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Introduction

Let's Keep Walking

ZHU, WEIMO

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Medicine & Science in Sports & Exercise: July 2008 - Volume 40 - Issue 7 - p S509-S511
doi: 10.1249/MSS.0b013e31817c72af
  • Free

Walking is humankind's oldest and most basic form of physical activity, and its value to health has long been recognized. "I have two doctors-my left leg and my right leg," George Trevelyan said. An ancient Chinese saying advises "walk rather than take a carriage." Yet, "walking" itself is walking away from the daily experience of being human; this is especially true in developed countries. According to a recent US population survey (2), only 34% of the respondents were regular walkers (five times 30-min walking per week), 45.6% were occasional walkers (walked, but did not meet the PA recommendation), and 20.7% were never walkers. The results of the 2001 National Household Travel Survey indicated that "walk" accounted for only 8.6% of the total travel modes (see http://nhts.ornl.gov/2001/index.shtml). From 1977 to 1995, walking trips decreased from 9.3% to 5.5%. Similarly, children's daily walking has been significantly decreasing over the past several decades. The number of trips made by foot or bicycle has declined 37% between 1977 and 1995 (4), and about 50% of 5- to 15-yr-old American school children or youth are driven to school in privately owned motor vehicles compared to only about 10% who walk (6). This is true even for students living only a short distance from their school. According to the Centers for Disease Control and Prevention (1), for children living less than 1 mile from school, only 31% of trips are made by walking.

The consequence of a sedentary less-walking lifestyle to the population's health status and economic burden has been significant. As an example, a review of the national surveys conducted in 1960 through 1994 found that 54.4% of adults 20 to 74 yr were overweight (BMI ≥ 25) and that the prevalence of obesity (BMI ≥ 30) was 22%, up from 14% from 1976 to 1980 (3). Similar trends have also been found in children. About 15% of 6- to 19-yr-olds were classified as overweight in 1999-2000, up from about 5% from 1988 to 1994, according to the National Health and Nutrition Examination Survey (5). The economic impact of obesity is also significant. In 1996 alone, it is estimated that about 4.19 million cardiovascular disease cases were associated with obesity, which led to about $22.17 billion in direct medical costs that year (7).

To help reverse the trend of the decline in walking and to provide a forum to update and address critical measurement and research issues as well as practical concerns related to walking and health research, a major joint effort was made by the American College of Sports Medicine (ACSM) and the University of Illinois at Urbana-Champaign (UIUC). An international conference, "Walking for Health: Measurement and Research Issues and Challenges," was held at UIUC on October 13-15, 2005, which had four specific aims:

  1. to provide updated and multidisciplinary views on walking and health research and practice;
  2. to address critical measurement and research issues and challenges in walking and health research and explore the potential of the latest technologies and methods for the challenge of increasing walking;
  3. to provide an exchange of the latest research progress in walking and health research; and
  4. to provide training on measurement and statistical methods and programming skills.

The conference was also a new extension of the "ACSM-UIUC Kinesmetrics1 Symposium Series" created by two organizations to systematically address critical measurement and research issues related to physical activity and health.

The "Walking for Health" conference was exceptionally successful. More than 300 participants from more than 17 countries participated in this 3-d conference. A faculty of 43 internationally recognized scholars and their colleagues presented their latest research at the conference. A variety of topics were covered in 10 sections (with a total of 36 presentations) of the conference including "Walking and public health," "How many steps a day?" "Intervention to increase walking," "Walking assessment devices," "Multilevel modeling of walking," "How many days?" "Assessing subpopulations' walking behaviors," "New techniques and issues in assessing walking behaviors," and "In-depth discussion of issues raised." The conference also included three well-attended preconference workshops with topics on "Agent-based modeling of physical activity behaviors," "Designing/supporting effective community walking programs," and "Validation of a walking behavior measure," respectively. In addition, a total of 107 peer- reviewed or selected posters were presented at the conference. Finally, through the "We Move Kids" program created by the conference, 12 physical education teachers selected from all over the country (Maine to Florida to Washington) attended the conference. They, along with 11 other pedagogy researchers and public health professionals, participated in a roundtable during the conference to discuss how schools and teachers can help promote children's physical activities in school settings.

