News Release 

Increased walking activity associated with long-term health benefits


Short term pedometer-based walking interventions can have long-term health benefits for adults and older adults, according to new research published in the open-access journal PLOS Medicine on 25 June. Tess Harris and colleagues from St George's University of London, UK and other institutions, conducted two trials of walking interventions which aimed to increase step count and physical activity. Not only did the investigators see sustained increases in physical activity at 3-4 years in the intervention group participants, they also noted fewer cardiovascular events and fractures.

Physical activity has been shown to be protective for many health conditions, and inactivity is a key risk factor contributing to the global burden of disease. However, long-term follow-up of physical activity trials is lacking. Here, two randomised controlled trials of 12-week pedometer-based walking interventions in primary care were followed up with long-term data from primary health records at 4 years.

The team studied data from 1297 participants of the PACE-UP and PACE-Lift trials. People in the intervention arms were less likely to have a cardiovascular event (Hazard Ratio 0.34, 95% CI 0.12-0.91, p = 0.03) or a fracture (HR 0.56, 95% CI 0.35-0.90, p = 0.02) than those in the control arms. No differences were seen in incidence of diabetes or depression in people in the intervention as compared with those in the control arms. Based on these observations, about 61 people would need to receive the walking intervention to prevent one cardiovascular event and 28 people to prevent one fracture. Although the rates of adverse health events were low in this study, and were restricted to only those recorded in primary care records, under-recording would not have differed by intervention status, so should not have led to bias.

The authors note that "short-term walking interventions can produce long-term health benefits and should be more widely used to help address the public heath inactivity challenge."


Research Article


The research was supported by the National Institute for Health Research (NIHR) UK: PACE-UP trial and 3-year follow-up by the Health Technology Assessment (HTA) Programme NIHR (grant number 10/32/02); PACE-Lift trial by the Research for Patient Benefit (RfPB) Programme NIHR (grant number PB-PG-0909-20055); the PACE-UP 3-year follow-up was also supported by the Collaboration for Leadership in Applied Health Research and Care (CLAHRC) South London. Authors who received funding for the initial trials were TH, DGC, SK, CV, PW, MU, SI, UE, and JF-R.

Competing Interests:

I have read the journal's policy and the authors of this manuscript have the following competing interests: TH, ESL, FH, IC, SD, CF, CW, SA, PW, MU, JI, and DGC report grants from NIHR Health Technology Assessment (HTA) Programme, grants from NIHR Research for Patient Benefit Programme (RfPB), and grants from NIHR Collaboration for Leadership in Applied Health Research (CLAHRC) South London, during the conduct of the study for themselves or their institution. SK, CV, SI, UE, and JF-R report grants from NIHR HTA Programme, grants from NIHR RfPB, during the conduct of the study for themselves or their institution. There are no other relationships or activities that could appear to have influenced the submitted work.


Harris T, Limb ES, Hosking F, Carey I, DeWilde S, Furness C, et al. (2019) Effect of pedometer-based walking interventions on long-term health outcomes: Prospective 4-year follow-up of two randomised controlled trials using routine primary care data. PLoS Med 16(6): e1002836.

Image Credit: Fotorech, Pixabay

Author Affiliations:

Population Health Research Institute, St George's University of London, Tooting, London, United Kingdom

Pragmatic Clinical Trials Unit, Queen Mary's University of London, London, United Kingdom

Gerontology and Health Services Research Unit, Brunel University, London, United Kingdom

Institute for Social Marketing and Public Health, University of Stirling, Stirling, Scotland, United Kingdom

Research Department of Primary Care and Population Health, University College London, London, United Kingdom

Department of Sport Medicine, Norwegian School of Sport Sciences, Oslo, Norway

Department of Population Science, King's College London, London, United Kingdom

Institute of Medical and Biomedical Education, St George's University of London, Tooting, London, United Kingdom

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