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Walking or cycling to work linked to lower risk of heart disease and early death

Photo by Max Bender on Unsplash
Active commuters were 30 percent less likely to die of a fatal cardiovascular event (like a heart attack or stroke) during the study period.

Using active modes of travel, such as walking or cycling, to get part or all of the way to work is associated with a reduced risk of cardiovascular disease and early death, according to a British study published Monday in the journal Heart.

The benefits appear to be even greater for people who also walk or cycle for transport when doing errands or other daily activities.

“Our results are consistent with previous research suggesting that replacing exclusive car use with more active travel patterns may be beneficial for health,” the authors of the study conclude.

Lack of physical activity is one of the major risk factors for heart attacks, stroke, heart failure and other types of cardiovascular disease. It is also a risk factor for early death. Yet, with jobs becoming increasingly sedentary and working hours longer, many people are finding it difficult to incorporate physical activity into their daily lives. 

Indeed, less than half of American adults get the minimum amount of exercise recommended by current public health guidelines: at least 150 minutes of moderate-intensity physical activity, or 75 minutes of vigorous-intensity physical activity, each week.  

Integrating physical activity into ordinary daily journeys — not just to work, but also to other destinations, such as shops, restaurants, places of worship and friends’ homes — offers a relatively easy way of meeting those guidelines, say the authors of the current study.

Study details

For the study, researchers used data collected from more than 350,000 people participating in UK Biobank, a large database set up in the United Kingdom to help that country’s health officials collect information about preventing, diagnosing and treating a wide range of diseases. The participants were recruited during the years 2006-2010, at which time they ranged in age from 37 to 73. They were then followed for an average of seven years.  

At the start of the study, the participants filled out extensive electronic questionnaires, which included information about their health and various lifestyle characteristics, including which modes of travel they used to get to work and to other places. Based on the answers about their travel habits, the participants were divided into two groups: those who said they used their car exclusively to get around and those who reported more “active” patterns of travel — walking, cycling or public transit, either alone or in combination with a car.

About half (52 percent) of the participants said they were “regular commuters” (people who commuted to work three or more times a week). And about two-thirds of those regular commuters said they relied exclusively on a car to get to work. Cycling was much less common: Only 8.5 percent of the participants said they regularly cycled part or all of the way to work.

The study kept close track of major health-related events among the participants, including heart attacks and strokes. Deaths from all causes were also recorded.

Key findings

When all that data was analyzed, the researchers found that regular commuters with more active patterns of travel — those who walked or cycled at least part of their journey to work — were 11 percent less likely to experience a heart attack, stroke or other form of cardiovascular disease during the seven years of the study than the participants who commuted exclusively by car.  

The active commuters were also 30 percent less likely to die of a fatal cardiovascular event (like a heart attack or stroke) during the study period.

When people used active travel for both commuting to work and for getting to other destinations, their risk of a fatal cardiovascular event fell even lower — by 43 percent.

In addition, people who were not regular commuters but who used active modes of travel for their everyday errands and appointments were 8 percent less likely to die during the study than their non-commuting peers who relied on a car for such tasks. 

These findings took into account various factors already known to lower the risk of heart disease, such as age, smoking, fruit and vegetable consumption and socioeconomic status. 

The researchers also did not include in their final analysis any participants who developed cardiovascular disease or died within two years of follow-up. That was done to minimize the likelihood of “reverse causation” — the possibility that people in the early stages of disease were avoiding active modes of travel because of their illness.

Limitations and implications

This was an observational study, so no firm conclusions can be drawn about cause and effect. Other factors, not identified in the study, might explain the results. Still, these findings are supportive of previous studies that have found an association between active travel and improved health and wellbeing, including psychological well-being — even when the traveling is not done for commuting to work.

As University of Utah epidemiologist April Mohanty points out in a commentary accompanying the study, this latest study “provides the best evidence to date that active (vs passive) noncommute travel is associated with better health outcomes, including among individuals who do not regularly commute.”

“This is an important finding, as many individuals may work remotely, do not work, or only commute occasionally and need additional strategies (eg, active noncommute travel) to incorporate regular physical activity into their routines.” 

FMI: Heart is an open-access journal, so both the study and the commentary can be read in full at the journal’s website.  

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