Effects of Walking on LDL Cholesterol and Cardiometabolic Risk Factors in Postmenopausal Women: A Scoping Review

Abstract

Background: Postmenopausal women face an increased risk of cardiovascular disease. While aerobic physical activity is widely recommended, the specific effect of walking on low-density lipoprotein cholesterol (LDL-C) remains unclear. LDL-C is a key modifiable cardiovascular risk factor, yet it has been inconsistently evaluated in exercise-focused studies. This scoping review aimed to examine LDL-C as a cardiometabolic outcome in studies evaluating walking-based aerobic interventions among postmenopausal women.

Methods: A scoping review was conducted between April and June 2025, following PRISMA guidelines. PubMed, Embase, Scopus, and the Cochrane Library were systematically searched for studies published between 2010 and 2025. Eligible studies included randomized controlled trials, cohort, and cross-sectional studies evaluating walking as an aerobic intervention in postmenopausal women and reporting outcomes on LDL-C (primary outcome), body mass index (BMI), or glucose (secondary outcomes). Two reviewers independently screened studies and assessed risk of bias using RoB 2 and the Newcastle–Ottawa Scale.

 Results: Nine studies comprising 3,629 postmenopausal women aged 45–75 years met the inclusion criteria, with walking defined as aerobic physical activity performed at a moderate intensity threshold. Interventions varied in duration, intensity, and supervision. Only two studies reported significant reductions in LDL-C, whereas six found no significant change. BMI reductions were observed in three studies, and all three studies reporting glucose outcomes demonstrated improvement. Substantial heterogeneity in study design and intervention protocols limited comparability, and most studies were judged to be at high risk of bias.

Conclusions: Walking-based aerobic interventions may improve some cardiometabolic markers in postmenopausal women; however, effects on LDL-C are inconsistent. Future studies should employ standardized walking protocols, ensure adequate intervention duration and supervision, and consistently assess LDL-C over time to clarify its role as a cardiovascular risk marker in this population.