This supplement is a summary of this timely and fruitful conference. During the conference, selected faculty formed 10 writing teams, and a specific topic was assigned to each team. The team met and developed their writing plans at the conference and completed the manuscripts in the following months. The submitted manuscripts were then reviewed by external reviewers and modified according to the reviewers and consulting editor's comments and suggestions. In addition, a consensus report based on the "We Move Kids" roundtable meeting or discussion was developed. These 11 articles can be organized into the following five themes:

  1. Walking and public health
    • The Importance of Walking to Public Health, by I-Min Lee and David M. Buchner
    • Epidemiology of Walking and Type 2 Diabetes, by Carl J. Caspersen and Janet E. Fulton
  2. Critical measurement issues related to walking
    • Walking and Measurement, by David Bassett, Matthew T. Mahar, David A. Rowe, and James R. Morrow, Jr.
    • Revisiting "How Many Steps are Enough?" by Catrine Tudor-Locke, Yoshiro Hatano, Robert P. Pangrazi, and Minsoo Kang
    • How Many Days Was That? We're Still Not Sure, But We're Asking the Question Better! by Tom Baranowski, Louise C. Mâsse, Brian Ragan, and Gregory Welk
  3. Correlates and intervention of walking behavior
    • Built Environment Correlates of Walking: A Review, by Brian E. Saelens and Susan L. Handy
    • Interventions to Increase Walking Behavior, by David M. Williams, Charles Matthews, Candace Rutt, Melissa A. Napolitano, and Bess H. Marcus
  4. New methods for assessing and modeling walking behavior
    • New Techniques and Issues in Assessing Walking Behavior and Its Contexts, by Patty S. Freedson, Keith Brendley, Barbara E. Ainsworth, Harold W. Kohl III, Eva Leslie, and Neville Owen
    • Multilevel Modeling of Walking Behavior: Advances in Understanding the Interactions of People, Place, and Time, by Abby C. King, William A. Satariano, Jed Marti, and Weimo Zhu
  5. Walking and selected subpopulations and setting
    • Assessing Walking Behaviors of Selected Subpopulations, by Guy C. Le Masurier, Adrian E. Bauman, Charles B. Corbin, James F. Konopack, Renée M. Umstattd, and Richard E. A. van Emmerik
    • "We Move Kids" - The Consensus Report from the Roundtable to Examine Strategies for Promoting Walking in the School Environment, by Wojtek Chodzko-Zajko, Weimo Zhu, Terry Bazzarre, Darla Castelli, Kim Graber, and Amelia Woods

These articles, along poster abstracts which will be published online by ACSM, present the importance of walking to public health and a summary of current "hot" issues in related walking research, which also addresses walking research needs and point out future research directions for the field. The supplement should be a "must-read" document for any researcher and practitioner interested in promoting physical activity and health through walking.

The success of the conference and publication of this supplement could not have happened without the support of many organizations and individuals.

I would like take this opportunity to thank the following:

  • ACSM and UIUC, the sponsor organizations, for their full support;
  • all sponsors for their financial contributions and support;
  • the organization and scientific committees of the conference for their time, advice, and support;
  • all faculty of the conference for their time, contribution, and support;
  • the authors of the articles and abstracts for their time, contributions, and support;
  • all reviewers for their timely assistance, expertise, and contribution;
  • the members in my Kinesmetrics laboratory, Heidi Krahling, Miyoung Lee, Yong Gao, Youngsik Park, Marco S. Boscolo, and Lin Yang, for their time, hard work, and support; and
  • all conference participants for their participation and involvement.

Finally, I want to give my special appreciation to Jane Senior and James R. Whitehead at ACSM and Wojtek Chodzko-Zajko at UIUC for their advice and full support throughout. Without them, the success of the conference would have been impossible.

"Walking gets the feet moving, the blood moving, the mind moving. And movement is life," Carrie Latet said.

REFERENCES

1. Centers for Disease Control and Prevention. Barriers to children walking and biking to school-United States, 1999. MMWR. 2002;51(32):701-4.
2. Eyler AA, Brownson RC, Bacak SJ, Housemann RA. The epidemiology of walking for physical activity in the United States. Med Sci Sports Exerc. 2003;35(9):1529-36.
3. Flegal KM, Carroll MD, Kuczmarski RJ, Johnson CL. Overweight and obesity in the United States: Prevalence and trends, 1960-1994. Int J Obes Relat Metab Disord. 1998;22(1):39-47.
4. McCann B, DeLille B. Mean Streets 2000: Pedestrian Safety, Health and Federal Transportation Spending. Surface Transportation Policy Project, Washington, D.C., 2000. Available at: http://www.transact.org/report.asp?id=132. Accessed May 15, 2007.
5. Ogden CL, Flegal KM, Carroll MD, Johnson CL. Prevalence and Trends in Overweight Among US Children and Adolescents, 1999-2000. JAMA. 2002;288:1728-32.
6. U.S. Department of Transportation. Federal Highway Administration. Our nation's travel: 1995 NPTS early result report. Washington, DC: U.S. Government Printing Office, 1997 (FHWA-PL-97-028).
7. Wang G, Zheng ZJ, Heath G, Macera C, Pratt M, Buchner D. Economic burden of cardiovascular disease associated with excess body weight in U.S. adults. Am J Prev Med. 2002;23(1):1-6.

1Kinesmetrics is a discipline intended to develop and apply measurement theory, statistical, and mathematical analyses to the field of kinesiology.
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