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  • Power Walking for Adults: Benefits, Technique & Results

    Power Walking for Adults: Benefits, Technique & Results

    Power Walking for Adults: Benefits, Technique & Results

    You already know how to walk — but power walking might be the smartest cardio upgrade you haven’t tried yet.

    Here’s a number that might surprise you: according to the American Heart Association, physical inactivity contributes to nearly 1 in 10 premature deaths in the United States. And yet, one of the most effective tools for cardiovascular health is something almost every adult can do, requires zero equipment, and can fit into a lunch break — power walking.

    Not strolling through the park. Not window-shopping at a leisurely pace. Power walking is a purposeful, technique-driven form of cardio that sits in a sweet spot between casual walking and running — challenging enough to deliver real results, low-impact enough to be sustainable for decades.

    If you’ve ever written off walking as “not enough,” this article is going to change your mind. You’ll learn what power walking actually is, the science behind why it works, how to do it correctly, and what kind of results you can realistically expect — with a clear plan to get started today.

    Why Power Walking Matters More Than You Think

    Most adults don’t have a motivation problem — they have a sustainability problem. Intense workout programs get started and abandoned. Joints flare up. Schedules don’t cooperate. That’s exactly where power walking earns its place.

    A landmark study published in Arteriosclerosis, Thrombosis, and Vascular Biology — part of the National Runners’ and Walkers’ Health Study — found that brisk walking reduced the risk of hypertension, high cholesterol, diabetes, and coronary heart disease by amounts comparable to running, when energy expenditure was matched. In other words, it’s not the speed that matters most — it’s the effort and consistency.

    Power walking elevates your heart rate into a moderate-to-vigorous aerobic zone, typically between 60-80% of your maximum heart rate. That’s the zone the American College of Sports Medicine (ACSM) recommends for improving cardiovascular fitness, managing weight, and reducing chronic disease risk in healthy adults.

    What makes power walking especially relevant for adults aged 25-60 is the low injury risk. Running carries a reported injury rate of 37-56% per year, largely due to impact forces. Power walking dramatically reduces that stress on knees, hips, and ankles — which makes it a smarter long-term strategy for most people who aren’t competitive athletes.

    It also fits. You can power walk during a lunch break, before work, or after dinner. No gym. No class schedule. No learning curve beyond a few technique adjustments.

    The Science Behind Power Walking and How It Actually Works

    Power walking isn’t just “fast walking.” It’s a specific movement pattern that changes how your body recruits muscles, burns fuel, and responds cardiovascularly.

    The key distinction from regular walking is intentional biomechanics: a faster cadence (steps per minute), an engaged core, active arm drive, and a heel-to-toe stride with full hip extension. These elements together increase oxygen demand and caloric expenditure significantly — without the impact of running.

    Research published in the Journal of Sports Sciences found that walking speed is one of the strongest predictors of metabolic health outcomes in adults. Walkers who moved at a pace classified as brisk or faster (typically above 3.5 mph) showed significantly better cardiovascular markers compared to those walking at slower speeds, even when total steps were similar.

    One common myth worth busting: many people believe you need to be out of breath to benefit from cardio. Power walking challenges that assumption. Because it keeps you in a sustained aerobic zone without pushing into anaerobic thresholds, it’s actually highly effective for fat oxidation — your body’s preferred fuel system during moderate-intensity, sustained movement.

    Harvard Health Publishing notes that a 155-pound person can burn approximately 300-370 calories per hour power walking at a 4 mph pace — comparable to many gym classes. The difference is in the sustainability and accessibility.

    Power walking also engages more muscle groups than people assume. Active arm swing recruits the shoulders, upper back, and core. Maintaining upright posture activates the glutes and hip flexors. A conscious heel-to-toe roll engages the calves and tibialis anterior. This isn’t just a lower-body exercise — done correctly, it’s a functional, full-body movement pattern.

    How to Get Started: Technique and Progression

    Before adding speed or distance, nail the mechanics. Poor technique won’t just limit your results — it can create the exact joint stress you’re trying to avoid.

