“If you are in a bad mood, go for a walk. If you are still in a bad mood, go for another walk.” Those words, widely attributed to the ancient Greek physician Hippocrates are almost certainly apocryphal.
However, they reflect the father of modern medicine’s belief in movement as essential to health.
Hippocrates may not have prescribed walking by name but he advocated exercise as a cornerstone of physical and mental wellbeing. In its modern incarnation, putting one foot in front of the other is a fully fledged category in exercise science. Its range of options is limited only by the imagination.
Among myriad choices:
- Nordic walking: specially designed poles engage the upper body, turning a simple walk into a full-body workout;
- Japanese walking: the latest addition to high-intensity interval training (HIIT) walking;
- Fartlek (the Swedish word for “speed-play”) walking: a less structured form of HIIT;
- “Fart” walking: after a big meal, not to be confused with fartlek walking;
- Weird walking: part mindfulness, part urban scavenger hunt, a fitness trend that emerged in 2023, aimed at walking to spot something strange or amusing; and
- Backwards walking: as the name suggests, it involves putting one foot behind the other.
Other variations make walking a versatile part of the exercise toolkit for mind-body health. All engage different muscles, different bodily systems and suit different needs, as Johannesburg sports physician Jon Patricios explains.
Patricios is professor of sports and exercise medicine at Wits University’s faculty of health science, where he leads the Wits Sports and Health (WiSH) research group. He is one of SA’s leading voices on exercise and preventive healthcare. It’s an understatement to say he advocates for walking.
Patricios calls walking “one of the most beneficial, accessible forms of exercise” with benefits for the heart, brain, joints and life’s most social aspects.
These apply not just to elite athletes, but across the board, regardless of age or fitness level.
“Even low to moderate intensity walking can have a significant impact. Keys are consistency and duration, not intensity alone,” he says.
Unlike most forms of exercise, walking adapts to you and your needs, not the other way around.
Patricios gets to the heart of the matter with cardiovascular benefits: “The heart is a muscle that responds like other muscles do to exercise.”
Walking helps to enlarge the heart, “in a healthy way”. It helps to lower bad cholesterol, raise good cholesterol, reduce blood pressure and significantly cuts heart disease, heart attack and stroke risk.
It improves metabolic health, helps with weight management and reduces the risk of chronic diseases such as diabetes and osteoporosis (bone-thinning disease).
Patients with joint pain, especially those diagnosed with osteoarthritis, are often told to avoid exercise. Patricios sees that as outdated, counterproductive advice.
“Walking is not only safe for people with osteoarthritis,” he says. “It’s actually beneficial.”
People with joint problems think they should rest but inactivity often makes things worse by stiffening the joint. “Cartilage needs load to be preserved and joint fluid needs to circulate,” Patricios says.
Walking and joint health
Walking is a weight-bearing exercise, which is important for joint health, he says. It lubricates joints, strengthens muscles around them and improves mobility. It helps preserve function, reduce pain and improve quality of life for people with joint conditions.
“It’s a very good way of helping to maintain bone density, particularly as one gets older. Movement, done mindfully and consistently, is part of the solution, not the problem.”
Walking is also good for cancer patients. Doctors are diagnosing cancers earlier. The increasing incidence makes accessible interventions that may positively influence prognosis more relevant than before.
Walking is a public health tool, not just a personal one. It is low-risk, high-reward, and available to almost everyone
Patricios shares a striking finding from a Wits study he co-authored with researchers from institutions across three countries, using Discovery Health’s oncology cohort, and published in the British Journal of Sports Medicine in February 2025.
The researchers found that cancer patients who performed regular physical activity before diagnosis for as little as 60 minutes a week had markedly better outcomes. They showed a reduction in adverse cancer outcomes, including disease progression and premature death, of up to 47%, which Patricios calls “quite remarkable”.
The study has novel strengths. It represents one of the largest data sets globally investigating the association between cancer prognosis and physical activity. Researchers also measured physical activity directly, rather than relying on self-reporting.
Patricios is not suggesting walking as a cure for cancer and the researchers note the study’s limitations. It’s observational, in other words, associational, therefore it cannot prove causation.
Its implication is powerfully clear: physical exercise, walking chief among them, is a clinically meaningful intervention with wide-ranging benefits for cancer patients.
“Knowing that as little as 60 minutes of regular weekly exercise may reduce the likelihood of cancer progression by 27% and [premature] death by 47% should encourage all doctors to use exercise as medicine,” says Patricios.
Cognitive benefits of walking
Walking’s cognitive benefits are just as compelling. Patricios cites research showing that it boosts creativity, problem-solving and memory. Problem-solving skills may improve by up to 60%, he says, referencing functional brain scans showing increased blood flow during and after walking.
For older adults, walking helps maintain brain volume and may delay the onset of dementia and Alzheimer’s disease.
“Walking actually helps maintain brain volume. It’s one of the simplest things you can do to protect your cognitive health.”
Social connection
Walking improves mood, reduces anxiety and depression, and helps with sleep. Patricios calls it a “natural antidepressant”.
He highlights the social dimension of walking, which is often overlooked in clinical discussions. “Group walks, park runs, park walks [and] community events all create shared experiences that people enjoy together.”
For those looking to increase intensity, Patricios recommends HIIT walking as an effective way of challenging the body to adapt.
“You can do it by walking briskly for a few minutes then slowing down and repeating that cycle. It improves fitness, metabolic health and insulin resistance.”
Fartlek walking is “playful, informal and effective”. It allows you to alternate walking and running, for example, between landmarks, such as lamp posts.
Japanese interval walking, developed at Fukuoka University, is more structured. It uses a three-minute walk followed by a three-minute run or jog, repeated for 30-60 minutes. It is not intense enough to cause bodily stress, but just enough to stimulate the heart, lungs, and brain. “It showed significant improvements in fitness and metabolic markers,” Patricios says.
Importantly, though the World Health Organisation (WHO) recommends 150-300 minutes of exercise a week, newer research shows benefits of smaller “exercise bites”.
Says Patricios, “think about taking the three flights of stairs to your office”.
Post-meal and backwards walking
On benefits of postprandial “fart walking”, Patricios says there’s some evidence that it might aid digestion and help regulate blood sugar. However, any postprandial exercise should be “of shortest duration and low intensity”. After a big meal, blood is diverted to the gastrointestinal system, so high-intensity exercise is “not ideal”.
The lesser-known practice of walking backwards, Patricios says, involves “quite considerable co-ordination and challenges the brain in unique ways”.
It engages different muscle groups — hamstrings, glutes and calves. It may help with knee health and proprioception — the body’s ability to sense its position, movement and balance in space without needing to look. It raises the risk of falling and should be done only in a safe, preferably flat environment. For most people, “it is not practical”, Patricios says.
His closing messages are simple: “Walking is a public health tool, not just a personal one. It is low-risk, high-reward, and available to almost everyone. It doesn’t matter who you are or [what] your ability [is], you will derive benefits.”
In a world saturated with wellness gimmicks and expensive interventions, walking remains stubbornly low-tech and effective. It’s not just exercise. It is cheap medicine waiting right outside your door. Hippocrates would have heartily endorsed Patricios’ prescriptions.
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