PAMF Health Blog

Be Well, Be Well Informed

Why Walking Is Important for Your Health

Posted on May 13, 2014 | 12 comments


If you think about exercise only in terms of intense cardio workouts such as running or biking, you may be missing out on the very health benefits you are trying to gain. In this blog post, Ronesh (Ron) Sinha, M.D., a PAMF internal medicine doctor, explains why the simplest exercises, such as walking, are the most important for our health.  

Re-evaluating Our Approach to Exercise

Back in the days when physical activity was a natural part of our life and daily habits, it was assumed that we took enough steps to interrupt the damaging metabolic effects of prolonged sitting frequently enough to disrupt fat storage and inflammation. So with this foundation of baseline essential non-exercise physical activity (NEPA), the recommendation was to add on an additional four to five exercise sessions a week. The core of NEPA includes activities like walking, climbing stairs, picking up objects off the ground and doing some squatting, all of which used to be a natural part of daily movement. It’s tragic that we now have to create a separate term for this (NEPA) and make a deliberate attempt to restore it into our daily, unnatural sedentary lifestyles.

Many of the patients doctors see today are lacking NEPA, which I simply quantify through daily steps using a pedometer or activity device. A 20-minute walk at lunch is better than nothing, but not nearly enough to get you to your NEPA goal. The bare essential daily minimum is 5,000 daily steps and optimal is 8,000-10,000 steps or more. I encourage you to know your number, and if you are not getting sufficient NEPA, prioritize that first.

Nearly All Health Risks Lowered

If you look at parts of the world where people live the longest, they aren’t doing intense daily cardio workouts, running or cycling countless miles, or attending bootcamps. They simply walk, stand, bend and squat more throughout the day, and do much of it outdoors. I also want to highlight that nearly all of the health risks I see in my patients can be improved by walking more steps.

Studies show that walking:

  • Lowers blood sugar and triglycerides after meals
  • Lowers inflammation
  • Modestly lowers body fat
  • Lowers stress and improves immunity
  • Prevents falls in the elderly
  • Increases longevity

What other evidence do you need to get you walking more?

The Gym Does Not Replace NEPA

Once you get your NEPA to a reasonable level, now you can start layering some cardio workouts and weight training a few times a week, but do not use those exercise sessions as a replacement for NEPA. A compilation of 18 studies, including nearly 800,000 people done by UK researchers, showed that prolonged sitting throughout the day doubled the risk of diabetes, heart disease and death despite moderate-to-vigorous exercise. Another study done in people 60 and older showed that regardless of exercise, every hour spent sitting doubled the risk of becoming disabled. Bottom line is 30 to 40 minutes on the elliptical doesn’t earn you 12 hours of sitting. Frequent, intermittent movement with the right eating strategy not only helps burn fat, but it also reduces inflammation, which is at the root of all chronic diseases (heart disease, cancer, Alzheimer’s, etc.) and premature aging. In addition, keep in mind that there is a growing body of evidence showing that continuous chronic endurance training may actually increase heart disease risk. If you are an avid distance runner or triathlete and want to live longer, it may be wiser to switch your running shoes for walking shoes every now and then. Don’t get me wrong. Achieving your endurance goals or a personal best in your favorite exercise (running, cycling, etc.) or sport is a great accomplishment, but keep in mind that the real accomplishment for most of us is longevity, disease prevention, and optimal brain and body health. For these goals, NEPA is absolutely essential.

SinhaR_2007Ronesh (Ron) Sinha, M.D., a Palo Alto Medical Foundation internal medicine doctor, contributed this blog post. Dr. Sinha works closely with the South Asian community to help reduce heart disease and diabetes risk, and provides corporate health lectures to promote wellness in the workplace. You can follow him on Twitter at @roneshsinha.


Please note that we are unable to respond to personal medical questions through the comments feature below. For information about personalized health care, or if you need help in choosing a PAMF physician, please visit Becoming a PAMF Patient ( or call 1-888-398-5677. If you are a PAMF patient, you can email your doctor securely via our My Health Online program. Thank you


  1. I was in line at the grocery store the other day. In front of me was a man doing his shopping. It was his birthday. 100 years. He attributed his good health and age to walking. He said he walked a mile everyday.