    Core Technique Checklist:

    • Posture: Stand tall with your chin parallel to the ground. Avoid the forward lean that many people develop when trying to walk fast. Your spine should be neutral, not hunched.
    • Arm swing: Bend your elbows at roughly 90 degrees and drive them back (not across your body). This forward-backward arm action is what separates power walking from regular walking and is key to increasing speed naturally.
    • Foot strike: Land on your heel and roll through to push off with your toes. This heel-to-toe motion activates the full kinetic chain of your lower leg.
    • Hip engagement: Think about driving through your hips with each step. Full hip extension at the back of the stride is what activates the glutes and generates power.
    • Cadence target: Aim for 100-120 steps per minute for brisk walking. Using a metronome app or walking playlist with the right BPM can help you find and hold this rhythm.

    Beginner (Weeks 1-3): Start with 20-minute sessions, 3 days per week. Focus on technique over speed. A 3.0-3.5 mph pace is a solid starting point. You should be able to speak in short sentences — slightly breathless, but not gasping.

    Intermediate (Weeks 4-8): Increase to 30-40 minutes, 4 days per week. Add one incline session per week — even a 5% grade significantly increases caloric burn and lower-body engagement. Target 3.5-4.0 mph on flat terrain.

    Advanced (Week 9+): Incorporate intervals — alternating 2 minutes of maximum-effort power walking with 1 minute of recovery pace. This structure mirrors the principles of interval training and can be layered into your routine 1-2 times per week. For more on interval principles, see Interval Training for Adults: Burn Fat and Build Fitness.

    Common Mistakes That Sabotage Power Walking Results

    Power walking looks simple — and that’s exactly why people underestimate how easy it is to do incorrectly. Here are the most common errors and how to correct them.

    Mistake 1: Taking longer strides instead of faster ones. When people want to speed up, the instinct is to reach further forward with each step. But overstriding actually puts the brake on — it creates impact at the heel and slows your momentum. The fix: keep your stride compact and increase your step rate (cadence) instead. More steps per minute, not longer steps.

    Mistake 2: Skipping the arm drive. Many walkers let their arms hang or swing loosely. This wastes energy and limits your natural speed ceiling. Active arm swing isn’t just for show — it counterbalances your leg movement and rhythmically increases pace. Practice the 90-degree elbow bend and drive each elbow backward with intention.

    Mistake 3: Keeping the same flat route every day. Walking the same course at the same effort level is comfortable — but your body adapts quickly. After 3-4 weeks, the same walk produces fewer cardiovascular and metabolic benefits. Rotate between flat terrain, hills, and interval efforts to keep your body challenged. Adding even a modest incline changes the entire demand profile of the workout.

    Mistake 4: Ignoring recovery. Power walking is low-impact, but it’s still a physical stressor. Adults who go from sedentary to daily power walking often experience calf tightness, shin discomfort, or hip flexor fatigue. Schedule at least 1-2 rest days per week, and include post-walk stretching — especially for the calves, hamstrings, and hip flexors. For a complementary approach, explore Flexibility Training for Adults: Move Better, Feel Stronger.

    Mistake 5: Not tracking intensity. “I went for a walk” is not a training dose. Without tracking pace, duration, or heart rate, it’s impossible to know if you’re progressing. Use a fitness tracker, a phone GPS app, or simply time yourself over a known distance. The data keeps you honest and motivated.

    What to Pair With Power Walking for Better Results

    Power walking is a complete cardiovascular workout on its own — but pairing it with complementary habits amplifies your results significantly.

    Protein intake: The Academy of Nutrition and Dietetics recommends 1.2-1.6 grams of protein per kilogram of body weight per day for active adults. This supports muscle recovery and helps preserve lean mass, especially important as adults age and natural muscle loss accelerates. Prioritize lean sources: chicken, eggs, Greek yogurt, legumes, fish.

    Hydration: The ACSM recommends drinking 16-20 oz of water 2 hours before exercise and 6-12 oz every 20 minutes during activity. Power walking outdoors in warm weather increases sweat loss significantly. Dehydration — even at 2% of body weight — impairs both performance and recovery.

    Strength training: Power walking primarily conditions your cardiovascular system and lower body endurance. Pairing it with 2 days per week of resistance training preserves muscle mass and bone density — both critical concerns for adults over 40. Dumbbell-based routines are an accessible complement. See Dumbbell Training for Adults: Build Strength and Burn Fat for a practical starting point.

    Sleep: Research from the National Sleep Foundation shows that regular moderate exercise improves sleep quality and duration. The relationship works in reverse too — poor sleep impairs recovery, reduces motivation, and increases cortisol levels that can stall fat loss. Aim for 7-9 hours per night as a baseline.

