FitProven
Evidence Breakdown
Based on 9 studies
THE BIGGER QUESTION
Whether this one statement holds is settled above. What to actually do about it is a wider question, weighed across every claim that bears on it.
Evidence map
For & against, at a glance
RCT
Pro
Nemoto K et al. · 2007Mayo Clinic ProceedingsThe originating trial of "interval walking training" (IWT), the protocol now circulating as the "Japanese walking method". 246 middle-aged and older adults (60 men, 186 women; mean age 63 ± 6 y) were randomized over 5 months to no training, moderate-intensity continuous walking (~50% peak aerobic capacity, ≥8,000 steps/day, ≥4 days/week), or high-intensity interval walking (alternating 3 min at >70% and 3 min at ~40% peak aerobic capacity, ≥5 sets/day, ≥4 days/week). In the interval group isometric knee extension rose 13%, knee flexion 17%, peak aerobic capacity 8% (cycling) and 9% (walking) — all significantly greater than the continuous-walking group (P<.01) — and the fall in resting systolic blood pressure was larger in the interval group (P=.01); the continuous group differed little from no training. Adherence was poor in both arms (only 11 of 19 men and 31 of 68 women completed the interval protocol), and the trial was single-centre and unblinded.
0.56
The originating trial of "interval walking training" (IWT), the protocol now circulating as the "Japanese walking method". 246 middle-aged and older adults (60 men, 186 women; mean age 63 ± 6 y) were randomized over 5 months to no training, moderate-intensity continuous walking (~50% peak aerobic capacity, ≥8,000 steps/day, ≥4 days/week), or high-intensity interval walking (alternating 3 min at >70% and 3 min at ~40% peak aerobic capacity, ≥5 sets/day, ≥4 days/week). In the interval group isometric knee extension rose 13%, knee flexion 17%, peak aerobic capacity 8% (cycling) and 9% (walking) — all significantly greater than the continuous-walking group (P<.01) — and the fall in resting systolic blood pressure was larger in the interval group (P=.01); the continuous group differed little from no training. Adherence was poor in both arms (only 11 of 19 men and 31 of 68 women completed the interval protocol), and the trial was single-centre and unblinded.
Design RCT (0.8) × quality 0.70 = impact 0.56
View sourceRCT
Neutral
Ichihara Y et al. · 2025Journal of Diabetes InvestigationRandomized controlled trial from Tokushima University — a second research group independent of the Shinshu originators — in 50 people with diabetes and low isometric knee extensor strength, allocated to 5 months of interval fast walking (n=25) or moderate-intensity continuous walking (n=25), both prescribed at 120 min/week. The interval group did **not** gain more knee extension strength than the continuous group (no significant between-group difference in change), directly failing to reproduce the leg-strength result that is the headline of the original 2007 trial. Interval walking did produce significantly greater gains in gait speed (P<0.01) and in the physical component of health-related quality of life (P<0.05). Small sample and a population selected for lower-limb weakness.
0.52
Randomized controlled trial from Tokushima University — a second research group independent of the Shinshu originators — in 50 people with diabetes and low isometric knee extensor strength, allocated to 5 months of interval fast walking (n=25) or moderate-intensity continuous walking (n=25), both prescribed at 120 min/week. The interval group did **not** gain more knee extension strength than the continuous group (no significant between-group difference in change), directly failing to reproduce the leg-strength result that is the headline of the original 2007 trial. Interval walking did produce significantly greater gains in gait speed (P<0.01) and in the physical component of health-related quality of life (P<0.05). Small sample and a population selected for lower-limb weakness.
