrastructure leads to a lack of interest in walking, pollution and mosquitoes also hindrance individuals to go outside of the home for a walk.

However, there are some practical approaches to develop an interest in walking such as mass awareness, good infrastructure facilities in the neighborhood parks like pavement in the park, providing adequate facilities in offices and schools and make it compulsory to spend adequate time in the physical exercise to relax. Make the people aware of the benefits of walking like it burn calories, strengthen heart, boost immune system, lower blood sugar level etc. Government should impose strict guidelines for using private vehicles in the vicinity of home for routine work.

In conclusion, individuals should have to make a regular practice to invest quality time in walking to avoid many uninvited diseases and benefited over the long run.

Great effort, Delhi!

Careful with some of your vocabulary – we don’t really say ‘in the ancient time’ for example.

Try not to use a word twice in a sentence as well.

the ideas in paragraph one are not properly developed.

Why do you say that, Tahereh?

In this modern era, the number of individuals who are engaged in walking is decreasing at an starting pace due to some reasons such as ,lack of facilities,busy schedule of people.However,this can be tackled by some measures such as introducing public parks and prohibition of private vehicles for short distances.

There are many causes why people are less engaging in walking,but an acute cause is busy lifestyle of people.To elucidate it,most of the people are becoming materialistic and in order to fulfill their needs people spend most of their time on worplaces.Therefore,they do not have time for walking.The another contributing factor is that , people do not have access to facilities realated to exercise. In other words , in most of the rural areas there is lack of proper place for walking which is why they are not able to walk in their leisure time .One perfect example of this is that ,most of my friends from rural area spend their leisure time on social media rather than walking as there is not any kind of public park in their area.

However, this case can be resolved by some solutions,but a long term solution is that government should introduce public parks or pavement areas in rural areas so they can feel motivated in order to go for walk in their free time.An added solution is that, usage of private vehicles should be banned for short distances by government which would result to reduction of pollution.Not only this,but it can also indirectly encourage people to walk to their short distance destinations.Thereby, adopting these solutions people can be encouraged to walk.

In conclusion, although nowadays people are less interested in walking due to less free time and lack of facilities,they can be motivated by providing facilities and by banning use of private vehicles for short distances.

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Benefits Of Walking (Essay Sample) 2023

Benefits of walking.

Walking is an important movement that humans require. Taking a walk each day is equivalent to keeping the doctor away because of numerous benefits accrued from this physical activity. First walking helps in losing weight. Research estimate that on average a woman that walks each day lowers the risk of obesity by five percent. It achieves this by facilitating the body to regulate its response to insulin that reduces belly fat. It also mobilizes the use of fats and alters the body composition, thereby lessening some fats in the body. Additionally, walking increases metabolism thus, burning additional calories. Moreover, walking has shown to counteract the weight-promoting gene, whereby it reduces its effectiveness by half in people that walk briskly every day.

Secondly, it boosts the immune system. Walking for about thirty minutes each day results in the increase of cells of the immune system in the body. These cells increase the protection level of the body and its ability to fight diseases consequencing in reduced chances one getting sick by forty-three percent. Moreover, it protects one from flu and colds by limiting instances of ailing from the two and by regulating the severity of their symptoms.

Walking prevents cancer. Research by American Cancer Society found that walking for an average one to seven hours per week could reduce the risk of cancers of breast and uterine. Walking achieves this by breaking down the estrogen hormone into benign or harmful byproducts and plummeting fatty tissues present in the bodies of women that produce estrogen.

Walking does wonders to the brain by boosting the memory and increasing creativity. When an individual walks for thirty to forty minutes three times in a week, there is the potential for hippocampus increase by two percent. Moreover, walking upsurges the planning and memory part of the brain thus, decelerating the shrinking of brain and onset of loss of memory prevalent among old people. Walking also inspires improved creativity. When an individual feels stuck or cannot get a solution to a particular problem, walking is helpful accelerating the production of numerous creative responses.

The mood is improved, and stress reduces. Walking is a crucial no-calories strategy of enhancing one’s mood. It modifies the nervous system by reducing feelings of anger and hostility and producing endorphins that naturally kills pain eliciting happiness. Walking outdoors exposes people to sunlight that diminishes instances of Seasonal Affective disorder. Additionally, walking lower stress due to the experience of the green nature that attracts positive feelings and relaxation.

Walking slashes the risk of various chronic diseases. Researchers document that walking lowers the levels of blood sugar in the body and risk of diabetes. Instances of stroke and high blood pressure lessen significantly, as walking provides the body with an effective cardio exercise that lowers the bad cholesterol and increases the good cholesterol. Thus, reducing the risk of these ailments.