    How Long Until You See Results and What to Track

    Realistic expectations matter. Power walking is a long-game strategy — not a 7-day transformation. Here’s what the research actually supports:

    Weeks 1-2: You’ll likely notice improved energy and slightly better mood. This is largely due to increased endorphin activity and improved sleep quality. Don’t expect visible physical changes yet — but they’re coming.

    Weeks 3-6: Cardiovascular efficiency improves. Many people notice they’re less winded climbing stairs, walking at a faster pace feels easier, and resting heart rate may begin to drop. A 2019 review in the British Journal of Sports Medicine found that even 150 minutes per week of brisk walking produced measurable improvements in VO2 max and blood pressure within 4-6 weeks.

    Weeks 8-12: With consistent effort and appropriate nutrition, body composition changes become visible. Waist circumference, how clothes fit, and energy levels are the most reliable early indicators — not the scale alone, which fluctuates for many reasons.

    Key metrics to track:

    • Resting heart rate (lower is generally better)
    • Average pace per mile over the same route
    • Session duration and weekly total minutes
    • Perceived exertion (how hard a given pace feels over time)
    • Waist-to-hip ratio or how your clothing fits

    If you’ve been consistently power walking 4+ days per week for 12 weeks and see no improvement in any measurable area, it may be time to consult a registered dietitian or certified personal trainer to reassess your approach. Results vary significantly based on starting fitness level, nutrition, sleep quality, and stress load.

    Frequently Asked Questions About Power Walking

    Is power walking as effective as running for weight loss?
    When caloric expenditure is matched, research suggests the outcomes are comparable for cardiovascular health markers. Running burns more calories per minute, but power walking can be sustained longer with far less injury risk — which often means more total weekly activity over time. For many adults, power walking produces better long-term results precisely because they can stick with it.

    How fast do I need to walk for it to count as power walking?
    Most fitness professionals define power walking as a pace between 3.5 and 5.0 mph, with intentional technique — arm drive, engaged core, and heel-to-toe foot strike. For reference, 3.5 mph means covering a mile in about 17 minutes. The “talk test” is a reliable gauge: you should be able to speak in short phrases, but holding a full conversation should require effort.

    Can power walking help with belly fat specifically?
    You can’t spot-reduce fat from any specific area, but research consistently shows that sustained aerobic exercise — including brisk walking — reduces visceral fat (the deep abdominal fat linked to metabolic disease). A study published in the Journal of Nutrition found that brisk walking combined with moderate caloric adjustment was effective at reducing waist circumference over a 12-week period.

    Do I need special shoes for power walking?
    Not necessarily “special,” but appropriate footwear matters. Running shoes with excessive heel cushioning can actually hinder the natural heel-to-toe roll of power walking. Look for walking-specific shoes or neutral running shoes with moderate heel drop and flexible forefoot. Replace them every 300-500 miles — worn-out cushioning is a common cause of shin splints and knee discomfort.

    Can I power walk every day?
    Many healthy adults can power walk daily, especially if they alternate intensity levels — harder sessions 3-4 days and easier recovery walks on others. However, if you’re starting from a sedentary baseline, build up gradually. Daily high-intensity power walking without recovery time is a common cause of early burnout and overuse injuries in beginners.

    Start Walking With Purpose Today

    Power walking isn’t a consolation prize for people who can’t run. It’s a deliberate, science-supported cardiovascular strategy that works — and one that’s accessible at almost any fitness level.

    The research is clear: consistency at moderate intensity beats intensity done sporadically. And power walking, done correctly and progressively, delivers real cardiovascular benefits, supports healthy body composition, and can be sustained for years without the joint wear and tear of higher-impact options.

    Your next step — literally — is a 20-minute walk today with your elbows at 90 degrees, your core gently engaged, and a pace that has you breathing just hard enough to notice. That’s where results begin.

    Small, consistent steps done with intention outperform ambitious plans done sporadically every single time.

    Wellness Disclaimer: This article is for informational and educational purposes only. The content is not intended to replace professional medical, nutritional, or fitness advice. Always consult a qualified healthcare provider, registered dietitian, or certified fitness professional before starting a new health program or making significant changes to your lifestyle.

