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.  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.  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.  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.  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. 
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.  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.  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.  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.  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.  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. 
Depression and anxiety
Walking appears to have a positive effect on mental health, with the most evidence for depression.  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 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.  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.  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. [17-19] 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). 
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.  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.  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.  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. [23,24]
- 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.
- Treadmill. This machine can be adjusted for speed and incline to help increase or decrease intensity. Always ask for a demonstration or read equipment directions carefully before using a treadmill for the first time.
- 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.
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. 
- 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. 
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.  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. [27,28]
- Williams PT, Thompson PD. Walking versus running for hypertension, cholesterol, and diabetes mellitus risk reduction. Arteriosclerosis, thrombosis, and vascular biology. 2013 May;33(5):1085-91.
- US Department of Health and Human Services. Physical activity guidelines for Americans, 2nd edition. Washington (DC): US Government Printing Office; 2018.
- Omura JD, Ussery EN, Loustalot F, Fulton JE, Carlson SA. Peer Reviewed: Walking as an Opportunity for Cardiovascular Disease Prevention. Preventing Chronic Disease. 2019;16.
- Tanasescu M, Leitzmann MF, Rimm EB, Willett WC, Stampfer MJ, Hu FB. Exercise type and intensity in relation to coronary heart disease in men. JAMA. 2002 Oct 23;288(16):1994-2000.
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- Hu FB, Sigal RJ, Rich-Edwards JW, Colditz GA, Solomon CG, Willett WC, Speizer FE, Manson JE. Walking compared with vigorous physical activity and risk of type 2 diabetes in women: a prospective study. JAMA. 1999 Oct 20;282(15):1433-9.
- Murtagh EM, Nichols L, Mohammed MA, Holder R, Nevill AM, Murphy MH. The effect of walking on risk factors for cardiovascular disease: an updated systematic review and meta-analysis of randomised control trials. Preventive medicine. 2015 Mar 1;72:34-43.
- Paula TP, Viana LV, Neto AT, Leitao CB, Gross JL, Azevedo MJ. Effects of the DASH diet and walking on blood pressure in patients with type 2 diabetes and uncontrolled hypertension: a randomized controlled trial. The Journal of Clinical Hypertension. 2015 Nov;17(11):895-901.
- 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.
- Kelly P, Williamson C, Niven AG, Hunter R, Mutrie N, Richards J. Walking on sunshine: scoping review of the evidence for walking and mental health. British Journal of Sports Medicine. 2018 Jun 1;52(12):800-6.
- 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.
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- 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.
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- 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.
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