A study published in the open-access journal PLOS ONE analyzed data from the Centers for Disease Control and Prevention Behavioral Risk Factor Surveillance System, drawing on survey responses from almost 400,000 U.S. adults. The objective was to know which leisure-time physical activities people prefer and whether those options align with federal activity guidelines.

Walking is most popular but not the most effective for fitness goals

The results were notable. Walking appeared as the most frequently reported leisure-time physical activity across both urban and rural groups. In fact, roughly 44.1% of adults indicated that walking was their main form of exercise.

However, popularity did not translate into achieving recommended health standards. Based on the analysis, individuals who primarily walked had the highest likelihood of not meeting either aerobic or muscle-strengthening guidelines compared with other exercise categories. Even more significant, only about one in four walkers (25%) satisfied both recommended benchmarks, while approximately 22% failed to meet either requirement at all. In contrast, participants who reported running, resistance training, or conditioning workouts as their primary activities were considerably more likely to achieve federal physical activity targets.

What the guidelines actually require

The American College of Sports Medicine recommends that adults get:

• At least 150 minutes per week of moderate-intensity aerobic activity
• Plus muscle-strengthening exercises on two to three days per week

While walking can contribute to aerobic activity mainly if done briskly, it generally does not fulfill the strength-training requirement on its own.

Rural vs urban differences in activity patterns

The study also revealed geographic variations in exercise behavior. Rural residents were more likely to participate in activities such as gardening, hunting, and fishing, whereas urban residents showed higher engagement in running, cycling, dancing, and weight training. Despite differing preferences, urban participants were overall more likely to meet both aerobic and strength-based guidelines compared to rural populations. Researchers suggest that access to facilities, infrastructure availability, and cultural influences may contribute to these differences.

Why this matters: muscle is a key part of health

A key takeaway from the study is that physical activity guidelines are not just about movement, but about different types of movement. Walking supports cardiovascular fitness and daily activity levels, but it does not significantly develop or preserve muscle mass. This distinction is important because muscle deterioration begins gradually with age. Research indicates that adults may lose around 3% to 8% of muscle mass per decade after age 30, a condition known as sarcopenia. This decline is associated with slower metabolism, increased fat storage, reduced mobility, and higher risk of falls and fractures in later life.

Resistance training helps counteract this decline. Studies show it can increase lean muscle mass, boost resting metabolic rate by approximately 7%, and reduce body fat. A large meta-analysis also found resistance training linked to:

• 15% lower risk of all-cause mortality
• 19% lower cardiovascular disease mortality
• 14% lower cancer mortality

The most notable benefits were observed with around 60 minutes per week of resistance exercise, making it a time-efficient health strategy. Additionally, resistance training supports mental well-being by improving mood and increasing BDNF (brain-derived neurotrophic factor), which promotes brain health and neural growth.

What truly makes the difference

The study aligns with broader longevity research suggesting that higher-effort activities tend to deliver stronger physiological benefits.

Running, weight training, and conditioning workouts share a common feature: they sufficiently challenge the body to trigger adaptation. Walking, although beneficial, generally remains in a lower-intensity range that may not fully satisfy all fitness requirements on its own.

In practical terms:

• Walking supports general cardiovascular health, mental well-being, and daily movement
• Resistance training builds and preserves muscle, supports metabolism, and reduces age-related decline
• Higher-intensity cardio (running, cycling, HIIT) improves cardiovascular fitness more efficiently and helps meet aerobic goals faster

Expert perspective from the study

The researchers emphasized that the findings are not meant to discourage walking but to emphasize gaps between perception and results.

As lead researcher Christiaan Abildso explained:

“We expected to see that walking would continue to be the most common physical activity. However, it was surprising to see that nearly one in four adults who walk as their main activity did not meet either of the physical activity guidelines. That is, they reported less than the recommended 150 minutes per week of moderate-intensity aerobic activity and fewer than the recommended two days per week of muscle-strengthening activity, such as yoga or exercises with resistance bands,”

He also pointed to wider environmental and structural elements influencing activity levels:

“What we might be seeing in these rural–urban differences in preferences may just reflect what people have access to or what is culturally supported. In our work, we see a need to continue to support our partners in small towns and rural places by creating physical, social, and cultural conditions that support physical activity. This could mean creating a wide shoulder on a country road for running and cycling, helping a senior centre with their chair exercise programming, creating or improving park spaces, expanding the national network of rail trails, renovating abandoned and dilapidated structures (brownfields) into viable activity centres, keeping school facilities open to the public, and many other strategies. Everyone needs to ask, ‘how does what we’re doing affect physical activity?’, in order to help get people more active, more often, in more places,”

FAQs:

1. Is walking good for health?
Yes, walking supports heart health and general well-being. It is a low-impact activity suitable for most people.

2. Can walking replace all exercise?
Not entirely, because it does not build muscle strength effectively. A balanced routine usually includes strength training.