    Content reviewed by our wellness editorial team, with references to peer-reviewed research and guidelines from leading health organizations.

  • Interval Training for Adults: Burn Fat and Build Fitness

    Interval Training for Adults: Burn Fat and Build Fitness

    Interval Training for Adults: Burn Fat and Build Fitness

    If your workouts feel like they’re taking forever but delivering too little — interval training might be exactly what your routine has been missing.

    You’ve probably heard it before: someone swears they transformed their fitness in half the time by switching up how they train. And while that kind of claim usually deserves a healthy dose of skepticism, there’s a version of it that holds up to science. Interval training — the practice of alternating between periods of higher effort and active recovery — has decades of research behind it, and it consistently delivers measurable improvements in cardiovascular health, fat metabolism, and endurance for everyday adults.

    But there’s a lot of noise out there about what interval training actually is, how hard it needs to be, and whether it’s safe if you’re not already in great shape. Spoiler: it’s far more flexible than most people realize.

    In this guide, you’ll learn the real science behind interval training, how to get started regardless of your current fitness level, the most common mistakes that stall progress, and what realistic results actually look like. No hype, no extreme promises — just practical guidance grounded in evidence.

    Why Interval Training Matters More Than You Think

    The most common reason adults give up on exercise is time. And it’s a legitimate barrier — between work, family, and everything else life throws at you, carving out 60 to 90 minutes for a workout five days a week simply isn’t realistic for most people.

    This is where interval training earns its reputation. Research published in the Journal of Physiology found that short bouts of higher-intensity interval work — even as brief as 10 minutes of actual effort within a 20-minute session — produced comparable cardiovascular adaptations to 45 minutes of moderate continuous exercise in sedentary adults.

    Beyond time efficiency, interval training triggers a phenomenon often called excess post-exercise oxygen consumption, or EPOC. This refers to the elevated rate at which your body continues to consume oxygen — and burn calories — after a session ends. The American College of Sports Medicine (ACSM) notes that higher-intensity interval work tends to produce a greater EPOC response than steady-state cardio, meaning your body keeps working even after you’ve stepped off the treadmill.

    For adults in their 30s, 40s, and 50s, interval training also plays a meaningful role in preserving cardiovascular health. The American Heart Association recommends at least 150 minutes per week of moderate-intensity aerobic activity — and structured intervals can help you hit that target without spending hours in the gym.

    The Science Behind Interval Training: How It Actually Works

    Interval training isn’t just a trendy workout format — it’s a specific physiological stimulus. When you push your body beyond its comfortable aerobic zone for a sustained period, then allow it to partially recover before pushing again, you’re forcing adaptations that steady-state exercise at a single pace simply doesn’t produce at the same rate.

    At the cellular level, intervals stress your mitochondria — the energy-producing structures inside your muscle cells. A landmark study from McMaster University, published in the Journal of Applied Physiology, demonstrated that interval training significantly increased mitochondrial density in skeletal muscle, improving the body’s ability to generate energy aerobically over time. More mitochondria means better endurance, more efficient fat oxidation, and improved overall stamina.

    One persistent myth worth busting: you have to go all-out for intervals to work. In reality, the “intensity” required is relative to your personal fitness baseline. Research shows that working at 70-85% of your maximum heart rate during work intervals — challenging but not maximal — is enough to drive meaningful adaptation in most adults. You don’t need to feel like you’re about to pass out for the training to count.

    Another commonly misunderstood point: intervals are not exclusively a running or cycling thing. Interval principles apply to swimming, rowing, elliptical work, walking (yes, walking intervals are legitimate), and even strength circuit training. The structure — work hard, recover, repeat — is what defines it, not the specific modality.

    How to Get Started With Interval Training

    The biggest mistake beginners make is going too hard too soon. Interval training has a lower floor than most people assume — meaning you can start very conservatively and still see real results.

    Here’s a practical framework to get you started:

    Step 1: Choose Your Modality

    Pick an activity you can sustain for 20-30 minutes: walking, jogging, cycling, swimming, rowing, or even jump rope. The best modality is the one you’ll actually do consistently. If you’re new to exercise or returning after a long break, walking intervals are a legitimate and effective starting point — and you can explore cycling-based interval approaches as you progress.