Design RCT (0.8) × quality 0.65 = impact 0.52
View sourceUmbrella Review
Con
Crowley E et al. · 2022Translational Sports MedicineUmbrella review of 11 systematic reviews and meta-analyses on how training intensity affects VO2max in healthy adults. Every included review found that training raised VO2max at any intensity, but the head-to-head picture is split: three meta-analyses reported small-to-moderate advantages for high-intensity interval training over lower-intensity continuous training (with substantial heterogeneity and suspected publication bias), while three others found the difference trivial or inconclusive. The authors concluded the apparent intensity advantage is "small, trivial, or inconclusive" once confounders are accounted for, and explicitly noted that work-matched training loads are required for accurate comparison — many primary trials did not equalise total training impulse. Interval advantages were larger with 2-4 min intervals, higher volumes, and in older or less-fit participants; younger, fitter people responded comparably or better to continuous training.
0.76
Umbrella review of 11 systematic reviews and meta-analyses on how training intensity affects VO2max in healthy adults. Every included review found that training raised VO2max at any intensity, but the head-to-head picture is split: three meta-analyses reported small-to-moderate advantages for high-intensity interval training over lower-intensity continuous training (with substantial heterogeneity and suspected publication bias), while three others found the difference trivial or inconclusive. The authors concluded the apparent intensity advantage is "small, trivial, or inconclusive" once confounders are accounted for, and explicitly noted that work-matched training loads are required for accurate comparison — many primary trials did not equalise total training impulse. Interval advantages were larger with 2-4 min intervals, higher volumes, and in older or less-fit participants; younger, fitter people responded comparably or better to continuous training.
Design Umbrella Review (0.95) × quality 0.80 = impact 0.76
View sourceMeta-Analysis
Con
Lindner R et al. · 2023International Journal of Sports MedicineSystematic review and meta-analysis comparing moderate-to-vigorous continuous training with high-intensity interval training for VO2max in women. Both modalities raised VO2max substantially from baseline, and the improvements were statistically indistinguishable from one another: continuous training +3.20 ml/kg/min (95% CI 2.73-3.67) versus interval training +3.16 ml/kg/min (95% CI 2.09-4.24), P>0.05. Session frequency improved results for both, and longer intervals outperformed shorter ones. The authors concluded the two are equally effective for improving VO2max in women, with method differences more apparent in younger than older women. Not walking-specific, and interval protocols were heterogeneous.
0.55
Systematic review and meta-analysis comparing moderate-to-vigorous continuous training with high-intensity interval training for VO2max in women. Both modalities raised VO2max substantially from baseline, and the improvements were statistically indistinguishable from one another: continuous training +3.20 ml/kg/min (95% CI 2.73-3.67) versus interval training +3.16 ml/kg/min (95% CI 2.09-4.24), P>0.05. Session frequency improved results for both, and longer intervals outperformed shorter ones. The authors concluded the two are equally effective for improving VO2max in women, with method differences more apparent in younger than older women. Not walking-specific, and interval protocols were heterogeneous.
Design Meta-Analysis (1.0) × quality 0.55 = impact 0.55
View sourceRCT
Pro
Nemoto K et al. · 2007Mayo Clinic ProceedingsThe originating trial of "interval walking training" (IWT), the protocol now circulating as the "Japanese walking method". 246 middle-aged and older adults (60 men, 186 women; mean age 63 ± 6 y) were randomized over 5 months to no training, moderate-intensity continuous walking (~50% peak aerobic capacity, ≥8,000 steps/day, ≥4 days/week), or high-intensity interval walking (alternating 3 min at >70% and 3 min at ~40% peak aerobic capacity, ≥5 sets/day, ≥4 days/week). In the interval group isometric knee extension rose 13%, knee flexion 17%, peak aerobic capacity 8% (cycling) and 9% (walking) — all significantly greater than the continuous-walking group (P<.01) — and the fall in resting systolic blood pressure was larger in the interval group (P=.01); the continuous group differed little from no training. Adherence was poor in both arms (only 11 of 19 men and 31 of 68 women completed the interval protocol), and the trial was single-centre and unblinded.
