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Oct. 11, 2000 -- The next time you're ready to tee off, consider the results of a new study. Walking the golf course has numerous health benefits for middle-aged adults, according to a recent report in The American Journal of Medicine. But if you decide to forgo the cart, it's a good idea to check with the doctor first, especially if you have risk factors for heart disease.

The findings also shed light on the value of low- to moderate-intensity exercise. "Many studies suggest that vigorous exercise is needed to improve aerobic fitness, but better endurance maybe a more important goal for everyday life," says lead author Jari Parkkari, MD, PhD, chief physician at Finland's Tampere Sports Medicine Research Center. "Walking not only improves endurance, but reduces the risk of heart disease as well," he tells WebMD.

In fact, walking 18 holes twice a week improved many risk factors among men. "By burning 1,750 calories a round, HDL 'good cholesterol' rose 5%, LDL 'bad cholesterol' fell 4%, and total cholesterol fell 2%. They also lost 5 lb and reduced abdominal fat by 8%, all in five months," Parkkari says. Of course, pulling a handcart full of golf clubs for 10 miles a week isn't a good idea for everyone.

"Because walking doubles the load on the heart, it can cause symptoms quicker in those at risk for [heart problems]," says cardiologist and marathon runner Paul Robinson, MD, a 67-year-old associate professor at Emory University School of Medicine in Atlanta. "Most middle-aged adults can start a walking program without any difficulty," he cautions, "but check with your doctor if you're a smoker or have any of these risk factors":

"If you're at risk, your doctor can give you an exercise prescription," Robinson tells WebMD. "And even if you don't have risk factors, but have been physically inactive, it's probably a good idea to just walk nine holes at first. And by all means, get help quickly if you develop any of the following symptoms," he advises:

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