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Active commuting: An easy and effective way to improve health

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... Active commuting (AC) is most often defined as walking, cycling, or other human-powered modes of transport (in-line skating, skateboarding) used for the practical purpose of getting from one place to another in everyday life (1). AC is also perceived as an easy and effective tool to increase the level of daily PA among school-aged children (2,3). Active commuting to school was independently associated with greater levels of PA and lower levels of body fatness and obesity in adolescents. ...
... Strategies to increase PA, such as promoting active school travel, are important (2,4,7). Concurrently, a large body of research has indicated that AC plays an important role in increasing the overall level of PA in children and youth (4,(12)(13)(14)(15), that the promotion of AC should focus on children who spend too much time using a computer, and that attention should also be drawn to safety concerns associated with AC to and from school (12,16). ...
Article
Objective: Overweight and obesity in adolescents is associated with many health risks and considerable direct and indirect healthcare costs. The purpose of this study is to examine trends in the prevalence of overweight and obesity in 11-, 13- and 15-year-old adolescents in the Czech Republic from 1998 to 2014. Methods: Data from five self-reported survey rounds (1998, 2002, 2006, 2010, and 2014) of the Health Behaviour in School-aged Children Study (HBSC) were used to assess trends in overweight and obesity among Czech adolescents. The total sample consisted of 19,103 adolescents (51.2% girls). A logistic regression analysis was used to assess trends in different age and gender categories. Results: From 1998 to 2014 a significant increase in the prevalence of overweight and obesity was observed among boys in all age categories (11 years old 22.2%1998- 28.3%2014; 13 years old 17.9%1998- 26.7%2014; 15 years old 9.8%1998- 20.8%2014) and among 15-year-old girls (6.0%1998- 10.9%2014). None of the age and gender categories showed an overall decrease over the 16-year period. In boys, the prevalence of overweight was significantly higher with steeper negative trends compared with girls. However, stabilization in overweight rates was observed between 2010 and 2014 in all age and gender groups. Conclusion: Nationally representative self-reported data show a significant increase in overweight (including obesity) prevalence among children from 1998 to 2014 in the Czech Republic. The results also suggest stabilization in overweight prevalence between 2010 and 2014. Continuing research is needed to determine future trends while interventions aimed at reducing overweight and obesity in children should be implemented on different levels of public policy.
... No obstante, aún resulta complejo diseñar intervenciones que sean efectivas en incrementar los niveles de AF de la población. Algunos sugieren que desplazarse activamente (ya sea caminar o andar en bicicleta), o también conocido como AF asociada al transporte (transporte activo), podría ser una forma efectiva de incrementar los niveles de AF y cumplir con las recomendaciones internacionales de AF 4 . ...
... Diversos estudios a nivel mundial han demostrado los beneficios del transporte activo, tanto en la reducción de adiposidad, como también en la reducción del riesgo de sufrir enfermedades cardiovasculares [4][5][6][7] . Sin embargo, en Chile no existen estudios en población general que hayan reportado los efectos del transporte activo sobre el riesgo de obesidad y reducción de marcadores de adiposidad. ...
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Background: Active commuting is associated with a lower risk for obesity in developed countries. Aim: To investigate the association between active commuting and obesity risk in Chile. Material and methods: Active commuting was measured using the Global Physical Activity Questionnaire (GPAQ v2) in 5,293 participants from the Chilean National Health Survey 2009-2010. Body mass index (BMI) and waist circumference (WC) were the study outcomes. The association between active commuting and obesity was investigated using linear and logistic regression analysis. Results: Thirty four percent of responders [95% confidence intervals (CI): 32.6-35.1] were passive commuters. Active commuters had a lower BMI and WC than their passive counterparts. Thirty minutes increment in active commuting were associated with a -0.20 kg.m-2 lower BMI [95% CI: -0.33 to -0.07, p < 0.01] and a -076 cm lower WC [95% CI: -1.08 to -0.43, p < 0.01]. The odds of having a BMI > 25 kg.m-2 was 0.93 [95% CI: 0.88 to 0.98, p = 0.01] per every 30 minutes' increment in active commuting, whereas the odds for central obesity was 0.87 [95% CI: 0.82 to 0.92, p < 0.01]. Conclusions: Active commuting is associated with a lower adiposity and lower risk for obesity in Chilean adults.
... Active transportation, such as walking or cycling, is associated with a reduced incidence of cardiovascular disease and mortality [15,16]. Thus, it is an accessible and cheap alternative for more people to become physically active [17]. This type of physical activity can be easily integrated into everyday life, particularly for those not interested in engaging in other kinds of activities such as sports, training in gyms, etc. [18]. ...