0.56
The originating trial of "interval walking training" (IWT), the protocol now circulating as the "Japanese walking method". 246 middle-aged and older adults (60 men, 186 women; mean age 63 ± 6 y) were randomized over 5 months to no training, moderate-intensity continuous walking (~50% peak aerobic capacity, ≥8,000 steps/day, ≥4 days/week), or high-intensity interval walking (alternating 3 min at >70% and 3 min at ~40% peak aerobic capacity, ≥5 sets/day, ≥4 days/week). In the interval group isometric knee extension rose 13%, knee flexion 17%, peak aerobic capacity 8% (cycling) and 9% (walking) — all significantly greater than the continuous-walking group (P<.01) — and the fall in resting systolic blood pressure was larger in the interval group (P=.01); the continuous group differed little from no training. Adherence was poor in both arms (only 11 of 19 men and 31 of 68 women completed the interval protocol), and the trial was single-centre and unblinded.
Design RCT (0.8) × quality 0.70 = impact 0.56
View sourceRCT
Neutral
Ichihara Y et al. · 2025Journal of Diabetes InvestigationRandomized controlled trial from Tokushima University — a second research group independent of the Shinshu originators — in 50 people with diabetes and low isometric knee extensor strength, allocated to 5 months of interval fast walking (n=25) or moderate-intensity continuous walking (n=25), both prescribed at 120 min/week. The interval group did **not** gain more knee extension strength than the continuous group (no significant between-group difference in change), directly failing to reproduce the leg-strength result that is the headline of the original 2007 trial. Interval walking did produce significantly greater gains in gait speed (P<0.01) and in the physical component of health-related quality of life (P<0.05). Small sample and a population selected for lower-limb weakness.
0.52
Randomized controlled trial from Tokushima University — a second research group independent of the Shinshu originators — in 50 people with diabetes and low isometric knee extensor strength, allocated to 5 months of interval fast walking (n=25) or moderate-intensity continuous walking (n=25), both prescribed at 120 min/week. The interval group did **not** gain more knee extension strength than the continuous group (no significant between-group difference in change), directly failing to reproduce the leg-strength result that is the headline of the original 2007 trial. Interval walking did produce significantly greater gains in gait speed (P<0.01) and in the physical component of health-related quality of life (P<0.05). Small sample and a population selected for lower-limb weakness.
Design RCT (0.8) × quality 0.65 = impact 0.52
View sourceUmbrella Review
Con
Crowley E et al. · 2022Translational Sports MedicineUmbrella review of 11 systematic reviews and meta-analyses on how training intensity affects VO2max in healthy adults. Every included review found that training raised VO2max at any intensity, but the head-to-head picture is split: three meta-analyses reported small-to-moderate advantages for high-intensity interval training over lower-intensity continuous training (with substantial heterogeneity and suspected publication bias), while three others found the difference trivial or inconclusive. The authors concluded the apparent intensity advantage is "small, trivial, or inconclusive" once confounders are accounted for, and explicitly noted that work-matched training loads are required for accurate comparison — many primary trials did not equalise total training impulse. Interval advantages were larger with 2-4 min intervals, higher volumes, and in older or less-fit participants; younger, fitter people responded comparably or better to continuous training.
0.76
Umbrella review of 11 systematic reviews and meta-analyses on how training intensity affects VO2max in healthy adults. Every included review found that training raised VO2max at any intensity, but the head-to-head picture is split: three meta-analyses reported small-to-moderate advantages for high-intensity interval training over lower-intensity continuous training (with substantial heterogeneity and suspected publication bias), while three others found the difference trivial or inconclusive. The authors concluded the apparent intensity advantage is "small, trivial, or inconclusive" once confounders are accounted for, and explicitly noted that work-matched training loads are required for accurate comparison — many primary trials did not equalise total training impulse. Interval advantages were larger with 2-4 min intervals, higher volumes, and in older or less-fit participants; younger, fitter people responded comparably or better to continuous training.
