Mortality risk comparing walking pace to handgrip strength and a healthy lifestyle: a UK Biobank Study

Aims Brisk walking and a greater muscle strength have been associated with a longer life; whether these associations are influenced by other lifestyle behaviours, however, is less well known. Methods Information on usual walking pace (self–defined as slow, steady/average, or brisk), dynamometer– assessed handgrip strength, lifestyle behaviours (physical activity, TV viewing, diet, alcohol intake, sleep, and smoking), and body mass index was collected at baseline in 450 888 UK Biobank study participants. We estimated 10–year standardised survival for individual and combined lifestyle behaviours and body mass index across levels of walking pace and handgrip strength. Results Over a median follow–up of 7.0 years, 3808 (1.6%) deaths in women and 6783 (3.2%) in men occurred. Brisk walkers had a survival advantage over slow walkers, irrespective of the degree of engagement in other lifestyle behaviours, except for smoking. Estimated 10–year survival were higher in brisk walkers who otherwise engaged in an unhealthy lifestyle compared to slow walkers who engaged in an otherwise healthy lifestyle: 97.1% (95% confidence interval: 96.9, 97.3) vs 95.0% (94.6, 95.4) in women; 94.8% (94.7, 95.0) vs 93.7% (93.3, 94.2) in men. Body mass index modified the association between walking pace and survival in men, with the largest survival benefits of brisk walking observed in underweight participants. Compared to walking pace, for handgrip strength there was more overlap in 10–year survival across lifestyle behaviours. Conclusion Except for smoking, brisk walkers with an otherwise unhealthy lifestyle have a lower mortality risk than slow walkers with an otherwise healthy lifestyle.