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Intervention Studies
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De Geus et al. (2007)Oost-Vlaanderen, Belgium |
Trial to assess effects of active travel on fitness; 10 men and 8 women passive travellers selected and matched for sex and age; asked to cycle minimum of 2 km each way 3 days a week.Measurements at baseline, 12 and 24 weeks: Fitness test – measured maximal heart rate and oxygen consumption. |
Aged 33–5444% women |
Cycle commuting showed significant improvements in fitness after 12 weeks as measured by absolute and relative maximal power and maximal exhaustion. |
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De Geus et al. (2008, 2009)Oost-Vlaanderen, Belgium |
Controlled trial to assess effects of active travel on fitness and cardiovascular health; 92 participants; 74 passive commuters (men and women) asked to cycle to work at least 3 times a week. 18 controls commuted as usual. 87% completion rate. Compliance of 38% in first 6 months and 34% in the second 6 months. Travel diary and distance recorder on bicycles measured activity. Measurements at baseline, 6 and 12 months: BMI; Fitness test – maximal external power and peak oxygen uptake; Overall activity levels; Blood pressure; Cholesterol; QOL; Leisure-time physical activity |
Intervention GroupMean age 43 (+/−5 SD)BMI 26 (+/−3.8 SD)Control GroupMean age 49 (+/−7 SD)BMI 24.9 (+/−2.9 SD) |
Minutes and calories burned per week through all physical activity were higher in the intervention group than the control group (but not statistically significant for minutes in the second 6-month period). |
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Hendriksen et al. (2000)Amsterdam, Netherlands |
RCT to assess effects of active travel on fitness and BMI; 122 participants randomised and stratified for age and sex.Minimum intervention group participation was 3 km each way three times a week for 6 months. After 6 months the control group could commence cycle commuting at any frequency or distance they chose. 94% completion; after 1 year 13 had dropped out (11%). |
Sedentary workers of 2 companies. Aged 25–56.29% womenIntervention Group: Mean age:Male 38.1 (+/−6.3 SD) range 26–56; Female 37.1 (+/−6.3) range 27–48; BMI: Male 25 (+/−2.3 SD) range 20–31; Female 26 (+/−4.6 SD) range 20–37Control Group: Mean age:Male 38.6 (+/−6.4 SD) (25–54); Female 36.3 (+/−6.9 SD)(29–49); BMI: Male 24 (+/−3.1 SD)(20–35); Female 25 (+/−4.7 SD) (18–36) |
No significant weight change in control or intervention group after 1 year.Maximal external power increased in the intervention group 13% in the first 6 months while it stayed the same in the control group.Maximal oxygen uptake – significant change in men only in intervention group in first 6 months. |
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Mutrie et al. (2002)Glasgow, UK |
RCT to assess effect of promotional pack on active travel. 295 participants; 89% participation; Participants not blind; 66% response rate at 6 months; Control group given intervention to encourage active travel after 6 months. |
Employees at 3 public sector workplaces64% women;Mean age 38 (range 19–69);76% in social classes 1 & 2 |
3 of 8 SF36 subscales significantly improved in the mean intervention group score compared with the control group: Mental Health (72 to 76 vs. 73 to 71); Vitality (57–64 compared with 61); General Health (71 to 76 vs 75 to 73) |
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Oja et al. (1991, 1998)Finland |
RCT to assess effects of active travel on various health outcomes;160 eligible volunteers selected from 860 participants in a postal survey71 passive commuter participants;96% participation; 10 weeks intervention group active commuting (mean 2.4 km walk or 9.7 km cycle), control group passively travelling. Followed by 10 weeks both groups actively travelling; Intervention compliance - 78% of workdays; Control compliance - 92% of workdays. |
44% women.Intervention Group: Mean age: Male 41.7 (+/−7.2 SD)Female 38.4 (+/−8.2 SD)BMI: Male 25.1 (+/−2.7 SD); Female 24.4 (+/−3.5 SD); Control Group: Mean age: Male 40.5 (+/−7.6 SD)Female 38.4 (+/−8.4 SD)BMI: Male 25.7 (+/−2.4 SD); Female 24 (+/−3.9 SD) |
