People with a precursor to Type 2 diabetes could reduce their risk of having a heart attack or stroke by walking at a moderate pace for about 20 minutes a day, an international trial suggests.

The study in Friday's online issue the medical journal The Lancet included data from more than 9,000 people in 40 countries with impaired glucose tolerance, a precursor to diabetes that researchers say affects nearly eight per cent of the adults worldwide.  

Each increase of 2,000 more steps a day from the start of the study was associated with a 10 per cent lower risk of cardiovascular disease, after following participants for an average of six years, Dr. Thomas Yates from the University of Leicester in the UK and his co-authors estimated.

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Walking is the most common and preferred choice of physical activity, researchers say. (Mindaugas Kulbis/Associated Press)

"These findings provide the strongest evidence yet for the importance of physical activity in high risk populations and will inform diabetes and cardiovascular disease prevention programs worldwide," said Yates.
"Changing physical activity levels through simply increasing the number of steps taken can substantially reduce the risk of  cardiovascular disease," he added.
The researchers said 531 cardiovascular deaths, heart attacks and non fatal strokes occurred over the six years. 

Adjusting for body mass index, initial activity level, age and sex did not make a difference in the findings.
The findings were from the NAVIGATOR trial, a randomized, placebo-control trial testing two drugs in people with cardiovascular disease, impaired glucose tolerance or another risk factor.
"We believe that the NAVIGATOR trial adds compelling and reassuring evidence for the benefits of physical activity on cardiovascular health," Giuseppe Pugliese and Stefano Balducci from La Sapienza University in Rome said in a commentary published with the study. 
Like the study's authors, the pair said rigorous and objective assessments of physical activity and fitness are needed.
The study was funded by Novartis Pharmaceuticals. Several authors reported receiving funding, or fees for consultation, from Novartis and other pharmaceutical companies. 

With files from Reuters