Slow Walking, Obesity May Increase Type 2 Diabetes Risk

People who walk slowly and have obesity may have a considerably higher risk of developing type 2 diabetes, according to a new study.

People who walked slowly had a 2- to 2.5-fold higher risk of type 2 diabetes than those who walked briskly. However, among people who walked briskly, those with obesity had a 10 to 12-fold higher risk of type 2 diabetes than those with a normal body mass index (BMI).

“Slow walking pace is a risk factor for type 2 diabetes independent of adiposity [body fat levels]. Promoting brisk walking as well as weight management might be an effective type 2 diabetes prevention strategy given their synergistic effects”, the researchers wrote.

The study, “Association between walking pace and incident type 2 diabetes by adiposity level: A prospective cohort study from the UK Biobank,” was published in Diabetes, Obesity & Metabolism.

The World Health Organisation (WHO) defines obesity as an abnormal or excessive accumulation of fat that can impact health. A BMI of 18.5 to 24.9 is deemed normal, 25 to 29.9 is classified as overweight, and a BMI over 30 is considered obese. Obesity, along with large waist circumferences (greater than 88 cm for women and 102 cm for men), elevates the risk of type 2 diabetes. Improving eating habits, increasing physical activity, and losing weight can significantly reduce this risk.

Past studies show that inactive people with obesity are 7.4 times more likely to develop type 2 diabetes than highly active people with normal weights. However, most of these studies have assessed total physical activity without considering walking pace alone.

Now, UK researchers investigated how walking pace and body fat levels affect type 2 diabetes risk. They studied 194 304 Caucasians (average age 56, 55.9% women) with records of their body weight, body fat, waist circumference and walking pace in the UK Biobank database.

A total of 22.9% of participants had obesity, 43.7% had overweight, and 33.5% had a normal weight. Women’s average waist circumference and BMI were 84.1cm and 27, respectively and 96.3cm and 27.7 for men. Most participants (52%) walked at an average pace, while 41.2% walked briskly and 6.6% walked slowly. After a median follow-up of 5.4 years, 4564 participants (42% women and 58% men) developed type 2 diabetes.

Slow Walking, Obesity and Diabetes Risk

Compared to brisk walkers, average or slow-paced walkers had a 2 to 2.5-fold higher risk of type 2 diabetes. The risk of type 2 diabetes was even higher when obesity was combined with a slow walking pace. Specifically, women with obesity, high waist circumference or body fat levels who walked slowly had a 12.7-, 17.9- and 10.5-fold higher risk of developing type 2 diabetes than those with a brisk walking pace and normal BMI, low waist circumference or low body fat levels, respectively. Similar results were seen in men; those with slow walking pace and obesity, high waist circumference or body fat levels had a 15.4-, 9.8- or 10.2-fold higher risk of diabetes than those with a brisk walking pace and normal BMI, low waist circumference or low body fat levels.

“Compared to brisk walking pace, slow walking pace was associated with a higher risk of type 2 diabetes, independent of sociodemographic and lifestyle factors among White-European people,” the researchers wrote. “The risk of type 2 diabetes was doubled when slow walking pace was combined with obesity, high WC [waist circumference] or BF% [body fat %]”, they added.

Based on these results, the researchers note that walking pace and body fat levels affect diabetes risk independently and must be addressed simultaneously to get the best health outcomes.

The researchers also noted their study was limited by excluding other ethnicities and allowing participants to report their walking pace.

“This finding suggests that people with high body fat are more vulnerable to slow walking and that increasing their walking speed during physical activity, where feasible, could potentially be effective as it could reduce body fat”, the researchers wrote.

Randomised controlled trials are needed to validate this hypothesis.

The Takeaway

That being inactive and having overweight or obesity increases the risk of diabetes is not news. But it is interesting that walking slowly can independently increase diabetes risk regardless of body fat levels.

The UK’s Chief Medical Officers recommend that adults aim to be physically active daily. They should aim for at least 150 minutes of moderate-intensity activity, such as brisk walking, playing sports or cycling; or 75 minutes of high-intensity activity, such as running; or shorter durations of very high intense exercise, such as sprinting or stair climbing; or a combination of moderate, high and very high intense activity weekly.

They also recommend exercising on at least two days a week to develop or maintain strength in the major muscle groups. Examples include weight-lifting, heavy gardening, or carrying heavy shopping.

It is good to break up long periods of sitting with light activity, such as stretching, going on short walks, dancing, or being active around the home.

Try These Tips

  1. Make a list of exercises or activities you enjoy.
  2. Choose one or more you can easily fit into your daily routine and gradually build up to doing them for at least 30 minutes five days a week if you’ve been inactive for a long time.
  3. Remember to include strength-training activities, such as weight-lifting or bodyweight exercises that work your large muscles.

References

  1. World Health Organisation. (2021) Obesity and overweight. Available: https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight. Accessed: April 29 2023
  2. Department of Health and Social Care. (2019) UK Chief Medical Officers’ Physical Activity Guidelines. Available: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/832868/uk-chief-medical-officers-physical-activity-guidelines.pdf. Accessed 29 April 2023.