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Background Active transportation is a crucial sort of physical activity for developing sustainable environments and provides essential health benefits. This is particularly important in Latin American countries because they present the highest burden of non-communicable diseases relative to other worldwide regions. This study aimed to examine the patterns of active transportation and its association with sociodemographic inequities in Latin American countries. Methods This cross-sectional study was conducted in eight countries. Participants (n = 8547, 18–65 years) self-reported their active transportation (walking, cycling, and total) using the International Physical Activity Questionnaire. Sex, age, ethnicity, socioeconomic level, education level, public and private transport use, and transport mode were used as sociodemographic inequities. Results Participants spent a total of 19.9, 3.1, and 23.3 min/day with walking, cycling, and total active transportation, respectively. Mixed and other ethnicity (Asian, Indigenous, Gypsy, and other), high socioeconomic level as well as middle and high education level presented higher walking than Caucasian, low socioeconomic and education level. Private transport mode and use of ≥ 6 days/week of private transport showed lower walking than public transport mode and ≤ 2 days/week of private transport. Use of ≥ 3 days/week of public transport use presented higher walking than ≤ 2 days/week of public transport. Men had higher cycling for active transportation than women. Use of ≥ 3 days/week of public transport use presented higher cycling than ≤ 2 days/week of public transport. ≥6 days/week showed lower cycling than ≤ 2 days/week of private transport use. Men ( b : 5.57: 95 %CI: 3.89;7.26), black (3.77: 0.23;7.31), mixed (3.20: 1.39;5.00) and other ethnicity (7.30: 2.55;12.04), had higher total active transportation than women and Caucasian. Private transport mode (-7.03: -11.65;-2.41) and ≥ 6 days/week of private transport use (-4.80: -6.91;-0.31) showed lower total active transportation than public transport mode and ≤ 2 days/week of private transport use. Use of 3–5 (5.10: 1.35;8.85) and ≥ 6 days/week (8.90: 3.07;14.73) of public transport use presented higher total active transportation than ≤ 2 days/week of public transport use. Differences among countries were observed. Conclusions Sociodemographic inequities are associated differently with active transportation across Latin American countries. Interventions and policies that target the promotion of active policies transportation essential to consider sociodemographic inequities. Trial registration ClinicalTrials.Gov NCT02226627. Retrospectively registered on August 27, 2014.
... The benefits of physical activity has been extensively represented by leisure time, such as physical exercise, but evidence shows that these benefits can also be obtained through walking or cycling, as "active travel" or "active transportation" [8,9]. Active transportation has been demonstrated to be an excellent strategy for increasing physical activity level, because it is a daily behavior, an opportunity to create a healthy habit and relatively cheap alternative [10,11]. Besides, it can be integrated into everyday life particularly for those not involved or interested in engaging in leisure time physical activity [12]. ...
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Purpose: The aim of this study was to determine the association between active transportation and obesity indicators in adults from eight Latin American countries. Methods: Data from the ELANS study, an observational multi-country study (n: 8336; 18-65 years), were used. Active transportation (walking and cycling) and leisure time physical activity was assessed using the International Physical Activity Questionnaire (long version). The obesity indicators considered were: body mass index, and waist and neck circumference. Results: In the total sample, the average time dedicated to active transportation was 24.3 min/day, with the highest amount of active transportation being Costa Rica (33.5 min/day), and the lowest being Venezuela (15.7 min/day). The countries with the highest proportion of active transportation were Ecuador (71.9%), and the lowest was Venezuela (40.5%). Results from linear regression analyses suggest that active transportation was significantly and independently associated with a lower body mass index (β: -0.033; 95% CI: -0.064; -0.002), but not with waist circumference (β: -0.037; 95% CI: -1.126; 0.390 and neck circumference (β: -0.007; 95% CI: -0.269; 0.130). Conclusions: Active transportation is significantly associated with a lower body mass index. Governments should incentivize this type of transportation as it could help to reduce the obesity pandemic in Latin America.
... These benefits can be obtained by performing structured PA (during leisure-time); but they can also be obtained through using walking or cycling as forms of transportation (hereafter 'active travel') Step It Up, 2015). In fact, walking or cycling may also be a good way for people who are inactive to become active (Andersen, 2016). ...
