Background
Lifestyle interventions, including Nordic walking, a whole-body exercise session, are beneficial for metabolic diseases, including diabetes. However, evidence from research studies or meta-analyses on the efficacy of Nordic walking in improving clinical outcomes in patients with diabetes/prediabetes remains inconclusive.
Purpose
This systematic review and meta-analysis investigated the efficiency of Nordic walking on anthropometrics, glycemic control, lipid profiles, blood pressure, and peak oxygen uptake (VO(2)peak) in adults with prediabetes/diabetes.
Methods
A systematic literature search was performed across PubMed, Web of Science, the Cochrane Library, Scopus, and Embase until June 2025. We included randomized controlled trials (RCTs) involving adults with prediabetes or diabetes that compared the Nordic walking effect with a control trial. Data on clinical outcomes, including anthropometrics, glycemic control, lipid profiles, blood pressure, and VO(2)peak, were extracted for meta-analysis and presented as mean difference (MD).
Results
A total of six RCTs, comprising 321 adults with prediabetes or diabetes (63% male), were included in the analysis. Meta-analysis results showed that compared with control, Nordic walking significantly decreased body weight (MD = -0.79 kg, p = 0.02), and marginally reduced waist circumference (MD = -0.82 cm, p = 0.07). Notably, Nordic walking decreased glycated hemoglobin (HbA1c) (MD = -0.37%, p = 0.0001) but showed high heterogeneity (I (2) = 69%). Subgroup analysis revealed a greater reduction of HbA1c in adults with diabetes (MD = -0.49%, p < 0.00001) than that of adults with prediabetes (MD = -0.2%, p = 0.001). However, Nordic walking did not affect fasting blood glucose or homeostasis model assessment of insulin resistance (HOMA-IR). Additionally, Nordic walking significantly increased high-density lipoprotein (HDL) cholesterol (MD = 0.07 mmol/L, p = 0.005), while showing no beneficial effects on total cholesterol, triglycerides, and low-density lipoprotein. Nordic walking appears to improve VO(2)peak but does not affect systolic or diastolic blood pressure.
Conclusions
Nordic walking exerted beneficial effects on body weight, HbA1c, and HDL in adults with prediabetes or diabetes. Our findings support that Nordic walking can be a practical intervention in managing or treating diabetic complications.