A combination of exercise and an energy-boosting supplement may improve physical fitness in children and adults with Friedreich’s ataxia (FA), although the added benefit of the supplement over exercise alone remains unclear, according to results from a clinical trial.

Those who participated in a 12-week program combining aerobic and strength training with nicotinamide riboside supplementation saw a significant increase in cardiopulmonary fitness, the body’s ability to supply oxygen to muscles during physical activity, compared with trial participants who did not exercise and received a placebo.

However, researchers found no significant difference between the combination group and participants who followed the same exercise program without supplementation, indicating the study did not show a clear added benefit of the supplement beyond exercise alone.

“The combination of nicotinamide riboside plus exercise for 12 weeks was safe and increased cardiopulmonary fitness in children and adults with Friedreich’s ataxia,” the researchers wrote. “Longer studies are needed to establish whether adding nicotinamide riboside to exercise could be considered as part of a long-term, comprehensive treatment approach.”

The study, “Safety and efficacy of individualised exercise and NAD⁺ precursor supplementation in patients with Friedreich’s ataxia in the USA: a single-centre, 2 × 2 factorial, randomised controlled trial,” was published in The Lancet Neurology.

Fatigue, safety worries limit participation

FA is caused by mutations that reduce the production of frataxin, a protein needed for cells to generate energy. When frataxin levels are too low, cells in energy-demanding tissues, such as the nervous system, heart, and muscles, gradually deteriorate, leading to FA symptoms including impaired coordination, fatigue, muscle weakness, and difficulty walking. People with FA also have markedly reduced cardiopulmonary fitness.

Although current guidelines recommend exercise to help manage symptoms, clinical evidence in people with FA is limited, and participation is often low due to barriers such as fatigue and safety concerns, the researchers noted.

Studies in other conditions have shown that supplementation with NAD+ precursors — compounds that raise levels of NAD+, a molecule involved in cellular energy production — can improve muscle function. These findings have raised the possibility that increasing NAD+ might complement or enhance the benefits of exercise alone. However, there’s limited research on whether these therapies might improve FA patients’ ability to exercise.

The team of researchers in the U.S. conducted a 12-week clinical trial (NCT04192136) involving 66 people with FA enrolled at a single center in Philadelphia from September 2020 to April 2025.

Half of the participants were children, ages 10 to 17, and half were adults, ages 18 and older. Most (56%) were male. The overall mean age was 20.3. At the start of the study, participants generally had lower-than-average muscle mass and slightly higher body fat compared with reference values for the general population.

Participants were randomly assigned to one of four groups: 17 received a placebo and served as controls, 17 received only the NAD+ precursor nicotinamide riboside, 16 followed a structured exercise program and were given a placebo, and 16 followed the exercise program in addition to supplementation with nicotinamide riboside. All participants completed the study.

The exercise program consisted of three aerobic and two resistance training sessions per week, performed at home under remote supervision. Participants took nicotinamide riboside or placebo orally each day using weight-based dosing: one capsule (300 mg) for patients weighing 24-48 kg (about 53-110 lbs) and three capsules (900 mg) for patients weighing more than 72 kg (about 159 lbs). The study’s main goal was to assess changes in peak oxygen uptake (VO₂), a key measure of cardiopulmonary fitness.

At the end of the 12-week program, participants who received both exercise and nicotinamide riboside showed the greatest improvements in cardiopulmonary fitness. Peak VO₂ increased by 13.2% in the combination group, compared with a 3.9% decline in the control group.

VO₂ rose by 9.5% with exercise alone and 5% with nicotinamide riboside alone, but those changes were not statistically significant compared with controls.

The combination was not significantly more effective than exercise alone, indicating no clear added benefit from the supplement.

Some secondary measures improved. Compared with controls, the combination group reached higher maximum workloads during exercise, and oxygen pulse — a measure of how efficiently the body uses oxygen — improved in both the combination and exercise-only groups. Participants in the combination group also reported spending more time in physical activity and leisure exercise.

The interventions were generally safe and well-tolerated. No serious adverse events were reported, and all side effects were mild or moderate. The most common ones were skin problems (53%), gastrointestinal symptoms (45%), upper respiratory infections (35%), and falls (20%).

Falls, a known barrier to exercise in FA, occurred at similar rates across all groups, and no increase in heart-related or other adverse events was seen in participants assigned to exercise.

In an accompanying commentary, “Targeting exercise, energy, or both in Friedreich’s ataxia,” published in The Lancet Neurology, two researchers in Germany highlighted the study’s implications.

The trial’s findings extend existing clinical evidence on the benefits of exercise in FA by using an objective measure of fitness, such as peak VO₂, and by demonstrating that a home-based intervention is feasible, they wrote. Further studies “are needed to determine durability and clinical significance of fitness gains and to clarify any incremental contribution of nicotinamide riboside beyond structured exercise,” they said.