Pick up the pace! Slow walkers four times more likely to die from COVID-19, study finds

[Klaralven]

The study of 412,596 middle-aged UK Biobank participants examined the relative association of body mass index (BMI) and self-reported walking pace with the risk of contracting severe COVID-19 and COVID-19 mortality.

The analysis found slow walkers of a normal weight to be almost 2.5 times more likely to develop severe COVID-19 and 3.75 times more likely to die from the virus than normal weight fast walkers.

Professor Yates, Lead Researcher for the study and a Professor of Physical Activity, Sedentary Behaviour and Health at the University of Leicester said:

"We know already that obesity and frailty are key risk factors for COVID-19 outcomes. This is the first study to show that slow walkers have a much higher risk of contracting severe COVID-19 outcomes, irrespective of their weight.

https://www.sciencedaily.com/releases/2021/03/210316083755.htm

[womanofthehills]

1. My friend's brother-in-law - a daily runner aged 50 just died of Covid

and a really obese Facebook friend just barely had any symptoms.

[Ms. Toad]

9. It's really unpredictable -

And there are a lot of indications that it is not BMI that creates the risk - but other conditions that often co-exist with obesity.

[Celerity]

14. diabetes for sure is a serious comorbidity nt

[Ms. Toad]

18. But I come from a very long line of diabetes -

everyone who descended from my grandfather who is my age or older has (type 2) diabetes. About half are skinny as a rail. So, while type 2 diabetes does co-exist with obesity in a lot of people - there are many obese people who are not diabetic, and some versions of type 2 diabetes that are unrelated to weight.

So while BMI may be correlated with a higher risk, it is not necessarily the cause of higher risk (so it may not be a risk, in the absence of other comorbidities).

[Celerity]

20. You are working in a reverse fashion from what I was, I meant that the odds are pretty high

if you are obese (and certainly morbidly so) that you are also diabetic or in end stage pre-diabetes.

In general, your odds of having heath problems (from any one or more of many areas) are increased when you are obese, and massively so when you are morbidly obese.

[Ms. Toad]

22. I am intentionally working in the reverse fashion.

Because there is such prejudice against people who are obese, or even just overweight, I look first to actual diseases. I know far too many people whose medical complaints are dismissed because it is assumed the complaints are merely the product of obesity, when they are cancer, or other severe medical conditions that non-overweight people acquire with similar frequency - most of whom are are diagnosed in a timely fashion because they aren't just dismissed as being caused by being fat.

[Celerity]

26. that has no logical bearing on my scientific point I made, and it is not prejudice

I am not here to get involved in a debate over your issues, sorry

My points stand as scientifically valid, their logic is sound.


cheers

[Ms. Toad]

27. Only about 30% of obese people have type 2 diabetes

so your assertion that "if you are obese (and certainly morbidly so) that you are also diabetic or in end stage pre-diabetes" is simply inaccurate.

And it is not "my issue" - It is a serious health concern that when the medical profession treats obesity as the root of all evil it frequently leads to inadequaate medical care, including delaying diagnosis for a whole host of serious health conditions (including cancer).

[Celerity]

28. Now you literally misquoted me

So done here

Goodbye

[Ms. Toad]

29. No. I literally (as in copy/paste) quoted you.

Your comment:

I meant that the odds are pretty high

if you are obese (and certainly morbidly so) that you are also diabetic or in end stage pre-diabetes.

My quote:

so your assertion that "if you are obese (and certainly morbidly so) that you are also diabetic or in end stage pre-diabetes" is simply inaccurate.

If you want me to add the introductory phrase, "I meant that the odds are pretty high" It doesn't help you, since the odds are only 3 in 10.

[Celerity]

30. you are playing cleverclogs games with my statement

what I said was

I meant that the odds are pretty high if you are obese (and certainly morbidly so) that you are also diabetic or in end stage pre-diabetes

Now, counting all, NOT just obese (counting just obese and morbidly obese, the rate is even higher)


Half of Americans have diabetes or a high risk for it — and many of them are unaware

https://www.latimes.com/science/sciencenow/la-sci-sn-diabetes-in-america-20170718-htmlstory.html





also

(and this is from 2017, 4 years ago, and with a year plus of COVID and the resultant lock down for millions upon millions and reduced physical activity/poor diet for many, I am sure it is worse)

[Ms. Toad]

31. I'm not playing games at all.

Just using your words, and noting that they are not accurate.

[Celerity]

32. you left out parts, and then made incorrect claims based off that

my statement was accurate when taken as a whole

[Ms. Toad]

33. 30% is not "pretty high odds" so it was not accurate as a whole.

Which is precisely my point. The assumption that obesity means the presence of certain disdases - or that obesity means that no other medical cause exists for symptoms both lead to inadequate medical care.