Article
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Background: Active travel such as walking or cycling has been associated with more favorable health outcomes. However, evidence on patterns of transportation in Latin America is scarce. Therefore, the aim of this study was to quantify and characterise socio-demographic patterns of public, private and active travel in Latin American countries. Methods: Data from the Latin American Study of Nutrition and Health, a population-based, cross- sectional survey conducted in eight Latin American countries including Argentina, Brazil, Chile, Colombia, Costa Rica, Ecuador, Peru and Venezuela (n 1⁄4 9218; age range: 15–65 years). Trans- portation modes include public (bus, taxi, subway and train), private (car and motorcycle) and active (walking and/or cycling). Outcomes for this study include time spent in different modes of transportation. We performed overall and country-specific descriptive analyses to examine dif- ferences by sex, age, socioeconomic and education level. Results: For the overall cohort, public transport represent 34.9% of the total travel time, whereas private, walking and cycling represent 48.2%, 10.6% and 6.3% of the total travel time. Time spent using public travel was highest in Venezuela (48.4%); Peru had the highest proportions of private travel (52.5%); Time spent walking and cycling was highest in Costa Rica (14.8% and 12.2%, respectively). The average travel time spent in public and private transport were 299.5 min/week (95% CI: 292.4307.0) and 379.6 min/week (95% CI: 368.0, 391.5) respectively; figures for walking and cycling were 186.9 min/week (95% CI: 181.8, 191.9) and 201.1 min/ week (95% CI: 187.8, 216.9). Conclusions: Public and private transport were the most common forms of travel in Latin America. Active travel (walking or cycling) represent 17% of total physical activity, therefore, promoting and providing the right infrastructure for active commuting could translate in increasing the population overall levels of physical activity in Latin America.
... These benefits can be obtained by performing structured PA (during leisure-time); but they can also be obtained through using walking or cycling as forms of transportation (hereafter 'active travel') Step It Up, 2015). In fact, walking or cycling may also be a good way for people who are inactive to become active (Andersen, 2016). ...
Article
Full-text available
Background Active travel such as walking or cycling has been associated with more favorable health outcomes. However, evidence on patterns of transportation in Latin America is scarce. Therefore, the aim of this study was to quantify and characterise socio-demographic patterns of public, private and active travel in Latin American countries. Methods Data from the Latin American Study of Nutrition and Health, a population-based, cross-sectional survey conducted in eight Latin American countries including Argentina, Brazil, Chile, Colombia, Costa Rica, Ecuador, Peru and Venezuela (n = 9218; age range: 15–65 years). Transportation modes include public (bus, taxi, subway and train), private (car and motorcycle) and active (walking and/or cycling). Outcomes for this study include time spent in different modes of transportation. We performed overall and country-specific descriptive analyses to examine differences by sex, age, socioeconomic and education level. Results For the overall cohort, public transport represent 34.9% of the total travel time, whereas private, walking and cycling represent 48.2%, 10.6% and 6.3% of the total travel time. Time spent using public travel was highest in Venezuela (48.4%); Peru had the highest proportions of private travel (52.5%); Time spent walking and cycling was highest in Costa Rica (14.8% and 12.2%, respectively). The average travel time spent in public and private transport were 299.5 min/week (95% CI: 292.4307.0) and 379.6 min/week (95% CI: 368.0, 391.5) respectively; figures for walking and cycling were 186.9 min/week (95% CI: 181.8, 191.9) and 201.1 min/week (95% CI: 187.8, 216.9). Conclusions Public and private transport were the most common forms of travel in Latin America. Active travel (walking or cycling) represent 17% of total physical activity, therefore, promoting and providing the right infrastructure for active commuting could translate in increasing the population overall levels of physical activity in Latin America.
... 5 Active travel has promising associations with lower levels of cardiovascular disease (CVD) risk factors, 6 7 and it is a feasible form of physical activity for those who do not enjoy sports. 8 In the systematic review and meta-analysis of Hamer and Chida, 9 active travellers had 11% lower risk of CVD, with a potential for greater effects in women. Further, there appears to be even larger benefits of commuter cycling compared with walking. ...
Article
Objectives We aimed to examine the relationship between cycling (particularly commuter cycling) and risk factors associated with cardiovascular diseases (CVDs) including body composition, blood lipids and cardiorespiratory fitness. This study differed from our recent (Part 1) systematic review in that risk factors for CVD were analysed as continuous variables rather than being present or absent. Design Systematic review and meta-analysis. Eligibility criteria We searched four databases (Web of Science, MEDLINE, SPORTDiscus and Scopus). All quantitative studies, published until August 2017, were included when a general population was investigated, cycling was assessed either in total or as a transportation mode, and CVD risk factors were reported. Methods We analysed body composition, physical activity (PA), cardiorespiratory fitness (CRF), blood lipids and blood pressure (BP). Skinfold, waist circumference and body mass index were analysed and prioritised in that order when more than one measure were available. PA included measures of counts per minutes, moderate-to-vigorous PA or minutes per week. CRF included results of maximal tests with or without expired air or submaximal test. For blood lipids and BP, separate analyses were run for low-density and high-density lipoprotein, triglycerides, total cholesterol, systolic BP and diastolic BP. Studies were excluded when reporting dichotomous outcomes or when cycling and walking were combined. Heterogeneity was investigated using I ² . Results Fifteen studies were included; the majority reported commuter cycling. In total, we included 5775 cyclists and 39 273 non-cyclists. Cyclists had more favourable risk factor levels in body composition −0.08 (95% CI −0.13 to −0.04), PA 0.13 (95% CI 0.06 to 0.20), CRF 0.28 (95% CI 0.22 to 0.35) and blood lipids compared with non-cyclists. There was no sex difference in risk reduction. Conclusion/implication Cycling mitigated the risk factor profile for CVD. A strength of this systematic review is that all the risk factors were analysed as continuous variables. These data provide evidence for practitioners, stakeholders, policy-makers and city planners to accommodate and promote cycling. Systematic review registration PROSPERO CRD42016052421.