Design Umbrella Review (0.95) × quality 0.80 = impact 0.76
View sourceMeta-Analysis
Con
Lindner R et al. · 2023International Journal of Sports MedicineSystematic review and meta-analysis comparing moderate-to-vigorous continuous training with high-intensity interval training for VO2max in women. Both modalities raised VO2max substantially from baseline, and the improvements were statistically indistinguishable from one another: continuous training +3.20 ml/kg/min (95% CI 2.73-3.67) versus interval training +3.16 ml/kg/min (95% CI 2.09-4.24), P>0.05. Session frequency improved results for both, and longer intervals outperformed shorter ones. The authors concluded the two are equally effective for improving VO2max in women, with method differences more apparent in younger than older women. Not walking-specific, and interval protocols were heterogeneous.
0.55
Systematic review and meta-analysis comparing moderate-to-vigorous continuous training with high-intensity interval training for VO2max in women. Both modalities raised VO2max substantially from baseline, and the improvements were statistically indistinguishable from one another: continuous training +3.20 ml/kg/min (95% CI 2.73-3.67) versus interval training +3.16 ml/kg/min (95% CI 2.09-4.24), P>0.05. Session frequency improved results for both, and longer intervals outperformed shorter ones. The authors concluded the two are equally effective for improving VO2max in women, with method differences more apparent in younger than older women. Not walking-specific, and interval protocols were heterogeneous.
Design Meta-Analysis (1.0) × quality 0.55 = impact 0.55
View sourceShowing the 4 strongest of 9 studies. Tap any node to expand its detail.
Evidence
PRO (3)
PRO RCTn=2460.70 Nemoto K, Gen-no H et al. (2007)
Interval walking vs continuous walking: isometric knee extension +13%, knee flexion +17%, peak aerobic capacity +8-9%, and a larger fall in resting systolic blood pressure (P = .01); continuous walking barely differed from no training
The originating trial of "interval walking training" (IWT), the protocol now circulating as the "Japanese walking method". 246 middle-aged and older adults (60 men, 186 women; mean age 63 ± 6 y) were randomized over 5 months to no training, moderate-intensity continuous walking (~50% peak aerobic capacity, ≥8,000 steps/day, ≥4 days/week), or high-intensity interval walking (alternating 3 min at >70% and 3 min at ~40% peak aerobic capacity, ≥5 sets/day, ≥4 days/week). In the interval group isometric knee extension rose 13%, knee flexion 17%, peak aerobic capacity 8% (cycling) and 9% (walking) — all significantly greater than the continuous-walking group (P<.01) — and the fall in resting systolic blood pressure was larger in the interval group (P=.01); the continuous group differed little from no training. Adherence was poor in both arms (only 11 of 19 men and 31 of 68 women completed the interval protocol), and the trial was single-centre and unblinded.
Weighted 0.70 — 246 randomised over 5 months — a well-sized trial for this field, and the randomised three-arm design directly isolates interval vs continuous walking. Held below 0.8 because it is single-centre and unblinded, and adherence was poor (only 42 of 87 in the interval arm met the training target), so the reported contrast is vulnerable to selection among completers. Funding could not be verified (paywalled; indexed only as "Research Support, Non-U.S. Gov't").
Mayo Clinic Proceedings
PRO RCTn=270.55 Karstoft K, Winding K et al. (2013)
Interval walking raised VO2max by 16.1 +/- 3.7% and cut body mass, fat mass, visceral fat and mean/maximum CGM glucose (all P <= 0.05), while energy-matched continuous walking changed on no outcome
Independent replication from Copenhagen (not the Shinshu group) and the first to hold energy expenditure constant. 32 adults with type 2 diabetes were randomized to control (n=8), continuous walking (n=12) or interval walking (n=12, alternating 3 min low / 3 min high intensity), training five 60-min sessions per week for 4 months, with accelerometer and heart-rate monitoring confirming that training energy expenditure and mean intensity were comparable between the two walking groups. Only interval walking improved VO2max (+16.1 ± 3.7%, P<0.05), reduced body mass, fat mass and visceral fat (P<0.05), and lowered mean and maximum continuous-glucose-monitor glucose (P=0.05 and P<0.05); the energy-matched continuous walkers changed on no outcome. Small per-arm sample, unblinded, and confined to type 2 diabetes.
