Transcription
So, walking is probably the most underrated health intervention that exists. I recommend it to all of my patients. And I get that that sounds like a bit of a bold claim when we live in this world full of expensive gym memberships and protocols and Pelaton and supplement stacks and all of that other expensive stuff. But the research on what consistent daily walking does to your body is remarkable. You can't really ignore this stuff. And most people have no idea how far these benefits actually go beyond just sort of burning a few calories here and there.
I'm Dr. Alex. I'm an emergency medicine doctor with nearly a decade working across the NHS. And my goal these days is to help you prevent the end-stage disease that I see every single day to teach you what I've learned over the years. Now, one thing that I've noticed consistently during this time is that there is a clear difference between patients who walk into the cubicle and those who struggle to walk. The ones still walking regularly as they get older, they recover faster, they have fewer complications, and they stay independent for longer. What we know is that movement is one of the most powerful predictors of how well somebody ages and how long you live.
Now, I'm only 33, so you'd think that this wouldn't really apply to me yet. But we got a golden Labrador called Mango about a year ago. We got him as a little tiny baby, and as his exercise tolerance increased, as he got bigger, we had to walk him further and further every single day. So now we walk him three times a day, morning, afternoon, and evening. And the changes that I noticed in myself were really hard to ignore. My baseline fitness increased. My legs became noticeably stronger because we live in such a hilly area. My mood got significantly better. This is probably the most remarkable thing that I noticed about myself and my appetite became much more regular as well. I'm somebody that craves really sugary foods all the time. So, when I'm telling you that this research is really compelling, I'm also telling you that it matches what I've experienced firsthand.
So, in this video, what I'm going to do is walk you through nine things that consistently show up in the research when people walk every single day. We'll talk about your heart health, your kidneys, your liver, your joints, your muscle, and ultimately your entire longevity. And at the end of the video, what I'll do is give you a specific framework for actually implementing all of this because that's the part that most videos seem to skip over. And just really quickly before we carry on, only about a quarter of you who watch these videos have actually subscribed to the channel. So if you find these videos useful, then please, please, please consider subscribing. It really, really does help an enormous amount.
So the first one, and the evidence here is about as robust as it gets in lifestyle medicine, is that walking has a significant effect on your cardiovascular risk. There are tons of studies out there, but there's a very large meta-analysis published in the European Journal of Preventative Cardiology, which collected data from over 400,000 people, and it found that walking was associated with a significant reduction in cardiovascular mortality. And the dose-response relationship was incredibly clear, meaning that more steps correlated with a lower risk with the benefits sort of starting to plateau out somewhere between seven and 10,000 steps per day for cardiovascular outcome specifically.
Now, what's happening physiologically is that regular walking improves your endothelial function, which is the health of the inner lining of your blood vessels. And I talk about this all the time. It seems to be pretty much every video now. And what that does is that it reduces the stiffness of your arteries. It improves your resting blood pressure. It improves your lipid profile. And it reduces systemic inflammation. And all of those things are independent cardiovascular risk factors that walking addresses all at the same time. The landmark Nurses Health Study, which followed over 72,000 women over eight years, found that those who walked briskly for at least 3 hours per week, had a 35% lower risk of a heart attack compared to people who didn't walk, people who were sedentary. Now, that is a staggering reduction from something as simple as walking.
Now, number two is all about your blood pressure. And this one deserves its own section because hypertension, high blood pressure is one of the most common conditions that we see in emergency medicine every single day. I would say that probably over half of the people that I see have a blood pressure over 140 systolic. And that is getting into pretty dangerous territory there. And the reason it's so important is because it damages your blood vessels silently over years and it's a major driver of heart attacks and strokes and kidney disease and walking done consistently has a really meaningful effect on it. There was a really big study published in the journal of hypertension and it was looking at these types of walking interventions in different groups of people and it found average reductions of around 3 to four millimeters of mercury which is the unit of blood pressure in systolic blood pressure which is the top number from regular walking programs. Now that might not sound like much, but in population terms, a three-point reduction in your average systolic blood pressure is associated with massive reduced rates of stroke and heart attacks. And for people with stage one hypertension, so below 140 systolic, that kind of reduction from lifestyle alone can sometimes be enough to avoid medication or at least delay it for a few years.
