8/7/13
by Cole Petrochko
Staff Writer, MedPage Today

Active modes of traveling to work, such as walking or biking, were associated with a lower likelihood of obesity and diabetes, U.K. researchers found.

Compared with using driving a car or taking a taxi, walking to work was associated with a 20% reduced risk of being obese and a 40% reduced risk of diabetes, according to Anthony Laverty, MSc, of the Imperial College London, and colleagues. Those who cycled to work had a 37% lower risk of obesity and a 50% lower risk of diabetes.

Only walking to work was associated with a decreased risk of hypertension compared with driving (adjusted OR 0.83, 95% CI 0.71-0.97), they wrote online in the American Journal of Preventive Medicine.

The authors noted that obesity and excess weight are common to roughly 62% of the English population, as is hypertension in 30% and diabetes in 5.5%. They added that active travel promotes physical activity and produces an environmental net benefit.

Past research has shown that walking and biking to work were associated with reduced blood pressure, insulin, and levels of triglycerides. Also, in a study of female nurses who walked or biked to work, active transporters gained less weight than those who didn’t use such active methods of going to work.

The authors looked at associations between active travel versus inactive travel with cardiovascular risk factors, as well as sociodemographic factors associated with various forms of transportation in a population of 20,458 English workers participating in the Understanding Society survey.

The survey included participants ages 16 to 65 and who worked and provided information about travel to work.

Additionally, data were stratified by age, gender, ethnic group, education, socioeconomic class, and residence. The survey assessed travel through question about method of travel to work and distance traveled. Participants also provided information about height and weight, as well as self-reported hypertension and diabetes status.

More than two-thirds of participants used a private transport — car or taxi — to get to work (69%), while 12% walked, 3% biked, and 16% used public transportation.

By demographic, women were more likely than men to use public transportation or walk, and were less likely to cycle to work. Younger participants (ages 16 to 29) were more likely than older participants to use public transportation to walk, while only those ages 50 to 65 were less likely to cycle to work. Nonwhites were more likely than whites to use public transportation or walk to work.

Although the researchers considered use of public transportation a form of active transportation, it was only associated with significant reductions in body mass index (-0.24, 95% CI -0.46-minus 0.14) and overweight or obese status (aOR 0.85, 95% CI 0.77-0.95). Walking was associated with reductions in BMI, obese or overweight status, diabetes, and self-reported hypertension. Cycling was associated with reductions in BMI, overweight or obese status, and diabetes, but not self-reported hypertension when studied alone.

Among those who walked or cycled and provided data on distance traveled, walking 2 miles or less was not associated with a lower mean BMI compared with those who used private transportation. Walking and cycling 2 miles or more was associated with lower odds of self-reported hypertension.

They concluded that “more vigorous forms of active travel may confer greater benefits than public transport,” as well as private modes of transportation.

The authors noted that the study was limited by the use of cross-sectional data so reverse causality cannot be ruled out. The study also excluded those not in the labor market, and relied on self-reported data on hypertension, BMI, and diabetes. The study also didn’t take into account other forms of physical activity or other forms of active travel other than during the work commute.

• Reviewed by Zalman S. Agus, MD Emeritus Professor, Perelman School of Medicine at the University of Pennsylvania and Dorothy Caputo, MA, BSN, RN, Nurse Planner

last updated 08.07.2013