Walking for Health 9781614011088, 1614011087

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A Harvard Medical School Special Health Report

Walking for Health

Why this simple form of activity could be your best health insurance

In this report: Health benefits of walking Walking technique and safety tips Finding the right shoes 5 types of walking workouts Warm-ups and post-walk stretches Walking for weight loss How to stay motivated over the long term

Price: $29

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WALKING FOR HEALTH SPECIAL HEALTH REPORT

Medical Editor Lauren E. Elson, MD Physical Medicine and Rehabilitation Instructor, Harvard Medical School Fitness Consultant Michele Stanten Walking Coach Certified Fitness Instructor, American Council on Exercise Executive Editor Anne Underwood Copy Editor Robin Netherton Creative Director Judi Crouse Production Manager Lori Wendin Photographer Thomas MacDonald Published by Harvard Medical School Gregory D. Curfman, MD, Editor in Chief Patrick J. Skerrett, Executive Editor In association with Belvoir Media Group, LLC, 535 Connecticut Avenue, Norwalk, CT 06854-1713. Robert Englander, Chairman and CEO; Timothy H. Cole, Executive Vice President, Editorial Director; Philip L. Penny, Chief Operating Officer; Greg King, Executive Vice President, Marketing Director; Ron Goldberg, Chief Financial Officer; Tom Canfield, Vice President, Circulation. Copyright © 2015 by Harvard University. Permission is required to reproduce, in any manner, in whole or in part, the material contained herein. Submit reprint requests to:

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ISBN 978-1-61401-108-8 The goal of materials provided by Harvard Health Publications is to interpret medical information for the general reader. This report is not intended as a substitute for personal medical advice, which should be obtained directly from a physician.

Contents Walking: An ideal form of exercise . . . . . . . . . . . . . . . . . . . .2 It’s easy. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 It’s healthy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 It’s fun . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

Should you check with your doctor first? . . . . . . . . . . . . . . .7 Advice Advice Advice Advice

for for for for

people people people people

with with with with

heart conditions . . . . . . . . . . . . . . . . . . . . 7 diabetes . . . . . . . . . . . . . . . . . . . . . . . . . . 8 arthritis . . . . . . . . . . . . . . . . . . . . . . . . . . 8 COPD . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

First steps: Starting a walking program . . . . . . . . . . . . . . 10 Where to walk . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 Types of walking . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 How much is enough? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 Technique . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 Essential gear . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 Avoiding injuries . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 Safety tips . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21

Walking workouts and more . . . . . . . . . . . . . . . . . . . . . . . 23 Walking warm-up . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24 1. Easy walking workout . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27 2. Interval walking workouts . . . . . . . . . . . . . . . . . . . . . . . . . . . 28 3. Walking workout with a resistance band . . . . . . . . . . . . . . . . . 30 4. Nordic walking workout . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33 5. Mindful walking workout . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34 Post-walk stretches . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35 Strength training for walkers . . . . . . . . . . . . . . . . . . . . . . . . . . . 38

Walking through the seasons . . . . . . . . . . . . . . . . . . . . . . 41 Walking in the winter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41 Walking in the summer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43 Dress for success . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44

Walking for weight loss . . . . . . . . . . . . . . . . . . . . . . . . . . . 45 Go faster . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45 Climb hills . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47 Grab some poles . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48 Take the stairs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48

Going the distance: Staying motivated . . . . . . . . . . . . . . . 49 Get support . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49 Use a pedometer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49 Try apps to keep you motivated . . . . . . . . . . . . . . . . . . . . . . . . . 50 Sign up for an event . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50 Be kind to yourself . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51

Resources . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52

Walking: An ideal form of exercise

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echnically, you started walking way back when you were about a year old. And unless you have some type of disability or condition that prevents you from walking, you’re still doing it—as you have practically every day of your life. But most Americans don’t do enough walking in the course of their daily lives to reap the myriad of health benefits it has to offer. In this report, we’re going to focus on walking for health. This requires a more sustained effort, but it’s totally doable—and the rewards are worth it. Every year, more and more studies document the benefits of regular exercise. It can help prevent or alleviate numerous health conditions, and unlike prescription drugs—which always seem to have prohibitive lists of side effects—it has effects that are overwhelmingly positive, such as improved mood, better sleep, and less stress. Some experts even claim that if exercise could be bottled, it would be the most prescribed medicine. There are many forms of exercise, of course. But because you have decades of experience with walking, it’s the perfect way to ensure that you get your daily dose. You can even socialize while doing it. By opening up this report, you’ve already signaled an interest in starting a regular walking program. In this chapter, we’ll show you some of the reasons why that is an excellent decision.

It’s easy Have you ever resolved on New Year’s Day to start exercising more—only to find that you didn’t have the time or couldn’t afford expensive lessons, classes, or gym fees? Maybe concerns about injuries kept you on the sidelines. Walking could just be the way to keep your resolution. Here’s why. You already know how to do it. Just put one foot in front of the other. There’s no learning curve like you would have if you took up a new activity, such as Zumba or tennis. 2

Walking for Health

You can do it anywhere. Step out your front

door. Take a walk from where you work. You can walk around areas that you frequent, such as the grocery store, a shopping center, a place of worship, the library, the doctor’s office, the hair salon, or the homes of friends and family. There are even indoor options, such as malls, office buildings, hospitals, or airports. You don’t need any special equipment. If you’re walking for exercise, it’s best to have a comfortable pair of shoes, preferably sneakers. But that’s it! While there are some items of clothing and gear that can make walking more enjoyable (see “Walking through the seasons,” page 41), they are not essential. It’s gentle on your knees—and the rest of your body. Unlike running, you keep one foot on the

ground at all times when you’re walking, making it a low-impact, joint-friendly type of exercise. Not surprising, then, that walkers have a much lower risk of exercise-related injuries than runners—just 1% to 5% for walkers, versus 20% to 70% for runners.

It’s healthy More than 2,400 years ago, Hippocrates said, “Walking is a man’s best medicine.” Today, there’s a lot of research to back up his statement. The Harvard Nurses’ Health Study, which has been tracking the health behaviors of more than 200,000 women for more than three decades, has shown that moderate walking for an average of 30 minutes a day can lower the risk of heart disease, stroke, and diabetes by 30% to 40%, and the risk of breast cancer by 20% to 30%. If you need more specific reasons to lace up your shoes and head out the door, here are a few. It protects your heart. Cardiovascular disease is the leading cause of death in the United States, but in many cases, it is preventable. According to one study, a third of all heart attacks and deaths due to heart disease in middle-aged women could be avoided if the w w w.h ealt h .ha r va r d.e du

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women simply walked for exercise. journal Health Education Research. Harvard researchers followed more Those 4,000 steps are approximately than 70,000 women ages 40 to 65 equivalent to two miles of walkfor eight years and found that walking—an amount that may also be ers were less likely to die from heart enough to offset the increased risk disease. Those who logged three or of dying from heart disease that more hours a week (or 25 minutes people with diabetes have. Walking a day) reduced their risk of dying at least one mile per day has been by 35%. Even those who were sedshown to cut that risk in half, based entary at the beginning of the study on research from the University of lowered their risk if they started California, San Diego. walking during the study. So it’s It helps lower blood pressure. never too late! High blood pressure is a primary Walking is equally protective risk factor for heart disease and in men, too, according to an analystrokes, but walking is an effecsis that looked at the results of 18 tive way to lower blood pressure, studies involving a total of more Moderate walking for an average of 30 according to a review of 27 studies. then 450,000 men and women. And minutes a day can lower your risk of heart While most of the study participants for both sexes, just five-and-a-half disease, stroke, and diabetes by 30% to did not have high blood pressure, 40%, without the side effects of pills. miles a week (or three-quarters of the research showed reductions of 5 a mile a day), even at a leisurely to 11 points in systolic blood pres2-mph pace (that means a mile in 30 minutes) offers sure (the first number in a reading) and 3 to 8 points protection. At that easy pace, you have to walk about for diastolic pressure (the second number). 23 minutes a day to start reaping benefits. If you pick If your blood pressure is between 120/80 and it up to a moderate 3 mph (a mile in 20 minutes), you 140/90—in the category considered “prehypertencan hit the goal with 15 minutes of walking a day. sive”—you might want to break up your walking People who walked longer distances, walked at a faster throughout the day. In a study from Arizona State pace, or did both enjoyed the greatest protection. University, 11 prehypertensive adults either walked It helps stave off diabetes. Inactivity promotes briskly for 30 minutes every afternoon or did three type 2 diabetes. Working your muscles more often and 10-minute walks—one each in the morning, aftermaking them work harder improves their ability to use noon, and evening—for a total of 30 minutes a day. insulin and absorb blood sugar (glucose). This puts While both regimens lowered blood pressure, mulless stress on your insulin-making cells. Findings from tiple short walks resulted in a lower average blood the Nurses’ Health Study and the Health Profession- pressure over 24 hours and reduced the number of als Follow-up Study suggest that walking briskly for spikes throughout the day, compared with taking one a half-hour every day reduces the risk of developing longer walk. type 2 diabetes by 30%. For those already at risk, doing It reduces falls and fractures. When you were shorter bursts of walking throughout the day may be a kid, a broken bone was an opportunity for all your even more effective. One study found that a 15-min- friends to sign your cast, but as you age, falling and ute walk immediately after every meal provided better breaking a bone can be a serious problem. Among blood sugar regulation than a single daily 45-minute older adults, falls are the leading cause of both nonfamorning walk. If you already have diabetes, increasing tal and fatal injuries. One out of five people who sufactivity throughout the day by 4,000 steps or more can fer a hip fracture from a fall dies within a year. While improve levels of HbA1c, a highly sensitive marker the statistics are frightening, they are not a reason to of blood sugar, according to a study published in the hunker down on the sofa to avoid a fall. Staying active ww w. h ealt h . h ar v ar d . e du

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Myth : Walking doesn’t count as exercise Despite all the benefits that have been associated with walking, many people—even walking fans—too often think that they have to be sweating or huffing and puffing for an activity to count as a workout. That simply isn’t the case. Take for instance the National Runners’ and Walkers’ Health Studies. Researchers at the Lawrence Berkeley National Laboratory in Berkeley, Calif., have been tracking about 150,000 walkers and runners since the 1990s. In one of their latest studies, they found that when walkers and runners burned an equal number of calories from their workouts, they received similar health benefits over six years. Walkers and runners reduced their risk of high blood pressure, diabetes, and heart disease by similar levels. When assessing risk for high cholesterol, the researchers found that walkers actually had a slightly greater reduction in risk. In the Nurses’ Health Study, researchers assessed more than 72,000 women over eight years and drew similar conclusions. The women who walked the most—three or more hours per week at a brisk pace—were 35% less likely to suffer a coronary event such as a heart attack. The risk reduction was similar to that seen in women who did more vigorous forms of exercise, such as running. So next time you go out for a walk, you can be confident that it counts as exercise, and that even if you don’t break a sweat, your body is benefiting.

keeps your muscles strong and flexible so you’ll be less likely to take a spill. And weight-bearing activities like walking will keep your bones stronger so you’ll be less likely to break one if you do fall. The Nurses’ Health Study found that women who walked at least four hours a week (35 minutes a day) had a 41% lower risk of sustaining a hip fracture compared with women who walked less than an hour a week. It counteracts the effects of weight-promoting genes. Harvard researchers looked at 32 obesity-pro-

moting genes in more than 12,000 men and women to determine how much these genes contribute to body weight. Then they examined the people’s exercise habits and found that in men and women who walked briskly for about an hour a day, the genetic effect was cut in half. It reduces the risk of developing breast cancer.

More than 70 observational studies have found that physically active women have a lower risk for breast 4

Walking for Health

cancer. In 2013, an American Cancer Society study of more than 70,000 women zeroed in on walking in particular. The results showed that women who walked seven or more hours a week had a 14% lower risk of developing breast cancer than those who walked three or fewer hours a week. And walking provided protection even if women were overweight, used supplemental hormones, or had other risk factors. If you’ve been diagnosed with breast cancer, walking has other benefits. It can help you to feel less anxious and fatigued, a common side effect of treatments. It can also reduce your risk of a recurrence and death. Women who walked three to five hours a week at about 3 mph after receiving a breast cancer diagnosis were up to 40% less likely to suffer a negative outcome, according to a Harvard study of about 3,000 women. It helps tame a sweet tooth. If you’re a self-proclaimed chocoholic, start walking! A 15-minute walk has been shown to curb cravings for chocolate, according to a study from the University of Exeter in the United Kingdom. Another study from the same group found that walking for 15 minutes can also reduce the amount of chocolate you eat in stressful situations. People who sat quietly before performing a stressful task with a bowl of chocolates nearby ate almost twice as much candy as those who walked. And the latest research confirms that walking can reduce cravings and intake of a variety of sugary snacks. It improves sleep. A 45-minute morning walk may help you fall asleep faster when bedtime comes, according to research published in the journal Sleep. During the yearlong study, researchers found that postmenopausal women who took five or more morning walks a week fell asleep faster than those who took fewer morning walks or those who walked in the afternoon. However, if you have insomnia, it may take awhile for your sleep to improve. In a small study from Northwestern University, researchers found that exercising during the day did not affect that night’s sleep for women (average age of 61) with insomnia. But after 16 weeks of walking for 30 minutes three times a week, the women were sleeping an average of 46 minutes longer a night. It sharpens your thinking. Walking five miles a week helps maintain brain volume and reduces w w w.h ealt h .ha r va r d.e du

memory problems in people who have mild cognitive impairment or Alzheimer’s disease, according to a 10-year study from the University of Pittsburgh. (A decline in brain volume means that brain cells are dying.) Even healthy adults benefited if they walked six miles a week. In particular, the hippocampus—a section of the brain that’s crucial to memory—normally shrinks by 1% to 2% a year in older adults without cognitive impairment. In a study related to the one above, researchers found that walking six miles a week for a year not only offset the shrinkage, it actually increased hippocampal volume by 2%. Walking also appears to enhance brain connectivity so a person is better at planning, prioritizing, strategizing, and multitasking. When 65 sedentary people, ages 59 to 80, walked for 40 minutes three times a week for a year, brain scans showed greater connectivity, according to a University of Illinois study.

It boosts your mood. Anyone who’s taken a walk when feeling blue knows that it’s a great on-the-spot mood booster—and studies support this. But even for more serious depression, walking is a viable remedy. In fact, it can be just as effective as drugs, according to a study published in the journal Psychosomatic Medicine. When researchers prescribed either an antidepressant or 30 minutes of walking or jogging three times a week to a group of men and women diagnosed with major depression, they observed similar improvements in both groups. Walking can even help in tough-to-treat cases. In a study of people whose depression appeared resistant to medications, researchers in Portugal found that combining drug treatment with walking produced results. Participants walked 30 to 45 minutes five days a week. After 12 weeks, 26% no longer had symptoms, and an additional 21% of them showed improvement.

“Sitting disease”—and why walking is the cure

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tand up for your health. We mean that literally. Our society is by and large a sedentary one, where people spend far more time sitting than they did in previous generations—an average of 13 hours a day versus three in a true agricultural society—and that’s a problem. The latest research shows that too much sitting may be more dangerous than smoking. It is now associated with 34 chronic diseases or conditions, including heart disease, diabetes, some types of cancer, back pain, depression, and possibly even premature death, according to 18 studies that involved over 800,000 people in the past 16 years. How can something that seems so safe cause so many problems? The human body is designed for activity. When muscles are inactive, they don’t take up glucose from the bloodstream as efficiently. Blood pressure rises. Sleep suffers. There are even changes on the cellular level. A key gene (called lipid phosphate phosphatase-1, or LPP1) that helps prevent blood clotting and chronic, low-grade inflammation functions optimally when you engage in regular exercise. Spending too many hours in chairs suppresses the gene to the point that even daily workouts don’t have an effect on it. One study of healthy people in their 20s found that after just three consecutive hours of sitting, there were changes in arteries of the same type that may contribute to heart disease. However, those who stood up and moved around for just five minutes an hour prevented these changes. Even 30 minutes of daily

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exercise isn’t enough to counteract all the bodily harm that too much bottom time wreaks. What matters just as much is what you do in all those long hours in between. The benefits of sitting less are so compelling that two years ago, the American Medical Association issued a recommendation encouraging employers to offer alternatives to sitting, such as standing or treadmill desks. But you don’t have to invest in a standing desk to reap the benefits of getting out of your chair. Simply add short walks throughout your day. In one study, taking a 15-minute stroll after meals lowered blood glucose levels, while remaining sedentary was associated with sharp spikes in glucose. Here are some more ways to increase activity: • Set your watch or computer alarm every hour as a reminder

to get up and move around a little. • Take phone calls standing up. • Get up and do a few exercises or just move around during

TV commercials. • Skip drive-throughs. • Park far away from entrances. • Take the stairs instead of elevators and escalators.

For more on the benefits of routine physical activity, see “Everyday walking,” page 12.

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It eases joint pain. Walking lubricates Studies show that spending time in parks joints and strengthens the surrounding musor near water can boost your mood. cles to keep them healthy. Studies have shown that walking five to six miles a week may even protect you from developing osteoarthritis, a degenerative condition of the joints that causes joint pain, swelling, stiffness, and weakness. Knees and hips are the most commonly affected joints. If you have osteoarthritis, getting up and moving around is probably the last thing that you want to do when your joints hurt. But research shows that walking can actually reduce pain. Walking also reduces the risk of becoming dis- to catch up or get to know someone better. And if you abled if you have arthritis. Working up to 150 minutes need to have a tough conversation with someone, try of walking a week seems to offer the most benefit. doing it while walking. Striding side by side can make It improves immune function. Walking can discussions easier because you’re more relaxed than boost your immunity and protect you during cold when you’re sitting face to face. and flu season. During a 12-week study of 1,002 men You can get “me” time. Heading out by yourself and women, Appalachian State University research- can be a good way to escape the demands and expecers found that walkers stayed the healthiest. Those tations that occupy much of your time. As you stroll, who logged at least 20 minutes a day, five times a you can clear your head, relax, and reflect. It can be week, experienced 43% fewer sick days than those valuable, quiet “me” time, allowing you to return who exercised once a week or less. And if they did refreshed. Or, you can take along an iPod and listen to get sick, it was for a shorter duration, and symptoms music or podcasts that you don’t seem to find the time were milder. for during the day. It can lengthen your life. How would you like You can enjoy a dose of nature. Studies show to increase your life expectancy by three-and-a-half that spending time in parks or near water can boost years? All it takes is 30 minutes of walking five days your mood. Walking is a great way to get out in nature. a week, according to research that reviewed the findYou can gain a new perspective. If you always ings of six studies that, together, involved more than drive through your downtown area, park your car one 650,000 people. As little as 15 minutes a day resulted day and stroll instead. The world is different when you in almost two extra years. Work up to an hour a day, view it at 3 mph instead of 25 or 30 mph. You might and you could live more than four years longer. And discover an interesting shop, observe intricate archiwith all the other benefits of walking, those extra years tecture, or meet a friendly person. Walk around your are likely to be very good ones. neighborhood and strike up conversations with your neighbors. You might even pick up landscaping ideas. You can be more creative. Stanford University It’s fun researchers found that people generated twice as many To some people, exercise feels like drudgery. With creative responses to problems when walking comwalking, however, you can pamper yourself in mul- pared with sitting. And the creative juices continued tiple ways. to flow even when they sat down after their walk— You can do it with others. Invite family, friends, another good reason to take a walking break during or co-workers to join you for a walk. It’s a great way the workday.