    Step 2: Start With a Simple 1:2 Work-to-Rest Ratio (Beginner)

    For your first two to three weeks, alternate 30 seconds of increased effort with 60 seconds of easy recovery. Aim for 6 to 8 rounds, bookended by a 5-minute warm-up and 5-minute cooldown. Total session time: around 20-25 minutes.

    Step 3: Progress to a 1:1 Ratio (Intermediate)

    After three to four weeks, when your recovery improves, match your work and rest periods: 45 seconds on, 45 seconds easy, or 1 minute on and 1 minute recovery. Increase rounds to 8-12. ACSM guidelines suggest progressing volume before intensity — more rounds before harder effort.

    Step 4: Explore Structured Protocols (Advanced)

    More structured formats like Tabata (20 seconds on, 10 seconds off, 8 rounds) or traditional HIIT protocols (3-4 minutes hard, 3 minutes easy, repeated 4-6 times) are well-documented in research and appropriate once you’ve built a base. If you’re interested in combining intervals with strength work, resistance band training pairs well with interval-style circuits.

    Step 5: Keep Frequency Realistic

    Two to three interval sessions per week is enough for most adults. More is not always better — adequate recovery between sessions is where much of the adaptation actually happens.

    Common Mistakes That Sabotage Your Interval Training Results

    Even well-intentioned exercisers make these errors regularly — and most of them are easy to correct once you know what to look for.

    Mistake 1: Skipping the Warm-Up
    Jumping into high-effort intervals cold dramatically increases injury risk and blunts performance. Your body needs 5-8 minutes of gradually increasing activity to prep joints, prime the cardiovascular system, and signal your muscles to shift into a higher gear. A rushed warm-up isn’t just ineffective — it’s a common cause of avoidable strain, especially in adults over 40.

    Mistake 2: Making Every Session a Max-Effort Session
    This is one of the most widespread errors in interval training. Going all-out every time leads to accumulated fatigue, poor form in later rounds, and eventually, overtraining symptoms like chronic soreness, poor sleep, and declining performance. Your harder sessions should be genuinely hard — but not every session should hit that ceiling. Alternate between moderate-intensity interval days and more vigorous ones.

    Mistake 3: Neglecting Recovery Intervals
    The recovery portion of interval training isn’t filler — it’s part of the stimulus. Cutting rest short might feel productive, but it prevents your heart rate from returning to the target recovery zone, making the next work interval less effective. Honor your rest periods. They’re doing more than you think.

    Mistake 4: Doing Too Much Too Soon
    Increasing duration, intensity, and frequency simultaneously in the first few weeks is a recipe for burnout and injury. Apply the 10% rule as a starting guideline: don’t increase total weekly volume by more than 10% from one week to the next. It feels slow at first, but it compounds effectively over weeks.

    Mistake 5: Ignoring How You Feel
    Heart rate monitors and fitness trackers are helpful, but your perceived exertion and how your body feels day to day are equally important signals. Interval training should feel challenging but controlled during work periods — if you’re dizzy, nauseous, or feel sharp pain at any point, stop and reassess. Results vary significantly based on individual baseline fitness and health history.

    What to Eat to Support Your Interval Training

    Interval training is more metabolically demanding than a casual walk, and your nutrition should reflect that — without overcomplicating it.

    Before Your Session: A small carbohydrate-containing snack 30-60 minutes before training can improve performance and reduce fatigue. The Academy of Nutrition and Dietetics recommends easily digestible options like a banana with nut butter, oatmeal, or a small whole-grain toast with light toppings. Avoid heavy, high-fat meals within two hours of a session.

    After Your Session: Post-interval recovery depends on protein for muscle repair and carbohydrates to replenish glycogen. Research published in the Journal of the International Society of Sports Nutrition suggests consuming 20-40 grams of protein within an hour or two after a training session supports muscle protein synthesis. Greek yogurt, eggs, a protein shake, or grilled chicken with complex carbs are practical choices.

    Hydration: Even moderate interval sessions can produce significant sweat loss. The ACSM recommends drinking approximately 17-20 oz of water 2-3 hours before exercise, and continuing to hydrate during and after your session based on thirst and body weight changes. For sessions longer than 45-60 minutes, a small amount of electrolytes may help replace sodium and potassium lost through sweat.