Old age becomes better through walking. The senior people are urged to remain physically active for better health. Adopting a behavior of walking from a young age helps people when old to stay mobile and independent. Additionally, walking for these people reduces cases of physical disability by continuously providing circulation and nutrition to joints, lowers body weight and delays the occurrence of ailments such as dementia and Alzheimer’s.

If an individual wants to add more years to their lifespan, adopting a walking regimen in their lives is recommended. The activity is arguably one of the most pleasurable activities in a day and even more so because they trigger lowering of chronic ailments, improves mood and reduces stress and boosts the immune system, creativity, and memory. Moreover, it stimulates loss of weight, prevents cancer and makes lives of the elderly better.

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How Walking Changes Us

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By David L. Ulin

May 12, 2020

IN PRAISE OF WALKING

A New Scientific Exploration

By Shane O’Mara

IN PRAISE OF PATHS

Walking Through Time and Nature

By Torbjorn Ekelund

“My God,” Bruce Chatwin once averred, “is the God of Walkers. If you walk hard enough, you probably don’t need any other god.”

We know that walking is good for us, that “if undertaken in regular doses,” as Shane O’Mara writes in “In Praise of Walking: A New Scientific Exploration,” “it provides the small, cumulative and significant positive changes for lung, heart and especially brain health.” What interests me, however, is less physiological, more elusive: walking as a way of life.

I am a city walker, which is to say I walk to root myself. I define my neighborhood by walking, both its boundaries and my place within them, my connection to community. Even in the middle of a lockdown, I am out most mornings, to get exercise, yes, but also to remind myself of where I am. This is the hard part — to pay attention, to remain in the present, to look outward as well as inward, now from behind the forbidding filter of my face mask, while recognizing, as Torbjorn Ekelund reflects in “In Praise of Paths: Walking Through Time and Nature,” that “the path is order in chaos.”

Despite their echoed titles, “In Praise of Walking” and “In Praise of Paths” offer two very different approaches. The first is clinical and the second experiential; to move between them is like going back and forth from laboratory to street. This is perhaps unsurprising, given that O’Mara is a professor of experimental brain research at Trinity College Dublin, and Ekelund is a founder of the Norwegian nature journal Harvest . But the contrast also reflects starkly different responses to the questions of how and why we walk — what walking means.

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Confirming the Causal Role of Consistent Contexts in Developing a Walking Habit: A Randomized Comparison With Varied Contexts

Affiliations.

1 Brandeis International Business School, Brandeis University, Waltham, MA, USA.
2 Division of Geriatrics and Palliative Medicine, Weill Cornell Medicine, New York, NY, USA.
PMID: 39225981
DOI: 10.1093/abm/kaae045

Background: Physical activity interventions using habit development may help people increase and then maintain physical activity increases over time. Enacting behavior in consistent contexts is a central component of habit development, yet its causal role in habit development in health behaviors has not been confirmed.

Purpose: This study tests the causal role of consistent context in habit development in health behavior, using a randomized control trial of a planning intervention to develop a walking habit in 127 insufficiently active, working, midlife adults in a real-world setting.

Methods: We compare participants who plan walking in consistent contexts with controls who plan walking in varied contexts and with controls not required to plan on a change in average daily steps (measured using an accelerometer) and inhabit automaticity during a 4-week intervention and at a 4-week follow-up.

Results: As expected, consistent and varied context planners increased walking during the intervention, but only consistent context planners developed (and maintained) habit automaticity. Counter to expectations, consistent context planners did not show walking maintenance. However, across conditions, participants who developed more habit automaticity during the intervention also maintained walking more (decreased less). Having a routine daily schedule moderated some effects. Notably, no-plan controls with greater routine developed more habit automaticity, mediated by walking in more consistent contexts.

Conclusions: This study confirms the causal role of consistent contexts in developing a walking habit, in a real-world setting, with an important but challenging population for physical activity interventions and identifies a facilitating condition common for many: a routine schedule.

Keywords: Automaticity; Consistent contexts; Habit; Physical activity; RCT; Routine schedule.

