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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
  1. Emmanuel Stamatakis1,2,
  2. Paul Kelly3,
  3. Tessa Strain3,4,
  4. Elaine M Murtagh5,
  5. Ding Ding1,2,
  6. Marie H Murphy6
  1. 1 Epidemiology Unit, Charles Perkins Centre, University of Sydney, Sydney, New South Wales, Australia
  2. 2 Prevention Research Collaboration, Faculty of Medicine and Health, School of Public Health, University of Sydney, Sydney, New South Wales, Australia
  3. 3 Physical Activity for Health Research Centre, Institute for Sport, Physical Education and Health Sciences, University of Edinburgh, Edinburgh, UK
  4. 4 MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
  5. 5 Mary Immaculate College, University of Limerick, Limerick, Ireland
  6. 6 Sport and Exercise Sciences Research Institute, University of Ulster, Coleraine, Northern Ireland
  1. Correspondence to Professor Emmanuel Stamatakis, Epidemiology Unit, Charles Perkins Centre, University of Sydney, Camperdown, NSW 2006, Australia; emmanuel.stamatakis{at}


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 remains 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 body mass index (BMI).

Methods Prospective pooled analysis of 11 population-based baseline surveys in England and Scotland between 1994 and2008 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 cardiovascular disease (CVD) mortality.

Results 50 225 walkers were entered in the core analyses. Among participants who did not experience an event in the first 2 years of follow-up (n=49 731), walking at an average or brisk/fast pace was associated with a reduced risk of all-cause (20% (95% CI 12% to 28%) and 24% (95% CI 13% to 33%), respectively) and CVD mortality (24% (95% CI 9% to 36%) and 21% (95% CI 1% to 38%), respectively), compared with reporting walking at a slow pace. In stratified analyses, such associations were evident among those over 50 years, those not meeting the physical activity recommendations and those who did not undertake vigorous-intensity activity. There were no interactions by sex or BMI. No associations were seen between pace and cancer mortality.

Conclusion Walking benefits health. Assuming causality, these analyses suggest that increasing 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.

  • walking
  • physical activity
  • epidemiology
  • public health
  • cohort study
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  • Funding This analysis was not financially supported directly by any individual, agency or institution. The harmonisation of the pooled data sets used in this analysis was funded by the National Institute for Health Research (UK) through a grant to ES. ES and DD are funded by the National Health and Medical Research Council (Australia) through a Senior Research Fellowship and an Early Career Research Fellowship, respectively.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Ethics approval Multiple Research Ethics Committees in England and Scotland.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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