Physicians' Academy for Cardiovascular Education

Walking and running comparably reduce CHD risk factors

Williams PT, Thompson PD. - Arterioscler Thromb Vasc Biol. 2013 May;33(5):1085-91. doi: 10.1161/ATVBAHA.112.300878.

Walking versus running for hypertension, cholesterol, and diabetes mellitus risk reduction.

Williams PT, Thompson PD.
Arterioscler Thromb Vasc Biol. 2013 May;33(5):1085-91. doi: 10.1161/ATVBAHA.112.300878.


Guidelines on physical activity assume that activities of different intensities can be combined to achieve a minimum recommended dose. Moderate activities are those that expend 3- to 6-fold the energy expenditure of sitting at rest (3-6 metabolic equivalents (METs). Walking is generally of moderate intensity and is specifically recommended by  some health institutes [1-4]. It is, however, unknown, whether equivalent doses of moderate and vigorous (>6 METs) give the same health benefits [5].
The current analysis therefore aimed to determine whether equivalent energy expenditure by moderate and vigorous exercise produces similar reductions in coronary heart disease (CHD) risk factors. Associations are investigated of incident hypertension, hypercholesterolemia and type 2 diabetes mellitus to reported exercise in the National Runners’ Health Study II and the National Walkers’ Health Study [6-8]. In these studies, energy expenditure is assessed from weekly distance run or walked, as opposed to time spent exercising in many other studies.

Main results



These data suggest that equivalent doses of running (a vigorous exercise) and walking (moderate) are both associated with grossly equivalent risks reductions of new onset hypertension, hypercholesterolemia and diabetes mellitus. Risk is further reduced when exercise dose exceeds 1.1-1.8 METh/d, where type of exercise does not seem to matter.
Runners had an on average more than twice exercise dose, and it is proposed that the higher estimated caloric expenditure(per time) accompanied with it may account for reducing CHD risk factors and possibly CHD events. This may explain why some studies that measures exercise by time spent indicate that vigorous exercise seems more beneficial, simply because more calories can be expended per minute in vigorous exercise as opposed to moderate exercise. Therefore, the authors claim and demonstrate that exercise energy expenditure is better calculated from distance than from time.


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1. Pate RR, Pratt M, Blair SN, et al. Physical activity and public health. A recommendation from the Centers for Disease Control and Prevention and the American College of Sports Medicine. JAMA. 1995;273:402–407.
2. Haskell WL, Lee IM, Pate RR, et al. Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Med Sci Sports Exerc. 2007;39:1423–1434.
3. US Department of Health and Human Services. 2008 Physical activity guidelines for Americans. Washington (DC):ODPHP Publication No. U0036. 2008;61 [cited 2010 Oct 10]. 61 p.
pdf/paguide.pdf. Accessed October 10, 2010.
4. World Health Organization. Global Strategy on Diet, Physical Activity, and Health. 2006. Accessed Jan 19, 2012.
5. Swain DP, Franklin BA. Comparison of cardioprotective benefits of vigorous versus moderate intensity aerobic exercise. Am J Cardiol. 2006;97:141–147.
6. Williams PT. Walking and running are associated with similar reductions in cataract risk. Med Sci Sports Exerc. December 27, 2012. DOI:
Abstract/publishahead/Walking_and_Running_Are_Associated_with_Similar.98471.aspx. Accessed April 1, 2013.
8. Williams PT. Greater weight loss from running than walking during 6.2-yr prospective follow-up. Med Sci Sports Exerc. 2013;45:706–713.
9. Williams PT. Effects of running and walking on osteoarthritis and hip replacement risk. Med Sci Sports Exerc. January 30, 2013. DOI:10.1249/MSS.0b013e3182885f26.
Abstract/publishahead/Effects_of_Running_and_Walking_on_Osteoarthritis.98453.aspx. Accessed April 1, 2013.
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