RESUMO
OBJECTIVES: Physical exercise has beneficial effects on cardiovascular risk factors. Knowledge about the effect of exercise intensity, specifically walking speed, on cardiovascular risk factors is limited. We report the relationship between walking speed and changes in cardiovascular risk factors in participants of a 12-day walking tour to Santiago de Compostela. DESIGN: Prospective cohort study. SETTING: Single-centre study with healthy middle-aged volunteers. PARTICIPANTS: Healthy middle-aged men (n=15) and women (n=14). Subjects using lipid-lowering medication were excluded. INTERVENTION: Participants walked 281±10 km of the classical route to Santiago de Compostela in 12 days in 2009. PRIMARY AND SECONDARY OUTCOME MEASURES: Walking speed was recorded and blood pressure, weight, waist circumference, lipids and glucose were measured every other day. Changes in risk factors were compared between gender-pooled groups with faster and slower walking speed. Second, the relationship between walking speed and changes in risk factors was quantified using a linear mixed effects model. RESULTS: In the faster walking speed (4.6±0.2 km/h) group, high-density lipoprotein cholesterol (HDL-c) increased more than in the slower walking speed (4.1±0.2 km/h) group (difference in change between groups: 0.20; 95% CI -0.02 to 0.42 mmol/l), while low-density lipoprotein cholesterol (LDL-c) and total cholesterol decreased more in the slower walking speed group (differences in changes between groups: LDL-c: -0.50; 95% CI -0.88 to -0.12 mmol/l and total cholesterol: -0.75; 95% CI -1.19 to -0.31 mmol/l). A 1 km/h higher walking speed was related to an increase in HDL-c (0.24; 95% CI 0.12 to 0.30 mmol/l), LDL-c (0.18; 95% CI -0.16 to 0.42 mmol/l) and total cholesterol (0.36; 95% CI 0.12 to 0.60 mmol/l), adjusted for age, gender, smoking, body mass index and heart rate, during the whole walking tour. CONCLUSIONS: Walking the same distance faster improves HDL-c more, while LDL-c and total cholesterol decrease more with lower walking speed independent of changes in body weight in healthy middle-aged subjects.
RESUMO
OBJECTIVE: Physical exercise has multiple beneficial health effects. Yearly, over five million persons walk a pilgrimage in various parts of the World, and this number is increasing. Here we report the effects on vascular function and cardiovascular risk factors of a 12-day pilgrimage to Santiago de Compostela in Spain. METHODS: Twenty-nine healthy male and female subjects between 40 and 70 years were included in the intervention group. The intervention consisted of the last 280 km of the pilgrim route to Santiago de Compostela. Twenty-nine control subjects were age- and gender-matched. Measures of endothelial function, vascular stiffness, autonomic function, and cardiovascular risk factors were measured 2 months and 2 weeks before the pilgrimage and 2 weeks and 2 months afterwards. During the pilgrimage cardiovascular risk factors, including weight, lipids, glucose and blood pressure were measured every other day. RESULTS: The mean daily walking distance during the pilgrimage was 23.42±0.80 km taking 5.39±0.36 h/day. From start to end, HDL-cholesterol increased (0.20±0.30 mmol/L; +15%), while LDL-cholesterol (-0.6±0.6 mmol/L; -17%) and weight (-1.4±1.8 kg; -2%) decreased. After an initial rise, blood pressure came back to baseline. Two months after the pilgrimage a 2.0 kg weight loss persisted compared to the controls. There was no change in any vascular function parameter compared to the controls. CONCLUSION: Walking a pilgrimage immediately influences major cardiovascular risk factors as a consequence of (strenuous) exercise and, likely, dietary changes. Two months after the pilgrimage these changes came back to baseline, except for weight loss. There was no effect on vascular function.