(no excerpt)

Risk of misdiagnosis, health-related quality of life, and BMI in patients who are overweight with doctor-diagnosed asthma

I read their stories as they came in—frank and heartbreaking tales, too often told by loved ones who survived the fat people they’d lost to misdiagnosis. Cancer, multiple sclerosis, thyroid conditions. And every time, the doctor’s recommendation was the same: “Just lose weight.”

https://medium.com/s/story/the-bias-epidemic-8f27e79bd21c

That happened to a patient who eventually went to see Dr. Scott Kahan, an obesity specialist at Georgetown University. The patient, a 46-year-old woman, suddenly found it almost impossible to walk from her bedroom to her kitchen. Those few steps left her gasping for breath. Frightened, she went to a local urgent care center, where the doctor said she had a lot of weight pressing on her lungs. The only thing wrong with her, the doctor said, was that she was fat.

“I started to cry,” said the woman, who asked not to be named to protect her privacy. “I said: ‘I don’t have a sudden weight pressing on my lungs. I’m really scared. I’m not able to breathe.’”

“That’s the problem with obesity,” she said the doctor told her. “Have you ever considered going on a diet?”

It turned out that the woman had several small blood clots in her lungs, a life-threatening condition, Dr. Kahan said.

https://www.nytimes.com/2016/09/26/health/obese-patients-health-care.html

When she was 17, Hiles developed bronchitis and walking pneumonia, which turned into daily coughing attacks. "Doctors said, 'If you lost weight, you wouldn't have this many coughing fits,'" she recalled.

"I was very active, but I wasn't losing weight and my breathing was just getting worse," she explained, noting she danced and was naturally active on campus. "Any time I went to see the doctor to figure out why I couldn't shake this cold or that cold, I was given an antibiotic and told to lose weight."

Her coughing fits became so severe she was unable to control her bladder and had to resort to wearing adult diapers. In addition, the coughing often resulted in vomiting. And still, doctors responded with, "We don't know what to tell you — it's clearly just weight-related."

. . .

Hiles was 23 when her new primary care physician suggested she see another kind of doctor. . . But before she could see the pulmonologist, Hiles had another bloody coughing fit, which landed her in the ER and ultimately led doctors to find a tumor in her bronchial tube. Hiles was forced to have surgery to remove her entire left lung, which was black and rotting with dead tissue.

Fat people aren't shocked a doctor diagnosed a woman with cancer as 'just fat'

These are examples of the phenomenon that form the basis of the subthread I started.

[Celerity]

34. You keep leaving out the 2nd part.

Your 30% figure is wrong as I said either diabetic OR late stage pre diabetic.

[SergeStorms]

2. Just what we need...

more people running around without looking where they're going. I went to the supermarket yesterday and I was lucky to get out alive. Everyone was just cutting around corners without looking if anyone was coming the other way. Absolutely no courtesy or consideration on display whatsoever.

[Ocelot II]

3. How slow is slow walking vs. fast walking?

[spooky3]

4. Misleading! There is no indication at the linked site that this study ascertained

cause and effect. The authors didn't show that walking pace causes COVID severity. It appears the authors simply measured correlation at a given point in time, and may not have controlled other variables. If so, there are many possible explanations of this correlation. For example, underlying health problems, or increasing age, could cause both slower walking and severity of COVID-19.

[nocoincidences]

5. Thank you!

You just saved me having to compose a post saying exactly what you said.

[spooky3]

7. LOL! :-)

[Mr.Bill]

37. Exactly.

It's just like saying people with poor vision are more likely to have more severe Covid symptoms.

[hlthe2b]

6. Full of confounding. Slow walkers also include those with osteoarthritis that also affects the young

and lean (former?) athletes.

If one wants to look at associated risk among the obese? Fine. BMI is at least a reasonable proxy. Self-reported slow walking (alone) is not.

[muriel_volestrangler]

10. The study has references about walking pace being a good proxy for fitness

Walking pace is a central indicator of whole-body physical fitness, frailty, reserve and resilience [6], with self-reported walking pace consistently found to be strongly associated with cardiorespiratory fitness, cardiovascular mortality and all-cause mortality, along with being a powerful marker of longevity [6,7,8,9,10]. Indeed, self-reported walking pace has been shown to be a stronger predictor of cardiovascular mortality than other measures of physical activity or function [9, 10], with self-reported slow walkers having a low life expectancy even in those with normal weight [8]. These findings suggest that self-reported walking pace acts as a simple easy to collect measure of overall physical health status. However, although well researched with cardiovascular and all-cause mortality outcomes, this hypothesis has not been established for infectious disease.

https://www.nature.com/articles/s41366-021-00771-z

[hlthe2b]

11. It is a confounded measure. BMI is an imperfect proxy for obesity (the extremely muscular

will be coded as obese), but it can be addressed with other variables. To use walking speed alone as a measure of fitness is far more problematic. So, no. The epidemiologic literature (not "Nature" would disagree). Walking distance and regularity may well be a far more accurate assessment, along with adjustment for other fitness activities (e.g., cycling) especially for a significant subpopulation. Alternately, nearly every elite athlete with walking-related disabilities or injuries would be assessed as unfit and thus assumed at risk for severe adverse outcomes from COVID-19. Not to mention the tons of other unaddressed confounding factors, from preexisting disease & conditions to concurrent medications to nutritional deficiencies impacting immunity to...