Should you check with your doctor first?

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ithout a doubt, physical activity can help you live a longer, healthier, and more productive life. Almost any healthy person can safely take up walking. But it’s wise to talk to a doctor if you have any questions about your health or if you plan to do more strenuous activity, such as interval walking (see page 28)—especially if you haven’t been active recently. Definitely speak to a doctor if you have any injuries or a chronic or unstable health condition—for example, heart disease (or several risk factors for it), a respiratory ailment (such as asthma), high blood pressure, joint or bone disease (including osteoporosis), a neurological illness, or diabetes. Also consult your doctor if you suspect you may have an illness that would interfere with an exercise program or if you have been experiencing any symptoms such as chest pain, shortness of breath, or dizziness. The Physical Activity Readiness Questionnaire (PAR-Q), a tool developed by the Canadian Society for Exercise Physiology, can help you determine whether you should talk to your doctor before embarking on, or ramping up, any fitness program. You can find it at www.health.harvard.edu/PAR-Q www.health.harvard.edu/PAR-Q. The basic form covers people ages 15 to 69. If you are older than that, check with your doctor. If you do need to speak to a doctor, bring, fax, or email descriptions of the exercises you plan to do and ask if you can safely undertake them. Your doctor may feel your selections are fine, or might wish to modify certain moves or suggest substitutions. If necessary, your doctor can refer you to a physiatrist (a physician who specializes in physical medicine and rehabilitation), a physical therapist, or another specialist for evaluation. These professionals can tailor an exercise prescription to enhance recovery after surgery or injuries, or to work around chronic problems that interfere with exercise by sparking pain or limiting movements. They can also tell you whether certain types of exercises will be helpful or harmful given your situation. Usually, you’ll be able to find safe, enjoyable ww w. h ealt h . h ar v ar d . e du

When to call your doctor immediately Whenever you perform any exercise, including walking, it’s safest to stop and call your doctor for advice if you experience any of these symptoms: ✔ upper-body discomfort, including chest pain, aching, burning, tightness, or a feeling of fullness ✔ faintness or loss of consciousness ✔ wheezing or shortness of breath that takes more than five minutes to go away ✔ pain in bones or joints. Persistent or intense muscle pain that starts during a workout or right afterward, or muscle soreness that persists more than one to two weeks, also merits a call to your doctor. (By contrast, delayed muscle soreness that starts 12 to 48 hours after a workout and gradually abates is normal.) You should also call your doctor if the routine you’ve been doing for a while without discomfort starts to cause you pain. Ask your doctor whether any other warning signs specific to your health history warrant a call.

activities, though some precautions may be in order. For example, if you have certain bone or joint diseases, you may need to avoid very fast walking.

Advice for people with heart conditions If you’ve suffered a heart attack or been diagnosed with heart disease, not only is walking permissible, but it’s a must for a longer, healthier life. Even people with heart failure may benefit from supervised, moderate exercise. If you have heart failure, ask your doctor to recommend a cardiac rehabilitation program with a supervised exercise component, or see if there is one at a local hospital, so you can safely reap the benefits of exercise. Such supervised exercise is particularly helpful for anyone with heart disease who has not been active for a considerable time. Walking for Health

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Whether you walk on your own or with supervision, plan to start slowly and work gradually toward better fitness—and follow these safety tips. • Remember always to warm up at the beginning of a walk. Five minutes of easy walking prepares your muscles and heart for exercise. Also cool down afterward by slowing your pace. • Don’t push through fatigue. If you feel tired or have any heart symptoms, stop. • Be smart in the heat. Exercise in the morning or evening when temperatures aren’t so high. You’ll stay cooler if you wear lightweight, light-colored clothes made of fabrics that wick away sweat. (For more on safety during hot weather, see “Walking in the summer,” page 43.) • When it is cold, warm up indoors to reduce stress on your heart. Then, when you do go outside, cover your nose and mouth to warm icy air. (For more, see “Walking in the winter,” page 41.) • Plan ahead. Walk in an indoor shopping mall if it is too cold, too snowy, or too hot to exercise outside. Talk to your doctor about any additional modifications you should make during extreme weather.

Advice for people with diabetes Regular walking helps regulate blood sugar by burning calories in the form of glucose and making your body more sensitive to insulin. Once you start walking regularly, you may find you need to use less insulin or that your doctor can reduce the dosage of your diabetes medication. You’ll also protect your heart and brain. You do need to take certain precautions when walking for exercise, though, especially if you use insulin injections to help manage your diabetes. According to the American Diabetes Association, you should get the go-ahead from your doctor before starting a new exercise program. Your physician can offer advice after checking your heart, blood vessels, eyes, kidneys, nervous system, and feet. For example, you may need special footwear to protect your feet. Also talk to your health care team about maintaining safe levels of blood sugar during and after activity. You’ll need to schedule eating and exercise sessions properly to keep blood sugar levels steady. Before and 8

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after exercising, carefully monitor your blood sugar level. You may need to adjust your diet or (if you take insulin) your insulin doses. Once you have the goahead, follow these safety tips: • Keep carbohydrates like hard candy or glucose tablets with you when you exercise in case your blood sugar drops precipitously (hypoglycemia). Signs of hypoglycemia include sweating, trembling, dizziness, hunger, and confusion. • Drink sufficient water during and after exercise. • Wear a diabetes bracelet or ID tag, and carry phone numbers in case an emergency arises while you’re exercising.

Advice for people with arthritis Here’s a dilemma: the pain, soreness, and disability triggered by arthritis may make it hard to be active. Yet exercise, such as walking, can actually reduce pain and stiffness, while strengthening muscles that help support and protect joints. Discuss options with your doctor, particularly if you haven’t been exercising. If you have trouble walking, a physiatrist, physical therapist, or personal trainer with experience in working with people who have arthritis can help you choose bracing or adaptive equipment (see “Assistive devices,” page 9). To make walking easier, try these tips: • Schedule walks for times of the day when you are least likely to experience inflammation and pain. Avoid exercising when stiffness is at its worst. • Before walking, apply heat to sore joints or take a warm shower or bath. After walking, cold packs may be helpful. • Warm up by walking at a slower pace than normal. You might also want to try our warm-up exercises (see “Walking warm-up,” page 24). Remember to use slow movements during your warm-up and gradually extend your range of motion. • Progress slowly, and cut back on activity if your joints become warm, red, or painful. Work with your doctor to find and eliminate the cause of the pain. • Listen to your body. Never force a movement if you’re experiencing sharp pain or more discomfort than usual in a joint. • If you have rheumatoid arthritis, balance rest and w w w.h ealt h .ha r va r d.e du

exercise carefully: rest more to reduce inflammation, pain, and fatigue when your condition flares up, and exercise more when it calms down. Short rest breaks tend to help more than long periods spent in bed. • Exercise within a comfortable range of motion. If an exercise or movement causes significant pain, stop doing it! Discuss your options with a certified trainer or physical therapist.

Assistive devices

Advice for people with COPD

Hiking poles. Also known as trekking poles, these work like canes but look sportier, so you may feel more comfortable using them. In fact, some people without any pain or balance issues use a related type of pole, called Nordic walking poles, to get more out of their walks (see “Hiking,” page 14, and “Nordic walking,” page 14). Poles can help with balance problems by giving you two more points of contact on the ground. They may also help with joint pain by taking pressure off of your joints. And because you are using two of them, you maintain a more normal arm swing and gait pattern. If you need to carry anything, though, you’ll have to use a backpack.

Doctors used to think that people with chronic obstructive pulmonary disease (COPD) had little hope of improvement beyond the modest benefits of medication and oxygen therapy. But research and experience have shown otherwise. Whether your condition is moderate or advanced, if you continue to have breathlessness and other symptoms even when you are using medication, chances are you will benefit from exercise. Check with your doctor, however, before you embark on a new program. The best place to start is with pulmonary rehabilitation, a multifaceted program of exercise, breathing retraining, education, and other therapies that can help you feel better and carry out day-to-day activities with greater ease and independence. Walking is a great activity to complement pulmonary rehabilitation. Here’s some advice to make walking with COPD easier and safer. • Start with short walks at an easy pace. Stop and rest for two to three minutes whenever you are short of breath. • Choose flat routes instead of hilly ones to keep the intensity low. • Inhale through your nose, keeping your mouth closed, to warm and filter the air. • Exhale slowly and gently through pursed lips to improve lung action. • Remember to always warm up at the beginning of a walk. Cool down afterward by slowing your pace. • Avoid walking in areas with a lot of air pollution and on days when air quality alerts are issued. For those days, choose indoor options (see page 11). • Seek out indoor options when it is very cold or hot and humid outside. ww w. h ealt h . h ar v ar d . e du

Canes, walkers, and walking poles are assistive devices that may help alleviate pain or steady your balance so you can walk more. While you might feel uncomfortable or embarrassed using them, the alternative—walking less—will only make your condition worse, leading to more health problems and pain due to inactivity. Here are some devices that might help. Cane. A cane takes some of the weight off of painful areas of the body and can be helpful for a variety of problems, such as joint or muscle pain. It can also be helpful if you have problems with balance.

Rolling walker. This provides greater support to take weight off the spine and joints because of its wider base. It can also help people with conditions like spinal stenosis to maintain postures that make walking more comfortable. The small wheels, however, are better suited for indoor walking. Rollator. This device is similar to a rolling walker with bigger, more rugged wheels, making it a good choice for outdoor strolling. Most also have a pouch or basket for carrying things and a seat so you can take a break anytime you get tired. While you don’t need a doctor’s prescription to get this gear, it’s still a good idea to see a doctor about your problem. There may be other options that offer even greater improvements. For example, the unloader, a specialized knee brace, can relieve pain for people with severe osteoarthritis. Orthotics for foot pain are another example. While over-the-counter shoe inserts may help some people, others may require custom-made ones from a doctor. So don’t suffer alone and become less active. Talk to your doctor when you experience pain, discomfort, or anything else that interferes with your ability to walk.

• Because your blood levels of oxygen may fall with exertion, ask your doctor or rehabilitation specialist if you need to take along supplemental oxygen. • If you need assistance walking, try an assistive device (see above). In a recent study, people with COPD could walk farther and longer using a rollator than they could when walking unaided. Walking for Health

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First steps: Starting a walking program

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Wind resistance and varied terrain (unpaved roads, rocky trails, slopes that go uphill and down) also challenge your body in new ways to enhance benefits and boost calorie burn. In most communities, there are lots of outdoor options. Neighborhood. Just step out your front door. You can’t beat that for convenience. Unfortunately, not all neighborhoods are walker-friendly. You’ll be safest walking on sidewalks. If you live in an area without sidewalks, you should walk there only if there is little traffic and a decent shoulder along the road. If you are on the side of the road, walk against the traffic—not Where to walk with it—so you can see cars coming toward you (see The beauty of walking is that you can do it practically “Safety tips,” page 21). If it’s not safe to walk near your anywhere. Where you walk is a matter of personal home, consider walking in a neighborhood near your preference and safety. Some people enjoy the fresh air office or other locations that you frequent, like the and scenery of outdoor walking, while others prefer grocery store or a family member’s or friend’s home. the climate control and safety of walking indoors on Downtown. If your community or a nearby one a treadmill or at a mall. You’ll be more likely to stick has a downtown area, explore it on foot. You can winwith a walking routine if you walk dow-shop along the way or admire in an environment that is pleasant the architecture. Downtowns are and convenient. Whatever your a good place to walk because they preference, don’t get stuck in the usually have sidewalks and crossrut of always walking in the same walks to help keep you safe. If there location. A change of venue can are a lot of stores and restaurants prevent boredom and make your in the area, the sidewalks will usuwalks more interesting. ally be cleared of snow and ice in No matter what your preferwinter. And these establishments ence is, the most important thing offer refuge if you get caught in is that you walk consistently. the rain. Depending upon the time Keeping these alternatives in of day and the popularity of your mind can help you stay on track. downtown, the sidewalks might be crowded. If you’re just lookOutdoor options ing to do some leisurely strolling, Studies show that walking outthis probably won’t be a problem. side enhances the mood-boosting Downtowns are good places to walk because Simply go with the flow and stay effect of a walk, lowers levels of they usually have sidewalks and crosswalks to to the right as you walk, to avoid the stress hormone cortisol, and help keep you safe. If sidewalks are crowded bumping into others. If you want at midday, try walking before stores open. motivates people to walk more. to take a more vigorous walk, it’s 10

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ou’ve been walking for years. If you have kids, you helped them learn to do it. So what in the world don’t you know about walking? When you start walking for health, you may find there are actually a lot of points you’ve never considered. Where do you walk, if your neighborhood doesn’t have sidewalks? How do you find a good pair of walking shoes? What is proper walking technique? How much walking time should you aim for? This chapter will address these questions and more.

best to pick a time of day when the downtown area isn’t as busy, such as before stores open in the morning. Be careful of obstacles such as light posts or sign poles. Keep your eyes forward and scan your environment for potential dangers. And don’t text or check your email on your cellphone while walking—many distracted walkers have ended up walking into poles. Open-air shopping complexes. Similar to downtowns, these areas usually offer sidewalks and crosswalks, and they are usually cleared if there’s snow or ice. They also offer the shelter and the distraction of shops and restaurants. Some open-air malls even pipe in music. During store hours, leisurely strolling is best for these areas; however, before or after hours, when crowds thin, you can pick up the speed for a heart-pounding workout without having to weave in between people. Parks and trails. Studies show that people walk more if they live near parks or trails. These can vary greatly, ranging from flat paved or packed dirt paths to steeper gravel or rocky trails. They can stretch for less than a mile to hundreds of miles. If a leisurely walk is what you’re after, stick to level or gently rolling paths and avoid rocky terrain. Want to go for a speed walk? Paved or packed dirt paths are best. Trails with a steeper incline let you get a more vigorous trek without having to pick up your pace. Check with your local recreation department to find trails and walking paths in your area, or check the online trail guide from the Rails-to-Trails Conservancy at www.traillink.com. Tracks. You can usually find these at schools, but some parks offer them as well. Track surfaces vary from cinders or asphalt to synthetic materials like rubber or polyurethane. While some people may find going around and around an oval to be boring, others like having a smooth flat surface, no traffic, and a measured distance. Many tracks are a quarter-mile, so four laps would be a mile.

Indoor options When it’s icy, too hot, or too dark, it may not be safe to walk outside. Your outdoor options may also be limited if you live in an area with heavy traffic and no sidewalks. But don’t worry. There are indoor alternatives for walking—even right in your living room. ww w. h ealt h . h ar v ar d . e du

Here are a variety of indoor options that can help make it easier for you to keep up your walking year round. Remember that consistency is key. Malls. While you could walk around a mall anytime it’s open, arriving early, before the crowds, is the best way to get a good cardio workout. Check the hours at your local malls. Some have walking programs and will let you in before the stores open, so you don’t have to dodge shoppers. And the camaraderie you find with these programs will motivate you to come every week. If your mall has multiple floors, take advantage of the stairs. Alternate walking laps with some stair climbs to kick up your calorie burn and tone your legs and gluteal muscles faster. And don’t forget to park as far away from the entrance as is safe, to rack up more steps. Other indoor walking routes. You can log miles in a variety of locations, such as hospitals, airports, office buildings, churches, or schools. Some of these locations, such as the office building where you work or the apartment building where you live, may be more conducive to short walks throughout the day. Some even mark paths and post distances. Your living room—or any other room in your house. Simply stepping in place will burn calories—

about 250 in an hour if you weigh 180 pounds. Try doing it while you watch your favorite TV show. Even if you step during the commercials only, you can burn about 150 calories during a typical hour-long show. Do speed laps around your house and climb stairs to boost your calorie burn even higher. For a more formal walking-based workout, try one of these: • A walking workout DVD is similar to a cardio exercise DVD, but the moves are more basic. You’ll do things like marching in place and walking forward and backward, and add knee lifts, kicks, and side stepping for variety. The music and enthusiastic instructors make walking in place more fun. You can find a variety of walking DVDs for sale online. • If you have the money and space for a treadmill, there’s no excuse for not walking. You can walk any time of the day and in any kind of weather. Treadmills are a good option if watching TV or reading while you walk will help you to exercise consistently. Just be careful that the distraction doesn’t Walking for Health

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What if your neighborhood isn’t walkable?

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eople who live in communities where they can walk to stores and restaurants do more walking. This puts people in nonwalkable areas at a disadvantage, as far as walking is concerned. But even if your community is not walker-friendly, you can usually find walkable pockets. To discover them, start thinking about the places you go, and see if you can walk anywhere from those places. So instead of driving to the garden center for a watering can, then driving to Barnes and Noble for some books, and then getting back in your car to drive to Panera for lunch, make a shopping center with all of these stores your destination. Park your car in a central area and walk from store to store. If you have too many purchases, drop them off at your car in between—taking extra steps is a good thing! If there’s a destination that you frequent such as a doctor’s office, hair salon, or bank, look to see what other destinations are within a radius of a half-mile to a mile. You might find that when you go to the hair salon, you could also walk to the bank and post office. Grouping errands in this way gets you out of your car. That means less sitting time (see “‘Sitting disease’—and why walking is the cure,” page 5), which is good for your heart and your waistline. Driving your car less is also good for the

slow you down—or trip you up. If you’re motivated by seeing your progress, a treadmill lets you easily track your speed and distance. You also get to control the incline, climbing steep hills or whizzing along flat stretches. Preprogrammed workouts that automatically adjust the speed and incline for you offer new challenges and keep walking interesting. For a safe treadmill workout, familiarize yourself with the controls before you hop on. Then, stand on the side rails as the belt starts moving. While the belt is moving at a slow speed, step onto it and begin walking. You should aim to walk without holding on to the side rails even if that means going at a slower pace; you’ll get a more effective workout if you stand tall and swing your arms. A gym or fitness center. If a personal treadmill isn’t an option, you might want to consider joining a fitness center to have access to a treadmill, especially during seasons when walking outdoors may be difficult in your area. Before you sign up, make sure to visit the facility at the times you plan to work out. You want to make sure that all of the treadmills aren’t taken. 12

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Even if your neighborhood has no sidewalks, you can find places to walk. One easy way is to group errands, so that you walk from one store to another instead of driving. environment and good for your budget, too, since you’ll save money on gas. And when more people are out walking in an area, crime rates go down. Plus, it’s a chance to meet and interact with new people.