... 12 13 However, physical activity can take place in other domains of everyday life 14 and active commuting represents an alternative means for increasing physical activity. 15 16 In the recently published global action plan on physical activity for 2018-2030, WHO recommends to strive for increasing active transport, 17 and policy makers are investing to improve bike infrastructure. 18 19 Still, the current evidence to support beneficial health effects of active commuting by bike is based mainly on observational studies and only a few intervention studies. ...
Article
Objectives To evaluate effects of active bike commuting or leisure-time exercise of two intensities on peripheral insulin sensitivity (primary outcome), cardiorespiratory fitness and intra-abdominal adipose tissue mass (secondary outcomes). Methods 188 physically inactive, healthy women and men (20-45 years) with overweight or class 1 obesity were recruited. In the 6-month trial, 130 participants were randomised to either: no intervention (CON), active commuting (BIKE) or leisure-time exercise of moderate (MOD, 50% VO 2 peak) or vigorous (VIG, 70% VO 2 peak) intensity. 100 completed follow-up testing. Exercise prescription was 5 days/week with a weekly exercise energy expenditure of 1600 kcal for women and 2100 kcal for men. Testing was performed at baseline, 3 months and 6 months. Results Peripheral insulin sensitivity (ml/min/pmol insulin/L) increased (improved) by 24% (95% CI 6% to 46%, p=0.01) in VIG compared with CON at 3 months. Peripheral insulin sensitivity increased (improved) by 20% in BIKE (95% CI 1% to 43%, p=0.04) and 26% in VIG (95% CI 7% to 47%, p<0.01) compared with CON at 6 months. Cardiorespiratory fitness increased in all exercise groups compared with CON at 6 months; but the increase was higher in those that undertook vigorous exercise than those who did moderate exercise. Intra-abdominal adipose tissue mass diminished across all exercise groups in comparison to CON at 6 months. Conclusions Active bike commuting improved cardiometabolic health; as did leisure-time exercise. Leisure-time exercise of vigorous intensity conferred more rapid effects on peripheral insulin sensitivity as well as additional effects on cardiorespiratory fitness than did moderate intensity exercise. Trial registration NCT01962259
... Active transportation, i.e. walking or cycling for transportation purposes, may be a feasible way to incorporate PA into daily routines as it could be conducted not only to school or work, but also to various destinations like the grocery shop or the city centre. In turn, active transportation could increase total PA levels, prevent obesity and promote health [16][17][18]. ...
Article
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Aims: First, to describe the rationale for developing a combined summary score, the Healthy and Sustainable Dietary and Physical Activity habits (HSDPA) score, incorporating four selected dietary and physical activity aspects: (a) the New Nordic Diet, (b) local and sustainable foods, (c) active transportation and (d) non-exercise outdoor activities. Secondly, to describe the experiences from constructing the HSDPA score. Methods: Relevant literature covering the four aspects of interest was reviewed to secure a well-grounded rationale and a theory-based approach. To measure compliance with such a broad approach targeting diet, physical activity, health and environmental sustainability, the HSDPA score was constructed including one subscale for each aspect. The four subscales were constructed from questionnaire items and were equally weighted, entailing a range from 0-10 points, hence the total HSDPA score ranged from 0-40 points. Results: In retrospect, we believe that the rationale for creating the HSDPA score is reasonable. Still, emphasizing fewer, but the most relevant aspects, such as reduced meat consumption and active transportation, may represent a more functional solution than the broad approach suggested herein, both for promoting public health and environmental sustainability, and for developing a feasible measurement tool. Conclusions: Our experiences illustrate the importance of methodological perspectives and scrutiny related to both the development and testing of complex summary scores. Nevertheless, we think that combined summary scores could be applicable for use within epidemiological studies and for measuring the effects of interventions, if accounting for the methodological limitations as far as possible.
... From a public health perspective, exercise is a timeconsuming factor in everyday life. As recently suggested by Andersen [7] and supported by longitudinal and crosssectional data, active commuting may be an easy and effective way to increase daily activity levels [3,[8][9][10][11]. Interestingly, a meta-analysis by Hamer and Chida [12] found a protective effect of active commuting on cardiovascular outcomes (mortality, myocardial infarction, coronary heart disease, hypertension, and stroke), which was more profound among women than men. ...