Moving on to number three, which is that your blood sugar regulation improves massively. So every time you walk, your contracting leg muscles take up glucose from the bloodstream through a pathway that is partially independent of insulin. You don't need insulin to be working perfectly for this to happen. The muscle contraction itself drives glucose into the muscle cells, which means that walking after meals specifically is one of the most effective ways to blunt the post-meal glucose back that would otherwise occur. Now, there was a study published in diabetes care which found that three 15-minute walks after meals reduced your 24-hour blood glucose levels more effectively than a single 45-minute walk taken at another point in the day. So, the timing really does matter and this is something that we suggest all the time to our patients. And for people who are insulin resistant or pre-diabetic or trying to manage type 2 diabetes and what we know is that 40% of you watching this will be in that sort of broad category. This is not a minor finding. It is genuinely a really powerful tool that costs nothing and has zero side effects. Consistently lower meal glucose means lower average insulin levels, less glycation damage to blood vessels, and over time a really meaningful reduction in the metabolic drivers of chronic disease.
Number four is all about your kidney health. Now, and from what I can gather, a lot of you watching these videos are really interested in the health of your kidneys, which is fantastic. So, let's just talk about this one then. So there was a big study that followed over 6,000 people with chronic kidney disease and it found that those who walked regularly had a significantly lower risk of progression to kidney failure compared to those who were sedentary who didn't walk even after controlling for all of the other important variables. And there were lots of different mechanisms at play here. So what we know is that regular walking reduces your blood pressure which directly reduces the filtration pressure inside the glomerulus which is the tiny sort of filtering units in the kidney and that reduced pressure slows the rate of kidney damage over time. Walking also improves your insulin sensitivity and reduces your blood sugar which as I just covered in the previous section is one of the major drivers of kidney damage and it reduces systemic inflammation as well which is another independent driver of kidney disease progression. Now the benefits here are largely indirect. They come through improvements in blood pressure, blood sugar and inflammation but they are absolutely real and they have been tested again and again. So, just check out the research papers in the description if you want to learn more.
Number five is all about your liver this time. So, non-alcoholic fatty liver disease is one of the most common liver conditions in the developed world, perhaps the most common. And it affects probably around 25 to 30% of adults. And most people who have it will never know. It develops when fat accumulates in the liver cells, initially causing no symptoms at all, but potentially progressing over years to inflammation and scarring and then possibly causing some pain later down the line. Eventually, it can even cause cirrhosis and liver failure. And one of the most effective interventions for it, backed by years and years of research, is regular aerobic exercise, including just plain boring walking. There was a systematic review published in the journal of hepatology which is a pretty important journal all about the liver and it found the exercise interventions including moderate intensity walking significantly reduced the amount of liver fat even in the absence of significant weight loss. And that's a really important point because it means that the liver benefits aren't just about losing weight. The movement itself has a direct metabolic effect on how the liver handles fat. We know that regular walking increases the rate at which the liver oxidizes fatty acids. It reduces the delivery of free fatty acids from fat tissue into the liver and it improves insulin sensitivity which is a common theme here which reduces the fat producing signaling that drives accumulation in the first place.
So number six is that your joint health actually improves despite what most people assume here. So most people think that walking can be bad for your joints, especially your knees, and that if you've got arthritis, then you should rest. But the evidence says pretty much the opposite. So cartilage, which you've all heard of, is the cushioning tissue inside your joint. It doesn't have its own blood supply. So the only way that it gets nutrients is from the fluid inside the joint. And that fluid only gets circulated when you move. So when joints stop moving regularly, they become stiffer, less nourished, and more likely to break down over time. And not many people have ever been told this. There was this large long-term study called the osteoarthritis initiative which followed thousands of people with or at risk of knee arthritis and it found that people who walked regularly had less pain and less loss of function over time than those who didn't walk. And walking also builds up the muscles around your joints. So your quads, your glutes, your hips. And what we know is that stronger muscles around a joint means less pressure going directly through it. They're almost like shock absorbers. And what that does is that it protects the joints over time.
So let's talk about muscle specifically now. So number seven, now as we get older, we naturally lose muscle. It's called sarcopenia. And I've mentioned this a few times in other videos in the past. Now, it's one of the main reasons people become frail, that they fall over and lose their independence as they become elderly. Now, let me just be really honest here. Walking isn't the same as lifting weights. And if you actually want to build muscle, then you need to do more than just walk. But for keeping the muscle that you've got, staying coordinated and slowing down that age-related decline, regular walking honestly makes a massive difference. There was a study in the American Journal of Clinical Nutrition that found that people who walked more each day held on to significantly more lean muscle mass over a 4-year period compared to those who didn't. Now, part of that is metabolic. We know that walking helps your body to use insulin properly, which supports muscle maintenance. And the other side of it is that keeping your legs moving every single day if you can keeps this brain-to-muscle connection really sharp which really matters for a lot of people as you get older in terms of balance and avoiding falls.