Types of walking All walks are good for you. But there’s more than one way to walk. Depending upon your goals, you may need to try a different type of walking. Here is an overview of different styles of walking and how each may benefit you. Everyday walking. This is ambling around your house or place of work, walking to and from your car, strolling around shopping, or any other incidental activities that require a little bit of walking. Up until recently, these short bursts of walking were pretty much ignored by physical activity researchers. But 15 years ago, Mayo Clinic researchers started to track this type of movement using underwear outfitted with motion sensors. They found that obese people sat two-and-a-half hours more and expended 350 fewer calories a day than lean people who lived in similar environments and had similar diets and jobs. The difference was how often the lean workers got up from their desks and walked around during the day. Another Mayo Clinic study demonstrated that this incidental activity (formally known as non-exerw w w.h ealt h .ha r va r d.e du

cise activity thermogenesis, or NEAT) could prevent weight gain, even when food intake was increased. When a group of people were fed an extra 1,000 calories a day, some of them naturally became more active throughout their day and avoided gaining weight. Those who didn’t compensate by moving around more put on pounds. Other studies have found that even for avid exercisers, being active throughout the day is essential for good health (see “‘Sitting disease’—and why walking is the cure,” page 5). To know if you’re getting enough everyday activity, strap on a pedometer and see how many steps you take throughout the day, minus any structured walks for exercise or other types of workouts. • Less than 5,000 steps a day = sedentary • 5,000 to 7,499 steps a day = low activity • 7,500 to 9,999 steps a day = somewhat active If you find that you’re not as active as you should be throughout the day, gradually build up to at least 7,500 steps a day by adding 1,000 to 2,000 steps to your daily total each week until you reach your goal. If you’re like most people, you will need to add structured walks (either leisure or fitness type; see below) to hit the 10,000-step goal that is often recommended for health benefits. Even higher step counts—around 12,000—are recommended for weight loss. Leisure walking. Strolling while chatting with a friend or walking the dog are examples of leisure walking. Even window-shopping, if you’re not starting and stopping too much, could be considered leisure walking. When you’re walking leisurely or strolling, you’re relaxed and moving easily. Your effort is light enough that you’d be able to sing while you walked. A walk at this level of intensity is great for socializing or just relaxing. Fitness walking. This type of walking is faster and more purposeful. Fitness walking can be done at a variety of levels, but basically it’s a brisk pace (see “How fast is brisk?” on page 28). You should be breathing harder and your heart beating faster, but you should still be able to speak in complete sentences. Studies show that if you consciously think, “I’m going to walk briskly,” you will hit the right stride. Power or speed walking, which is done at a faster pace, would ww w. h ealt h . h ar v ar d . e du

also be categorized as fitness walking. If you’re looking to become fitter, lose weight, or improve cholesterol, glucose, or blood pressure, this is the type of walking you should be doing most often. Interval walking. For this type of walk, you alternate fast walking for short periods of time with equal or longer intervals of slower or moderate-paced walking to recover. High-intensity interval training has been used for decades by elite athletes to gain a competitive edge, but recent studies show it’s beneficial for all levels of exercisers. If you walk at the same pace day after day, your body becomes accustomed to that level of activity, and benefits such as weight loss and cardio improvements start to plateau. Intervals are a fun, easy way to get you out of your comfort zone for just a little while—plus you’ll burn more calories and get fitter faster. Intervals are also a good solution to the common “I don’t have time to exercise” excuse, since you can accomplish more in less time. Most interval routines are based on time—speed up for 30 or 60 seconds, then recover for one or two minutes. You can do fast intervals for as little as eight seconds or up to four minutes, then recover for an equal or longer length of time. Some interval workouts, such as Tabata, an interval workout designed by a Japanese researcher, actually have a shorter recovery—20 seconds at high intensity with 10-second recovery bouts. If you don’t like to watch your watch while you’re walking, try one of these methods to create intervals: • Use landmarks: walk fast for one block or past two mailboxes, and then go slowly for two blocks or four mailboxes. • Count steps: walk fast for 25 steps, then recover for 75 steps. Some people like the focus and meditative effect of counting. • Let music guide your workout: walk fast for one song, and then ease up for two songs. If you’re outdoors, keep the volume low and use only one earbud. • If you’re on a treadmill, use mileage: speed up for one-tenth of a mile, and then recover for fourtenths of a mile. • Walk on hilly terrain. This provides natural intervals, as you push yourself to climb and then recover on the downhill. Walking for Health

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Originally from Finland, Nordic walking is gradually gaining popularity in this country, too. One advantage is that it gives you more of an upperbody workout.

enable you to engage your upper body more. And the tips are designed more for speed and a workout, not stability. Interest in Nordic walking is growing more slowly in the United States than in Europe, but there are signs that it is becoming more popular. For example, the Portland (Oregon) Half Marathon has a Nordic walking division. There are a wide variety of poles, some adjustable and some not. Some of the companies that make the poles also recommend their own techniques for using them. Mindful walking. By taking a mindful walk, you get the benefits of meditation without having to sit still. There are a variety of ways to do it, from simply walking with more awareness to following a more structured routine. Unlike many other types of walking, the goal is not to go faster or get a better workout. The focus is on calming down, reducing stress, and relaxing. Walking with awareness means paying more attention to your surroundings, your thoughts, or the physical sensations, such as the wind blowing against your face or your foot landing on the ground and rolling from your heel to your toes. Breath walking and labyrinth walking are examples of more structured mindful walks. A simple type of breath walking combines walking, breathing, and counting—for example, counting four steps while breathing in and four steps while breathing out. Some w w w.h ealt h .ha r va r d.e du

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No matter how you do it, adding some intensity bursts to your walk will speed up your results and keep your workouts interesting. Hiking. This is simply walking in the woods or some other natural setting. Instead of pavement, the trail could be dirt, gravel, or even rocks. As with other types of walking, there are different levels of difficulty—from level, well-groomed trails to steep, rocky routes marked with trail blazes that require more attention to ensure you stay on the right path. Many hiking trails require that you drive to them, and most people will spend longer periods of time hiking than going for a typical walk. Many will bring food and stop at scenic spots for breaks. Because of the terrain, the pace tends to be more leisurely, but obstacles and elevation can still make some hikes vigorous. If you have any hip or knee problems, using a pair of hiking or trekking poles (see “Assistive devices,” page 9) may be helpful, especially on downhills. While uphill climbs challenge your cardiovascular system, walking down hills is harder on muscles and joints, and the force on your knees is three or four times greater than when you’re walking on level ground. Poles may make your hikes more enjoyable, too, by improving your posture, helping with stability, and reducing your risk of an injury such as a broken ankle, according to research. And you may feel better the next day. British researchers had 19 novice hikers with poles and another 18 without poles complete a seven-mile hike that included a 3,400-foot climb and descent. Afterward, the hikers with poles reported less muscle soreness and recovered faster. Nordic walking. With its origins in Finland, this type of walking—also called pole walking—uses two poles that resemble ski or hiking poles. Nordic walking is usually done on fairly level terrain, and it’s different from using poles for hiking. In hiking, poles are used for balance and to take pressure off of joints and may be placed upright in front of the body. The motion for Nordic walking is similar to cross-country skiing, with the poles slanting back behind you, and it adds an upper-body component to regular walking to increase calorie burn and tone more muscles. As for the poles themselves, they are different, too. Nordic walking poles have different hand straps that

people find that doing this makes it easier for them to calm their minds. Other types of breath walking may use specific breathing techniques or patterns of breathing. Each is designed to produce different results, such as controlling your moods, increasing your energy, or improving your mental clarity. Labyrinth walking has been used for hundreds of years for spiritual centering, contemplation, or prayer, but it doesn’t have to be religious. A labyrinth looks like a maze, but it doesn’t have any dead ends. The serpentine path leads to the center and should be walked in a slow, deliberate manner as you clear and calm your mind. You could recite a prayer or chant or contemplate a question to focus your mind. Labyrinths can be found indoors—for example, at certain churches, where they are designed into the floor—or outdoors at spiritual retreat centers, gardens, or even schools. You can locate labyrinths near you using the World-Wide Labyrinth Locator at www.labyrinthlocator.com www.labyrinthlocator.com, or you can make your own labyrinth using stones, sticks, chalk, or plants. For a simple breath walking routine to get you started, see the “Mindful walking workout” on page 34. You can find more guidance, including videos, books, and apps, by searching for “breath walking” or “walking mindfully” online. Racewalking. This has been an Olympic sport since the early 1900s with 20K (12.4-mile) and 50K (31-mile) events, but shorter races are available at other venues. More technical than other types of walking, racewalking has rules. For example, one foot must always be on the ground, and the front leg must remain straight from the point of contact with the ground until the body passes directly over it. At competitions, judges are placed along the route to evaluate technique, and racewalkers can be disqualified if they break the rules. Racewalking technique can help you to walk even faster. Elite racewalkers may average a mile in less than eight minutes. With training, average racewalkers can often get to a pace of a mile in 10 or 11 minutes. Racewalking clinics are offered for people interested in learning the technique. The methods for increasing speed that are discussed in this report are based on racewalking but are not as formal. ww w. h ealt h . h ar v ar d . e du

How much is enough? The Physical Activity Guidelines for Americans from the U.S. Department of Health and Human Services urge all adults to get 150 minutes of moderate aerobic exercise per week (for example, 30 minutes on each of five days) or 75 minutes of vigorous aerobic activity. Depending upon the speed or intensity of your walks, walking could be classified as either moderate or vigorous. While the guidelines provide a good target, plenty of research has shown that walking has benefits even if you don’t hit the recommendations. Some is better than none. However, more is better, according to a review of 22 studies—particularly when it comes to reducing your risk for heart disease. Walkers who go longer or faster lower their risk more than those who take shorter walks or go at slower paces. Note that the guidelines also urge all adults to perform two or more sessions of strength training per week as well, with at least 48 hours in between to allow muscles to recover. While walking does not provide strength training per se, you can include some upperbody strength work by doing the “Walking workout with a resistance band” (see page 30) and the “Nordic walking workout” (see page 33). We’ve also included some specific strength exercises at the end to round out your program (see “Strength training for walkers,” page 38).

Technique People are often surprised to learn that there’s more to walking than simply putting one foot in front of the other. In fact, a little technique goes a long way to making your walks more enjoyable and more effective. Technique is especially important if you are hoping to become fitter and lose weight, because it will enable you to walk faster and longer. When you’re standing tall, your muscles will move through a greater range of motion for a more powerful stride. Improving your walking posture will help you to look and feel more confident, too—and you’ll look slimmer before losing a single pound. It will also help alleviate aches and pains and allow you to take deep breaths for more energy. Walking for Health

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For any type of walking The following rules will help you maintain good form. Stand tall. Many people bring that hunched-overthe-computer posture to their walks. This position makes it harder for you to breathe and may contribute to backaches. Other people lean backward. Instead, extend your spine as if you were being lifted from the crown of your head. Place your thumbs on your lower ribs and your fingertips on your hips. As you stand up tall, notice how the distance in between increases. Try to maintain this elongation as you walk. Eyes up. If you’re looking down at your feet, you’re putting unnecessary stress on your upper back and neck. Bring your gaze out about 10 to 20 feet in front of you. You’ll still be able to spy obstacles ahead and prevent upper-body tension. Shoulders back, down, and relaxed. Roll your shoulders up, back, and then down. This is where your shoulders should be as you walk—not pulled up toward your ears. Think about keeping your shoulders away from your ears to reduce upper-body tension and allow for a freer arm swing. Swing from your shoulders. Let your arms swing freely from your shoulders, not your elbows. Swing your arms forward and back, like a pendulum. Don’t bring them across your body or let them go higher than your chest. Maintain a neutral pelvis. Keep your abs tight, but don’t tuck your tailbone under or stick your belly out and overarch your back. Step lightly. You should be rolling from heel to toe as you stride, not landing flat-footed with a thud. And don’t reach your leg far out in front of you. That increases impact on your joints and actually slows you down. You want a smooth, quiet stride—no bouncing or plodding along—to reduce your risk of injury.

For heart-pumping workouts The following techniques will help you pick up your pace and increase your heart rate. Bend your arms. You wouldn’t run with your arms at your sides—it would slow you down. The same goes for walking. Like a pendulum, the shorter your arm is, the faster it swings. And since your body likes to be in sync, your legs will speed up to stay in step 16

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with your arms. Bend your elbows 85 to 90 degrees and swing your arms forward and back—not side to side or diagonally across your body. Your hands can be in relaxed fists or open, whatever is most comfortable to you as long as you are not clenching your fists. Keep your shoulders down, not scrunched up toward your ears. Bending your arms also prevents swelling caused by blood accumulating in your hands as you walk longer distances. Land on your heel. As your leg swings forward, your heel should be the first part of your foot that makes contact with the pavement. Focus on keeping your toes up as you land. This facilitates the heel-totoe walking motion that will carry you farther and faster than if your foot slaps down on the ground with each step. Roll from your heel to your toes as smoothly as possible. Finally, push off with your toes. Push off strong. Focus on really pushing off the ground to propel yourself forward. For maximum power, bend at the ball of your foot, raising your heel as if you were trying to show the person behind you the sole of your shoe. Take shorter, quicker steps. One of the most common mistakes people make when trying to walk faster is overstriding, taking longer steps than normal. Instead of speeding you along, big steps actually slow you down because it’s harder to get your body weight over an outstretched leg. In a sense, your leg acts as a brake, creating a choppy stride and increasing impact that may make you more susceptible to an injury. Instead, focus on shorter, quicker steps—placing your front leg almost right under you as you fall into your next step. This allows for a smoother, rolling stride that makes it easier for you to shift your body weight over your front leg and swing your back leg forward. The result: a faster walking speed. Keep your front leg straight. From the time your foot lands on the ground until it is under your body, keep it straight, but not locked. This will prevent bouncing. You’ll have a smoother stride and be able to propel yourself forward more easily. As always, be sure to maintain good posture (see “For any type of walking,” above left). This may seem like a lot to think about, but you don’t have to do it all at once. Start from the top of the list and focus on w w w.h ealt h .ha r va r d.e du

one tip at a time. Pay attention to this at the beginning of your walk, and then periodically check (don’t constantly focus on it) to see if you are maintaining good form. If not, simply readjust. Do this for about a week and then move on to the next tip. Some changes may happen quickly, while others may take some time to become habit. For more advice on how to walk even faster, see “Go faster,” page 45.

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Essential gear

slip it on, try on another, and another, until you find one that feels great right away. To find the best shoe for you and get a good fit, follow these tips: Go to a specialty running store that also has walking shoes. You’ll get more personal, expert

advice than if you go to a large chain retailer. The staff is more knowledgeable and will ask you about your activity and watch you walk to help you get a pair that’s right for you and your activity level. A shoe with cushioning and support is a must, but more is not necessarily better (see “Myth: The more support and cushioning in a walking shoe, the better,” page 18). You can even bring in a pair of old shoes so they can observe the wear pattern, which tells them a lot about how you walk. Shop late. For the best fit, go shoe shopping at the end of the day—your feet naturally expand with use during the day and may swell in hot weather. Choose socks first. The thickness of your socks can affect how shoes fit. Either buy the socks first, or take your favorite socks with you. (For more on sock choice, see “How to find the right socks,” page 18.)

One of the reasons walking is such an appealing form of exercise is that you don’t need a lot of expensive gear. The only essentials are a comfortable pair of walking shoes and socks. What constitutes maximum comfort, though, is likely to vary from one person to another and may even vary for you depending upon the type of walking you’re doing. For example, for a slower-paced walking meeting during the workday, you could wear a pair of stylish dress shoes that are designed for movement, such as those by Dansko, Ecco, or Merrell. But when you go out for a walk with the goal of getting a good workout, you’ll want an Consider walking and runathletic shoe. ning shoes. Yes, you can wear You don’t necessarily have a running shoe for walking, to buy new walking shoes right because both are designed for now. If you have a pair that feels forward motion. Often there good on your feet, you can use When you start a walking program, your two are more running shoe options, them to get started. When you most important pieces of equipment are simply making it easier to find a good do go shoe shopping, remem- a good pair of shoes and socks. fit. However, don’t wear walkber that you don’t have to spend ing shoes to run. They are not a fortune. Scottish researchers designed for the higher impact. tested running shoes that cost $80 to $150, and they Also, avoid cross-trainers or tennis shoes, which are found that the lower-priced shoes performed just as designed for side-to-side movement. well as the higher-priced ones. Give it a bend. Grab the toe and heel of a shoe and pull them toward each other. The shoe should How to find a good walking shoe bend easily at the ball of the foot. If it doesn’t, look for No two pairs of feet are the same, so it’s impossible to another style that is more flexible for greater range of recommend a specific shoe that will suit everyone. The motion and an easier push-off. most important factor when choosing a walking shoe Go for a low heel. Avoid shoes with big bulky is comfort. If the shoe doesn’t feel good as soon as you heels, which can impede the natural rolling foot ww w. h ealt h . h ar v ar d . e du

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Myth: The more support and cushioning in a walking shoe, the better

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hoes with thick, cushiony soles are commonly believed to help protect your joints and reduce pain. But research is challenging that conventional wisdom, suggesting that thinner, more flexible soles actually put less load on the knees. Researchers at Rush University Medical Center in Chicago compared walking barefoot against walking in four types of shoes: clogs, “stability” walking shoes with a thick heel and sole (Brooks Addiction Walkers), walking shoes with a thin heel and sole (Puma H-Street), and flipflops. Using special camera equipment, they analyzed the gaits of 31 volunteers with knee arthritis. The results, reported in 2010 in Arthritis Care & Research, showed that walking in clogs or stability walking shoes produced 15% more load on the knees than did walking in thinner walking shoes or flip-flops, which were both equivalent to walking barefoot. The researchers offered a couple of possible explanations. Elevated heels

increase loads on the inside of the knee, a common spot for arthritis. While clogs and stability walking shoes don’t come to mind when we think about highheeled shoes, the models used in this study, which are fairly standard, had heel heights of one to two inches—an inch or more higher than those of the thin-soled shoes and the flip-flops. The stiffer soles of the clogs and stability walking shoes may also affect a person’s gait, putting more load on the inner part of the knee. The same researchers reported several years ago that walking barefoot is associated with lower knee loads than walking with shoes, perhaps because the unshod foot flexes and pronates (rolls in somewhat, so the arch

motion of walking and may make you more susceptible to tripping. Make sure you have wiggle room. Your feet swell during walks, especially long ones. You should have at least one finger’s width between your longest toe and the front of your shoe. Take a test walk. If the store doesn’t have a treadmill, ask to go outside for a test walk. At the very least, lap the store several times to get a feel for the shoe. Try on several brands for comparison. If you notice any rubbing, discomfort, or sore spots, move on to the next pair. Replace sneakers regularly. Materials inside sneakers that provide support and cushioning usually wear out long before your shoes look like they need to be replaced. Most walkers should replace their shoes every 300 to 500 miles. If you’re overweight or wear very lightweight shoes, aim for the lower end of the range.