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Obesity and exercise constitute important factors for cardiovascular disease risk, but the long-term effects of different exercise modalities on haemostatic biomarkers are not well elucidated. We investigated the effects of 6 months of active commuting or leisure-time exercise on measures of fibrin turnover in individuals who are overweight and obese. Ninety younger (20–40 years), sedentary, healthy women and men who are overweight and obese (BMI: 25–35 kg/m ² ) were randomised to 6 months of habitual lifestyle (CON, n=16 ), active commuting (BIKE, n=19 ), or leisure-time exercise of moderate (MOD, ∼50% VO 2 peak reserve, n=31 ) or vigorous intensity (VIG, ∼70% VO 2 peak reserve, n=24 ). Fasting blood samples (baseline and 3 and 6 months) were analysed for cholesterols and triglycerides, thrombin generation, prothrombin fragment 1 + 2, D-dimer, fibrin clot properties, and fibrinolytic activity. We observed no differences between CON, BIKE, MOD, and VIG during the intervention and no time effects for any of the variables measured despite increased VO 2 peak in all exercise groups. We found no difference between CON and all exercise groups combined and no gender-specific effects of exercise. Our findings suggest that thrombin generation capacity, coagulation activation, fibrin clot structure, and lysability are unaffected by long-term active commuting and leisure-time exercise in women and men who are overweight and obese.
... Active transportation, like walking or cycling for transportation purposes, may be a feasible and time efficient way to incorporate PA into daily routines, potentially increasing PA levels [7,8]. Thus, active transportation could promote health [7,[9][10][11][12][13][14][15], prevent obesity [16,17], and decrease future healthcare costs [18]. It has been calculated that increased PA would translate into significant health gains, entailing major socioeconomic gains for the society [19]. ...
Article
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Background: The present study aims to increase bicycling and level of physical activity (PA), and thereby promote health in parents of toddlers, by giving access to different bicycle types. There is a need for greater understanding of e-bikes and their role in the transportation network, and further effects on PA levels and health. Moreover, longtail bikes could meet certain practical needs not fulfilled by e-bikes or traditional bikes, hence increased knowledge regarding their feasibility should be obtained. No previous studies have investigated whether providing an e-bike or a longtail bike over an extended period in a sample of parents of toddlers influence objectively assessed amount of bicycling and total PA level, transportation habits, cardiorespiratory fitness, body composition and blood pressure. Methods: A randomized cross-over trial will be performed, entailing that participants in the intervention group (n = 18) complete the following intervention arms in random order: (i) three months access to an e-bicycle with trailer for child transportation (n = 6), (ii) three months access to a longtail bicycle (n = 6), and (iii) three months access to a regular bicycle with trailer (n = 6), in total nine months. Also, a control group (n = 18) maintaining usual transportation and PA habits will be included. A convenience sample consisting of 36 parents of toddlers residing in Kristiansand municipality, Southern Norway, will be recruited. Total amount of bicycling (distance and time), total level of PA, and transportation habits will be measured at baseline and in connection to each intervention arm. Cardiorespiratory fitness, body composition and blood pressure will be measured at baseline and post-intervention. Main outcome will be bicycling distance and time spent cycling. Discussion: New knowledge relevant for the timely issues of public health and environmental sustainability will be provided among parents of toddlers, representing a target group of greatest importance. There is a call for research on the influence of e-bikes and longtail bikes on travel behavior and PA levels, and whether voluntary cycling could improve health. If the present study reveals promising results, it should be replicated in larger and more representative samples. Eventually, inclusion in national public health policies should be considered. Trial registration: ID NCT03131518 , made public 26.04.2017.
... Many long-term exercise interventions have targeted increases in LTPA [15][16][17][18][19], but physical activity occurs in several different domains of everyday life: at home, during transport, at work and during leisure [20]. Meeting physical activity guidelines in leisure time alone may be challenging [21], so to increase physical activity in other domains of everyday life, such as active commuting, is an attractive alternative [22]. Data from population studies have shown that active commuting is associated with decreased mortality [23], a beneficial cardiovascular profile [24,25], and lower fatness and higher fitness [26]. ...
Article
Regular physical activity is efficacious for improving metabolic health in overweight and obese individuals, yet, many adults lead sedentary lives. Most exercise interventions have targeted leisure time, but physical activity also takes place in other domains of everyday life. Active commuting represents a promising alternative to increase physical activity, but it has yet to be established whether active commuting conveys health benefits on par with leisure time physical activity (LTPA). A 6-month randomized controlled trial was designed to investigate the effects of increased physical activity in transport (bicycling) or leisure time domains (moderate or vigorous intensity endurance exercise). We included 188 overweight and class 1 obese sedentary women and men (20–45 years) of which 130 were randomized to either sedentary controls (n = 18), active commuting (n = 35) or moderate (n = 39) or vigorous (n = 38) intensity LTPA. At baseline and after 3 and 6 months, participants underwent a rigorous 3-day biomedical test regimen followed by free-living measurements. In a sub-sample, physical activity level and energy expenditure were monitored by means of personal assistive technology and the doubly labeled water technique. Additionally, the delivery, reception and routinization of the exercise regimens were investigated by ethnological fieldwork. One year after termination of the intervention, participants will be invited for a follow-up visit to investigate sustained health effects and continuous physical activity adherence. By combining biomedical, technological and humanistic approaches, we aim to understand the health benefits of physical activity in different domains of everyday life, as well as how to improve adherence to physical activity.