Weighted 0.55 — 27 unique participants contributing 32 analysed pre/post trials (control 8, continuous 12, interval 12), because 5 people completed two conditions -- so the arms are small and not fully independent, and the headline n=32 overstates the sample. Unblinded, 4 months, type 2 diabetes only. Its real strength is holding training energy expenditure and mean intensity constant between the walking arms, which isolates the interval PATTERN from total work. Independent of the Shinshu originators and publicly funded.
Funding: Danish Centre for Strategic Research in Type 2 Diabetes (DD2) via the Danish Agency for Science (09-067009, 09-075724); AP Moller Foundation; Trygfonden; European Foundation for the Study of Diabetes
Diabetes Care
PRO Crossover Trialn=14INDUSTRY0.50 Karstoft K, Clark MA et al. (2017)
Interval walking cut maximum glucose by 1.8 mmol/l (P = 0.04) and glycaemic variability (MAGE) by 1.7 mmol/l (P = 0.02), while work-matched continuous walking and the control period produced no significant change
Randomized crossover trial in 14 adults with type 2 diabetes comparing 2 weeks of interval walking (alternating ~59% and ~90% of peak VO2), 2 weeks of continuous walking (~76% of peak VO2) and a control period, with 4-8 week washouts. Critically, the two walking conditions were matched for oxygen consumption, i.e. total aerobic work was held equal. Interval walking reduced maximum glucose (-1.8 mmol/l, P=0.04) and glycaemic variability (MAGE -1.7 mmol/l, P=0.02), with mean glucose trending down (-0.7 mmol/l, P=0.08), while the work-matched continuous walking and the control period produced no significant change. Whole-body oxidative stress (8-iso PGF2α) was unchanged by any condition, so the mechanism behind the interval advantage remains unexplained. Very small sample and only 2 weeks per arm.
Weighted 0.50 — Only 14 participants (13 for CGM after a sensor failure) and just 2 weeks per arm -- the smallest and shortest trial in this literature. Offsetting that, the two walking conditions were matched for oxygen consumption, so total aerobic work was held equal, which is the cleanest available isolation of the interval pattern itself. Type 2 diabetes only; no duality of interest declared; the mechanism remains unexplained since oxidative stress was unchanged.
Funding: TrygFonden; Danish National Research Foundation (DNRF55); Novo Nordisk Foundation; Augustinus Fonden; Diabetesforeningen; Krista og Viggo Petersens Fond
Diabetologia
AGAINST (2)
AGAINST Umbrella Review0.80 Crowley E, Powell C et al. (2022)
Training raised VO2max at every intensity; the head-to-head advantage of high-intensity interval training over continuous training was judged 'small, trivial, or inconclusive' — 3 of the pooled reviews favoured HIIT, 3 found the difference trivial or inconclusive
Umbrella review of 11 systematic reviews and meta-analyses on how training intensity affects VO2max in healthy adults. Every included review found that training raised VO2max at any intensity, but the head-to-head picture is split: three meta-analyses reported small-to-moderate advantages for high-intensity interval training over lower-intensity continuous training (with substantial heterogeneity and suspected publication bias), while three others found the difference trivial or inconclusive. The authors concluded the apparent intensity advantage is "small, trivial, or inconclusive" once confounders are accounted for, and explicitly noted that work-matched training loads are required for accurate comparison — many primary trials did not equalise total training impulse. Interval advantages were larger with 2-4 min intervals, higher volumes, and in older or less-fit participants; younger, fitter people responded comparably or better to continuous training.