How to find the right socks Socks are the other essential piece of gear. This oftenoverlooked item helps keep your feet dry and blisterfree, and athletic socks cushion the impact of your feet 18

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gives) in a more natural fashion. Flexible soles may allow for a motion that more closely resembles walking barefoot. But don’t jump directly from stiff soles to minimalist running shoes. Gradually change them, or you could set yourself up for more problems. Nor should you start walking in flipflops or going barefoot. Both can affect your gait in ways that can cause pain in the leg, hip, and lower back, and they can leave your feet vulnerable to injuries, such as sprained ankles, tendinitis, and broken toes. Here’s the bottom line: If you’re happy with the shoes you’re walking in and don’t have any aches or pains, then don’t change a thing. But if you wear a very cushiony or stiff shoe and you’re having problems, it may be worth trying a slightly more flexible shoe with a somewhat lower heel.

hitting the ground by 6% to 20%, according to one study. Again, you don’t have to run out and buy new ones today, but as you walk more, having the right pair will make your walks more enjoyable. The wrong pair of socks can make even the best shoes feel crummy. Avoid cotton socks. Once they’re wet—either from the weather or sweat—they stay wet, putting you at more risk of developing a blister. Instead, choose socks made of synthetic fabrics that wick away moisture. Find the right thickness. You’ll find a variety of thicknesses when shopping for socks. Some people prefer very thin socks, so it’s almost like you’re not wearing any, while others prefer the cushioning of thicker socks. It’s a matter of personal preference, so try a few pairs to find the one that’s right for you— and do that before you buy new shoes, to make sure that your shoes and socks work well together for more comfortable walking. For more gear and clothing suggestions, see “Walking through the seasons” on page 41. These items aren’t required, but they can make your walks more enjoyable. w w w.h ealt h .ha r va r d.e du

Avoiding injuries Because walking is low-impact, you’re less likely to get injured than with higher-impact activities, but it’s still possible. You can reduce your chances of suffering an injury with some commonsense approaches. In this section, you’ll also find remedies to some less serious—but annoying—problems, such as blisters, that you may encounter as you walk more or faster.

How to avoid serious injuries The following will help keep you safe and pain-free. Listen to pain. Pain is the body’s way of telling you that if you persist in what you’re doing, you will either injure yourself or worsen an existing injury. It’s important that you listen to your body and respond appropriately. Some discomfort is typical with exercise—usually in muscles, which may develop fatigue during exercise or some stiffness the next day. But exercise shouldn’t hurt. Call your doctor if you suffer an injury, such as a sprained ankle or a fractured bone; experience sharp, shooting pain, especially in a joint, that doesn’t go away; or notice pain outside of your walks, such as foot pain in the morning, that doesn’t resolve. Wear good shoes. The right shoes can help you avoid injuries in the first place (see “How to find a good walking shoe,” page 17). But shoes wear out, and walking in worn shoes can make you more susceptible to injuries. Research shows that it’s best to replace your shoes about every 300 to 500 miles. Practice proper form. This will ensure that you’re not putting too much stress on one part of your body, which could lead to problems. For example, if you’re bending at your waist instead of standing up tall, you might experience lower back pain. For information on good walking form and technique, see “Technique,” page 15. Pace yourself. In this case, pacing doesn’t refer to your speed. For the purposes of injury prevention, pacing means increasing the intensity or duration of your walks gradually over time. For example, don’t jump suddenly from doing 30-minute moderate strolls to hour-long interval workouts. If you’re just getting started, follow the “Easy walking workout” on page 27, which will gradually build you ww w. h ealt h . h ar v ar d . e du

up to the recommended 150 minutes of moderate activity each week. Pacing also means allowing time for rest and recovery. In other words, don’t attempt fast walking or interval walks every day of the week. Instead, allow a rest day (which might include easy walking to ensure that you get at least five days of exercise in a week) between these higher-intensity walks. Be aware that training too hard or too often can cause overuse injuries, like stress fractures and inflamed tendons and ligaments. Adjust your training, if needed. Decrease the intensity of your workout if you are having difficulty finishing an exercise session, feel fatigued for the rest of the day after a walk, or suffer persistent aches and pains in joints after exercising. If you feel sick, hold off on exercise entirely until you feel well again for at least 24 hours. Watch the weather. Hot, humid weather or cold conditions can increase your risk of problems. See “Walking in the winter,” page 41, and “Walking in the summer,” page 43, for ways to stay safe. Drink up. The right level of hydration starts well before you lace up your sneakers. Drinking enough— but not too much—before, during, and after your workouts will keep your muscles functioning at a high level. You’ll also feel better and have more energy. For most people, simply drinking water is sufficient. But if you’re working out especially hard or it is a particularly hot day, choose sports drinks that replace fluids plus essential electrolytes. (Just remember these types of drinks may have a lot of calories, so don’t overdo it.) Warm up and stretch. These steps may seem unnecessary. After all, you don’t warm up to walk across the parking lot from your car to the supermarket. When you start walking for exercise, however, you’ll find that these are important parts of your walking workouts. Warming up helps you make the transition from being inactive to active and may protect you from injury. Stretching afterward is important to prevent stiff muscles that can also increase your risk of injuries. For more information, see “Walking warm-up,” page 24, and “Post-walk stretches,” page 35. RICE it. RICE—which stands for rest, ice, compression, and elevation—is the basic treatment for Walking for Health

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most minor injuries and should be your first response when pain hits. Even if your injury is serious enough to call your doctor right away, get ice on it in the meantime. For minor injuries, if pain does not respond to self-treatment within a few days, call your doctor. Make a slow return. If you stop exercising for a while, drop back to a lower level of exercise when you get started again and gradually build back up. For example, take shorter walks or walk at a slower pace. Each week, increase your frequency, duration, or intensity a little more until you’re back to your prehiatus routine. (Don’t increase all of them at the same time, though.)

How to avoid (and treat) minor problems Even a small source of discomfort can sideline you from your walking program. Here’s how to dodge the most common ones. Blisters. Keep your feet dry and minimize friction. Well-fitting shoes and moisture-wicking socks will go a long way toward reducing problems. Make sure that you choose socks without seams that may rub, and select the right size to prevent bunching. Some walkers have found that using double-layer socks or wearing two pairs—for example, a thin liner sock under your regular sock—can help prevent blisters. Others swear by BodyGlide (a lubricant sold in running and sporting goods stores) or petroleum jelly. Applied directly to the feet, either one creates a slippery protective barrier. As for keeping feet dry, antiperspirant on the feet can help the moisture-wicking socks. At the first sign of a sore spot, apply moleskin or a bandage to prevent a full-fledged blister. Chafing. You can develop chafing anywhere skin rubs against skin—for example, your underarms or inner thighs—or where clothing rubs against skin, such as under the band of a sports bra or inside the thigh area of shorts. To prevent chafing, choose clothes that are seamless in these areas and made of wicking fabrics. Sweat can make chafing worse. Lubricants such as BodyGlide (also used to prevent blisters on the feet), petroleum jelly, or baby oil can help, too. For chafing between your legs, you might want to try wearing compression shorts under your regular shorts or pants. 20

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Swollen hands. When you’re swinging your arms down at your sides for a long period of time, the motion causes blood to pool in your fingers, which can lead to swelling. To prevent this, keep your arms bent at 90-degree angles. If you’re bending your arms but still notice a problem, you might be bending them in the forward position but extending them on the backswing. Imagine your arm is in a cast and keep it bent all the time. If you’re still noticing swelling, open and close your fingers periodically as you swing your arms to increase circulation. You can also raise one arm over your head and wiggle your fingers for 15 to 30 seconds while holding your other arm bent up at your side so your fingers are by your shoulder and pointing toward the sky. Alternate arms a few times

Keep your feet happy Your feet are your most valuable walking asset, so make sure that you’re taking good care of them. Purchasing the right shoes and socks is definitely a great place to start. But you’ll also want to take good care of your feet when you’re not exercising. Following are some easy ways to pamper your feet and prevent problems. Limit heel time (for women). High heels can contribute to back and knee problems, not to mention a variety of foot problems. Stick to heels no higher than three-quarters of an inch whenever possible. Put your feet up. For at least a few minutes a day, lie back with your feet propped up to reduce swelling and improve circulation. Go barefoot. Your feet need time to breathe and stretch out. Walking barefoot also works the muscles in your feet more than walking in shoes. However, you should limit your barefoot walking to indoor environments where you don’t have to worry about stepping on something—and also take care not to stub your toes. Stretch your toes. Here’s another way to counteract all the time your feet are confined in shoes: lace your fingers in between your toes and hold for a minute or so for each foot. Aim to do this at least once day. Massage your feet. To help revive tired feet, roll each one over a tennis ball or a cold or frozen water bottle. Give yourself a foot massage or enlist your significant other. The rubbing and kneading will ease soreness or stiffness and increase circulation. Keep your toenails trimmed. This will prevent rubbing against the front of your sneakers that could cause problems.

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and repeat any time you notice some swelling or tingling in your hands. Side stitch. Remember running as a kid, only to have a shooting pain in your side stop you in your tracks? That’s a side stitch. They’re less likely to occur when you’re walking, but if one does, slow down and put your hands behind your head and take deep breaths. You can also try bending forward slightly while massaging or pressing on the area where you feel pain. It should resolve in just a few minutes. A side stitch is believed to be a cramp or spasm in your diaphragm. Some experts say that side stitches become less frequent as you become more fit. Others claim that strengthening your abdominal muscles may help. (That’s a good reason to do the exercises described in “Strength training for walkers,” page 38.) Cramps. Cramps can occur for a variety of reasons. Dehydration is one, so make sure you’re drinking enough water or a sports drink with electrolytes. For muscle cramps, stop and stretch the muscle. If the cramps continue, talk to your doctor. If it’s stomach cramps that are causing the problem, make sure that you’re waiting at least an hour after eating before doing brisk or higher-intensity walks. Also try to avoid caffeine and dairy foods before walking because

these types of foods cause problems for some people. And check your form; excessive bouncing as you walk can upset your stomach, too. Shin pain. This is a common site of discomfort when you try to walk faster. For immediate relief, stop walking and stretch your shins for a few minutes. Point and flex each foot and rotate it in both directions to ease the pain, and then start walking again. Slowing down a bit will also help. If shin pain occurs as you try to speed up, it is usually because of muscle fatigue. As your muscles become more conditioned, it should be less of a problem. (If you have pain that doesn’t go away when you slow down or stop walking, you should check with your doctor.) For more tips on managing shin pain, see “Oh, my aching shins,” page 47.

Safety tips Walking is generally safe, but the environment can pose hazards. You should always be prepared for problems or emergencies. Familiarize yourself with the area. Walking in new locations makes walking more adventurous and interesting, but before your first jaunt in a new place, scout out the area. Either drive around it at the time of day when

Walking speed may predict how long you live

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s you get older, the stroll that was once a walk in the park may get difficult for any number of reasons: angina, arthritis, bad balance, failing vision. In the later decades of life, walking becomes as much an indicator of health as a promoter of it. Researchers at the University of Pittsburgh have published research in The Journal of the American Medical Association showing that after about age 65, how fast you walk may predict how long you have to live. Walking, or gait, speed has long been recognized as a proxy for overall health and vitality and has been measured in many research projects. The University of Pittsburgh researchers pooled results of nine studies and found a remarkably consistent association between faster gait speed and longer life in both men and women ages 65 and older. More precisely, each increase of 0.1 meter per second in gait speed was associated with a 12% reduction in the risk of dying during a study’s follow-up period (the follow-up periods varied). They also calculated that people with gait speeds

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of 1 meter per second or faster lived longer than would be expected given their age or gender. (One meter per second is equivalent to 2.2 mph and just a bit slower than the speed needed to cross the street at most timed traffic lights.) When the researchers factored in body mass index, blood pressure, prior hospitalization, and several other factors, the relationship between gait speed and longevity didn’t change much. In other words, walking speed seemed to be independently associated with life expectancy, not just a marker for other conditions that would affect it. So does this mean that if you’re older and you work on improving your walking speed, you’ll live longer? Unfortunately, observational studies, which are based on statistical associations, don’t allow scientists to draw cause-and-effect conclusions like that. On the other hand, countless other studies have correlated physical activity with better health and longer life. For the vast majority of people at any age, regular walking improves health.

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you plan to walk, or if that’s not possible—for example, on trails—ask a friend or family member to join you the first time. Whenever you’re hiking, it’s always a good idea to hike with someone else, in case of injury. Carry ID. In case of an emergency, you want medical personnel to know any relevant information and be able to contact your family. You can grab your license or other identification card before you head out for a walk, but there’s always a chance you might forget it. That’s why it’s wise to invest in an ID bracelet or tag that you wear or attach to your sneaker or waist pack. Keep it with your sneakers, so you’ll always have it when you walk. You can find ID products at sporting goods stores, or search “runner identification” online. Or if you have an old driver’s license, keep it in your pack or jacket. Even if you walk with someone else, you should carry medical information and contact numbers that your friend may not be aware of. Bring your cellphone. You want to have your phone so you can call someone if you need to—for example, if you’re not feeling well or if you injure yourself and can’t complete your walk. No texting while walking, though! In a one-year study, about 135 walkers had to go to the emergency room for injuries sustained from this common practice. Have some cash. Or a credit card. It may come in handy if you run out of water or need a snack, or in the unlikely event that you’d need to take a cab or bus back home. If you’re walking in a retail area, you’ll be thankful that you have it if you find a great deal on something you want. Just finish your walk before you stop to make a purchase. Walk against traffic. If you have to walk in the road because there are no sidewalks, the general rule is to walk against traffic so you can see what’s coming. The exceptions are when you’re walking up hills or around curves. In these situations, you’ll want to switch to the opposite side of the road, walking with traffic, since drivers coming up a hill or heading into a bend will see you sooner. You want the drivers to spot you with enough time to react, if necessary. As soon as you crest the hill or round the bend, immediately cross the street, so that you’re walking against the traffic again. On winding roads, you may end up switch-

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ing sides frequently. No matter what side you’re on, always be alert, and remember: if you can’t see a car coming, the driver can’t see you either. Use only one earbud. It’s safest to unplug when you’re walking because you want to stay alert to your surroundings for possible hazards, such as cars or dogs. To do that effectively, you need to be able to hear what’s going on around you. Wearing earbuds impairs that ability. However, many people find that listening to music or audiobooks motivates them to walk more. If you rely on audio inspiration for your walks, keep the volume low and wear only one earbud so you can hear what’s going on around you. If you’re walking on streets, take out the earbud closest to traffic so you can be alert to cars approaching from behind (and make sure you’re facing into traffic). If you’re on a path with runners, cyclists, and skateboarders, leave out your left earbud, since they should be passing on the left and you’ll be better able to hear them as they approach. Wear brightly colored clothing. To avoid blending into your surroundings, dress in red, yellow, or other vibrant colors instead of dark or drab colors like black, gray, navy, or dark green. The more visible you are to motorists, the more time they have to react to your presence on the road, and the safer you’ll be. Glow in the dark. If you walk at dawn or dusk, invest in reflective gear—the more the better. Jackets or shirts made of reflective material are a good place to start. Add a hat with reflectors and some type of reflective gear on your lower body, like shorts or pants with a reflective strip, sneakers with reflectors, or both. The more you look like a human being as opposed to random lines or spots, the quicker motorists will be able to identify you. A flashlight is also important so you can see where you’re stepping, and avoid hazards such as branches or uneven pavement. Be cautious about walking alone at night. This may be the only time that you can fit in a walk, and it can be very pleasant. But if you do walk after dark, choose areas that are safe, well-lit, and have sidewalks—and if possible, venture out with someone else. Also avoid places with lots of trees and shrubs and any remote areas.

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Walking workouts and more

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hile any walking you do is beneficial, establishing an actual walking program will help you reap the health benefits we described in the first chapter (see “It’s healthy,” page 2). Of course, you can simply put on your walking shoes and go. But the following workouts will give you the structure you may need to begin a successful program. Once you’ve mastered the “Easy walking workout” (see page 27), try some of the other workouts to amplify the benefits. To boost cardiovascular health, for example, you can try one of the “Interval walking workouts” (see page 28). To develop more upper-body strength at the same time you’re walking, try the “Walking workout with a resistance band” (see page 30) or the “Nordic walking workout”

(see page 33). For greater stress reduction, try the “Mindful walking workout” (see page 34). Or switch from one workout to another to keep walking varied and fun. To give you a complete workout each time, we’ve also included a warm-up (see page 24) and post-walk stretches (see page 35). And we’ve included some strength exercises especially suitable for walkers (see page 38), so that you can do some strength training to complement your aerobic walking workouts. At the same time, you’ll be building up muscles you’ll use for walking. The Physical Activity Guidelines for Americans recommend two to three strength training sessions per week, with at least 48 hours in between.