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To investigate whether bicycling to school improves cardiometabolic risk factor profile and cardiorespiratory fitness among children. Prospective, blinded, randomised controlled trial. Single centre study in Odense, Denmark 43 children previously not bicycling to school were randomly allocated to control group (n=20) (ie, no change in lifestyle) or intervention group (ie, bicycling to school) (n=23). PRIMARY AND SECONDARY OUTCOME MEASURES: Change in cardiometabolic risk factor score and change in cardiorespiratory fitness. All participants measured at baseline returned at follow-up. Based upon intention-to-treat (ITT) analyses, clustering of cardiometabolic risk factors was lowered by 0.58 SD (95% CI -1.03 to -0.14, p=0.012) in the bicycling group compared to the control group. Cardiorespiratory fitness (l O(2)/min) per se did not increase significantly more in the intervention than in the control group (β=0.0337, 95% CI -0.06 to 0.12, p=0.458). Bicycling to school counteracted a clustering of cardiometabolic risk factors and should thus be recognised as potential prevention of type 2 diabetes mellitus and cardiovascular disease (CVD). The intervention did, however, not elicit a larger increase in cardiorespiratory fitness in the intervention group as compared with the control group. Registered at http://www.clinicaltrials.gov (NCT01236222).
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Cycling to school may potentially increase physical activity level in sedentary children. Transport to school occur twice a day and could improve cardiovascular health in children. Commuter cycling is associated with lower mortality and cardiovascular disease rate in adults, but limited evidence exists in children. Participants were 334 children (age 9.7 ± 0.5 years) who were followed up 6 years later. Mode of travel to school was investigated by questionnaire. Cardiovascular (CVD) risk factors were compared by mode of travel to school both at baseline and at follow up and for subjects who changed mode of transportation. No difference was found between walkers and passive travelers, and these groups were merged in the analysis. A consistent pattern of better CVD risk factor profile in commuter cyclists compared with children using other means of transport was found. Participants, who did not cycle to school at baseline, and who had changed to cycling at follow up, were fitter, had better cholesterol/HDL ratio, better glucose metabolism, and a lower composite CVD risk factor score than those who did not cycle at either time point. Cycling to school may contribute to a better cardiovascular risk factor profile in young people.
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The purpose of this study was to update the evidence on the health benefits of cycling. A systematic review of the literature resulted in 16 cycling-specific studies. Cross-sectional and longitudinal studies showed a clear positive relationship between cycling and cardiorespiratory fitness in youths. Prospective observational studies demonstrated a strong inverse relationship between commuter cycling and all-cause mortality, cancer mortality, and cancer morbidity among middle-aged to elderly subjects. Intervention studies among working-age adults indicated consistent improvements in cardiovascular fitness and some improvements in cardiovascular risk factors due to commuting cycling. Six studies showed a consistent positive dose-response gradient between the amount of cycling and the health benefits. Systematic assessment of the quality of the studies showed most of them to be of moderate to high quality. According to standard criteria used primarily for the assessment of clinical studies, the strength of this evidence was strong for fitness benefits, moderate for benefits in cardiovascular risk factors, and inconclusive for all-cause mortality, coronary heart disease morbidity and mortality, cancer risk, and overweight and obesity. While more intervention research is needed to build a solid knowledge base of the health benefits of cycling, the existing evidence reinforces the current efforts to promote cycling as an important contributor for better population health.
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To assess the effects of interventions to promote walking in individuals and populations. Systematic review. Published and unpublished reports in any language identified by searching 25 electronic databases, by searching websites, reference lists, and existing systematic reviews, and by contacting experts. Systematic search for and appraisal of controlled before and after studies of the effects of any type of intervention on how much people walk, the distribution of effects on walking between social groups, and any associated effects on overall physical activity, fitness, risk factors for disease, health, and wellbeing. We included 19 randomised controlled trials and 29 non-randomised controlled studies. Interventions tailored to people's needs, targeted at the most sedentary or at those most motivated to change, and delivered either at the level of the individual (brief advice, supported use of pedometers, telecommunications) or household (individualised marketing) or through groups, can encourage people to walk more, although the sustainability, generalisability, and clinical benefits of many of these approaches are uncertain. Evidence for the effectiveness of interventions applied to workplaces, schools, communities, or areas typically depends on isolated studies or subgroup analysis. The most successful interventions could increase walking among targeted participants by up to 30-60 minutes a week on average, at least in the short term. From a perspective of improving population health, much of the research currently provides evidence of efficacy rather than effectiveness. Nevertheless, interventions to promote walking could contribute substantially towards increasing the activity levels of the most sedentary.