Weighted 0.80 — k=11 systematic reviews covering 179 primary studies; the umbrella review never aggregates a pooled participant total, so the field is omitted. Independent (University of Limerick) with no declared conflicts, and unusually candid — it flags substantial heterogeneity, suspected publication bias in the reviews favouring HIIT, and the fact that many primary trials failed to work-match total training load. High multiplier, but capped because the synthesis can only be as good as the inconsistent reviews beneath it.
Funding: independent
Translational Sports Medicine
AGAINST Meta-Analysis0.55 Lindner R, Raj IS et al. (2023)
VO2max +3.20 ml/kg/min (95% CI 2.73-3.67) with continuous training vs +3.16 (95% CI 2.09-4.24) with interval training; difference not significant (P>0.05)
Systematic review and meta-analysis comparing moderate-to-vigorous continuous training with high-intensity interval training for VO2max in women. Both modalities raised VO2max substantially from baseline, and the improvements were statistically indistinguishable from one another: continuous training +3.20 ml/kg/min (95% CI 2.73-3.67) versus interval training +3.16 ml/kg/min (95% CI 2.09-4.24), P>0.05. Session frequency improved results for both, and longer intervals outperformed shorter ones. The authors concluded the two are equally effective for improving VO2max in women, with method differences more apparent in younger than older women. Not walking-specific, and interval protocols were heterogeneous.
Weighted 0.55 — k=20 trials, 584 participants, all-female and previously untrained cohorts. Cochrane RoB: no included study was low risk across all seven domains, and most were high risk for performance bias; the trials were small and the continuous-vs-interval comparisons were not always work-matched. Independent (the paper states it involved no financial support), but the underlying evidence base is weak and not walking-specific.
International Journal of Sports Medicine
NEUTRAL (4)
NEUTRAL RCTn=460.65 Ichihara Y, Mori H et al. (2025)
No between-group difference in knee extensor strength (the primary outcome); interval walking did improve gait speed (P < 0.01) and the physical component of quality of life (P < 0.05) over continuous walking
Randomized controlled trial from Tokushima University — a second research group independent of the Shinshu originators — in 50 people with diabetes and low isometric knee extensor strength, allocated to 5 months of interval fast walking (n=25) or moderate-intensity continuous walking (n=25), both prescribed at 120 min/week. The interval group did not gain more knee extension strength than the continuous group (no significant between-group difference in change), directly failing to reproduce the leg-strength result that is the headline of the original 2007 trial. Interval walking did produce significantly greater gains in gait speed (P<0.01) and in the physical component of health-related quality of life (P<0.05). Small sample and a population selected for lower-limb weakness.
Weighted 0.65 — 50 randomised but 46 analysed (25 continuous / 21 interval) -- all four dropouts fell in the interval arm, so attrition is differential. Unblinded, and fast-walking adherence reached only 62.1% of target, which biases the headline null on strength toward the null. Its value is independence: a second group, unconnected to the Shinshu originators, failing to reproduce their signature result.
Funding: Japan Association for Diabetes Education and Care (grant 2021-ELD-004)
Journal of Diabetes Investigation
NEUTRAL Prospective Cohortn=6790.45 Masuki S, Morikawa M et al. (2019)
peak aerobic capacity rose ~14% and the lifestyle-related disease score fell ~17%; fast-walking time drove the gains, with roughly 50 min/week of high-intensity walking needed before peak aerobic capacity improved meaningfully
Dose-response analysis of 679 middle-aged and older adults (65 ± 7 y) drawn from the Shinshu group's decade-long interval walking training database, all of whom completed 5 months of training with walking intensity and duration logged by accelerometer. On average peak aerobic capacity rose ~14% and the lifestyle-related disease score fell ~17%. The key finding is that fast-walking time was the determinant of the gains — roughly 50 min/week of high-intensity walking was needed before peak aerobic capacity improved meaningfully — while slow-walking time and total step count contributed little. Observational and uncontrolled with respect to a continuous-walking arm, but it isolates high-intensity time, rather than the interval structure itself, as the active ingredient.