4.5% (p = 0.02) net increase in maximal oxygen uptake in intervention vs control group and 10.3% net increase in maximum treadmill time (p = <0.001) and 5% (p = 0.06) increase in HDL cholesterol.No significant changes in serum total cholesterol or triglyceride concentrations.No changes in bodyweight or leisure-time physical activity in either group. |
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Prospective Cohort Studies
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Andersen et al. (2000)Copenhagen County, Denmark |
Prospective Cohort Study to assess association between active travel & all-cause mortality. 13375 women, 17265 men randomly selected, followed prospectively for average 14.5 years. Uses pooled data from 3 population surveys conducted in 1964, 1970 & 1971, 1976 & 1978; registered deaths to 1994. Bicycling to work reported by 783 women, 6171 men (average 3 hours/wk). |
Aged 20–9344% women |
Relative risk of all-cause mortality of 0.72 (95% CI 0.57–0.91) in cycle-commuters compared to non-cyclists.Adjusted for age, sex, education, leisure time physical activity, BMI, blood lipid levels, smoking and blood pressure. |
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Barengo et al. (2004)Eastern & South-west Finland |
Prospective Cohort Study; 16,824 women and 15,853 men drawn from independent random sample of national population register. Participation rate: Men 71–94% Women 78–95%6 cross-sectional surveys in 1972,1977, 1982, 1987, 1992, 1997 included: Self-administered questionnaire on physical activity behaviour in a typical week and assessing risk factors for CVD; Height, weight and blood pressure measured by a nurse and blood sample taken for serum cholesterol. Median follow-up 20 years.(13–25 years inter-quartile range) |
Aged 30–5951% womenMean age: Men 43.4 (SD 8.4); Women 43.8 (SD 8.5);BMI 25–29.9:Men 47.2%; Women 34.9%Active travel to and from work:Men Women<15 mins 64.3 54.315–29 17 20.130+ 18.7 25.6 |
Adjusted hazard ratio (95% CI)All cause mortality:Men:<15 min 1.0015–29 min 1.01 (0.92–1.11)30+ min 1.07 (0.98–1.17)Women:<15 min 1.0015–29 min 0.89 (0.78–1.02)30+ min 0.98 (0.88–1.09)Cardiovascular mortality:Men:<15 min 1.0015–29 min 1.08 (0.95–1.23)30+ min 1.05 (0.93–1.19)Women:<15 min 1.0015–29 min 0.78 (0.62–0.97)30+ min 0.97 (0.82–1.15) |
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Barengo et al. (2005)Eastern and South West Finland |
Prospective Cohort Study to assess association between active travel and risk of hypertension; Participation: Men 73–79%; Women 83–85%. After exclusions for use of hypertensives (2433) and incomplete data (828) leaving 5935 men and 6227 women. Population survey using independent random sample conducted in 1982, 1985, 1992. Self-administered questionnaire: 1 week of activity and demographics, Measured by a nurse: blood pressure, height, weight. |
Aged 25–6451% womenMean age: Men 43.5 (SD 8.6); Women 43.4 (SD8.5); BMI: Men 26.3 (SD3.5); Women 25.4 (SD4.4).Active travel: Men, Women<15 min:70, 53%15–29 min:16%,21%30+ min:14%, 26% |
Adjusted hazard ratio (95% CI) for hypertensionMen:<15 min/day 1.0015–29 min/day 1.05 (0.86–1.29)30+ min/day 0.84 (0.67–1.05)Women:<15 min/day 1.0015–29 min/day 0.90 (0.69–1.17)30+ min/day 1.06 (0.85–1.34)Men and Women<15 min/day 1.0015–29 min/day 0.98 (0.84–1.16)30+ min/day 0.96 (0.82–1.12) |
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Batty et al. (2001)London, UK |
Prospective Cohort Study to assess association between active travel and cause specific mortality. 12552 male participants. 16 men were missing travel information and 873 had non-comparable work grades so were excluded leaving 1163 for analysis.Workplace cohort survey in 1967 and 1969 measured: height, weight; blood pressure; lung function; cholesterol; glucose tolerance; questionnaire on demographics, health status and physical activity. Follow up = 25 years. |
Aged 40–640% womenTravel activity:0–9 min: 19.6%;10–19 mins: 44.9%20+ mins: 35.5% |
12 mortality endpoints but after adjusting for confounders there were no statistically significant differences between those who actively travelled more or less than 20 minutes on the (one-way) journey to work. |