Article
Background: Physical inactivity is a global pandemic responsible for over 5 million deaths annually through its effects on multiple non-communicable diseases. We aimed to document how objectively measured attributes of the urban environment are related to objectively measured physical activity, in an international sample of adults. Methods: We based our analyses on the International Physical activity and Environment Network (IPEN) adult study, which was a coordinated, international, cross-sectional study. Participants were sampled from neighbourhoods with varied levels of walkability and socioeconomic status. The present analyses of data from the IPEN adult study included 6822 adults aged 18-66 years from 14 cities in ten countries on five continents. Indicators of walkability, public transport access, and park access were assessed in 1·0 km and 0·5 km street network buffers around each participant's residential address with geographic information systems. Mean daily minutes of moderate-to-vigorous-intensity physical activity were measured with 4-7 days of accelerometer monitoring. Associations between environmental attributes and physical activity were estimated using generalised additive mixed models with gamma variance and logarithmic link functions. Results: Four of six environmental attributes were significantly, positively, and linearly related to physical activity in the single variable models: net residential density (exp[b] 1·006 [95% CI 1·003-1·009]; p=0·001), intersection density (1·069 [1·011-1·130]; p=0·019), public transport density (1·037 [1·018-1·056]; p=0·0007), and number of parks (1·146 [1·033-1·272]; p=0·010). Mixed land use and distance to nearest public transport point were not related to physical activity. The difference in physical activity between participants living in the most and least activity-friendly neighbourhoods ranged from 68 min/week to 89 min/week, which represents 45-59% of the 150 min/week recommended by guidelines. Interpretation: Design of urban environments has the potential to contribute substantially to physical activity. Similarity of findings across cities suggests the promise of engaging urban planning, transportation, and parks sectors in efforts to reduce the health burden of the global physical inactivity pandemic. Funding: Funding for coordination of the IPEN adult study, including the present analysis, was provided by the National Cancer Institute of National Institutes of Health (CA127296) with studies in each country funded by different sources.
Article
Sixty-eight previously sedentary volunteers (38 men and 30 women) were randomly divided into active and control groups and subjected to a 10-week programme of walking or cycling while commuting to and from work. The active commuters and the controls complied with the programme on 75-78% and 92% that of cycling 10 km. Cardiorespiratory strain of approximately 50% of maximal oxygen uptake V̇(O2) (max) in walking and 60% of V̇(O2max) in cycling was observed. Statistically consistent improvements caused by active commuting were seen in cardiorespiratory responses to both maximal and submaximal work and in metabolic response to submaximal work. Cycling was more effective than walking. These findings indicate that low-intensity walking and cycling to and from work improved cardiorespiratory and metabolic fitness.
Article
Sixty-eight previously sedentary volunteers (38 men and 30 women) were randomly divided into active and control groups and subjected to a 10-week programme of walking or cycling while commuting to and from work. The active commuters and the controls complied with the programme on 75–78% and 92% of the workdays, respectively. The mean walking distance was 3.5 km and that of cycling 10 km. Cardiorespiratory strain of approximately 50% of maximal oxygen uptake V̇O2max in walking and 60% of V̇O2max in cycling was observed. Statistically consistent improvements caused by active commuting were seen in cardiorespiratory responses to both maximal and submaximal work and in metabolic response to submaximal work. Cycling was more effective than walking. These findings indicate that low-intensity walking and cycling to and from work improved cardiorespiratory and metabolic fitness.
Article
To implement effective non-communicable disease prevention programmes, policy makers need data for physical activity levels and trends. In this report, we describe physical activity levels worldwide with data for adults (15 years or older) from 122 countries and for adolescents (13-15-years-old) from 105 countries. Worldwide, 31·1% (95% CI 30·9-31·2) of adults are physically inactive, with proportions ranging from 17·0% (16·8-17·2) in southeast Asia to about 43% in the Americas and the eastern Mediterranean. Inactivity rises with age, is higher in women than in men, and is increased in high-income countries. The proportion of 13-15-year-olds doing fewer than 60 min of physical activity of moderate to vigorous intensity per day is 80·3% (80·1-80·5); boys are more active than are girls. Continued improvement in monitoring of physical activity would help to guide development of policies and programmes to increase activity levels and to reduce the burden of non-communicable diseases.