Plain language summary

Developing an exercise habit may help people increase and then maintain physical activity. This study tests and confirms the role of exercising in consistent contexts as a cause of forming a daily walking habit. We use a randomized control trial of a 4-week planning intervention, with a follow-up 4 weeks after the intervention. Participants were 127 insufficiently active, working, midlife adults. We compared participants asked to plan their daily walks in consistent contexts from day-to-day, with participants asked to plan their walks in varied contexts and with participants not required to plan. As expected, consistent and varied context planners increased their daily walking steps (measured using an accelerometer) during the intervention compared to participants not required to plan. However, only consistent context planners developed (and then maintained) a daily walking habit, that is, where taking daily walks felt relatively automatic. Unexpectedly, consistent context planners did not show walking maintenance. However, across all participants, those who developed a stronger walking habit during the intervention maintained their walking more after the intervention ended. Lastly, having an existing routine daily schedule helped some participants. Those who were not asked to plan and had a more routine daily schedule also developed a daily walking habit.

© Society of Behavioral Medicine 2024. All rights reserved. For commercial re-use, please contact [email protected] for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact [email protected].

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Why is Medical Coding Important? 5 Benefits of Medical Coding on the Greater Healthcare System

Fact: about 15,000 medical coder positions open every year. That’s a lot of opportunity. With the healthcare system continuously expanding, now is the time to seize your potential in a broadening and important field. Plus, there’s a lot of room to grow, and always more to learn, so medical coding can provide the satisfaction you are looking for in a steady, ever-growing industry.

Medical coding is an exciting, behind-the-scenes job that maintains the smooth functioning of the healthcare system. Tasks like billing, data management, and communication among healthcare providers all fall under this expertise. Without it, insurance companies, hospitals, and other healthcare organizations would have a difficult time keeping track of patient records, payments, and service histories.

Let’s look a little deeper into why medical coding is important and how it could be part of your future.

What is medical coding?

Medical coding is the process of designating standardized codes to medical records using thorough physician documentation. Coders use specialized systems like the International Classification of Diseases (ICD) for diagnoses and the Current Procedural Terminology (CPT) for procedures.

Medical coders ensure that the information captured in medical records is translated into a format that can be universally understood. Medical billers —a subset of medical coders—handle billing, insurance claims, and communicating patient records rather than transcribe them.

Medical coding is not merely a technical task; it is a fundamental part of healthcare administration. Medical coders bridge that gap between healthcare providers and insurance companies, keeping services provided documented accurately and healthcare providers compensated appropriately. The role of the medical coder goes beyond simple data entry; it is about ensuring the accuracy and efficiency of the entire healthcare documentation process.

Why is medical coding important to healthcare as a whole?

Simply put, medical coding is what keeps the whole ship running. The efficiency and efficacy of the healthcare system is drastically improved due to coding processes. Medical coding ensures accuracy in billing and reimbursement processes. Medical coding guarantees that healthcare providers are paid fairly and reduces the number of denied claims and delayed payments.

For healthcare facilities to continue offering top-notch treatment, they must maintain this financial stability and responsibility. Plus, medical coding is needed for many other tasks, like:

Interpreting diagnoses and treatments
Managing and documenting medical data
Monitoring patient populations

Furthermore, patient care and policy-making are slowed to almost a standstill without correct coding. By guaranteeing accurate medical records as well as encouraging increased communication between providers, medical coders bring in better quality patient care, patient outcomes, and regulatory compliance, making sure that healthcare facilities adhere to rules and maintain patient safety.

5 benefits of medical coding careers

Medical coding is a superb career for those interested in the healthcare industry with an undeniable knack for attention to detail. Here are five benefits of a career in medical coding that may make it your dream job:

1. High demand and job security

One of the most compelling reasons to consider a career in medical coding is the high demand and job security. You’ll be a wanted commodity on the job market. Driven by factors such as an aging population and the increasing adoption of electronic health records, the healthcare system is constantly growing.

As a result, there is a growing need for skilled medical coders who can accurately document healthcare services.

2. Competitive salaries

In addition to job security, medical coding offers competitive salaries and many high-paying positions because of the demand in this line of work. Factors like geographic location, level of certification, and years of experience can influence salary levels, making medical coding not just a flexible career choice in schedule, but also in pay. Learn more here.

3. Flexibility and remote work opportunities

Flexibility is another significant benefit of a career in medical coding. Many healthcare facilities offer remote work opportunities for coders, letting them work from home and enjoy a better work-life balance. This flexibility has become increasingly appealing in today’s ideal work environment, especially after the COVID-19 pandemic, where remote work has become more common and desirable. The ability to work remotely also broadens the range of job opportunities available to medical coders, as they are not limited to positions in their immediate geographic area. Plus, some medical coding training programs are offered online, making this career even more obtainable with a convenient college path.