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Bere et al. (2011)Rotterdam, Netherlands & Kristiansand, Norway |
Prospective Cohort study to assess the relationship between cycling to school and weight status.890 participants at baseline, 890 completed two year follow up (54% participation).2 year follow up.Measurements at baseline and at follow up: questionnaire of demographics and travel mode, objective [dh]height and weight measures converted into BMI scores. |
Secondary school studentsMean age 13.3 years at baseline.42% cycled on 3 or more days per week at baseline. |
Odds Ratio (95% CI) of being overweight compared with the other groups:No cycling 1.05 (0.57,1.59)Started Cycling 1.22 (0.40,3.70)Stopped Cycling 3.19 (1.41,7.24)Continued to cycle 0.44 (0.21,0.88) |
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Besson et al. (2008)Norfolk, UKMoayyeri et al. (2010)
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Prospective Cohort Study14905 participants at baseline,2 LTFU, 99.99% participationMedian follow up 7 years, total 102,964 person-yearsMeasurements at baseline:Self-completed questionnaire of how people travelled to work and for other journeys – responses converted into MET.h.wk−1Measured BMI, blood pressure, smoking status, alcohol consumption, social class, medical history of CVD & cancerAssessed association of different domains of physical activity with bone strength and fracture risk. 60.5% participation rate, 96% completion rate. Mean follow-up time 7.5 years. Measurements: self-completed questionnaire of previous years' physical activity behaviour and quantitative ultrasound assessment of the heel. Participants followed up through NHS database to health endpoints. |
Men and women aged 45–79 |
For active travellers (>8 MET.h.wk−1):All cause mortalityHR 0.82 (0.67–1.00)Cardiovascular mortalityHR 0.79 (0.55–1.13)Adjusted Hazard ratios for any type of fracture and hip fracture were non-significant in both men and women, numbers of participants were small. |
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Chillon et al. (2012)SwedenCooper et al. (2008)Odense, DenmarkAndersen et al. (2011)Odense, Demark |
Prospective Cohort Study to assess the effects of active travel on fitness, fatness and cardio-metabolic risk factors.907 participants at baseline, 60% drop out rate,262 participants (142 girls, 120 boys) had complete records at 6 year follow up.Measurements:Height, weight, waist circumference, skinfold thickness and pubertal status.Questionnaire about usual travel to school mode.Cycle ergometer cardio-respiratory fitness test measured maximal oxygen uptake.Blood pressure and blood samples for cholesterol, triglycerides and insulin.Prospective Cohort Study; Survey of a representative sample of children to measure the effects of cycling to school on cardio-respiratory fitness (CRF). 771 invited to participate from 25 schools in 1997, 589 (310 girls, 279 boys) consented. Follow up after 6 years in 2003 re-examined 384 (214 girls, 170 boys). Completion 64%. Measurements: height, weight, skinfold thickness and pubertal status. Questionnaire about usual travel to school mode and journey time. Cycle ergometer cardio-respiratory fitness test measured maximal oxygen uptake. Accelerometer measured physical activity.Prospective Cohort Study to assess effects of cycling to school on cardiovascular risk factors. For participants see above. 50 participants excluded, 334 (57%) completed the study.Measurements: Same as Chillon et al. above. |
School ChildrenBaseline characteristicsBoys (SD) Girls (SD)Age 9.5 (0.4) 9.5 (0.4)BMI 17.2 (2.5) 17.1 (2.3)Walk 60% 49%Cycle 12% 13%Passive travel 28% 38%90% of cyclists reported journey time <15 minutes.Baseline characteristicsBoys (SD) Girls (SD)Age 9.7 (0.4) 9.6 (0.4)BMI 17.1 (2.0) 17.2 (2.5)Walk/Cycle 65.5% 65.3%88% of walkers and 95.5% of cyclists reported journey time <15 minutes.Same as Cooper above. |