    Avoid: Training fasted if you’re newer to intervals — while some experienced athletes train without eating beforehand, beginners often find that low blood sugar mid-session leads to dizziness and poor performance. The USDA Dietary Guidelines support fueling appropriately around physical activity for most adults.

    How Long Until You See Results and What to Track

    Managing expectations is one of the most important parts of any fitness program. Interval training is effective — but it follows a timeline, and that timeline varies by person.

    Week 1-2: You’re likely to notice session-to-session improvements in how you feel during recovery periods. Your heart rate will start returning toward its resting level faster between intervals — this is a real, measurable sign of cardiovascular adaptation.

    Week 3-6: Most adults report improved stamina during daily activities (climbing stairs, carrying groceries), better energy levels on non-training days, and a gradual improvement in how hard they can push during work intervals without feeling destroyed. Research from the British Journal of Sports Medicine suggests that significant cardiovascular markers — including VO2 max improvements — begin to appear within 4-6 weeks of consistent interval training.

    Week 6-12: Body composition changes, if they occur, typically become more visible in this range — particularly when paired with consistent nutrition habits. Muscle tone in the legs and core often improves noticeably. Sleep quality frequently improves as well, particularly when sessions are scheduled earlier in the day.

    What to Track: Resting heart rate (lower over time = good), rate of perceived exertion at a standard effort level (should feel easier over weeks), and session duration before fatigue sets in. You can also track how quickly your heart rate recovers between intervals as a simple performance marker.

    When to Reassess: If after 8 weeks you’re not seeing any improvements in recovery speed or stamina, consider whether you’re doing enough sessions per week, progressing gradually, or sleeping and eating adequately. A session with a certified personal trainer or a check-in with your physician can help identify whether something else is at play.

    Frequently Asked Questions About Interval Training

    Is interval training safe for beginners or people who are out of shape?
    Yes — with appropriate modifications. The key is starting at a low effort level and using a conservative work-to-rest ratio (1:2 or even 1:3). Walking intervals, for example, are a genuinely effective entry point. If you have a cardiovascular condition, hypertension, or joint issues, check with your healthcare provider before starting any new exercise program.

    How is interval training different from HIIT?
    HIIT (High-Intensity Interval Training) is a specific type of interval training where the work periods are performed at near-maximal effort. Interval training is the broader category that includes moderate-intensity intervals, tempo intervals, and other structured formats. HIIT tends to be more demanding and requires more recovery — it’s not always the right starting point for beginners.

    Can I do interval training every day?
    It’s generally not recommended, especially at moderate to high intensity. Your body needs time between sessions to repair and adapt. Two to three sessions per week is a well-supported frequency for most adults, with other days dedicated to lighter activity, strength training, or rest. You can explore Zone 2 cardio as a complement to your interval days — it trains a different energy system and supports recovery.

    Will interval training help me lose weight?
    Interval training can support fat loss when combined with appropriate nutrition — but it’s not a standalone weight management solution. The calorie burn per session can be meaningful, and the EPOC effect adds some additional burn post-session. However, dietary habits, sleep quality, and overall activity levels all play significant roles. Results vary considerably based on individual factors.

    What’s the best time of day to do interval training?
    Research is mixed on whether morning or afternoon training is definitively superior. What matters most is consistency — the best time is the time you can stick to. Many people find that morning sessions help with energy levels throughout the day, while others perform best in the early afternoon when body temperature and muscle function tend to peak.

    Start Small, Stay Consistent, and Let the Science Work

    Interval training isn’t a magic formula — but it is one of the most efficient, flexible, and well-researched tools available for improving your fitness as a busy adult. Whether you’re starting with 20-minute walking intervals or working up to structured HIIT protocols, the underlying principle remains the same: challenge your body, let it recover, and repeat consistently over time.

    You don’t need to overhaul your entire routine tomorrow. Start with two sessions this week using a 1:2 work-to-rest ratio for 20 minutes. Track how your recovery feels between intervals. Give it four weeks before evaluating. Small, consistent steps compound into real, lasting fitness improvements — and that’s a promise the research backs up.

    This article is for informational and educational purposes only. The content is not intended to replace professional medical, nutritional, or fitness advice. Always consult a qualified healthcare provider, registered dietitian, or certified fitness professional before starting a new health program or making significant changes to your lifestyle.

    Content reviewed by our wellness editorial team, with references to peer-reviewed research and guidelines from leading health organizations.