Weighted 0.45 — 679 adults completing 5 months of training with accelerometer-logged intensity — a genuinely useful dose-response dataset. But it is single-arm and uncontrolled with no continuous-walking comparator, and the dose-response runs on self-selected walking volume, so fitter or more motivated participants confound the gradient; peak aerobic capacity was accelerometer-estimated, not laboratory-measured. Publicly funded (Shinshu University Partnership Project, MEXT, JSPS, Japanese Ministry of Health, Labour and Welfare, Matsumoto City) with no competing interests declared.
Funding: Japan Society for the Promotion of Science (grant 18H04083), Shinshu University, and the Japanese Ministry of Health, Labour and Welfare
Mayo Clinic Proceedings
NEUTRAL Non-Randomized Trialn=6660.45 Morikawa M, Okazaki K et al. (2011)
peak aerobic capacity, thigh muscle strength, blood pressure, body weight, BMI, body fat and blood glucose all improved significantly (P<0.05), with the composite lifestyle-related disease score falling ~20%; blood lipids were the exception
Large uncontrolled field study from the Shinshu University group: 666 middle-aged and older adults (~65 y) completed 4-5 months of interval walking training (≥5 sets of 3 min fast at ≥70% VO2peak alternating with 3 min slow at ~40% VO2peak, ≥4 days/week). Peak aerobic capacity, thigh muscle strength, blood pressure, body weight, BMI, body fat and blood glucose all improved significantly (P<0.05), with a composite lifestyle-related-disease score falling ~20% on average; blood lipids were the exception. Gains were largest in participants with the lowest baseline fitness. There was no continuous-walking comparison group and no randomization, so this establishes that interval walking works, not that it beats walking steadily.
Weighted 0.45 — 666 analysed out of 826 who started — roughly 19% were dropped for incomplete measurements, a complete-case analysis with no intention-to-treat. Large for a field study, but uncontrolled: a before-versus-after design with no continuous-walking and no non-training comparison group, so it establishes that interval walking works, not that it beats walking steadily. No funding statement could be retrieved (paywalled, and the indexed record names no funder), so funding is omitted rather than assumed.
British Journal of Sports Medicine
NEUTRAL Prospective Cohortn=6960.45 Masuki S, Mori M et al. (2015)
~70% adherence over 22 months, with a ~12% increase in peak aerobic capacity and ~13% reduction in lifestyle-related disease score; adherence was predicted by lower baseline BMI and male sex (both P<0.0001)
Cohort analysis of 696 middle-aged and older adults (65 ± 7 y) enrolled in a 22-month interval walking training programme supported by an IT monitoring system. Average adherence was ~70% of the prescribed 4 days/week over the 22 months, and adherence tracked outcomes: a ~12% increase in peak aerobic capacity and a ~13% reduction in lifestyle-related disease score. Determinants of higher adherence were lower baseline BMI and male sex (both P<0.0001), plus non-smoking and a V1a receptor polymorphism in men. Relevant to long-term feasibility, but there is no continuous-walking comparator, and adherence was supported by technology and staff contact that a self-directed walker would not have.
Weighted 0.45 — 696 adults over 22 months — a large and unusually long adherence dataset — but observational, with no sedentary and no continuous-walking control group, and peak aerobic capacity was estimated from an accelerometer rather than measured in a laboratory (values run ~20% below true maximum). Adherence was propped up by IT monitoring and staff contact that a self-directed walker would not have. Publicly funded (MEXT, JSPS and the Japanese Ministry of Health, Labour and Welfare) with no conflicts declared, though the group's protocol depends on a commercial accelerometer.
Funding: Ministry of Education, Culture, Sports, Science and Technology (MEXT), Japan; Japan Society for the Promotion of Science (JSPS, grant 24689014); Japanese Ministry of Health, Labour and Welfare (grant H17-Chohju-Ippan-016)
Journal of Applied Physiology