Children who cycled to school increased their fitness 13% more than those who used passive modes and 20% more than those who walked during the 6 year period.Children who took up cycling during the follow up period increased their fitness by 14% compared with those who did not.No significant association between travel mode to school and fatness or cardiometabolic risk factors.Cardio-respiratory fitness (CRF) was significantly higher among girls (0.33W kg-1P<.001) and boys (0.34WW kg-1 P = 001) who cycled to school at either the beginning or the end of the study compared with those who did not cycle at either time. CRF of those who stopped cycling was no different to those who never cycled. Cycling at both time points and taking up cycling were significant predictors of CRF in 2003.Passive travellers and walkers had similar cardiovascular risk measures and were combined for analysis as ‘non-cyclists’.At baseline there were differences in fitness levels between cyclists and non cyclistsAt follow up there were differences between cyclists and non-cyclists in TG, TC/HDL, fasting glucose, HOMA and sum of z-scores (P<0.05).Children who took up cycling during the follow up period were significantly fitter, had significantly lower waist circumference, glucose, insulin, HOMA, TC/HDL values and clustered risk scores compared with those who did not. |
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Hayashi et al. (1999)Osaka, Japan |
Prospective Cohort Study; Workplace cohort survey to measure the association between duration of walk to work and risk of hypertension. Between 1981–1990 7979 enrolled; 1875 excluded because of hypertensionLeaving 6104 to participate but 87 were lost to follow up (1.4%) so full results only available for 6017 men; 99% completion.Measurements: Questionnaire of physical activity and lifestyle; Blood pressure; Fasting blood glucose; Follow up period 7–16 years. |
Employees of a gas company with sedentary occupation.0% womenAged 35–60Age 41.7+/−6.5BMI 22.6+/−2.6 |
Number Needed to Walk: NNT 111.1 for 11–20 minute walk to work compared with less than 10 minute walk to work.NNT 26.3 (CI 26.1–26.5) for 21+ minutes walk to work compared with less than 10 minute walk to work.Adjusted relative risk of hypertension:0–10 min: 1.0011–20 min: 0.88 (0.75–1.04)21+ min: 0.70 (0.59–0.95) |
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Heelan et al. (2005)Nebraska, USA |
Prospective Cohort Study; 600 children invited to participate;60% participation rate; 6.2% non-completers; Measurements at baseline and 6 months: Weight, height and Skinfold; self-administered questionnaire on travel mode to school. |
ChildrenAged 10.2 (+/−0.7) years.56% girlsBMI at baseline 19.4 (+/−3.7) |
After adjusting for baseline BMI the partial r = 0.03 P<0.05. For overweight children partial r = 0.10; P<0.05. For normal weight children, no significant relationship for BMI. No significant association between travel mode and body fat. |
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Hu et al. (2003)Eastern and South West Finland |
Prospective Cohort Study; Random population sample survey to assess association between active travel and type 2 diabetes risk. Measurements: Self-administered questionnaire re: medical history, socioeconomic factors, smoking, physical activity, occupational, leisure time and commuting. Baseline surveys with cohorts in 1982,1987 and 1992, 74–88% participation rate; Mean follow up period = 12 years |
Aged 35–6453% women |
Adjusted relative risk for type 2 diabetes0 min: 1.00;1–29 min: 0.96 (0.74–1.25)>/ = 30 min 0.64 (0.45–0.92) |
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Hu et al. (2005, 2007, 2007)Finland |
Prospective Cohort Study; To examine the association between active commuting and risk of coronary heart disease. Self-administered questionnaire surveys of smoking, socioeconomic, alcohol consumption, medical history, occupational, leisure time and commuting physical activity at baseline in cohorts in 1972, 1977, 1982, 1987, 1992 and 1997. 74–88% participation rate. Mean follow up = 18.9 years. |
Aged 25–6452% women |
Adjusted Hazard ratios of coronary heart disease:Men: 0 min: 1.00; 1–29 min: 0.99 (0.91–1.08); >/ = 30 min 0.99 (0.90–1.10); Women: 0 min 1.00; 1–29 min: 0.95 (0.83–1.08); >/ = 30 min 0.80 (0.69–0.92) |
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Lofgren et al. (2010)Malmo, Sweden |
