A slow usual walking pace has previously been associated with adverse health outcomes (Ganna and Ingelsson, 2015). The aim of the present observational study was to determine the association between walking pace and type 2 diabetes risk, and to determine the role of adiposity in mediating this.
A total of 194,304 white European participants in the UK Biobank study who did not have diabetes at baseline were evaluated. Usual walking pace was self-reported at study initiation and rated as slow, average or fast. Adiposity was defined according to BMI, waist circumference and percentage body fat; results followed similar patterns for all three adiposity definitions.
Over a median follow-up of 5.4 years, 4564 participants (2.3%) developed type 2 diabetes (42% women and 58% men). After adjustment for sociodemographic and lifestyle factors, but not adiposity, women with a slow (hazard ratio [HR], 2.52) or medium (HR, 1.75) walking pace were significantly more likely to develop type 2 diabetes than those with a fast walking pace. In men, the HRs were 2.05 and 1.60, respectively. Further adjustment for adiposity attenuated but did not eliminate the association.
Excess adiposity was the dominant risk factor for type 2 diabetes, and this drove most of the association between walking speed and diabetes risk in women, but not in men. At all levels and definitions of adiposity, slow walking pace was associated with greater type 2 diabetes risk. Thus, the authors conclude that both excess weight and slow walking pace are independent risk factors for type 2 diabetes. Promoting brisk walking as a weight management strategy might support type 2 diabetes prevention, although this on its own is unlikely to prevent type 2 diabetes if there is excess adiposity.
Vinod Patel highlights the growing evidence base that lifestyle interventions are effective, and encourages persistence even though they can be difficult.
25 May 2023