Terminology used in the workouts Following are definitions of the terms that we use in our walking workouts, warm-ups, stretches, and strength exercises. Repetitions (or reps). Each time you complete an exercise—from the starting position, through the movement, and back to the starting position—it is counted as a rep. If you cannot do all the reps at first, just do what you can, and then gradually increase reps as you improve. Set. One set is a specific number of repetitions. For example, eight to 10 reps often makes a single set. Usually, we suggest doing one or two sets. Intensity. Intensity measures how hard you work during an exercise. By paying attention to cues like breathing, talking, and sweating, you can measure intensity through perceived exertion. Tempo. This tells you the pace for the key movements in an exercise. For example, a 4-2-4 tempo means you should

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count to 4 as you do the first phase of the exercise (such as lifting a leg), hold the new position for a count of 2, and return to the starting position as you count to 4. If the tempo lists only two numbers, such as 4-4, that means you do not hold the position. Hold. Hold tells you the number of seconds to pause while maintaining a pose or position during an exercise. You’ll see this instead of “tempo” in stretches, which are held for up to 30 seconds, and some strength moves, such as planks. Rest. Resting gives your muscles a chance to recharge and helps you maintain good form. We specify a range of time to rest between sets (and sometimes between reps, for especially tiring exercises). How much of this time

you need will differ depending on your level of fitness and the intensity of the exercises. Starting position. This describes how to position your body before starting the exercise. Movement. Here you’ll find out how to perform one complete repetition correctly. Tips and techniques. We offer two or three pointers to help you maintain good form and make the greatest gains from the exercise. Make it easier. This gives you an option for making the exercise less strenuous. Make it harder. This gives you an option for making the exercise more challenging.

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Walking warm-up Instead of instantly going from 0 mph to 3 or 4, you’ll feel a lot better when your body has time to warm up. The best way to do this is to start by strolling at a slower pace for five to 10 minutes. This will warm up your muscles so they are more flexible. In addition, your heart rate and breathing will increase to get more blood and oxygen to fuel your working muscles. There are times when you might want to do a little more warming up, though—for example, if you’re

noticing some stiffness or if you want to target a particular area. Here are some warm-up moves you can do either before, during, or after your strolling warmup. They are also a good option if you’re waiting for your walking partner to join you, waiting at a light to cross the street, or warming up indoors in the winter. To see a video of these warm-up exercises (as well as the post-walk stretches on page 35), go to www.health.harvard.edu/walking-for-health-video. www.health.harvard.edu/walking-for-health-video

Foot rolls Starting position: Stand with your feet together. You can grab on to a chair or railing for balance if needed. Movement: Lift your heels and roll up onto your toes and hold. Slowly lower your heels, then roll back onto your heels, pulling your toes up. Where you’ll feel it: shins, calves, and feet Reps: 10 to 20

Tips and techniques: • Keep your head up. • Tighten your abs. • Stand tall. Don’t bend at the waist or lean forward. • Don’t lock your knees. • Keep your shoulders down and back, away from your ears. • Keep your toes and knees pointing forward. • Breathe comfortably.

Hold: 2 or 3 seconds

Leg swings Starting position: Stand tall with your feet together. Shift your weight to your left foot. You can grab on to a chair or railing for balance if needed. Movement: Slowly swing your right leg forward and back, increasing your range of motion by lifting your leg a little higher each time, up to about a foot or so off the ground. Squeeze your glutes on the backswing. Where you’ll feel it: hips, glutes, and legs Reps: 10 to 20 with each leg Hold: none

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Tips and techniques: • Keep your head up. • Tighten your abs. • Stand tall. Don’t bend at the waist or lean forward or back. • Keep your legs straight, but don’t lock your knees. • Keep your shoulders down and back, away from your ears. • Keep your toes and knees pointing forward. • Don’t swing so high that your back overarches or your upper body sways. • Breathe comfortably.

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Warm-up

Hip circles Starting position: Stand tall with your feet together and raise your right knee in front of you. You can grab on to a chair or railing for balance if needed. Movement: Slowly move your right knee clockwise in a circle, rotating from your hip. Do the recommended number of reps, then switch legs and repeat. Then repeat the sequence circling in the other direction. Where you’ll feel it: hips, glutes, and legs

Hold: none Tips and techniques: • Keep your head up. • Tighten your abs. • Stand tall. Don’t bend at the waist or lean forward or back. • Keep your shoulders down and back, away from your ears. • Keep your upper body stationary; the movement should come from your hip only. • Breathe comfortably.

Reps: 8 to 10 with each leg in each direction

Arm swings Starting position: Stand with your feet about shoulder-width apart and your arms at your sides. Movement: With your arms extended, gently swing your arms forward and back, swinging from your shoulders. Do the recommended number of reps, then bend your arms to about 90-degree angles and swing them for another set of reps. Where you’ll feel it: arms, shoulders, chest, and back Reps: 20 in each position, counting each arm swing forward as one rep Hold: none Tips and techniques: • Keep your head up. • Tighten your abs. • Stand tall. Don’t bend at the waist or lean forward or back.

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• Keep your shoulders down and back,

away from your ears. • Don’t swing your arms above shoulder

height. • Breathe comfortably.

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Warm-up

Torso twists Starting position: Stand with your feet shoulder-width apart and arms bent in front of your chest. Movement: Slowly rotate your upper body to the left as far as is comfortable, while keeping your lower body facing forward. Return to the center. Rotate to the right. Return to the center. That’s one rep. Do the recommended number of reps. Then repeat the sequence, but this time rotate your entire body,

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including your hips and legs, allowing the heel of the opposite foot to come off the ground (so as you rotate to the right your left heel will rise). Return to the center and rotate to the right, and back to the center again. That’s one rep in the new position. Where you’ll feel it: abs, back, and hips Reps: 10 to 15 in each position

Hold: none Tips and techniques: • Keep your head up. • Tighten your abs. • Stand tall. • Keep your shoulders down and back, away from your ears. • Keep the movement slow and controlled. • Breathe comfortably.

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WORKOUT 1

Easy walking workout You don’t need anything special to do this workout, just a good pair of shoes and socks.

If you haven’t been exercising, this workout is a great way to get started. You’ll gradually increase the amount of time you’re walking, building up to the recommended 150 minutes of moderateintensity exercise per week. For these walks, you don’t have to worry about technique. Just pay attention to your posture—stand tall with your head up, shoulders down and back, and abdominal muscles tight. (For more details, see “Technique,” page 15, and “How fast is brisk?” on page 28.)

Get started walking This eight-week program will take your walking from just 10 minutes a day up to 30 minutes, allowing you to build up gradually. WEEK

SESSIONS PER WEEK

1

WARM-UP

WALKING TIME

COOL-DOWN

DAILY TOTAL

WEEKLY TOTAL

7

3 minutes slow walking

5 minutes moderate walking

2 minutes slow walking

10 minutes

70 minutes

2

7

3 minutes slow walking

10 minutes moderate walking

2 minutes slow walking

15 minutes

105 minutes

3

6

3 minutes slow walking

15 minutes moderate walking

2 minutes slow walking

20 minutes

120 minutes

4

6

3 minutes slow walking

5 minutes moderate, 5 minutes brisk, 5 minutes moderate walking

2 minutes slow walking

20 minutes

120 minutes

5

6

3 minutes slow walking

5 minutes moderate, 10 minutes brisk, 5 minutes moderate walking

2 minutes slow walking

25 minutes

150 minutes

6

6

5 minutes slow to moderate walking

12 minutes brisk, 3 minutes moderate walking

5 minutes slow walking

25 minutes

150 minutes

7

6

5 minutes slow to moderate walking

15 minutes brisk walking

5 minutes moderate to slow walking

25 minutes

150 minutes

8

5

5 minutes slow to moderate walking

20 minutes brisk walking

5 minutes moderate to slow walking

30 minutes

150 minutes

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WORKOUT 2

Interval walking workouts

Interval workouts alternate higher-intensity activity, like brisk or fast walking, with lowerintensity activity, like moderate or slow walking (see “How fast is brisk?” below). Because they incorporate more vigorous activity, you can get more benefits from your walks—and in some cases, shorten the amount of time you are walking, while still getting benefits. If you’ve completed the “Easy walking workout” (see page 27) or are already walking for exercise, interval walks are a perfect next step. Here are three interval walking workouts to keep your walks fun and interesting and to challenge your body in new ways. If you’d like to walk longer, simply repeat the intervals more times. Or do less for a shorter workout. You can also gradually build up to the recommended number of intervals by just doing one or two the first week and increasing from there. Do only two or three interval workouts per week, on nonconsecutive days. Because they are higher intensity, your body needs time to recover. You can still do steady-paced low- to moderate-intensity walks on alternate days.

When doing intervals, you may want to time yourself. A sports watch can make tracking intervals easier.

How fast is brisk? Intervals rely on changing the pace of your walking. Following are descriptions of the different walking paces suggested in the walking workouts. Note that pace and intensity levels are very subjective and affected by your current fitness level. As you walk, remind yourself of the pace that you should be walking. In one study, 84 overweight, sedentary volunteers were told to remind themselves to walk briskly as they walked. It was the only direction that researchers gave to the group, yet even without athletic experience, all of them achieved heart rates in the range of 58% to 70% of their maximum, the target zone for moderate-intensity exercise. As you become fitter, you’ll likely be walking at a faster pace for each type of walking than you did at the beginning, but the effort will be similar. Most important, listen to your body and walk at a pace that’s appropriate for you. TYPE OF WALKING

PACE

HOW IT FEELS

INTENSITY

Easy

Leisurely stroll

Light effort, breathing easily; you can sing

Light

Moderate

Purposeful, like you have some place to get to

Some effort, breathing more noticeable; you can talk in full sentences

Light to moderate

Brisk

In a bit of a hurry

Moderate effort, breathing harder; you can talk in full sentences but need to take more breaths

Moderate

Fast

Late for an appointment

Hard effort, slightly breathless; you can talk in phrases

Moderate to vigorous

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Interval walking workouts

Short intervals This interval walking workout alternates a shorter, higher-intensity interval with a longer recovery interval. The goal for this walk is to push yourself to a fast or very fast pace for the speed interval, since it’s only for a short period. Then you’ll have more time to recover. This style of intervals is based on the vast majority of research that’s been done on the benefits of high-intensity interval training. SESSIONS PER WEEK

2 to 3

WARM-UP

INTERVAL WALKING

COOL-DOWN

TOTAL

5 minutes slow to moderate walking

1 minute 30 seconds moderate walking followed by 30 seconds fast or very fast walking. Repeat the sequence nine more times, for a total of 10 times.

5 minutes moderate to slow walking

30 minutes

Long intervals Because you’re going longer, this combination of intervals won’t be as intense as some of the other interval workouts. But it still produces better results than strolling at a steady pace. These are the same types of intervals that Japanese researchers used in a study of walkers ages 44 to 77. They found that after five months, the interval walkers, who did three 30-minute interval walks a week, had greater improvements in cardio fitness, leg strength, and blood pressure than the steady-paced strollers. SESSIONS PER WEEK

2 or 3

WARM-UP

INTERVAL WALKING

COOL-DOWN

TOTAL

5 minutes slow to moderate walking

3 minutes moderate walking, followed by 3 minutes brisk or fast walking. Repeat the sequence three times, for a total of four

5 minutes moderate to slow walking

34 minutes

Three-in-one intervals Instead of alternating just two intervals, you’ll be doing three intervals during this walk. The third interval is very short and designed to really get you out of your comfort zone. Most people can do more than they think they can, and this routine presents you with that challenge. This is a more vigorous workout and should be done only after you’ve been walking regularly for at least three months and have been doing some of the other interval walks for at least a month. Remember to pay attention to your body. SESSIONS PER WEEK

2 to 3

WARM-UP

INTERVAL WALKING

COOL-DOWN

TOTAL

5 minutes slow to moderate walking

30 seconds moderate walking followed by 20 seconds fast walking, and then 10 seconds very fast walking. Repeat the sequence two more times, for a total of three times. Then walk slowly for 2 minutes. Do the entire sequence a total of four times.

5 minutes moderate to slow walking

30 minutes

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WORKOUT 3

Walking workout with a resistance band

Resistance bands look like big, wide rubber bands. By stretching them with your arms while you walk, you can exercise your upper body at the same time your legs are getting a workout. It’s a perfect addition to your routine if one of your goals is to firm up or to build strength. Aim to do this workout two or three times a week, remembering to allow 48 hours before doing another upper-body strength session. Resistance bands are usually available anywhere exercise equipment is sold. They come in several levels of resistance, from very light to very heavy, designated by color. To find the right resistance, see how many repetitions of an exercise you can do: if less than eight, resistance is too high; if more than 12, it is too low. You can also increase the resistance of any band by adjusting your hand position to shorten its effective length. To decrease the resistance, do the

opposite—lengthen the amount of band between your hands. Start your workout by warming up for five to 10 minutes with some easy-paced walking, gradually increasing to a moderate pace. Then begin the first exercise, doing it while you continue to walk. After you complete the recommended number of reps, drape the band over your shoulders, speed up to a brisk pace, and walk for two minutes. Continue with each subsequent exercise followed by two more minutes of brisk walking. It’s natural to slow your pace when you are doing the band exercises. Finish with five to 10 minutes of easy walking to cool down. You can repeat the series of exercises for a longer workout. To make this workout easier, do the moves with a lighter resistance band or none at all. To make it harder, use a stronger resistance band or increase the number of reps, up to 20 reps for each exercise.

Chest presses Starting position: Place the exercise band around your back and under your armpits. Hold an end in each hand by your shoulders, palms facing down. Movement: While walking forward, extend your arms straight out in front of you, parallel to the ground. As you do this, count to two. Keep your arms in this position for a count of one, while continuing to walk forward. Then slowly return them to the starting position to a count of two. Muscles worked: chest, arms, glutes, and legs Reps: 8 to 12 Tempo: 2-1-2

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Tips and techniques: • Resist as you return to the starting position, so the band doesn’t jerk your arms back. • Keep your head up. • Tighten your abs. • Stand tall. Don’t hunch or round your shoulders forward as you extend your arms. • Don’t lock your elbows in the extended position, but maintain a slight bend in your arms. • Keep your shoulders down and back, away from your ears. • Keep your wrists straight, in line with your arms. • Breathe comfortably.

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Walking workout with a resistance band

One-hand pull-down Starting position: Hold a band overhead with your hands about 6 inches apart and elbows bent slightly. Movement: Keep your right arm stationary as an anchor as you pull your left hand down to a count of four, stretching the band to about chest level. Hold for a count of one. Slowly raise your arm back overhead to the starting position to a count of four. Do all reps with your left arm, then repeat with your right arm. Muscles worked: back, shoulders, glutes, and legs Reps: 8 to 12 on each side

Tempo: 4-1-4 Tips and techniques: • Resist against the band as you return to the starting position so the band doesn’t jerk your arms back. • Keep your head up. • Tighten your abs. • Stand tall. Don’t hunch or round your shoulders forward as you move. • Don’t arch your back. • Keep your shoulders down and back, away from your ears. • Keep your wrists straight, in line with your arms. • Breathe comfortably.

Overhead presses Starting position: Place the exercise band around your back and under your armpits. Hold an end in each hand by your shoulders, palms facing forward. Movement: Extend your arms straight up overhead, while walking forward to a count of two. Keep the arms extended for a count of one, then slowly return to the starting position to a count of two. Muscles worked: chest, arms, glutes, and legs Reps: 8 to 12 Tempo: 2-1-2

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Tips and techniques: • Resist as you return to the

starting position so the band doesn’t jerk your arms back. • Keep your head up. • Tighten your abs. • Stand tall. Don’t hunch or round your shoulders forward as you extend your arms. • Don’t lock your elbows as you press upward, but maintain a slight bend in your arms. • Keep your shoulders down and back, away from your ears. • Keep your wrists straight, in line with your arms. • Breathe comfortably.

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Walking workout with a resistance band

Pull-back Starting position: Hold a band out in front of you with your arms parallel to the ground, your hands about 6 to 10 inches apart, and your elbows slightly bent. Movement: Keep your left arm stationary as an anchor as you bend your right elbow and pull your right hand back, stretching the band, toward your hip to a count of four. Hold your right arm in this position for a count of one before slowly returning it to the starting position to a count of four. Do all reps with your right arm, then repeat with your left arm. Muscles worked: back, glutes, and legs

Tempo: 4-1-4 Tips and techniques: • Keep your elbow in and your arm close to your body as you pull it back. • Resist as you return to the starting position so the band doesn’t jerk your arms back. • Keep your head up. • Tighten your abs. • Stand tall. Don’t hunch or round your shoulders forward as you move. • Don’t arch your back. • Keep your shoulders down and back, away from your ears. • Keep your wrists straight, in line with your arms. • Breathe comfortably.

Reps: 8 to 12 on each side

Triceps push-down Starting position: Place the exercise band around your neck. Hold an end in each hand by your shoulders, palms facing down and elbows bent and pointing out. Movement: Extend your arms straight down in front of you to a count of two, keeping your arms close to your body. Hold for a count of one. Slowly return to the starting position to a count of two. Muscles worked: arms, glutes, and legs Reps: 8 to 12 Tempo: 2-1-2

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Tips and techniques: • Resist as you return to the starting position so the band doesn’t jerk your arms back. • Keep your head up. • Tighten your abs. • Stand tall. Don’t hunch or round your shoulders forward as you extend your arms. • Don’t lock your elbows as you press forward, but maintain a slight bend in your arms. • Keep your shoulders down and back, away from your ears. • Keep your wrists straight, in line with your arms. • Breathe comfortably.

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WORKOUT 4

Nordic walking workout

For this workout, you’ll need a pair of Nordic (or fitness) walking poles. Follow the instructions that came with your poles to ensure that you have the proper height and that you are using them in the correct way. Use the rubber tip if you are walking on asphalt or concrete. The spike tip is for walking on grass or dirt. Start by swinging your arms without gripping the poles as you walk. The poles will dangle from the straps on your wrists and drag along the ground. Your arms should be extended and swing naturally, coming up no higher than about waist height. As you become comfortable with this motion, lightly grasp the pole as it comes forward and press the pole tip down and back into the ground. As you extend your arm behind you, open your hand. The more you press down, the more upper-body muscles you will activate. The pole should always be pointing diagonally behind you. Don’t plant the pole out in front of you, as you would if you were using poles during hiking to take pressure off your joints. You should always maintain a relaxed grip and use the straps to press down. Focus on mastering the

technique before you increase your speed or the intensity with which you use the poles. The following plan will gradually get you used to walking with poles. Once you’re comfortable with the regimen below, you can try pole intervals. For the highintensity intervals, engage the poles more to really work your upper body, then let the poles dangle for your recovery. You can follow any of the interval workouts in this report (see “Interval walking workouts,” page 28) while you are pole walking. Have fun with it!