Prospective Cohort Study to assess whether active travel to school is associated with larger gain in bone mineral content and bone width than passive travel. 133 boys and 99 girls; 5 boys and 6 girls did not answer question on mode of transport so were excluded. 47 boys and 28 girls had no consistent mode of travel. So 39% boys and 34% girls were excluded before study began. 6% girls and 11% boys dropped out during study. 2 year follow up. Measurements taken at baseline and 2 years: Accelerometers worn for 4 days; Questionnaire on activity; bone mineral content. |
Age 7–9 years75% girls |
After adjustment there were no differences in annual changes in bone mineral content or bone width between children travelling actively or passively to school. |
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Luoto et al. (2000)Finland |
Prospective Cohort Study; To assess the effect of active travel on breast cancer risk. Random sample of 30,548 women sent postal lifestyle questionnaire between 1978–1984, 1986–1993. Data then linked to cancer registry data. Response rate 75–86% |
Aged 15–64100% women50%+ active commuters |
No significant difference in breast cancer risk by travel mode. Adjusted Relative Risk (95% CI): Staying at home: 1.00; Passive travel: 0.94 (0.66–1.34); <30 mins/day 0.89 (0.67–1.18); >/ = 30 mins/day 0.87 (0.62–1.24) |
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Matthews et al. (2007)Shanghai, China |
Prospective cohort study to assess association between active travel and all cause mortality. 93% participation rate; >99% completion rate. Mean follow up 5.7 years. Measurements:Interview re: activity in previous 5 years – exercise participation, household activities, active transport, occupational activity. Also, demographics, medical history, lifestyle behaviours, occupational history. |
Aged 40–70100% women |
Walking MET hours/day adjusted hazard ratio for all cause mortality.0–3.4 1.003.5–7.0 0.94 (0.81–1.09)7.1–10.0 0.83 (0.69–1.00)>/ = 10.1 0.86 (0.71–1.05)Cycling MET hours/day adjusted hazard ratio for all cause mortality:0 1.000.1–3.4 0.79 (0.61–1.01)>/ = 3.5 0.66 (0.40–1.07) |
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Pabayo et al. (2010)Quebec, Canada |
Prospective Cohort Study; 1170 participants; 78% completed study (1170/1492);Measurements at baseline, 1 and 2 years:structured interview,height and weight measurement converted into BMI z-scores |
ChildrenAged approximately 6 years.51.8% girls81.8% normal weight at baseline. |
Children who used active travel from kindergarten (aged 6) to grade 2 (aged 8) had an average BMI z-score 0.3 (p = 0.003) standard deviations lower than other children. No significant associations between sustained active travel and relative weight. |
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Rosenberg et al. (2006)Southern California, USA |
Prospective Cohort Study;1083 participants at baseline;85% participation, 924 completed all measurements.Measurements at baseline, 6, 12, 18 months:- Self-completed questionnaire on travel mode to school.- weight, height and skinfold. Accelerometers worn for 1 evening and the following morning (74% participation). Parents completed demographics survey (75% completion rate). |
4th grade pupils at elementary schools.46.8% girls |
Change in BMI and skinfolds over the study period was not significantly different for children classified as active or passive travellers. |
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Sato et al. (2007)Kansai, Japan |
Prospective cohort study;11,073 participants at baseline (87.6% participation rate), 77.4% completion rate.4 year follow up.Measurement – fasting plasma glucose, BMI, questionnaire of physical activity and lifestyle factors. |
Sedentary employees aged 40–55 yearsMean age 47.8+/−4.20% women |
Adjusted odds ratio of incidence of Type 2 diabetes:0–10 min:1.0011–20 min: 0.86 (0.70–1.06)21+ min: 0.73 (0.58–0.92) |
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Wagner et al. (2001, 2002, 2003)France & Northern Ireland |
Prospective cohort study to assess association between risk of CHD event and active travel. 91% participation rate. 9% LTFUMeasurements: Interview re: health, lifestyle, socioeconomic data and physical activity; BMI , waist circumference; Blood sample |
Aged 50–59 yearsMean age 54.9+/−2.90% womenBMI 26.6+/−3.4 |
Adjusted relative risk for CHD events 1.19 (0.81–1.76). |