The study in the OP is ridiculously confounded--along the lines of the infamous comparison of Utah v Nevada populations that would have you conclude "gambling causes cancer." I know you are British, but look up the differences in Utah v Nevada populations if this is not obvious to you as the ultimate example of confounding.

[muriel_volestrangler]

12. No, that's really a ridiculous comparison - "along the lines of 'gambling causes cancer'"

If you think that walking distance and regularity may well be a far more accurate assessment, you could do a study to investigate that, but the point is there are already studies showing that "self-reported walking pace has been shown to be a stronger predictor of cardiovascular mortality than other measures of physical activity or function".

Elite athletes are a tiny proportion of the population, and would not affect such a study.

"Medical history, including prevalent illnesses, were assessed by interview during baseline visit; ethnicity was self-reported and social deprivation defined by the Townsend Index (a composite measure of deprivation based on unemployment, non-car ownership, non-home ownership, and household overcrowding; negative values represent less deprivation)."

[hlthe2b]

39. It is the classic example used to teach those who do not understand the concept of confounding

as you, apparently do not. Yes, for anyone who understands epidemiological concepts it is the ultimate ridiculous example of correlation that does not equate to "cause and effect," but instead may be a relationship MASKED by unrelated factors--that is why it is used to teach the concept.

[muriel_volestrangler]

40. You are ignoring that brisk walking is an indicator of basic fitness

You think they are unrelated, but you're wrong. Gambling and cancer are indeed unrelated, but pretending that the relationship between walking pace and health is the equivalent of gambling and cancer is the ridiculous thing in this thread.

[hlthe2b]

41. It is a confounded proxy, inadequate without including additional variables to adjust for their .

affects or synergistic relationship. Some might argue skin color to be an adequate proxy for income and socioeconomic status (if you were rather race-ignorant) because percentage-wise more white Americans are wealthy. It is a confounded measure because of course other factors influence SES in the US and we surely have our share of poor white populations.

Correlation does not equate to causation and a well-conducted study adjusts for confounding, including in their choice of proxy variables. "Nature," which excels in presenting basic science studies/bench science studies, mostly drops the ball on epidemiological studies, generally publishing mere correlational, i.e., ecological studies based on trends To not learn these concepts will leave you increasingly "confounded," yourself.

As a Brit, there are well-done epi studies for you to learn from. Hell, even the original smoking and cancer study conducted by Sir Richard Doll and Sir Brandford Hill would a great starting place for you to learn these concepts. And, the BMJ, Lancet, and many other British journals can teach you what constitutes well-conducted epidemiological studies. Perhaps you may spend some time reading there. Then pull the fully discredited Andrew Wakefield's infamous MMR and autism study to see the impacts of poorly conducted epidemiology and why these concepts are so important.

[pnwmom]

38. Exactly. n/t

[Elwood P Dowd]

8. I go for a 35-40 minute walk just about every day

weather permitting. When I check the pace it's usually about 100-105 steps a minute. So, is that considered fast or slow?

[muriel_volestrangler]

13. "Brisk" was defined as over 4mph, slow under 3

so if you can work out your speed, you'll know how they'd categorize you. I would think it comes in the 'medium' category.

[Johnny2X2X]

15. In shape people

Not all that controversial, in shape people walk faster. We've already known that people in better shape survive all sorts of illnesses better than people out of shape.

The US has an obesity epidemic, we've been talking about if for decades, but no one is offering effective solutions yet. Obesity is the #1 health crisis in our country, it should be talked about everyday at a high level.

[Karma13612]

16. Agree!

And it would help if cities put up more cross walks at signaled intersections.

Hubby and I like to do ‘urban crawls” when we visit cities we are not familiar with. We park our car, and walk most places. We have found that some towns and cities don’t like to have cross walks at their intersections.

Makes for very scary walking experiences if traffic is heavy or there are multiple lanes in each direction.

Even though walking has become fairly ubiquitous in some areas, many are not evolved yet. And we could work on more bike paths as well.

Maybe with this new administration, we could have more incentives for cities and towns to make themselves walk/bike friendly.
Locally, there is a bike path on our street. Yet many cyclists still use the road because the bike path has to yield to motorists at each intersection. If you are on the street, then the motorists on the side streets must yield to them. And you can get a better speed on the street because it is straight and flat, while the bike path winds a bit and follows an uneven contour of the road.