Nordic walking plan This plan will gradually build you up to walking with poles for 30 minutes. On alternate days, you should walk without poles. Once you’ve completed this four-week plan and are comfortable with pole walking, you can increase the pressure on the poles for a greater upper-body workout. You can do this for an entire walk or alternate intervals of harder pressure (always keeping your hands relaxed) with lighter-pressure intervals. WEEK

SESSIONS PER WEEK

1

WARM-UP

WALKING TIME

COOL-DOWN

DAILY TOTAL

3

5 minutes slow walking with poles dangling

15 minutes at a moderate pace with light pressure on the poles

5 minutes slow walking, holding the poles without pressing them into the ground

25 minutes

2

3

5 minutes slow walking with poles dangling

15 minutes at a moderate pace: do 5 minutes with moderate pressure on the poles, then 5 minutes with light pressure, and finish with 5 minutes of moderate pressure

5 minutes slow walking with light pressure on the poles

25 minutes

3

3

5 minutes slow walking with light pressure on the poles

20 minutes at a moderate to brisk pace: do 10 minutes with moderate pressure on the poles, then 5 minutes with light pressure, and finish with 5 minutes of moderate pressure

5 minutes slow walking with light pressure on the poles

30 minutes

4

3

5 minutes slow walking with light pressure on the poles

20 minutes at a moderate to brisk pace with moderate pressure on the poles

5 minutes slow walking with light pressure on the poles

30 minutes

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WORKOUT 5

Mindful walking workout

The goal of this type of walking is to reduce stress and be more present in the moment. Attending to the following points will help: • Start by bringing your attention to the sensations in your body. • Breathe in through your nose, taking deep breaths. Feel your lungs expand from top to bottom rather than just at the top. • Engage your senses fully. Notice each sight, touch, and sound so that you savor every sensation. By learning to focus on the here and now, you may find yourself less likely to get caught up in worries about the future or regrets over the past. Some people refer to this practice as “walking meditation.”

A simple breath walking plan TIME

WALK

BREATH

5 minutes

Easy, leisurely stroll

Breathe normally, paying attention to your inhalations and exhalations

2 minutes

Moderate, purposeful walk

Match your breath to your steps, inhaling smoothly for four steps, then exhaling smoothly for four steps. Take deep breaths through your nose.

2 minutes

Moderate, purposeful walk

Match your breath to your steps, inhaling smoothly for six steps, then exhaling smoothly for six steps. Take deep breaths through your nose.

2 minutes

Moderate, purposeful walk

Match your breath to your steps, inhaling smoothly for eight steps, then exhaling smoothly for eight steps. Take deep breaths through your nose.

3 minutes

Moderate, purposeful walk

Choose the breath pattern (four, six, or eight steps) that is most comfortable for you. Or continue to alternate.

1 minute

Easy, leisurely stroll

Breathe normally.

Finished! If you’d like to walk longer, simply continue to match your breath to your steps. Or you could add a brisk walk that isn’t matched to your breathing. Then, you could go back to matching your breathing and steps to finish with mindful walking.

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Post-walk stretches Athletes stretch after exercise to prevent their muscles from tightening up. But many people forget to stretch after walking. You may think that walking is not enough of a workout to warrant it. This is not true. After walking, your muscles are warm and will

be more pliable. This is the best time to stretch, and it will help increase your range of motion and improve your overall flexibility. Aim to do this set of seven stretches at the end of every walk.

Calf stretch Starting position: Stand up straight with your feet together. Place your hands on the back of a chair or against a wall or tree with arms extended. Movement: Place your left foot 12 to 24 inches behind you and bend your right knee. Keep both feet flat and press your left heel into the ground. Hold. Return to the starting position, then repeat with your right leg back. This is one rep. Where you’ll feel it: calf, Achilles tendon, and ankle

Hold: 10 to 30 seconds Tips and techniques: • Hold a full-body lean from the ankle as you stretch. • Keep your toes pointing forward. • Keep your hips and shoulders squared, facing forward. • Stretch to the point of mild tension, not pain. • When holding the stretch, remain as still as possible, without bouncing. • Breathe comfortably.

Reps: 2 to 4

Soleus stretch Starting position: Stand up straight with your feet together. Hold the back of a chair or place your hands against a wall or tree with arms extended. Movement: Place your left foot 12 to 24 inches behind you and bend your right knee like you did for the calf stretch. Then slightly shift your weight toward your back leg and bend your left knee, keeping your left heel pressed into the ground. Hold. Return to the starting position, then repeat with your right leg back. This is one rep.

Hold: 10 to 30 seconds Tips and techniques: • Keep your toes pointing forward. • Keep your hips and shoulders squared, facing forward. • Maintain neutral posture with your shoulders down and back. • Stretch to the point of mild tension, not pain. • When holding the stretch, remain as still as possible, without bouncing. • Breathe comfortably.

Where you’ll feel it: deep calf muscle and Achilles tendon Reps: 2 to 4

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Post-walk stretches

Standing hamstring stretch Starting position: Stand with your feet together. Movement: Extend your right leg straight in front of you with your right heel on the ground and your toes pointing upward. Lean forward slightly from your hips and lower as if you’re sitting back, and place your hands on your left thigh for support. Keep your back straight. Hold. Return to the starting position. Repeat with your left leg. This is one rep. Where you’ll feel it: back of thigh Reps: 2 to 4

Hold: 10 to 30 seconds Tips and techniques: • Keep your chest lifted. • Shoulders should be down and back. • Keep your front leg straight, but don’t lock the knee. • If you feel any pressure behind the knee or at your back, don’t lean so far forward. • Stretch to the point of mild tension, not pain. • When holding the stretch, remain as still as possible, without bouncing.

Standing quadriceps stretch Starting position: Stand with your feet together. Place your right hand on the back of a chair for balance. Movement: Bend your left knee and bring your heel toward your left buttock. Grasp your left foot with your left hand. Hold. Slowly return to the starting position. Switch sides and repeat. This is one rep. Where you’ll feel it: front of thigh Reps: 2 to 4

Tips and techniques: • Don’t grasp your toes. • Don’t arch your back. • If you have trouble reaching your foot, loop a strap or belt around your ankle and gently pull the strap toward your buttocks. • Stretch to the point of mild tension, not pain. • When holding the stretch, remain as still as possible, without bouncing. • Breathe comfortably.

Hold: 10 to 30 seconds

Standing chest and shoulder stretch Starting position: Stand with your feet together and your arms at your sides. Movement: Clasp your hands together behind you. Gently raise your hands as far as is comfortable, pulling your shoulders back and opening up your chest. Hold. Return to the starting position. Where you’ll feel it: chest and shoulders Reps: 2 to 4 Hold: 10 to 30 seconds

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Tips and techniques: • If you have difficulty clasping your hand, hold a towel or strap between your hands. • Keep your shoulders down and back. • Don’t lean forward or excessively arch your back. • Stretch to the point of mild tension, not pain. • When holding the stretch, remain as still as possible, without bouncing. • Breathe comfortably.

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Post-walk stretches

Standing pretzel Starting position: Stand with your feet together and your hands on the back of a chair for balance. Movement: Place your right foot across your left thigh. Bend your left knee and lower into a sitting position. Hinge forward from your hips until you feel mild tension in your right hip and buttock. Hold. Slowly return to the starting position. Repeat with your left leg across your right thigh. This is one rep.

Reps: 2 to 4 Hold: 10 to 30 seconds Tips and techniques: • Keep your chest lifted and your eyes straight ahead. • Keep your back straight and your shoulders down and back. • Stretch to the point of mild tension, not pain. • When holding the stretch, remain as still as possible, without bouncing. • Breathe comfortably.

Where you’ll feel it: buttocks, hip, and outer thigh

Standing cat-cow Starting position: Stand up straight with your feet about shoulder-width apart. Keeping your back flat and chest and head lifted, bend at your hips and knees and place your hands on your thighs. Movement: Tuck your tailbone under, round your back, and bring your chin toward your chest. Hold. Slowly release and lift your head, chest, and tailbone toward the sky, arching your back. This is one rep. Where you’ll feel it: upper and lower back

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Reps: 2 to 4 Hold: 10 to 30 seconds Tips and techniques: • Keep your hips and shoulders squared, facing forward. • Shoulders should be down and back, away from your ears. • Stretch to the point of mild tension, not pain. • When holding the stretch, remain as still as possible, without bouncing. • Breathe comfortably.

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Strength training for walkers This no-equipment-required routine will help you strengthen key walking muscles. As a result, you’ll have more power in your stride, be able to maintain good

posture more easily and longer, and reduce your risk of an injury or aching joints. Aim to do this routine two or three times a week on nonconsecutive days.

Shoulder blade squeezes Starting position: Sit up tall in a chair with your chest lifted and shoulders back and down. Bend your arms so your elbows are at your sides and your hands in front of you, palms facing each other. Movement: Squeeze your shoulder blades together so your elbows move behind you. Hold. Slowly return to the starting position. Muscles worked: shoulders and upper back Reps: 8 to 12 Sets: 1 Tempo: 2-4-2

Tips and techniques: • Think of trying to hold a tennis ball between your shoulder blades. • Make sure the action is coming from your shoulder blades, not your arms. Your arms are just following along. • Keep your spine neutral and your abdominal muscles tight. • Breathe comfortably. Make it easier: Squeeze your shoulder blades together gently and hold for only 1 count. Make it harder: Hold the squeeze for 8 counts.

Opposite arm and leg raise Starting position: Kneel on all fours, knees hip-width apart. Align your shoulders over your wrists and your hips over your knees. Keep your head and spine in neutral alignment. Movement: Extend your right leg off the floor behind you while reaching your left arm out in front of you. Try to raise your extended leg and arm parallel to the floor. Hold. Return to the starting position, then repeat with your left leg and right arm. That’s one rep. Muscles worked: arms, shoulders, back, abs, hips, and legs Reps: 2 to 4 Sets: 1 to 2 Hold: 10 to 30 seconds

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Rest: 30 to 90 seconds between sets Tips and techniques: • Keep your shoulders and hips level to maintain alignment throughout. • Keep your head and spine neutral. • Think of pulling your hand and leg in opposite directions, lengthening your torso. Make it easier: Lift your arm only for 8 to 10 reps, then lift your leg only for 8 to 10 reps, using a 2-4-2 tempo for both. Make it harder: Lift and lower your arm and leg simultaneously for 8 to 10 reps at a 2-4-2 tempo.

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Strength training

Bridge Starting position: Lie on your back with your knees bent and feet flat on the floor, hip-width apart. Place your arms at your sides. Relax your shoulders against the floor. Movement: Tighten your abdominal muscles and your buttocks, press your heels into the floor, and lift your hips off the floor as high as is comfortable, or until they are in line with your shoulders and knees. Keep your hips even and spine neutral. Hold. Return to the starting position. Muscles worked: abs, back, buttocks, hips, and legs Reps: 8 to 12 Sets: 1 to 2 Tempo: 4-2-4 Rest: 30 to 90 seconds between sets

Tips and techniques: • Keep your knees in line with your feet. Don’t let your knees roll in. If this is difficult, place a ball or rolled-up towel between your knees. • Keep your shoulders down and back, relaxing them against the floor. • Don’t press into your hands to help lift. Make it easier: Instead of doing reps, simply hold the bridge position for 10 to 30 seconds. Do 1 or 2 sets of 2 to 4 reps. Make it harder: From the bridge position, raise your right foot off the floor and hold for 10 to 30 seconds. Repeat with your left foot off the floor. That’s 1 rep. Do 1 or 2 sets of 2 to 4 reps.

Harder

Knee plank Starting position: Start on your hands and knees.

Harder

Movement: Tighten your abdominal muscles, walk your hands out in front of you, and lower your upper body onto your forearms. Clasp your hands together and align your shoulders directly over your elbows. Point your toes behind you. Your body should be in line from head to knees. Hold. Then slowly return to the starting position. Muscles worked: arms, shoulders, abs, back, buttocks, and legs Reps: 2 to 4

Tips and techniques: • Keep your neck and spine neutral during the plank. • Keep your shoulders down and back. • Look at the floor in front of you. Don’t look up. Make it easier: Place your forearms on a desk or table and balance. Make it harder: From the knee plank position, lift your knees off the floor so you’re balancing on your toes, forearms, and hands.

Sets: 1 Hold: 15 to 60 seconds

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Strength training

Stationary lunge Starting position: Stand up straight with your left foot one to two feet in front of your right foot, hands on your hips. Shift your weight forward and lift your right heel off the floor. Movement: Bend your knees and lower straight down until your left thigh is parallel to the floor. Finish all reps, then switch legs and repeat. This completes one set.

Rest: 30 to 90 seconds between sets Tips and techniques: • Keep your front knee directly over your ankle. • In the lunge position, your shoulder, hip, and rear knee should be aligned. Don’t lean forward or back. • Keep your spine neutral and your shoulders down and back.

Muscles worked: buttocks and legs Reps: 8 to 12 on each side

Make it easier: Lower only halfway.

Sets: 1 to 2

Make it harder: Hold for 4 counts in the lunge position before returning to the starting position.

Tempo: 4-4

Tips and techniques: • Keep your abs tight. • Keep your spine neutral and your

shoulders down and back. • Evenly balance your weight between both feet. • Don’t allow your ankles to roll inward or outward. Make it easier: Lift your heels only an inch or so off the floor. Make it harder: Balance on one foot and do one-leg heel raises. Repeat with opposite leg. Harder

Heel raise Starting position: Stand up straight behind a chair. Lightly hold on to the back of chair with one or both hands, depending upon your ability. Position your feet slightly apart and evenly distribute your weight on both feet.

heels to the floor, maintaining good posture as you do. This is one rep.

Movement: Tighten your abdominal muscles. Lift your heels off the floor, rising up onto your toes and balls of your feet. Hold. Slowly lower your

Sets: 1 to 2

Muscles worked: backs of lower legs (calves) Reps: 8 to 12 Tempo: 3-1-3 Rest: 30 to 90 seconds between sets

Michele Stanten, the walking coach and fitness consultant for this report, served as the model for these workouts.

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Walking through the seasons “

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t’s too cold.” “It’s too hot.” “It’s raining.” Weatherrelated excuses are some of the most common reasons that walkers don’t walk. But with the right clothing and preparation, almost any type of weather can be walking weather. This chapter contains advice that will help you go from a fair-weather walker to an all-season pro. No matter what the weather conditions are, you should seek medical attention if you experience upper-body discomfort, including chest pain, aching, burning, tightness, or a feeling of fullness; faintness or loss of consciousness; wheezing or shortness of breath that takes more than five minutes to go away; unusual pain in bones or joints; or a new injury.

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Walking in the winter Always check with your doctor before exercising in cold weather if you have health conditions such as asthma, heart problems, or Raynaud’s disease. And be cautious about venturing out in ice and snow. Otherwise, the following tips will help you withstand the winter chill. Warm up indoors. Walk around your house or march in place to get blood flowing to your walking muscles. Cold air can make this transition to workout mode tougher, so doing it indoors will take stress off your heart and make winter walking feel easier. Wear synthetic fabrics. In the winter, dry equals warm. To stay dry, select shirts and leggings made from wicking materials like polypropylene or capilene that draw sweat away from your skin. If you wear cotton, it will stay wet and keep you wet. Dress in layers. Dressing in layers (see “How to layer up in winter,” page 42) allows you to remove layers as you warm up and replace them as you cool down. You’ll stay comfortable and avoid overheating. For outerwear, go waterproof. You need to protect against moisture from the outside, too, to prevent ww w. h ealt h . h ar v ar d . e du

Cold weather doesn’t have to scuttle your walking plan. Dress in layers, with moisture-wicking synthetic fabrics, a hat, and gloves.

rain or snow from leaving you soggy and cold. The best defenses are jackets, pants, and shoes made from a waterproof (not just water-resistant) yet breathable material, such as Gore-Tex. Choose dark colors on top. They’ll absorb sunlight to keep you warmer. Do this only if you’re walking when it’s light out. You may want to add a brightly colored vest, scarf, or hat so motorists can easily see you. Dress for slightly warmer temperatures. You’re going to heat up as you get moving, so don’t overbundle. The sweatier you are, the more easily you’ll become chilled. Instead, dress for temperatures about 10 degrees higher than they actually are. Protect extremities. Fingers are susceptible to frostbite, so keep them covered. Wear a thin, moisturewicking pair of gloves underneath heavier mittens or Walking for Health

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gloves. That way you can remove the outer layer without exposing your skin if your hands get sweaty. And don’t forget a hat! Leave jewelry at home. The metal gets cold and can make you feel colder. Cover your mouth and nose. This will warm the air as you inhale, making it easier to breathe on very cold or windy days. Walk at midday. This is usually when temperatures are the highest and sunlight is strongest, keeping you warmer. Start into the wind. If your walk is out and back, this will make your return trip easier. The wind also won’t be blowing in your face at a point when you’re more likely to be sweaty and get chilled. Wear shoes with rugged soles. You may need to trade in your regular walking shoes for a sturdier, hiking-style pair for better traction and more warmth. You can also get traction cleats, such as Stabilicers or Yaktrax, that slip on to any type of shoe and prevent you from slipping in icy conditions. Get noticed. With the days being shorter, it’s more likely that you’ll be walking when the light is dim. If you must do this, it’s all the more important to wear reflective gear so motorists can see you. The more reflective you are, the sooner you’ll be seen, especially

if some of the reflective material is on moving body parts like your arms and legs. Watch out for trouble signs. Numbness, loss of feeling, or a stinging sensation in your fingers or toes may signal frostbite. If you experience this, you should head indoors immediately and slowly warm the affected area, but don’t rub it. If numbness continues, seek emergency care. Hypothermia, or abnormally low body temperature, is another danger in the winter, especially if you get wet from rain, snow, or excessive sweat. Intense shivering is usually the first sign of hypothermia and should be your signal to head indoors. If you experience slurred speech, loss of coordination, or excessive fatigue, seek medical help right away. Stay hydrated. You can become dehydrated in the winter, too. To ensure that you’re hydrated when you start your walk, drink plenty of water before you leave. Depending upon the weather conditions and the length and intensity of your walk, you may also need to carry water with you. When you do, use a water carrier that allows your hands to be free. Various waist packs and belts will hold a water bottle. Heed warnings. When there are wind-chill advisories, frigid temperatures, or icy conditions, try one of the indoor options on page 11.

