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Published on: March 7, 2019
Association between active commuting and incident cardiovascular disease, cancer, and mortality: prospective cohort
Carlos A Celis-Morales1, Donald M Lyall2, Paul Welsh1
1Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow G12 8TA, UK.
Insights
Active commuting, especially cycling, significantly lowers the risk of cardiovascular disease (CVD), cancer, and all-cause mortality. Walking also reduces CVD risk, highlighting the health benefits of active travel for disease prevention and longevity.
Area of Science:
- Public Health
- Epidemiology
- Preventive Medicine
Background:
- Active commuting (walking, cycling) is promoted for health benefits.
- Sedentary commuting is linked to increased chronic disease risk.
- Understanding the specific impact of different active commuting modes on major health outcomes is crucial.
Purpose of the Study:
- To investigate the association between active commuting and incident cardiovascular disease (CVD), cancer, and all-cause mortality.
- To differentiate the health impacts of cycling versus walking as primary modes of active commuting.
- To assess the role of mixed-mode active commuting in disease risk reduction.
Main Methods:
- Prospective population-based study utilizing UK Biobank data.
- Involved 263,450 participants with detailed commuting mode information (active vs. non-active).
- Follow-up for incident CVD, cancer, and all-cause mortality over a median of 5.0 years.
Main Results:
- Cycle commuting was associated with significantly lower risks of all-cause mortality (HR 0.59), cancer incidence (HR 0.55), and cancer mortality (HR 0.60).
- Both cycling and walking commuting were linked to reduced risk of CVD incidence (cycling HR 0.54, walking HR 0.73) and CVD mortality (cycling HR 0.48, walking HR 0.64).
- No significant associations were found for walking commuting with all-cause mortality or cancer outcomes.
Conclusions:
- Cycle commuting demonstrates substantial benefits, reducing risks for CVD, cancer, and overall mortality.
- Walking commuting offers significant protection against cardiovascular disease, independent of confounding factors.
- Promoting active commuting, particularly cycling, is a viable strategy to mitigate the burden of major chronic diseases and reduce mortality.
Abstract:
Objective To investigate the association between active commuting and incident cardiovascular disease (CVD), cancer, and all cause mortality.Design Prospective population based study. Setting UK Biobank.Participants 263 450 participants (106 674 (52%) women; mean age 52.6), recruited from 22 sites across the UK. The exposure variable was the mode of transport used (walking, cycling, mixed mode v non-active (car or public transport)) to commute to and from work on a typical day.Main outcome measures Incident (fatal and non-fatal) CVD and cancer, and deaths from CVD, cancer, or any causes.Results 2430 participants died (496 were related to CVD and 1126 to cancer) over a median of 5.0 years (interquartile range 4.3-5.5) follow-up. There were 3748 cancer and 1110 CVD events. In maximally adjusted models, commuting by cycle and by mixed mode including cycling were associated with lower risk of all cause mortality (cycling hazard ratio 0.59, 95% confidence interval 0.42 to 0.83, P=0.002; mixed mode cycling 0.76, 0.58 to 1.00, P<0.05), cancer incidence (cycling 0.55, 0.44 to 0.69, P<0.001; mixed mode cycling 0.64, 0.45 to 0.91, P=0.01), and cancer mortality (cycling 0.60, 0.40 to 0.90, P=0.01; mixed mode cycling 0.68, 0.57 to 0.81, P<0.001). Commuting by cycling and walking were associated with a lower risk of CVD incidence (cycling 0.54, 0.33 to 0.88, P=0.01; walking 0.73, 0.54 to 0.99, P=0.04) and CVD mortality (cycling 0.48, 0.25 to 0.92, P=0.03; walking 0.64, 0.45 to 0.91, P=0.01). No statistically significant associations were observed for walking commuting and all cause mortality or cancer outcomes. Mixed mode commuting including walking was not noticeably associated with any of the measured outcomes.Conclusions Cycle commuting was associated with a lower risk of CVD, cancer, and all cause mortality. Walking commuting was associated with a lower risk of CVD independent of major measured confounding factors. Initiatives to encourage and support active commuting could reduce risk of death and the burden of important chronic conditions.
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