Wide-ranging health benefits from outdoor adult walking groups

1. A meta-analysis of outdoor adult walking groups as interventions found significant health benefits including improvement in body weight, blood pressure, total cholesterol, physical functioning, and risk of depression.

2. Outdoor walking group interventions were also found to be safe with a high level of participant adherence and a low rate of adverse effects.

Evidence Rating Level: 1 (Excellent)

Study Rundown: Walking groups are typically a group of individuals who participate in regular short outdoor walks led by trained non-medical personnel. Previous studies have found that walking groups are effective at promoting regular physical activity, but this was the first study to examine the overall health benefits of walking groups as a systematic review. The authors of this study reviewed the literature and found 42 studies that evaluated the health effects of walking groups. Through a meta-analysis, they found that walking groups have a wide-range of health benefits, including for blood pressure, body weight, physical functioning and fitness, and depression. Additionally, walking group interventions were found to have high levels of participant adherence and very low rates of adverse effects (mostly falls).

This study had a strong study design as it systematically reviewed the literature and found many high-quality studies (e.g. more than half of the studies were randomized controlled trials). A notable limitation is that the effect sizes of the intervention were small (e.g. 4mm Hg reduction in systolic blood pressure, 1% reduction in body fat), however, this may be due to the fact that three quarters of study interventions did not meet international guidelines for moderate activity. Overall, these findings contribute to the literature by demonstrating that walking groups are a safe intervention with multiple positive effects on health. Public health efforts and campaigns to promote regular physical activity should consider walking groups and their wide-range of health benefits.

Click to read the study in the British Journal of Sports Medicine

Relevant Reading: Walking and primary prevention

In-Depth [systematic review and meta-analysis]: 7 electronic databases and clinical trial registers were reviewed up to November 2013 for English language articles on outdoor walking groups with adult participants. 42 studies were included with a total of 1843 participants and over 74,000 participant-hours. Studies varied in study design including randomized controlled trials, controlled trials, pre-post, quasi-experimental, and cohort studies (22 of 42 studies were randomized control trials). Interventions varied widely including level of exercise intensity, duration of intervention (3 weeks to 1 year), and minutes spent walking (168 to 8580 minutes). Mean adherence was found to be 75% and there were 7 adverse events in over 74,000 participant hours recorded. A meta-analysis of 17 outcome measures common to studies conducted found significant reductions in several variables, including mean systolic blood pressure (−3.7 mm Hg, CI_95% −5.3 to −2.2), diastolic blood pressure (−3.1 mm Hg, CI_95% −4.2 to −2.1), body mass index (−0.7 kg/m2, CI_95% −1.2 to −0.2), and body fat (−1.3%, CI_95% −2.1 to −0.5). The effect of outdoor walking group interventions on waist circumference, fasting glucose, HbA1c, LDL or HDL cholesterol, and an overall mental health index were not found to be significant.

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