Article
Physical activity is associated with low mortality in men, but little is known about the association in women, different age groups, and everyday activity. To evaluate the relationship between levels of physical activity during work, leisure time, cycling to work, and sports participation and all-cause mortality. Prospective study to assess different types of physical activity associated with risk of mortality during follow-up after the subsequent examination. Mean follow-up from examination was 14.5 years. Copenhagen University Hospital, Copenhagen, Denmark. Participants were 13,375 women and 17,265 men, 20 to 93 years of age, who were randomly selected. Physical activity was assessed by self-report, and health status, including blood pressure, total cholesterol level, triglyceride levels, body mass index, smoking, and educational level, was evaluated. All-cause mortality. A total of 2,881 women and 5,668 men died. Compared with the sedentary, age- and sex-adjusted mortality rates in leisure time physical activity groups 2 to 4 were 0.68 (95% confidence interval, 0.64-0.71), 0.61 (95% confidence interval, 0.57-0.66), and 0.53 (95% confidence interval, 0.41-0.68), respectively, with no difference between sexes and age groups. Within the moderately and highly active persons, sports participants experienced only half the mortality of nonparticipants. Bicycling to work decreased risk of mortality in approximately 40% after multivariate adjustment, including leisure time physical activity. Leisure time physical activity was inversely associated with all-cause mortality in both men and women in all age groups. Benefit was found from moderate leisure time physical activity, with further benefit from sports activity and bicycling as transportation.
Article
The role of walking, as compared with vigorous exercise, in the prevention of cardiovascular disease remains controversial. Data for women who are members of minority racial or ethnic groups are particularly sparse. We prospectively examined the total physical-activity score, walking, vigorous exercise, and hours spent sitting as predictors of the incidence of coronary events and total cardiovascular events among 73,743 postmenopausal women 50 to 79 years of age in the Women's Health Initiative Observational Study. At base line, participants were free of diagnosed cardiovascular disease and cancer, and all participants completed detailed questionnaires about physical activity. We documented 345 newly diagnosed cases of coronary heart disease and 1551 total cardiovascular events. An increasing physical-activity score had a strong, graded, inverse association with the risk of both coronary events and total cardiovascular events. There were similar findings among white women and black women. Women in increasing quintiles of energy expenditure measured in metabolic equivalents (the MET score) had age-adjusted relative risks of coronary events of 1.00, 0.73, 0.69, 0.68, and 0.47, respectively (P for trend, <0.001). In multivariate analyses, the inverse gradient between the total MET score and the risk of cardiovascular events remained strong (adjusted relative risks for increasing quintiles, 1.00, 0.89, 0.81, 0.78, and 0.72, respectively; P for trend <0.001). Walking and vigorous exercise were associated with similar risk reductions, and the results did not vary substantially according to race, age, or body-mass index. A brisker walking pace and fewer hours spent sitting daily also predicted lower risk. These prospective data indicate that both walking and vigorous exercise are associated with substantial reductions in the incidence of cardiovascular events among postmenopausal women, irrespective of race or ethnic group, age, and body-mass index. Prolonged sitting predicts increased cardiovascular risk.
Article
Physical activity may help maintain cognitive function in older adults. To examine the relation of long-term regular physical activity, including walking, to cognitive function. Women reported participation in leisure-time physical activities on biennial mailed questionnaires beginning in 1986. We assessed long-term activity by averaging energy expenditures from questionnaires in 1986 through participants' baseline cognitive assessments (1995 to 2001). We used linear regression to estimate adjusted mean differences in baseline cognitive performance and cognitive decline over 2 years, across levels of physical activity and walking. Nurses' Health Study, including 18 766 US women aged 70 to 81 years. Validated telephone assessments of cognition administered twice approximately 2 years apart (1995 to 2001 and 1997 to 2003), including tests of general cognition, verbal memory, category fluency, and attention. Higher levels of activity were associated with better cognitive performance. On a global score combining results of all 6 tests, women in the second through fifth quintiles of energy expenditure scored an average of 0.06, 0.06, 0.09, and 0.10 standard units higher than women in the lowest quintile (P for trend <.001). Compared with women in the lowest physical activity quintile, we found a 20% lower risk of cognitive impairment for women in the highest quintile of activity. Among women performing the equivalent of walking at an easy pace for at least 1.5 h/wk, mean global scores were 0.06 to 0.07 units higher compared with walking less than 40 min/wk (P< or =.003). We also observed less cognitive decline among women who were more active, especially those in the 2 highest quintiles of energy expenditure. Women in the fourth and fifth quintiles had mean changes in global scores that were 0.04 (95% confidence interval, 0.02-0.10) and 0.06 (95% confidence interval, 0.02-0.11) standard units better than those in the lowest quintile. Long-term regular physical activity, including walking, is associated with significantly better cognitive function and less cognitive decline in older women.
Article
The project »Odense: The National Cycling City of Denmark« demonstrates in an urban setting the potential for promoting cycling as a means of transport. Bicycle traffic in the city has increased by 20%, and at the same time accidents involving cyclists have been reduced by 20%. Thus cycling can be health-promoting, and on a large scale injuries can also be reduced. Empirical studies show that the bicycle is not only a means of transport but a form of transport which makes it possible to combine the desire for health, physical well-being and the experience of rural and urban spaces with independence in transport.