Number eight is a really, really important one here. So what we know is that walking massively improves your mental health and your cognitive function. So the research on walking and mental health is really, really consistent. We know that it reduces depression, it reduces anxiety, it improves your mood and it lowers your stress levels. And these are not small effects at all. There was an enormous study published in the British Journal of Sports Medicine, and it found significant reductions in depression scores from walking across multiple studies and multiple populations. And the reasons for this are partly chemical. But we know that walking triggers the release of endorphins and endocannabinoids which are the brain's sort of natural mood-lifting compounds and it also reduces your cortisol levels which is your main stress hormone. Now the other thing that it does is that it increases something called BDNF brain-derived neurotrophic factor which is basically a fertilizer for your brain cells. And what it does is that it helps existing neurons survive and new ones to grow. And higher BDNF levels are linked to better memory, sharper thinking, and a lower risk of dementia across the board. It is really, really powerful stuff. The Framingham Heart Study, one of the longest running health studies in history, found that people who moved more had significantly lower rates of dementia over the long term. And as I said at the start, the mood benefit is something that I've noticed firsthand over the past year with Mango. It's one of those things that sounds like a bit of a cliché until you actually feel the difference.
Okay, so number nine is quite simply that you live longer when you add all of those benefits together. So better heart health, lower blood pressure, better kidney and liver function, better joints, more muscle, better mental health. The overall effect on your lifespan is massive. A study published in JAMA Internal Medicine, and you can check out this study in the description below. It followed almost 5,000 older women, and it found that those walking around 7 and a half thousand steps a day had significantly lower death rates from all causes. Yes, all causes compared to those doing around 2 and a half thousand. And the benefits seem to level off at around 7 and a half thousand steps, which is a really important point here. You don't need to be hitting 15, 20,000 steps a day. 7 and a half thousand is achievable for most people.
So, there we are then. Nine things that improve when you walk every day. I really hope I've convinced you of just how powerful it is. And what I want to do now is go through a sort of framework of how to actually implement all of this. What I found is that knowing that walking is actually good for you doesn't automatically make you do it. And most health videos don't really give you anything practical to work with. So here's how I would actually approach it if I wasn't walking every day.
Now the first thing to do is to actually find out where you are right now. How many steps do you do a day currently? There's a very good chance that your phone tracks this in the background. So look at your daily average from the last week if you can and use that as your starting point. If you don't have any data on this, then I would really recommend getting a really cheap fitness watch if you can. If you go on to Amazon or Google, just type in fitness watch. I can guarantee that something under £20 or $30 will come up.
So once you know how many steps you're doing a day or a week, just use that as your starting point. Now, if you're under 3,000 steps a day, the only goal for the next two weeks is to add one 10 to 15 minute walk per day. That's it. Starting small and building the habit gradually is what the evidence actually supports. After 2 weeks, that walk should feel pretty normal. It should be just part of your routine at this point. And then you add a second walk. And the best time to walk for the blood sugar reasons I mentioned earlier is after a meal. Even just 10 minutes makes a really meaningful difference to your glucose levels.
Now, the step target to aim for is roughly 7 to 8,000 per day for most people. Clearly, this will differ depending on your size, your age, how hilly it is where you live, but for most people around 7 and a half thousand a day gives you enormous benefits. And for pace, you want to be moving briskly enough that talking is easy, but singing would be hard. That you're a tiny bit out of puff, but you're not breathing really hard that you couldn't talk to your friend or your wife or husband or whoever. That is the sweet spot for your cardiovascular health and your metabolic health.
Now, the last and probably the most important thing to mention here is that none of this works without consistency. One single good walk doesn't really change anything, but six weeks of daily consistent walking starts to. So the idea is that you want to make it as easy as possible to build this into your routine to show up every single day. So same time, pick a route you like, somebody to go with if that helps. And if you can, then get a Labrador. Honestly, getting a dog was one of the best things that we've done for our health as a family.