title: The relationship between walking speed and changes in cardiovascular risk factors during a 12-day walking tour to Santiago de Compostela: a cohort study.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  Single-centre study with healthy middle-aged volunteers.
  
  
  METHODS
  Healthy middle-aged men (n=15) and women (n=14). Subjects using lipid-lowering medication were excluded.
  
  
  METHODS
  Participants walked 281±10 km of the classical route to Santiago de Compostela in 12 days in 2009.
  
  
  METHODS
  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.
authors.affiliation: Department of Vascular Medicine, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Remy H H
authors.initials: RH
authors.lastname: Bemelmans
authors.forename: Paulus P
authors.initials: PP
authors.lastname: Blommaert
authors.forename: Annemarie M J
authors.initials: AM
authors.lastname: Wassink
authors.forename: Blai
authors.initials: B
authors.lastname: Coll
authors.forename: Wilko
authors.initials: W
authors.lastname: Spiering
authors.forename: Yolanda
authors.initials: Y
authors.lastname: van der Graaf
authors.forename: Frank L J
authors.initials: FL
authors.lastname: Visseren