Self-rated walking pace and all-cause, cardiovascular disease, and cancer mortality: Individual participant pooled analysis of 50,225 walkers from 11 population British cohorts (Pre-published version)

Abstract

Background/Objectives: Walking pace is associated with risk of premature mortality. However, whether this relationship is independent of total volume of physical activity and highest physical activity intensity reached remain unclear. We examined the associations between walking pace and cause-specific mortality, investigating the potential modifying effect of factors such as total physical activity volume, highest physical activity intensity, age, sex and BMI. Methods: Prospective pooled analysis of 11 population-based baseline surveys in England and Scotland between 1994-2008 that were linked with mortality records. Multivariate-adjusted Cox proportional hazards models examined associations between walking pace (slow, average, brisk/fast) and all-cause, cancer, and CVD mortality. Results: 50,225 walkers were entered in the core analyses. Among participants who did not experience an event in the first two years of follow up (n=49,731), walking at an average or brisk/fast pace was associated with a reduced risk of all-cause mortality (20% (95%CI=12-28%) and 24% (95%CI=13-33%) respectively) and CVD mortality (24% (95%CI=9-36%) and 21% (95%CI=1-38%) respectively) mortality, compared to reporting walking at a slow pace. In stratified analyses, such associations were evident amongst those over 50 years, those not meeting the physical activity recommendations, and those who did not undertake vigorous intensity activity. There was no interactions by sex or BMI. No associations were seen between pace and cancer mortality. Conclusion: Walking i benefits health. Assuming causality, these analyses suggest that in-creasing walking pace could reduce risk for all-cause and CVD mortality. Walking pace could be emphasised in public health messages, especially in situations when increase in walking volume or frequency is less feasible.