The association of cycling with all-cause, cardiovascular and cancer mortality: findings from the population-based EPIC-Norfolk cohort

Shannon Sahlqvist, Anna Goodman, Rebecca K Simmons, Kay-Tee Khaw, Nick Cavill, Charlie Foster, Robert Luben, Nicholas J Wareham, David Ogilvie, Shannon Sahlqvist, Anna Goodman, Rebecca K Simmons, Kay-Tee Khaw, Nick Cavill, Charlie Foster, Robert Luben, Nicholas J Wareham, David Ogilvie

Abstract

Objectives: To investigate associations between modest levels of total and domain-specific (commuting, other utility, recreational) cycling and mortality from all causes, cardiovascular disease and cancer.

Design: Population-based cohort study (European Prospective Investigation into Cancer and Nutrition study-Norfolk).

Setting: Participants were recruited from general practices in the east of England and attended health examinations between 1993 and 1997 and again between 1998 and 2000. At the first health assessment, participants reported their average weekly duration of cycling for all purposes using a simple measure of physical activity. At the second health assessment, participants reported a more detailed breakdown of their weekly cycling behaviour using the EPAQ2 physical activity questionnaire.

Participants: Adults aged 40-79 years at the first health assessment.

Primary outcome measure: All participants were followed for mortality (all-cause, cardiovascular and cancer) until March 2011.

Results: There were 22 450 participants with complete data at the first health assessment, of whom 4398 died during follow-up; and 13 346 participants with complete data at the second health assessment, of whom 1670 died during follow-up. Preliminary analyses using exposure data from the first health assessment showed that cycling for at least 60 min/week in total was associated with a 9% reduced risk of all-cause mortality (adjusted HR 0.91, 95% CI 0.84 to 0.99). Using the more precise measures of cycling available from the second health assessment, all types of cycling were associated with greater total moderate-to-vigorous physical activity; however, there was little evidence of an association between overall or domain-specific cycling and mortality.

Conclusions: Cycling, in particular for utility purposes, was associated with greater moderate-to-vigorous and total physical activity. While this study provides tentative evidence that modest levels of cycling may reduce the risk of mortality, further research is required to confirm how much cycling is sufficient to induce health benefits.

Keywords: active commuting; active travel; physical activity.

References

    1. Woodcock J, Banister D, Edwards P, et al. Energy and Health 3. Lancet 2007;370:1078–88
    1. Shephard R. Is active commuting the answer to population health? Sports Med 2008;38:751–8
    1. Jarrett J, Woodcock J, Griffiths UK, et al. Effect of increasing active travel in urban England and Wales on costs to the National Health Service. Lancet 2012;379:2198–205
    1. Woodcock J, Givoni M, Morgan AS. Health impact modelling of active travel visions for England and Wales using an integrated transport and health impact modelling tool (ITHIM). PLoS ONE 2013;8:e51462.
    1. Kahlmeier S, Cavill N, Dinsdale H, et al. Health economic assessment tools (HEAT) for walking and for cycling. World Health Organization, 2011
    1. Andersen L, Schnohr P, Schroll M, et al. All-cause mortality associated with physical activity during leisure time, work, sports and cycling to work. Arch Intern Med 2000;160:1621–8
    1. Matthews CE, Jurj AL, Shu X, et al. Influence of exercise, walking, cycling and overall nonexercise physical activity on mortality in Chinese women. Am J Epid 2007;165:1343–50
    1. Sahlqvist S, Song Y, Ogilvie D. Is active travel associated with greater physical activity? The contribution of commuting and non-commuting active travel to total physical activity in adults. Prev Med 2012;55:206–11
    1. Sahlqvist S, Goodman A, Cooper A, et al. Change in active travel and changes in recreational and total physical activity in adults: longitudinal findings from the iConnect study. Int J Behav Nurt Phys Act 2013;10:28
    1. Besson H, Ekelund U, Brage S, et al. Relationship between subdomains of total physical activity and mortality. Med Sci Sport Exerc 2008;40:1909–15
    1. Khaw K-T, Jakes R, Bingham S, et al. Work and leisure time physical activity assessed using a simple, pragmatic, validated questionnaire and incident cardiovascular disease and all-cause mortality in men and women: The European Prospective Investigation into Cancer in Norfolk prospective population study. Int J Epidemiol 2006;35:1034–43
    1. Wareham N, Jakes R, Rennie K, et al. Validity and repeatability of the EPIC-Norfolk Physical Activity Questionnaire. Int J Epidemiol 2002;31:168–74
    1. Day N, Oakes S, Luben R, et al. EPIC Norfolk: study design and characteristics of the cohort. Br J Cancer 1999;80(Suppl 1):95–103
    1. Bingham S, Gill C, Welch A, et al. Validation of dieatary assessment methods in the UK arm of EPIC using weighted records, and 24-hour urinary nitrogen and potassium and serum vitamin C and carotenoids as biomarkers. Int J Epidemiol 1997;26:S137–51
    1. Ainsworth BE, Haskell WL, Leon A, et al. Compendium of physical activities: classification of energy costs of human physical activities. Med Sci Sport Exerc 1993;25:1192
    1. Sahlqvist S, Heesch K. Characteristics of utility cyclists in Queensland, Australia: an examination of the association between individual, social and environmental factors and utility cycling. J Phys Act Health 2012;9:818–28
    1. Winters M, Friesen MC, Koehoorn M, et al. Utilitarian bicycling: a multilevel analysis of climate and personal influences. Am J Prev Med 2007;32:52–8
    1. Foster C, Panter J, Wareham N. Assessing the impact of road traffic on cycling for leisure and cycling to work. Int J Behav Nutr Phys Act 2011;8:61.
    1. Pucher J, Buehler R. Making cycling irresistible: lessons from The Netherlands, Denmark and Germany. Transport Rev 2008;28:495–528
    1. Yang L, Panter J, Griffin SJ, et al. Associations between active commuting and physical activity in working adults: cross-sectional results from the commuting and health in Cambridge study. Prev Med 2012;55:453–7
    1. Wanner M, Götschi T, Martin-Diener E, et al. Active transport, physical activity, and body weight in adults: a systematic review. Am J Prev Med 2012;42:493–502
    1. Wagner A, Simon C, Evans A, et al. Physical activity and coronary event incidence in Northern Ireland and France. Circulation 2002;105:2247–52
    1. Hamer M, Chida Y. Active commuting and cardiovascular risk: a meta-analytic review. Prev Med 2008;46:9–13
    1. Park S, Rink LD, Wallace JP. Accumulation of physical activity leads to a greater blood pressure reduction than a single continuous session, in prehypertension. J Hyper 2006;24:1761–70
    1. Altena TS, Michaelson JL, Ball SD, et al. Single sessions of intermittent and continuous exercise and postprandial lipemia. Med Sci Spor Exer 2004;36:1364–71
    1. Schnohr P, Marott JL, Jensen JS, et al. Intensity versus duration of cycling, impact on all-cause and coronary heart disease mortality: the Copenhagen City Heart Study. Euro J Prev Cardiol 2012;19:73–80
    1. Goodman A, Brand C, Ogilvie D. Associations of health, physical activity and weight status with motorised travel and transport carbon dioxide emissions: a cross-sectional, observational study. Environ Health 2012;11:52.

Source: PubMed

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