4. Career advancement and specialization

Pursuing medical coding as a career also comes with the added benefit of better advancement and specialization, depending on where your interests are. Areas like auditing, compliance, or healthcare data analysis are all open to medical coders, each offering its own set of challenges and opportunities.

Further education and certifications can also help coders advance within the field, opening doors to higher pay and more responsibility. If you’re looking for a career with plenty of opportunities for advancement, medical coding may be perfect for you.

5. Impact on healthcare quality

Finally, a career in medical coding makes an incredible impact on other’s lives. Though it may not seem like it with medical coding taking place in the background of healthcare, correct documentation is what ensures patients receive the care they need. Keeping as little error as possible from destabilizing the process of care, medical coders are the foundation of the healthcare system’s efficiency.

How to start a career in medical coding

Medical coding requires a combination of education and certification. A postsecondary medical billing and coding program is typically the first step. Certifying organizations like the American Academy of Professional Coders (AAPC) and the American Health Information Management Association (AHIMA) offer credentials that showcase a coder’s skills and knowledge. These steps, combined, keep your job prospects and earning potential high, making this career a worthwhile investment.

Externships or practical opportunities are also encouraged while in school. These courses build the knowledge you need for a successful profession in medical coding. Make leaps and bounds in your dream career through the many programs institutions offer to prepare you for your responsibilities.

Pursuing your coding career

Medical coding is an essential component of the healthcare system. The benefits of medical coding are incredibly plentiful with so many far-reaching opportunities in patient care and public health. As healthcare evolves, the demand for skilled medical coders will only increase.

Interested in starting your career as a medical coder? Goodwin University offers an extensive medical coding training program built to prepare you for this important career in healthcare. Find out more about medical coding and the place it could take you by calling 800-889-3282 today.

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I watched the walking dead's last 3 spinoffs & predict this new character will die.

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The Walking Dead has produced three spinoff shows since the main show concluded, and after watching them, I believe one new character will die. Despite The Walking Dead ending in 2022, the franchise has continued through various spinoff shows, each following characters from the original series. So far, I've enjoyed each new story as they've managed to rediscover some of the magic that made the franchise so special. They all have their own individual traits and qualities that make them stand out, but The Walking Dead 's spinoffs have also repeated similar storylines , making me confident about one character's death.

With the ongoing shows taking place in fresh locations, I'm not surprised to see so many new additions to the zombie series. Although the protagonists are familiar, the spinoffs have introduced a variety of villains and supporting characters that haven't been seen previously in the franchise. The Ones Who Live also utilized unexpected cameos like Gabriel and Jadis, but the cast still predominantly consisted of new survivors, which was also the case in Daryl Dixon and Dead City . However, despite the abundance of fresh faces, I think one of Daryl Dixon 's upcoming additions may die based on the previous spinoffs .

Alicia Clark (Alycia Debnam-Carey) and Davon (Jessie T Usher) from Walking Dead Spinoffs

10 The Walking Dead Spinoff Characters Who Must Return In Future Shows

The Walking Dead spinoffs, like Fear the Walking Dead and Tales of the Walking Dead, have introduced characters who need to return in the future.

Carol Will Meet A New Character, Ash, In Daryl Dixon Season 2

Daryl dixon season 2's trailer teased ash helping carol on her journey to france.

Ash (Manish Dayal) in The Walking Dead: Daryl Dixon Season 2 Trailer

The Walking Dead: Daryl Dixon is set to introduce a new character named Ash, who will cross paths with Carol in season 2. While Daryl Dixon 's trailer left many parts of the upcoming story a mystery, it seemed to reveal how Carol gets to France in season 2 , with Ash being the pivotal factor. The teaser showed Ash and Carol boarding a plane, indicating the spinoff's new character is some sort of pilot. Having access to a plane instantly makes Ash intriguing and his pilot skills suggest he will be a valuable survivor , meaning he could have a big role.

Given the trailer also teased Carol and Daryl's reunion, it's clear Ash's plane will provide some sort of success in season 2, confirming his importance to the plot. Although his alliance with Carol means he will be significant in the first few episodes, I'm still not confident he'll make it out of the show alive. All signs point to Ash being a resourceful survivor who is capable of handling himself, but having watched the previous spinoff shows, I don't believe that'll be enough to avoid an unfortunate fate in Daryl Dixon season 2.

Based On The Walking Dead's Past Spinoffs, Ash Will Likely Get Killed

The walking dead's previous spinoffs have killed off plenty of its new characters.