Much to do.

[Johnny2X2X]

17. Public transportation

Public transportation is a huge factor. I know that sounds counterintuitive, but when you're in a country or city with great trains or buses, you're constantly walking to the train station or bus stop. People in Germany for instance walk several blocks whenever they go anywhere in a city. And their attitude about what is close by is totally different. Going to clubs in Berlin, my German friends would tell me, "Oh, it's so close, just get off at that stop and head north you can't miss it, it's only 12 blocks." 12 blocks? That's quite a haul.

Americans walk to their garage, get in their cars, drive, and park 100 feet from where they're going.

But I think our toxic food supply is the biggest factor. We consume too much added sugar and our portions are ridiculous in size here in America. And on top of that, we eat too quickly.

[Karma13612]

23. +1000 no question about it! ..nt

[llmart]

24. +1000

I could not agree more! Even here on DU it's not considered "nice" or politically correct to say that someone who is overweight or obese without someone jumping right in to chastise you about how liberals are supposed to be compassionate, etc. I don't believe it's right to make fun of someone who's obese (except Trump of course - all bets are off with him), but pointing out that we have an epidemic of obesity and with each passing generation it's getting worse is also criticized. For me, I'm mostly just concerned with the fact that being overweight or obese leads to so many health problems, least of which is type 2 diabetes, that we are all paying the price for it in the cost of medical insurance and care.

I'm 72 and been the same weight since I was about 12 other than my two pregnancies of course. I also get daily exercise - outside - even in winter in Michigan. I take zero meds and never have, and have no disease or illness except for vision problems. People in this country eat too damned much and convince themselves that they don't.

[Johnny2X2X]

25. Good for you

It's a lot more than self discipline though IMO. I think people are addicted to sugar in the US and have no idea they are and no idea the effects. The sugar addiction makes people eat when they are not really hungry and it makes people gorge themselves at one sitting and snack throughout the day.

I went to high school in the 80s, I could count on 1 hand the number of obese people in my class of 200 kids. Went to see a buddy's kid play high school football a couple years ago and the crowd was filled with obese kids, like 1 of every 4 would have been the heaviest kid that I went to high school with. It's a combination of a lot of things. But it is an absolute crisis and we need to start making some progress. When this generation of kids start to age, the impact on the health care system is going to be devastating.

My parents are a case study. My dad was a health nut his whole life, he was a national level distance runner, when he was 48 years old he could still run a 4:37 mile. When his knees went bad from all of the running he took up biking, and now at the age of 78 he bikes 30-40 miles 4 or 5 times a week. And when people picture an old man biking, they aren't picturing my dad, he's pushing himself and climbing hills standing up while passing younger people. My mom, never really exercised, never ate well, she was overweight the last 40 years, now at 78 her health is awful and her quality of life is for shit. Dad does everything, enjoys life and if cancer never comes could live to 100. Mom will be lucky to see 80.

[Celerity]

36. +100000

[Celerity]

35. Great post.

Don't let the denialists grind you down.

[Johnny2X2X]

42. Thanks, another point people miss

I have been heavier at times. The one thing fit people don't understand is how truly awful exercise is for obese people. For someone really out of shape, exercising vigorously means you are going to feel terrible for maybe days. And not just sore, you'll have headaches, be sick to your stomach, and will barely be able to function. I also think this has to do with sugar addiction.

Even now that I'm in pretty good shape it's easy for me to forget how hard exercise was for me 40 pounds heavier. And I wasn't extremely overweight. Have a disabled vet friend who is probably 250 lbs overweight, exercise could literally kill him right now. It's not as easy as "just exercising daily." You can get to a point where exercise isn't even a realistic option, then what do you do?

[CTyankee]

19. I "banked" my bone strength doing Jazzercise 3x per week for about 10 years. It has paid well.

Now I cycle away on my stationary bike several times a day while i am distracted watching TV. I lose track of the time. It is especially helpful for my knees, which are arthritic. I do my back exercises in bed before I get up each morning. That helps me avoid low back pain from the arthritis and puts me in a better mood to take on the day!

[MineralMan]

21. Sounds like correlation rather than causation.

Many reasons exist for a slow walking pace, like age, weight, medical conditions, etc. So walking slowly might not cause a higher death rate from the Covid virus. It's more likely to be the underlying reason for walking slowly.

[ananda]

43. Slow walkers... seriously?!!

Researchers must be really desperate for something
to research, no matter how stupid and insane.

[milestogo]

44. This makes me want to scream.

Surely slow walking is better than no walking.

And how do you get to fast walking without starting somewhere?

Walk faster, or you will die.