How to layer up in winter

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key to staying warm when you’re walking in cold temperatures is to stay dry—and that’s exactly what layering helps you to do. By removing layers as you warm up, you’ll avoid excessive sweating, which can cause you to become chilled, especially later in your walk. Then you can replace layers as you cool down to remain warm. This threestep layering system also wicks sweat away from your skin so it can evaporate and you stay drier. (You may not always need all three layers on both your upper and lower body, so customize it based on the conditions, your comfort level, and the type of walking you are doing.) With the right clothing, you might even enjoy winter walking. First layer: Start with a light synthetic fabric, such as CoolMax or polypropylene, closest to your skin on top and bottom. It will pull sweat away from your skin and dry quickly. Second layer: This is your insulation. Look for a fleece, sweater, or sweatshirt made of a synthetic fabric like Pol-

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artec or a wool blend that provides warmth while wicking away moisture. (Avoid cotton because it stays wet.) Depending on the temperature, you may want insulating bottoms, too. You can also select different thickness levels for more or less insulation or double up on this layer if it’s really cold. Third layer: This one protects you from wind, rain, or snow. A waterproof or water-resistant (depending on where you live) breathable jacket and pants, such as those made of Gore-Tex, will keep you warm and dry. Look for styles with vents that you can easily open and close to stay comfortable. Velcro or drawstrings at your waist and wrists will also prevent cold air from sneaking in. When choosing layers, dress for temperatures about 10 degrees higher than they are, because you’ll be generating your own heat as you get moving. And don’t forget to cover your ears, hands, and head.

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Walking in the summer Hot, humid weather may cause trouble if you have heart problems or asthma, so check with your doctor before walking in these types of conditions. If you’re good to go, here are some ways to stay cool and avoid heat-related problems. Choose synthetic fabrics. Moisture-wicking clothes are best for summer as well as winter. When the temperatures soar, wicking fabrics like polypropylene and capilene facilitate the evaporation of sweat to keep you cooler. By contrast, cotton stays wet and keeps you wet. Acclimate. If you’re walking regularly through spring, that will help to prepare you for the “dog days” of summer, but sometimes those heat waves sneak up on you. When they do, you need to back off from your usual routine. To acclimate, either shorten your walks or cut back on the intensity, and then gradually increase to your normal level over about 10 to 14 days. Walk in the early morning. Temperatures will be cooler and there will be less pollution. You’ll also avoid pesky bugs. If that doesn’t work with your schedule, then aim for evening walks. (Don’t forget a reflective vest if you’re walking after dark.) If you must go out during the day, try to avoid the hottest time, usually between 10 a.m. and 2 p.m. Choose a shady route. It can feel as much as 10 degrees cooler when you’re not in direct sunlight. In addition to feeling more comfortable, you’ll be less likely to overheat. Sip a slushy. It’s important to avoid dehydration, so have something to drink before you go. Water is an obvious and very good option. But in an Australian study, drinking a slushy before heading out in hot, humid conditions enabled runners to go 20% longer than those who drank water. You can make your own healthy version by blending ice with high-water fruits such as berries, watermelon, peaches, or plums. Carry water. Don’t just drink water before you leave. When the mercury is rising, you should carry water even for short walks. If you’ll be out for more than an hour, a sports drink is a good option. No matter what type of beverage you have, sip every 10 to 15 minutes while walking. To keep your hands free, wear a waist pack or belt that will hold your water bottle. ww w. h ealt h . h ar v ar d . e du

It’s important to stay hydrated while you’re walking, no matter what the weather’s like outside. It might be enough to drink before you leave, but you may also need to carry water with you.

Lighten up. Loose-fitting, lightweight, and lightcolored clothing reflect sunlight instead of absorbing it, keeping you cooler. Pale colors are also less likely to attract bugs. (If bugs are a problem, avoid scented versions of products like sunscreen, deodorant, and laundry detergent, too.) Get airy sneakers. Lightweight, breathable fabrics like mesh will make your feet sweat less than leather styles. Double up on eye protection. You’ll have better walking posture if you wear both sunglasses and a brimmed hat. When the sun is in your eyes, you’re more likely to look down, which can strain your back, slow you down, and make breathing harder. Slather sunscreen all over. Light-colored clothing provides minimal sun protection, so apply sunscreen underneath. Choose at least a 30 SPF and don’t miss the back of your neck, tips of your ears, and hands. You can also buy sun-protective clothing from companies such as Coolibar and Sun Precautions that is specially woven or treated to block harmful ultraviolet rays. Lubricate. Sweat makes you more prone to chafing. To minimize friction and avoid chafing under arms or between thighs, spread petroleum jelly or a product like BodyGlide (available at athletic stores) on areas that may rub (see “Chafing,” page 20). Hop in a pool. Walking in water is a refreshing alternative. Water also adds resistance that will tone your muscles. Walking for Health

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Watch out for trouble signs. If you experience muscle cramps, a headache, dizziness, lightheadedness, weakness, or nausea, you may be suffering from heat exhaustion or heatstroke. Stop walking and head for a cool place. Drink a beverage with some salt in it, like a sports drink, and rest. If symptoms don’t improve, seek medical attention. Find alternatives. When weather advisories warn that conditions are too dangerous for outdoor exercise, try an indoor walking option (see “Indoor options,” page 11). If summers are brutally hot and humid in your area, you might also want to invest in a seasonal gym membership for access to a treadmill.

Dress for success You don’t have to change your clothes to walk. However, there are some items beyond your basic walking shoes and socks that you may want to consider purchasing to make your walks even more enjoyable. A hat with a brim. It will help you maintain good posture by keeping sun or rain out of your eyes. Many people look down to shield their eyes. Even when you have sunglasses on, rays can sneak in over the top of your glasses, but a hat prevents it. Waterproof shoes. If you live in an area with a lot of rain, they may be worth it. Wet feet are more susceptible to blisters. Water carrier. Schlepping a water bottle in your hand can throw off your balance, slow you down, and cause achiness in your hand, arm, or even shoulder.

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There are a variety of waist packs and belts that allow you to stash your water bottle so your hands are free to swing. Leggings or slim-leg pants. If your goal is speed, you should avoid wide-leg pants or capris. The flapping with every step can be annoying and may even slow you down. Lycra or spandex bike shorts or leggings. These minimize friction when your thighs rub together and prevent chafing. If you’re not comfortable wearing them in public, slip a pair of regular shorts or pants over the top. Reflective clothing or gear. If you’re out in the early morning or late evening, wear reflective gear from head to toe. The more your reflections resemble a human form—instead of just some random lines or a moving dot—the safer you’ll be. Timer. If you’re doing intervals, they will be easier to track if you have a timer. Look for one that allows you to preset both work and recovery times and then alerts you when it’s time to speed up or slow down. You can buy an individual timer like GymBoss, use a sports watch with an interval function, or download a timer to your smartphone. Waist pack. Carrying things in your hands can throw off your symmetry, so stash your phone, keys, and anything else. A waist pack is preferable over a backpack because it’s less likely to affect your posture. If you’ll be walking more than half an hour or in warm conditions, look for a pack that also allows you to carry water.

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Walking for weight loss

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id you know that walking is the No. 1 form of physical activity among people who’ve successfully lost weight? The National Weight Control Registry is a study of more than 5,000 successful losers, who’ve lost 66 pounds on average and kept them off for an average of five-and-a-half years. When researchers reviewed the exercise habits of the group, walking topped the list, with 52% of men and women reporting that they walk a mile or more a day. So if weight loss is your goal, walking can definitely help, but you’ll need to do more than just put one foot in front of the other. If you’re starting from ground zero—the couch—then leisurely strolls around your block or accumulating steps throughout the day may be enough to get the needle on the scale moving. But if you keep doing the same thing day after day, the weight loss, along with other benefits, will likely plateau. To reignite your weight loss, you need to change things up—walk farther, walk faster, walk more often—to keep challenging your body. And the more vigorous your workout is, the longer your calorie burn stays revved up after you stop exercising. If you’re not up for going fast your entire walk, intervals are a good option. In a Danish study, when people with diabetes tried interval walking for four months, they lost six times as much weight—9.5 versus 1.5 pounds—and shed more belly fat than people with diabetes who didn’t vary their walking speed. The interval exercisers also had better blood sugar levels and increased their cardio fitness by 16%, while steady-paced walkers showed no improvement. Those are some pretty big differences that were obtained with just a little bit more effort—and not every walk has to be high-intensity. So if weight loss is your goal, start walking, and then gradually build up to some of the higher-intensity interval walking workouts (see page 28) to maximize your results. And keep reading: the following sections offer other ways in addition to speed to crank up your intensity. ww w. h ealt h . h ar v ar d . e du

Go faster The number of calories you burn increases exponentially as you go faster. Walkers in their 50s burned 53% more calories when they accelerated from 4.1 to 4.6 mph, compared with a similar half-mile bump from 3.6 mph, according to a study published in the British Journal of Sports Medicine. Counterintuitively, taking longer strides is not the best way to speed up. Rather, taking quicker steps with good posture (keeping your head up and not bending over) and proper technique (bending your arms and rolling from heel to toe) are the foundation for improving your pace. Once you’ve mastered these, the following tips will help you turn up your speed. Power your arm swing. Many people punch their arms forward because that’s the direction they’re focused on. But you’ll get more speed and power if you focus on your back muscles. Squeeze your shoulder blades and drive your elbows behind you, keeping them close to your body, not winging out to the sides.

Myth: Whether you walk a mile or run a mile, you’ll burn 100 calories It’s a common belief that whether you walk or run a mile, you’ll burn the same number of calories. However, it’s not that simple. Speed does matter (see below), but what matters even more when it comes to calorie burn is your weight. The heavier you are, the more calories you are going to burn in a mile no matter how fast you’re going. A 130-pound person will burn 72 calories walking one mile in 20 minutes. A 180-pound person walking at the same pace will burn 100 calories a mile. And a 200-pound person will burn 120 calories. As for walking speed, the number of calories burned per mile remains relatively steady until you speed up over a 4 mph pace (15-minute mile). You can burn up to about 45 more calories per mile as you speed up because your body has to work harder. If you can’t go that fast, don’t worry. You can burn just as many calories if you simply walk longer.

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How fast am I going? You can estimate your walking speed by counting the number of steps you take in one minute. You should count each step with each foot. Then find the number in the “Steps per minute” column on the right. The ranges allow for variations due to height. The low number applies to someone about 5 feet, 8 inches tall, while the high number would be for someone five feet tall. SPEED

MINUTES PER MILE

STEPS PER MINUTE

2.5 mph

24

105–110

3.0 mph

20

113–120

3.5 mph

17

122–128

4.0 mph

15

129–137

4.6 mph

13

140–148

5.0 mph+

12 or less

150+

Pull your arm back far enough so that your hand just passes your hip. Then let your arm swing naturally forward to chest height as you pull the other one back—so the work is on the backswing. Remember to keep your shoulders down and relaxed, not pulled up toward your ears. By recruiting your back muscles, you’ll also get some toning benefit. You can practice in a mirror while standing still to get the hang of it. It’s also a great warm-up to do before a strength workout. Squeeze your glutes. They are among the largest and most powerful muscles in your body, so take

advantage of them. Each time your heel strikes the ground, squeeze your buttock muscles. Imagine that you’re using those muscles to pull your body forward over your front leg. Practice this periodically (a minute or so at a time) during your warm-up, brisk walk, and cool-down. This technique also naturally shortens your stride. You can’t take big steps out in front of you when your glutes are activated and pulling your leg backward. Loosen up your hips. When you feel like you’re walking so fast that you want to run, it’s time to get your hips in on the action. Unfortunately, many of us have tight hips from too much sitting, and adding some hip motion may be challenging, so be patient. You want your hips moving forward and backward— not side to side like you’re on a dance floor. Imagine that your legs extend all the way up to your belly button (some of your walking muscles actually do go up into your abdomen). As your right leg steps forward, your right hip should sway forward, and then back as your right leg extends behind you. It’s not a big movement. To activate your hips, imagine you are walking on a yellow line in the road. As you step, bring each foot to the midline, but don’t cross your feet over it. Count your steps. This is a great exercise to do during an interval walk. Count the number of steps you take during the speed portion. Then next time

Myth: Walking with weights provides a better workout Many people think that they’ll burn more calories or tone their arms if they carry hand weights while walking. This idea became popular back in the 1980s when HeavyHands—foamcovered dumbbells with a strap—were created and promoted for walking. In theory, it makes sense. The more you weigh, the more calories you burn doing any type of activity. And doing upper-body exercises with weights will tone your muscles. But practically, the risks outweigh any benefits—and the benefits are minimal.

Skipping the weights is even more appealing if you consider the side effects of pumping iron while you walk. First, you might slow down. Your arms act like pendulums, swinging back and forth. The heavier a pendulum is, the slower it swings. When your arms slow down, so do your legs, because the nervous system is wired in such a way that your arms and legs like to be in sync. Even if you just slow down a little because of the weights (from 3.5 mph to 3.2 mph), you’re burning almost 20 fewer calories than if you walked as you normally do without weights.

Most hand weights designed for walking are 1 to 5 pounds. So if you weigh 150 pounds and walk for half an hour at 3.5 mph, you’d burn 153 calories. If you carry 5-pound weights (probably more than most people could manage for a half-hour walk), you’d burn an additional 12 calories. While every little bit helps, you’ll get a bigger calorie bump by leaving the weights at home and picking up the pace.

As for toning your arms and shoulders, doing actual exercises like chest and overhead presses or biceps curls when you’re not walking will firm you up faster, and you’ll be less likely to get injured. Swinging extra weight at the end of each arm puts a lot of stress on your shoulders, elbows, and wrists and could lead to strained muscles, ligaments, or tendons in these areas. And every pound you add increases the impact on your joints.

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Oh, my aching shins

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hen you increase your walking speed, the place you’re most likely to feel pain is in the shins. The muscle in the front of your lower leg—the anterior tibialis—is often weak from underuse. As you pick up the pace, this muscle is suddenly called upon to work much harder than usual. It is responsible for holding your toes up so your foot doesn’t slap against the ground as you land, and it burns out quickly. Many people refer to shin pain as shin splints, but not all pain in your shins falls under that description. Shin splints are the result of tears in the tissue that attaches the shin muscles to the bones in the lower leg. This type of injury is more common with high-impact activities such as running. If your shin pain occurs when you start to walk faster and subsides when you slow down, it’s probably not shin splints, but rather deconditioned muscles. To solve the problem, ease up a little and build your speed more slowly. The pain will go away as your muscles get stronger. In the meantime, here are some strategies to ease the ache and shape up your leg muscles. (If you continue to have shin pain after a week or two, or if it occurs even apart from your walks, you should check with your doctor.)

Squeeze your glutes as your heel touches the ground. This activates your gluteal muscles and shortens your stride so your shin muscles don’t have to work so hard. You’ll need to concentrate on your glutes to do this, which may also distract you from the discomfort in your shins. Slow down and stretch. If slowing down your pace doesn’t alleviate the pain enough, stop and do some simple stretches. Lift one foot off the ground at a time and rotate your foot clockwise and counterclockwise. Then, point and flex your foot. Repeat several times until you’re ready to start walking again. Increase ankle range of motion. Tight shin muscles can contribute to problems. For greater ankle flexibility, make sure that you stretch these areas after every walk. To do a simple shin

you speed up, see if you can take more. The more steps you take, the faster you are going. If you’re not doing intervals, simply time yourself for a minute at any point during a walk. You can also use this exercise to estimate your walking speed (see “How fast am I going?” on page 46). Focus on a spot ahead of you. Walkers who focused their attention on a cone ahead of them walked 23% faster to get to it than did walkers who looked at their surroundings as well as the cone, according to research published in the journal Motivation and Emotion. Even though they were moving faster, the focused group reported that the walk was easier than did those who spent more time looking around. Strength train. Strong leg and buttock muscles power your stride, and a strong core helps you stay pain-free as you sustain higher speeds. When a group of women, average age 61, did exercises to strengthen ww w. h ealt h . h ar v ar d . e du

stretch, place your right foot behind you with the tops of your toes on the ground. If you feel a stretch in your shin, then hold. If not, bend your knees slightly until you feel a gentle stretch, then hold. The hold should last for 10 to 30 seconds. Do this two to six times with each leg. Stretch your calves. Tight calf muscles make shin pain more likely as well—all the more reason to make sure that you stretch these muscles after every walk (see “Post-walk stretches,” page 35). Strengthen your shins. They will get stronger as you do more fast walking, but you can help that process along by adding some shin-strengthening exercises to your routine. Try walking on your heels with your toes lifted for 15 to 30 seconds, working up to two minutes, two or three times a week. This is a good exercise to do as a warm-up. When you’re chairbound, tap your toes, keeping your heels in contact with the ground as you lift your toes.

their quadriceps (the muscles in the front of their thighs), they were able to walk up to 15% faster after four weeks of training, according to one study. That’s enough to get most brisk amblers into walking’s supercharged calorie-burning zones. (To build stronger walking muscles, see “Strength training for walkers,” page 38.) Stretch. Flexibility also influences speed. Tight hip flexors (the muscles at the top of your thighs) limit your range of motion and prevent you from fully extending your leg behind you for a powerful push-off. To keep these key areas in tip-top shape, see “Post-walk stretches,” page 35. Yoga and certain forms of Pilates are also good workouts to target these muscles.

Climb hills Whether you head outdoors or crank up the incline on a treadmill, making your walks vertical gives your Walking for Health

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glutes a more intense workout. In one study, walking uphill activated three times as many muscle fibers in the buttocks compared with walking on level terrain. Translation: you’ll firm up your backside faster with hills. Adding incline also elevates your calorie burn by about 60% without any change in speed. Walking up hills may be a good alternative to fast walking for people who are obese or experience knee pain. In a Colorado State University study, researchers found that people got just as good a cardio workout walking slowly up an incline as they did when walking briskly on level ground—and the load on their knees was lower. With less stress on their joints, they would likely be less susceptible to pain and injury. If you’re doing hills outside, what goes up has to come down. That’s a good thing if you’re looking to reduce your risk of diabetes. In a small Austrian study, researchers found that downhill walking improved glucose tolerance, the body’s ability to handle blood sugar, more than walking uphill—8.2% versus 4.5%. But the uphills produced better results for lowering triglyceride levels. An 11% improvement was found with uphill walking, compared with a 6.8% improvement from going downhill. Researchers suspect the differences may have to do with the different types of muscle contractions specific to each activity. When walking uphill, avoid the tendency to lean into the hill. Stay as upright as possible. Take shorter steps and make sure that you’re landing on your heel and rolling through, not landing flat-footed. If you find that you’re lifting your knees more than six inches, you should shorten your steps. And for more power, make sure your back leg is extended before pushing off. Downhill, while not as strenuous from a cardio standpoint, may be more stressful on your knees. To reduce the impact of downhill walking, keep your steps short, land on your heel, and roll through to your toes. Don’t let your feet pound into the ground. Also make sure that you’re not leaning back, and keep your feet under you, not out ahead. On steeper slopes, you might want to keep your knees slightly bent. Using walking poles is a good way to reduce the strain if you can’t avoid going down hills. 48

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Grab some poles Walking poles add an upper-body workout to your walk that tones your arms, shoulders, and back and increases your calorie burn—without making you feel like you’re working harder. The motion for Nordic walking is similar to cross-country skiing. The poles should always be slanting diagonally behind you rather than upright in front of you. When the pole is planted, you push off of the pole, along with your back foot. Several studies have shown increases of 20% to 25% in cardiovascular workload and calorie burn. However, people using poles tend to report ratings of perceived exertion that are similar to walking without poles. So you can work harder, but it won’t feel so hard. For more information on pole walking, see “Nordic walking,” page 14, and for an actual walking workout, see “Nordic walking workout,” page 33.