    Think I will spend less time at the computer and more time walking.

    • Thanks for sharing, Gary. Great story and happy walking!

  2. Thank you for the interesting article, but it lacks some information that I feel is needed to affect a lifestyle change. Firstly, you state that a 20 minute walk at lunch “is better than nothing.” Most people can visualize a 20 minute walk, so that is communication is effective, but then you state that “The bare essential daily minimum is 5,000 daily steps and optimal is 8,000-10,000 steps or more.” The number of steps taken does not translate into any thing useful to me. If instead you tell your readers how long in minutes or how far in miles they should walk, your readers might have a better idea of what you are advocating.

    Secondly, many people must sit for hours at their jobs or in the in cars commuting to their jobs. So making them feel bad about the unchangeable realities of modern life doesn’t do much unless you are suggesting that your readers change occupations and become gardeners, mail carriers or olympic runners. If so, then say so. Otherwise, it would help if after stating “Bottom line is 30 to 40 minutes on the elliptical doesn’t earn you 12 hours of sitting,” that you might suggest some specific exercise goals for people who must sit for eight hours per day or major parts thereof.

    Thanks for the article. It is a worthy effort. I hope that you will expand on it. I get both walking and bicycling exercise regularly, but it would be nice to have some specific indicators to judge whether or not my efforts could be more beneficial health-wise.

    • Scott,

      Thanks for your response. Nowadays it is quite easy for anyone to estimate daily steps using their smartphone or a pedometer which is readily available and very affordable. In general 2,000 steps is about a mile. I by no means am recommending a job change to avoid prolonged sitting. Anyone with a desk job has the ability to interrupt periods of prolonged sitting by taking regular standing breaks or establishing a standing desk at home or work. This is becoming a standard at many workplaces and is essential for good health. My intention was not to make readers “feel bad.” I directly am witnessing the effects of prolonged sitting on metabolic and musculoskeletal health and think it is important for me to relay my experience and the growing body of research supporting the adverse health effects of prolonged sitting.

      – Dr. Sinha

  3. Every article by Dr. Sinha is impressive ! How lucky is the foundation and its patients to have such young Doctor who thinks *outside the box*! Just wonderful and refreshing!
    Thank you Dr.Sinha!

    • Baerbel,

      Glad to hear you are enjoying the articles. Thank you for your comment and we will relay your thoughtful feedback to Dr. Sinha. Best wishes!

  4. Thank you for a very enjoyable and informative article. It helped me understand the implications of being sedentary and the type of activities I should be incorporating as much as possible. I agree it’s sad we have to “artificially” recreate what used to be natural part of living, but I’m happy to read that more gardening will contribute to my health!

    • Glad to hear you enjoyed the article and found it useful. Thanks for visiting our blog and happy gardening!:)

  5. I started walking (with a pedometer) 20 yrs. ago when I was 54. I don’t walk quite as much now, but try to get in 10,000 steps a day in a 22 minute morning walk and often another 20 minute walk in the evening. Before that I had Crohns and 4 surgeries over 20 years. I have been well now for 20 yrs. I don’t know if there is any connection to the walking. Walking also reduced the stress some. I thank God for keeping me well to take care of my parents and now hope He will keep me well to take care of my husband. Lately I am having some leg pain behind one knee, especially walking downhil or down stairs. Is that caused by my 6 day walking?

    • Jan:

      Great job on your walking routine! The knee pain could be related to walking, but more often I see knee pain arising from sedentary folks who have very weak leg muscles that don’t provide adequate knee support. The only way to tell is by having your doctor examine your knee to see what the cause might be.

      – Dr. Sinha

  6. Thank you for the encouraging article – some of us have had those desk jobs for many years and I am working my way, very slowly, to cardio type goals. We must start somewhere though and it looks like I’m on the right track.

    • Thanks for your comment, Terra and glad to hear of your walking/cardio progress! Keep it up :)

Leave a Reply

Your email address will not be published. Required fields are marked *

You may use these HTML tags and attributes: <a href="" title=""> <abbr title=""> <acronym title=""> <b> <blockquote cite=""> <cite> <code> <del datetime=""> <em> <i> <q cite=""> <strike> <strong>