Despite how much I've enjoyed the franchise's new spinoffs, they have shared a trend that makes me fear for Ash in Daryl Dixon season 2. The recent shows have thrived when it comes to cinematography and character dynamics, but they haven't done a great job of treating their new additions with much care. The Walking Dead spinoffs have wasted several new characters , and killing most of its fresh faces has become a bad habit. Dead City kept some of its supporting cast alive heading into season 2, but the likes of Tommaso and Amaia were discarded after serving their purpose.

Rick and Michonne's spinoff killed off pretty much every important new addition.

The duo seemed like they could be crucial to Negan and Maggie's journey, but were killed off in quick succession once helping the protagonists with their objectives. The Ones Who Live was even worse for this, as Michonne's group of allies were all wiped out within one episode, while the key CRM introductions like Okafor, Thorne, and Major General Beale all met their demise before the show ended . Rick and Michonne's spinoff killed off pretty much every important new addition, which is why I think Ash may struggle to survive in Daryl Dixon , but there is a silver lining.

One Reason Ash Might Actually Survive In Daryl Dixon Season 2

Daryl dixon season 1 did a great job of making its new additions important.

Dead City and The Ones Who Live were extremely comfortable getting rid of its new characters, but Daryl Dixon treated them with more care, which could be key to Ash's survival. Although the spinoff killed off the likes of Quinn and Azlan, their deaths had a big impact on the story and Daryl Dixon was far less trigger-happy with killing off its survivors compared to the other shows . The likes of Laurent, Isabelle, Sylvie, Fallou, and Emile all felt like crucial allies who were kept around heading into season 2, proving the series won't just kill Ash for shock value.

The Walking Dead: Daryl Dixon has officially been renewed for season 3.

Even Genet and Codron both survived despite being the show's main villains, with Daryl Dixon season 2 even teasing a Codron redemption arc, which suggests there are big plans for the cast. Therefore, I do think Ash may still have a decent chance at survival, simply because Daryl's spinoff has treated its supporting characters much better than the other projects. However, with season 2 likely having even bigger stakes alongside Dead City and The Ones Who Live setting a worrying trend, I still have my doubts that Ash will have a long-term future in The Walking Dead .

The Walking Dead: Daryl Dixon

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The Walking Dead: Daryl Dixon is a spin-off series of the core franchise that stars Norman Reedus reprising his role as the titular Daryl Dixon. Waking up on the shores of France with no clue how he got there, Daryl attempts to navigate the chaos of a European country ravaged by the zombie outbreak to find his way back to the United States.

Education News

UPSC Main Paper 1 2024: Important essay topics, previous year’s question paper and more

UPSC Mains 2024 Essay paper: Exam pattern


Number of questions	Candidates need to attempt two questions, one from Section A and the other from Section B.
Total marks	250
Marks carried by each question	125
Duration	3 hours
Type of question	Subjective

UPSC Mains 2023 question paper for Essay

Upsc mains essay paper: important topics.

Justice and mercy balance precariously on the edge of circumstances.
The quest for knowledge is an ever-expanding journey toward the boundaries of understanding.
True greatness in life is found not in never stumbling, but in the resilience to rise each time we fall.
Clarity and comprehension emerge beyond the fog of doubt.
A nation’s strength is reflected in the safety and empowerment of its women.
Poverty extends beyond financial deprivation, encompassing the denial of opportunities and choices.
Progress should not compromise democracy and individual freedoms.
The mind holds the power to transform its own reality, creating heaven or hell within.
Compassion, empathy, and forgiveness are noble qualities that enhance the human experience.
In the face of change, some erect barriers while others harness the power of the winds to propel forward.
The greatest punishment for avoiding leadership is to be ruled by someone less capable.
The strongest minds often belong to those who speak the least.
Some rules are more respected when broken than when followed.
The strong do what they must, and the weak accept what they must.
True glory lies not in never falling, but in rising each time we do.
Power doesn’t corrupt; rather, people corrupt power.

Tips to prepare for UPSC Mains Essay paper

Five children have been arrested on suspicion of murder following the death of an 80-year-old man who was attacked in a park.

Bhim Kohli died in hospital after being assaulted while walking his dog at Franklin Park, in Braunstone Town, Leicestershire, on Sunday evening.

Leicestershire Police said a boy and a girl, both aged 14, and another boy and two girls aged 12, were in custody.

Officers have appealed for witnesses to come forward.

People in the area have spoken of their disbelief and sadness about what happened in the park, which is next to a primary school.