Take the stairs Even at a slow pace, you’ll burn calories two to three times faster climbing stairs than walking briskly on the level. Researchers in Canada monitored 17 healthy male volunteers with an average age of 64 while they walked, lifted weights, or climbed stairs. Stair climbing was twice as taxing as brisk walking on level terrain and 50% harder than walking up a steep incline or lifting weights. And peak exertion was attained much faster climbing stairs than walking, which is why nearly everyone huffs and puffs going upstairs, at least until the “second wind” kicks in after a few flights. Because stairs are so taxing, only the very young at heart should attempt to charge up long flights. But at a slow, steady pace, stairs can be a health plus for the rest of us. Begin modestly with a flight or two, and then add more as you improve. Take the stairs whenever you can; if you have a long way to go, walk part way, and then switch to an elevator. Use the railing for balance and security (especially going down), and don’t try the stairs after a heavy meal or if you feel unwell. The added benefit? The Harvard Alumni Study found that men who average at least eight flights a day enjoy a 33% lower death rate than men who are sedentary. That’s even better than the 22% lower death rate men earned by walking 1.3 miles a day. w w w.h ealt h .ha r va r d.e du

Going the distance: Staying motivated alking shoes? Check. Route to walk? Check. A walking schedule? Check. You have almost everything you need to maintain a successful walking program. You also obviously have motivation. You’re reading this report, after all. But you also need enough drive to keep you going. To find out how avid walkers keep up their mileage, University of Michigan researchers surveyed 71 veteran walkers who averaged 44-minute walks, six days a week—and had been walking on average for 15 years. The top three ways they stayed on track were • reminding themselves of all the benefits of walking • choosing beautiful settings for their walks • plotting out a schedule for walking as opposed to going out when they felt like it. Here are more strategies to help you overcome potential obstacles and make walking a lifelong habit.

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And why stop with just one walking partner? Become part of a walking community—either in person or online. Join—or even start—a walking club (see a list of existing clubs at www.walkers.meetup.com or follow the tips at www.health.harvard.edu/walking-clubs) or a program www.health.harvard.edu/walking-clubs like Walk with a Doc (www.walkwithadoc.org www.walkwithadoc.org), in which doctors lead group walks, for even more support. You can also sign up for e-newsletters on walking to get daily or weekly reminders to keep walking from the walking page at About.com (www.walking.about.com www.walking.about.com). You can also gain support by posting your goals and progress on Facebook or another social media site that you use. Many of the activity monitors, such as FitBit, and smartphone apps like MapMyWalk and Every Body Walk can automatically post your stats. This system makes you accountable to someone else.

Get support

Use a pedometer

Exercising with a partner can increase your chances of sticking with a program. You’ll be much more likely to hop out of bed if you know that your neighbor is waiting for you at the corner. This buddy system also makes walking more fun, as you chat about your days, share family stories, and even help each other through tough times. But friends and family don’t have to physically walk with you to provide support. Simply email or text the person after you’ve walked. If he or she doesn’t hear from you, then it’s time for your motivator-in-chief to gently prod you by giving you a phone call. If the other person has a walking program, too, you can fill this role for each other. You can also recruit friends and family members to support you by helping you find time to walk. Ask your partner or children to make dinner or clean up afterward so you can get a walk in. Ask a close co-worker to have walking meetings instead of seated ones. Turn lunch dates with a friend into walks in the park instead.

This simple device has been scientifically proven to get people to walk more, according to a review of 26 studies in The Journal of the American Medical Association. Over all, people who used a pedometer raised their physical activity by nearly 27%, adding about 2,500 steps a day (about one-and-a-quarter miles). Start by getting a baseline that tells you how many steps you normally take during the day. Clip on or turn on your pedometer on as soon as you get up in the morning and use it all day (except when bathing) until you go to bed. Go about your usual daily routine; don’t try to walk more than you normally do. Do this for two or three days, including at least one weekday and one weekend day, then average the results. If you already have a structured walking routine some days of the week, get a baseline for both walking and nonwalking days. Once you have your baseline number, aim to increase your daily step total about 1,000 to 2,000. After a week, bump your daily goal up another 1,000 to 2,000 steps. Continue this weekly increase until you

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reach at least 10,000 steps a day. If weight loss is your goal, achieving even more steps will speed results. You can purchase a pedometer at most stores that sell exercise equipment. Look for a model that is easy to read, is simple to use, and has a sturdy clip (or even a safety strap) to prevent it from falling off. If you have a smartphone, you can download a pedometer app— many at no cost, such as Moves, Breeze, and Pedometer++. One caveat: you’ll always have to have your phone on you if you want it to track all of your steps. For a more high-tech option, you might want to consider an activity monitor like FitBit, Jawbone, or Shine. In addition to step counts, these devices also track calorie burn, intensity of activity, and even your sleep patterns. Some of them have an idle alert: you can set a time period and if you are sitting for longer than that, it will vibrate to remind you to move—a great way to combat “sitting disease.”

Try apps to keep you motivated These potentially addictive apps take step counting to a whole new level of purpose, rewards, and fun. You might even end up finding more excuses to walk! They are all free, unless otherwise noted. Charity Miles. (www.charitymiles.org www.charitymiles.org). For every mile you walk, you’ll earn 25 cents for a cause of your choice. There are more than a dozen charities—including Habitat for Humanity, Autism Speaks, Wounded Warrior Project, and Pencils of Promise—from which to choose. The more you walk, the more you help. Daily Mile. (www.dailymile.com www.dailymile.com). This is like Facebook for the active crowd. You can track your workouts, “friend” people, and join discussions. Meanwhile, challenges amp up the motivational power of step counting. Walk all 2,448 miles of Route 66. Do a mile every day for a month or up to a year. Or, race to be the first to complete a distance or log the most miles in a set time period. Choose from over 200 walking challenges, or start your own and invite friends to join you. Geocaching. (www.geocaching.com www.geocaching.com). To engage in this high-tech treasure hunt, you pick a geocache in your area and use your GPS to find it. You’ll get a physical and mental workout as you navigate to the location 50

Walking for Health

and then search to find the geocache container. There are geocaches hidden all over the world. GymPact. (www.gym-pact.com www.gym-pact.com). Put your money where your mouth is. Pick a goal (10,000 steps or 30 minutes a day), decide how many days you’re going to do it, and set a penalty price. Every time you miss a day, you pay. If you succeed, you earn money. Virtual Walk. (www.virtual-walk.com). You may be walking around your neighborhood or on the treadmill, but this app will transport you to such sites as Washington, D.C., or Arches National Park in Moab, Utah, complete with photos and history. But you have to cover the real-life distances in between landmarks to unlock them. The Walk—Fitness Tracker and Game.

(www.thewalkgame.com www.thewalkgame.com). Fans of spy thrillers will enjoy this app, which is like an interactive audiobook. As you walk, you unlock audio clips that tell you the story, and you’re part of the action. There are 65 episodes, 800 minutes of audio, and hundreds of miles to keep you motivated. Cost: $2.99. Walker Tracker. (www.walkertracker.com). With about 50 competitions to choose from or the option to create your own, it’s easy to find a reason to get out and walk every day. Some involve walking a particular route, such as the Appalachian Trail or across the country. Cool feature: you’ll see your progress and everyone else’s on a map of the area.

Sign up for an event Train to walk a 5K (3.1 miles), 10K (6.2 miles), half marathon (13.1 miles), or even a marathon (26.2 miles). Once the domain of only runners, many events are now welcoming walkers. You just have to choose ones that keep their courses open long enough to accommodate your walking speed. For example, if you tend to walk at an 18-minute-mile pace, you’d want a 5K with at least a one-hour time limit, two hours for a 10K, four hours for a half marathon, and eight hours for a full marathon. This approach can be very effective because it combines several strategies into one. First, you’re setting a goal, which gives you more of a reason to get out and walk every day. If you tend to be deadline-oriented, race w w w.h ealt h .ha r va r d.e du

More tips to keep you on track Walking is so beneficial for your health that you don’t want to let it lapse. Try one or more of these strategies to keep going.

(The Harvard Special Health Report Get Healthy, Get a Dog has more information on this topic. See “Resources,” page 52.)

Have a backup plan. You can improve your chances of walking regularly by coming up with alternate walking options ahead of time. If you have a plan B, then when you sleep in and miss your morning walk, you’ll know that you’re going to walk during lunch instead. Or, maybe you know that dinner with friends will prevent you from taking your evening stroll, so instead you sneak in a 15-minute walk in the morning and another before you meet your friends. Keeping a pair of sneakers in your car gives you the option to squeeze in a walk whenever you have a little extra time.

“Read” and walk. Audiobooks can make the time pass quickly while you’re walking. Make a pact with yourself that you can only listen to an audiobook during your walks, in order to provide motivation. And remember, if you are walking outdoors, keep the volume low and use only one earbud, so you remain alert to your surroundings in case of trouble.

Create a cue. Many daily habits happen because something signals you to do them, like brushing your teeth in the morning and before bed. You can tie your walks to regularly scheduled activities, such as getting up in the morning or lunchtime. You could also use tasks such as grocery shopping. For example, drive to the grocery store, but take a walk before you start shopping. Over time you’ll relate walking with those activities, so they will remind you to take a walk. Get a four-legged walking companion. Studies show that people who have dogs walk more. If you’re up for the responsibility, getting a dog could be the catalyst that turns you into a habitual walker. But even if you can’t commit to having a dog, there are still ways that man’s best friend can keep you moving. Offer to walk your neighbor’s dog, or check with a local shelter. Many shelters need volunteers to walk the dogs.

day also gives you an immovable deadline by which you need to be ready. To sign up for these types of events, you also have to pay a registration fee. For some people, this paying to play motivates them because they don’t want to waste the money by not being able to complete the event. However, others may be motivated by a different type of monetary incentive—having to pay a penalty if they don’t follow through on walking every day (or any activity they’ve committed to). If that sounds like you, then bet with someone that you’ll do the event. Finally, events like races and charity walks also create communities—another proven way to stick with exercise. Many events have Facebook pages where participants can ask questions and meet others who are doing the race. And the more events you do, the more like-minded people you are going to meet. Many longterm friendships have started with a race. ww w. h ealt h . h ar v ar d . e du

Get a little rhythm. Music has been shown to inspire exercisers to go longer and harder. Remember the theme song from Rocky? Or Chariots of Fire? Or maybe Garth Brooks, Elton John, or Florence and the Machine is more your style. Any upbeat tunes can add energy to your steps and keep you motivated. Start with songs that have a slower beat to warm up, then choose higher-energy ones for the middle of your walk, and finish with a slower, relaxing tune. You can even alternate fast and slow songs for a musical interval walk. Just remember to keep the volume low and use only one earbud, to stay alert to your surroundings and safe. Make a change. A new walking route, even if it’s just heading to the next neighborhood, can invigorate your walking routine. But if that’s not possible, you can make a tried-andtrue route fresh again with a few tweaks, like going earlier or later. Or invite someone new to join you. Different personalities and conversation topics will keep you engaged. And you’ll see things differently if you walk your usual route in the opposite direction.

Be kind to yourself Don’t beat yourself up if you miss a workout! Next time you miss a workout or are thinking of skipping one, pretend that it’s your best friend having trouble. What would you say if he or she were struggling? Use that same supportive language to help yourself. Avoid “I can’t” thoughts or other put-downs. Instead, practice positive statements such as “I can do this!” “Look how well I did yesterday (or last week)!” “I am getting stronger.” Any time you notice toxic thoughts creeping in, think—or say aloud—“Stop!” And if you do slip, know that you’re not alone. It happens to everyone from time to time. The important thing is that you catch yourself before you fall. That means getting back into a routine as soon as possible, not letting one or two missed walks lead to weeks of little to no activity. Instead, shake it off, lace up your shoes, and head out the door for a walk! Walking for Health

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Resources Organizations American Academy of Physical Medicine and Rehabilitation 9700 W. Bryn Mawr Ave., Suite 200 Rosemont, IL 60018 847-737-6000 www.aapmr.org A national professional organization for physiatrists—medical doctors trained in physical medicine and rehabilitation—which promotes education and funds research in this area. A referral service on the website locates physiatrists by state.

American College of Sports Medicine 401 W. Michigan St. Indianapolis, IN 46202 317-637-9200 www.acsm.org ACSM educates and certifies fitness professionals, such as personal trainers, and funds research on exercise. A referral service on the website (http://certification.acsm.org/pro-finder http://certification.acsm.org/pro-finder) locates ACSM-certified personal trainers.

American Council on Exercise 4851 Paramount Drive San Diego, CA 92123 888-825-3636 (toll-free) www.acefitness.org ACE is a nonprofit organization that promotes fitness and offers a wide array of educational materials, including information for consumers on finding personal trainers and health coaches.

American Diabetes Association 1701 N. Beauregard St. Alexandria, VA 22311 800-342-2383 (toll-free) www.diabetes.org The association provides resources and information to people living with Type 1 and Type 2 diabetes, along with advice on preventing diabetes. It also hosts Step Out: Walk to Stop Diabetes, walks that are held across the country to raise awareness of diabetes and funding for programs.

American Heart Association 7272 Greenville Ave. Dallas, TX 75231 800-242-8721 (toll-free heart disease information) 888-478-7653 (toll-free stroke information) www.heart.org The AHA website provides educational materials on all aspects of heart disease and stroke. The organization also offers educational services and materials. AHA’s HeartWalks are walks organized across the country to raise money to help fight against heart disease and stroke.

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American Volkssports Association 1001 Pat Booker Road, Suite 101 Universal City, TX 78148 210-659-2112 www.ava.org This educational nonprofit organization has a grassroots network of about 300 active clubs, presenting more than 3,000 volkssporting events each year. These events feature noncompetitive walking, hiking, or biking, with walking being the most popular. The website provides links to clubs and events across the country.

America Walks P.O. Box 10581 Portland, OR 97296 503-757-8342 www.americawalks.org This national nonprofit organization is devoted to making America a great place to walk by promoting safe, convenient, and accessible walking conditions for all. The website provides information to help you make your community more walkable.

Arthritis Foundation 1330 W. Peachtree St., Suite 100 Atlanta, GA 30309 800-283-7800 (toll-free) www.arthritis.org The foundation has local chapters in many states. The website offers educational materials on arthritis, pain control, treatments, alternative therapies, and other topics. Walk to Cure Arthritis, the foundation’s annual community fundraising program, features 5K walks around the country.

National Institute on Aging Building 31, Room 5C27 31 Center Drive, MSC 2292 Bethesda, MD 20892 800-222-2225 (toll-free) www.nih.gov/nia This federal agency offers many helpful publications available to the public, including the free booklet Exercise and Physical Activity: Your Everyday Guide. The booklet, available online, includes simple tests to check your progress.

The President’s Council on Fitness, Sports and Nutrition 1101 Wootton Parkway, Suite 560 Rockville, MD 20852 240-276-9567 www.fitness.gov www.presidentschallenge.org The President’s Council on Fitness, Sports and Nutrition offers simple tips for healthy eating, weight loss, and an active lifestyle. The President’s Challenge website hosts activity logs and fitness calculators and two levels of fitness challenges.

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Resources Weight-Control Information Network 1 WIN Way Bethesda, MD 20892 877-946-4627 (toll-free) http://win.niddk.nih.gov

If weight loss is your goal, this book (by the fitness consultant for this Special Health Report) can help. In addition to an eightweek walking plan, it includes strength workouts, nutritional advice, recipes, and motivation to help you achieve your goals.

The Weight-Control Information Network offers free publications on obesity, weight control, physical activity, and nutrition.

Walking: A Complete Guide to the Complete Exercise Casey Meyers (Ballantine Books, 2007)

Publications

This research-packed book provides a compelling argument that walking in the best type of exercise. In addition, it provides how-to advice for getting more out of your walks.

The Complete Guide to Walking, New and Revised: For Health, Weight Loss, and Fitness Mark Fenton (Lyons Press, 2008) All things walking—from technique and gear to nutrition and complementary forms of exercise—are covered in this comprehensive book. It also includes a 52-week plan to make walking a permanent part of your life.

Get Healthy, Get a Dog: The benefits of canine companionship Elizabeth Pegg Frates, M.D., and Lisa Moses, V.M.D., Medical Editors (Harvard Medical School, 2014) This Special Health Report from Harvard Medical School outlines the health benefits of owning a dog, including the encouragement to walk together. To order, call 877-649-0457 (toll-free) or go to www.health.harvard.edu.

Nordic Walking Malin Svensson (Human Kinetics, 2009) This book covers everything you need to know about walking with poles. It includes advice on choosing poles, proper technique, and different walking surfaces, as well as workouts to do with your poles.

Walk Off Weight Michele Stanten (Rodale, 2010)

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Walking Your Blues Away: How to Heal the Mind and Create Emotional Well-Being Thom Hartmann (Park Street Press, 2006) This book looks at walking as bilateral therapy, engaging both sides of the brain, to restore mental, emotional, and spiritual well-being.

Websites About Health: Walking www.walking.about.com Advice for walkers of all levels from beginners to ultramarathoners on all topics from training plans and technique to gear, injury prevention, and nutrition.

Every Body Walk: The Movement to Get America Walking www.everybodywalk.org News and resources on walking, health information, a personal pledge form to start walking, as well as a place to share stories about individual experiences with walking.

My Walking Coach www.mywalkingcoach.com Motivation, support, and online coaching for walkers of all levels from walking coach and certified fitness instructor Michele Stanten, fitness consultant for this report.

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