Can walking 8,000 steps, at least 2 days a week, lower cholesterol & heart attack risk? Study says so

Reacting to the multiple studies on walking, Dr Deepak Puri, Director, Cardiovascular Thoracic Surgery, Max Super Specialty Hospital, Mohali, feels that a routine that is customized around a person’s life works best.

Current research suggests that walking 8,000 brisk steps or more per day is important for heart health. What is the viability of such guidelines?

The health benefits of walking have been proven beyond doubt by several studies since long and several guidelines have been formulated from time to time to suggest how much walking is needed to reduce the risk of heart attack and stroke. The American Heart Association (AHA) guidelines recommend either 150 minutes of brisk walk per week or 75 minutes per week of moderately high-intensity activities like jogging for optimally reducing cardiovascular risk. However, for busy professionals including healthcare professionals, it may be impossible to achieve this target due to lack of time. Therefore, it is well accepted that any amount of physical activity, even in small increments or intensity, can contribute towards reducing cardiovascular risk.

Regular walking not only burns excess calories but increases good cholesterol (HDL) levels and reduces bad cholesterol (LDL) as well as triglycerides. Apart from that, it promotes collateral vessel formation, thus improving circulation to the brain and heart. That’s how it reduces the risk of heart attack and stroke. Walking also activates our good hormones, reduces stress levels, improves immunity and reduces the risk of bone degeneration.

A new study demonstrates that walking just one or two days is still associated with a significant reduction in all-cause and cardiovascular mortality. What are your observations?

In our own clinical experience, I have observed that patients who walk regularly have better control of their lipid and sugar levels, have slower progression of atherosclerosis, report lower incidence of adverse events like recurrent blockages in native arteries as well as bypass grafts. These patients have better developed collateral blood vessels supplying heart muscles. Therefore, they minimise the chances of heart attacks and reduce the possibility of death over a period of five to 20 years after a bypass surgery.

What are the ill-effects of a sedentary lifestyle?

A sedentary lifestyle not only increases the risk of heart attacks as well as stroke but also increases the risk of other lifestyle diseases like high blood pressure, diabetes, cancers, joint problems, hypertension as well as depression.

What number of steps would you recommend for people to achieve maximum benefits of walking?

The number of steps depends on several factors apart from age and gender. The recommendation must be tailored according to everyone’s modifiable and non-modifiable risk factors, underlying health issues, profession, fitness as well as personal liking. The first step is individual risk evaluation, which should be followed by an assessment of a person’s BMI, waist circumference, blood pressure, heart rate, blood sugar and cholesterol levels. The next step is calculation of total calories consumed per day as part of your diet and total calories burnt in each activity per day and then determining how much physical activity is required to burn the excess calories consumed as well as stored within your body. Then you calculate walking how many steps is sufficient to achieve the desired result.

The next task is to formulate a plan where the person can gradually increase physical activities to reach the desired target. The nature of the physical activity must be designed according to the frequency, intensity, time and type that would suit the person best (FITT principle). Special routines must be devised for women as compliance is more difficult for them. And they are just as much exposed to the risk of cardiovascular disease, obesity and diabetes.

How would you define brisk walking? The study defines it as walking three miles an hour, with 8,000 steps being about four miles. At the above pace, it would take an hour and 20 minutes per day…

Brisk walking is a must to achieve risk reduction and must be optimised according to an individual’s capacity and need. It is important to slowly increase the intensity to reach a level when the person has difficulty talking to an accompanying person while walking. This period is known as warm-up time and subsequently the person can sustain the speed of brisk walk till he/she starts getting breathless or tired. Once this stage is reached, the individual can gradually slow down and stop to take rest.

The cycle can be repeated till the desired physical activity targets are achieved. I would like to emphasise here that just achieving 8,000 or in fact any number of steps is not sufficient unless the excess calories are burnt. Smokers and obese patients may face difficulties in achieving optimum physical activity targets. We must eliminate smoking and binge-eating.

I recommend short bursts of activity whenever possible. A brisk walk from the parking to the workplace, short walks after every hour of sitting, taking steps to the staircase instead of lift, walking while talking on the mobile phone or reading and walking to the market instead of going by car goes a long way in reducing risks.