On Tuesday it was busy with police vehicles, camera crews and reporters.

Later, some people arrived carrying flowers to leave as a tribute to Mr Kohli.

A neighbour of the victim, Deep Singh Kaila, 70, described the incident as "shocking".

He added: "He was a very nice guy. He was always there, working in the allotment. Everyone knows him."

Nick Brown, leader of Braunstone Town Council, said: "Everyone's shocked by these events. It's stunned the community.

"We're trying to pull together to listen to what people have got to say and support the family and friends.

"It's a close-knit community."

Police tape on a gate into a park with an officer in the background

Police said the victim had been near the park's Bramble Way entrance at about 18:30 BST when he was seriously assaulted by a group of young people who left the scene before emergency services arrived.

Five children were detained following inquiries, the force said.

Due to prior police contact with the victim, the force will be making a voluntary referral to the Independent Office of Police Conduct (IOPC), it added.

Detectives have been speaking to residents in the area and have appealed for anyone who was in the park on Sunday evening to come forward.

Nearby residents expressed their shock at hearing the news.

Julie March, 38, said: "It's tragic; we can't even comprehend how it happened.

"And it's just on our doorstep."

Emma Ghent, 34, said: "From what we have heard, he lives so close to us, so it is literally on our doorstep.

"He walks his dog every day in the park, and we have a dog; my husband walks the dog in the park.

"It could have been him; he could have been there at the same time.

"It's just horrible."

Det Insp Emma Matts said officers were trying to establish the details of the attack.

"A scene preservation will remain in place at the park while our investigation progresses," she said.

"Local officers are also in the area carrying out reassurance patrols and can speak to anyone in the local community who has concerns."

Officers have said they are particularly keen to speak to anyone who saw the victim before the assault or a group of young people leaving the area.

Additional reporting by: Dan Martin, Greig Watson and Ben Workman.

Follow BBC Leicester on Facebook , on X , or on Instagram . Send your story ideas to [email protected] or via WhatsApp on 0808 100 2210.

Leicestershire Police

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There are many benefits of adding walking into your daily routine, such as improving your heart health and aiding/ preventing type 2 diabetes. The first benefit of taking a walk is that it can help one maintain a healthy weight and help prevent numerous …show more content…. Going for a walking after a person has had a stressful day can help ...
IELTS Essay: Walking
IELTS Essay: Walking. This is an IELTS writing task 2 sample answer essay that is only available on my Patreon based on a real question from IELTS related to walking. Here is the questions itself: Despite the benefits for health, fewer people today than ever before exercise by walking. Why is this?
Benefits Of Walking Essay Sample 2023
Benefits Of Walking. Walking is an important movement that humans require. Taking a walk each day is equivalent to keeping the doctor away because of numerous benefits accrued from this physical activity. First walking helps in losing weight. Research estimate that on average a woman that walks each day lowers the risk of obesity by five percent.
How Walking Changes Us
If you walk hard enough, you probably don't need any other god.". We know that walking is good for us, that "if undertaken in regular doses," as Shane O'Mara writes in "In Praise of ...
Confirming the Causal Role of Consistent Contexts in Developing a
This study confirms the causal role of consistent contexts in developing a walking habit, in a real-world setting, with an important but challenging population for physical activity interventions and identifies a facilitating condition common for many: a routine schedule.
Why is Medical Coding Important? 5 Benefits
Goodwin University offers an extensive medical coding training program built to prepare you for this important career in healthcare. Find out more about medical coding and the place it could take you by calling 800-889-3282 today. Related. September 3, 2024 Goodwin University
I Watched The Walking Dead's Last 3 Spinoffs & Predict This New
The Walking Dead: Daryl Dixon is set to introduce a new character named Ash, who will cross paths with Carol in season 2. While Daryl Dixon's trailer left many parts of the upcoming story a mystery, it seemed to reveal how Carol gets to France in season 2, with Ash being the pivotal factor.The teaser showed Ash and Carol boarding a plane, indicating the spinoff's new character is some sort of ...
UPSC Main Paper 1 2024: Important essay topics, previous year's
The Civil Services Exam (CSE) is a prestigious and highly competitive gateway to top government positions in India. For 2024, over 1.3 million candidates sat for the CSE Prelims, with about 14,000 ...
Bhim Kohli death: Children held over Franklin Park attack
Bhim Kohli died in hospital after being assaulted while walking his dog in Franklin Park Five children have been arrested on suspicion of murder following the death of an 80-year-old man who was ...