Active commuting, such as walking or cycling, has been recommended as a feasible way of incorporating greater levels of physical activity into daily life
A meta-analysis of 173 146 participants reported that active commuting was associated with a lower risk of adverse cardiovascular outcomes
The work was limited by use of a heterogeneous range of cardiometabolic endpoints (including incident hypertension, diabetes, stroke, coronary heart disease, and cardiovascular disease (CVD)), and inconsistent adjustment for confounders between studies as well as no differentiation between commuting by walking and cycling
What this study adds:
Commuting by cycling was associated with a lower risk of all cause mortality and adverse CVD and cancer outcomes, and walking commuting was associated with lower risk of CVD incidence and mortality, in a dose dependent manner and independent of a range of confounding factors
Mixed mode commuting including a cycle component was associated with a lower risk of all cause mortality and cancer outcomes
Policies designed to affect a population level modal shift to more active modes of commuting, particularly by cycle (eg, cycle lanes, city bike hire, subsidised cycle purchase schemes, and increasing provision for cycles on public transport) may present major opportunities for the improvement of public health."