Work up to walking 45 to 60 minutes at a time several times a week, walking as slowly as you need to.

Set your own pace: Heart patients who take long, slow walks improve their health.

RODALE NEWS, EMMAUS, PA—A new study involving heart patients found that by walking longer distances, more slowly and more frequently than is usually prescribed in cardiac rehab, people with heart problems can make more significant strides toward recovery than even their cardiologists might anticipate.

THE DETAILS: Researchers from the University of Vermont College of Medicine in Burlington followed 74 overweight men and women with heart disease, all of whom received weight-loss counseling and were taking blood pressure and cholesterol medications. Half the participants were assigned to a new exercise regimen designed to burn 3,000 to 3,500 calories a week (via walking 45 to 60 minutes a day, five to seven times a week); the other half followed a standard cardiac rehab regimen meant to burn 700 to 800 calories a week (via walking 25 to 40 minutes a day, three times a week, at a brisker pace).

After five months, the folks who walked longer, slower, and more frequently lost an average of 18 pounds; the standard rehab regimen group, less than half that, averaging 8 pounds. Plus, the longer walkers lost more body fat and inches from their waistlines, and their cholesterol, blood pressure, and insulin-sensitivity readings improved significantly more than those of the standard rehab group. “The most important thing we found is that we improved the insulin sensitivity of the longer walkers, so we distanced them from being diabetic,” says lead study author Philip A. Ades, MD, director of cardiac rehabilitation and prevention at the University of Vermont College of Medicine. “When you do that, a whole host of risk factors for heart disease gets a lot better.”

WHAT IT MEANS: More exercise works better—a notion which, while seemingly intuitive, nevertheless represents a new direction in cardiac rehab. “Twenty or 30 years ago, when cardiac rehabs were first getting started, obesity wasn’t nearly as much of a problem as it is now,” shares Dr. Ades, “and heart patients stayed in the hospital, laid up in bed, much longer than they do now. So when the protocols were developed, getting people fit after all that inactivity was the primary goal, not losing weight.