1
|
Kalliolahti E, Aalto V, Salo P, Lanki T, Ervasti J, Oksanen T. Associations between commute mode use and self-rated health and work ability among Finnish public sector employees. Scand J Public Health 2024; 52:468-475. [PMID: 36942325 PMCID: PMC11179311 DOI: 10.1177/14034948231159212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 01/11/2023] [Accepted: 02/05/2023] [Indexed: 03/23/2023]
Abstract
AIM To determine the extent to which level of active commute mode use is associated with self-rated health and work ability. METHODS The data were sourced from the Finnish Public Sector Study survey in 2020 (n = 38,223). The associations between active commuting - assessed with the frequency of using active commute modes - and self-rated health and work ability were examined with negative binomial regression analyses. Passive commuting and low-to-moderate levels of active commuting were compared with active commuting, and the models were adjusted for sociodemographic factors, working time mode, and lifestyle risk factors. We also assessed separate associations between walking and cycling as a mode of commuting by additionally considering the commuting distance and the outcomes. RESULTS After adjustment, when using active commuters as a reference, passive commuters had a 1.23-fold (95% confidence intervals (CI) 1.19 to 1.29) risk of suboptimal self-rated health and a 1.18-fold (95% CI 1.13 to 1.22) risk of suboptimal work ability. More frequent and/or longer distance by foot and especially by bicycle, was positively associated with health and work ability. Never commuting by bicycle was associated with a 1.65-fold (95% CI 1.55 to 1.74) risk of suboptimal health and a 1.27-fold (95% CI 1.21 to 1.34) risk of suboptimal work ability when using high-dose bicycle commuting as a reference. CONCLUSIONS Passive commuting was associated with suboptimal self-rated health and suboptimal work ability. Our results suggest that using active commute modes, particularly cycling, may be beneficial for employee health and work ability.
Collapse
Affiliation(s)
- Essi Kalliolahti
- University of Eastern Finland, Institute of Public Health and Clinical Nutrition, Kuopio, Finland
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Ville Aalto
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Paula Salo
- University of Turku, Department of Psychology and Speech-Language Pathology, Turku, Finland
| | - Timo Lanki
- University of Eastern Finland, Institute of Public Health and Clinical Nutrition, Kuopio, Finland
- Finnish Institute for Health and Welfare (THL), Environmental Health, Kuopio, Finland
| | - Jenni Ervasti
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Tuula Oksanen
- University of Eastern Finland, Institute of Public Health and Clinical Nutrition, Kuopio, Finland
| |
Collapse
|
2
|
Michel S, Banwell N, Senn N. Mobility Infrastructures and Health: Scoping Review of studies in Europe. Public Health Rev 2024; 45:1606862. [PMID: 38841179 PMCID: PMC11150585 DOI: 10.3389/phrs.2024.1606862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 04/22/2024] [Indexed: 06/07/2024] Open
Abstract
Objectives Movement-friendly environments with infrastructure favouring active mobility are important for promoting physical activity. This scoping literature review aims at identifying the current evidence for links between mobility infrastructures and (a) behaviour regarding active mobility, (b) health outcomes and (c) co-benefits. Method This review was conducted in accordance with the PRISMA scoping review guidelines using PubMed and EMBASE databases. Studies included in this review were conducted in Europe, and published between 2000 and March 2023. Results 146 scientific articles and grey literature reports were identified. Connectivity of sidewalks, walkability, and accessibility of shops, services and work are associated with walking. Cycling is positively associated with cycle-paths, separation of cycling from traffic and proximity to greenspaces, and negatively associated with traffic danger. Increased active transportation has a protective effect on cardiovascular and respiratory health, obesity, fitness, and quality of life. Co-benefits result from the reduction of individual motorized transportation including reduced environmental pollution and projected healthcare expenditure. Conclusion Mobility infrastructure combined with social and educational incentives are effective in promoting active travel and reducing future healthcare expenses. A shift to active transportation would increase both individual and community health and decrease greenhouse gas emissions.
Collapse
Affiliation(s)
- Sarah Michel
- Department of Family Medicine, Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Nicola Banwell
- Interdisciplinary Centre for Research in Ethics (CIRE), University of Lausanne, Lausanne, Switzerland
| | - Nicolas Senn
- Department of Family Medicine, Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| |
Collapse
|
3
|
Bole A, Bernstein A, White MJ. The Built Environment and Pediatric Health. Pediatrics 2024; 153:e2023064773. [PMID: 38105697 DOI: 10.1542/peds.2023-064773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/23/2023] [Indexed: 12/19/2023] Open
Abstract
Buildings, parks, and roads are all elements of the "built environment," which can be described as the human-made structures that comprise the neighborhoods and communities where people live, work, learn, and recreate (https://www.epa.gov/smm/basic-information-about-built-environment). The design of communities where children and adolescents live, learn, and play has a profound impact on their health. Moreover, the policies and practices that determine community design and the built environment are a root cause of disparities in the social determinants of health that contribute to health inequity. An understanding of the links between the built environment and pediatric health will help to inform pediatricians' and other pediatric health professionals' care for patients and advocacy on their behalf. This technical report describes the range of pediatric physical and mental health conditions influenced by the built environment, as well as historical and persistent effects of the built environment on health disparities. The accompanying policy statement outlines community design solutions that can improve pediatric health and health equity, including opportunities for pediatricians and the health care sector to incorporate this knowledge in patient care, as well as to play a role in advancing a health-promoting built environment for all children and families.
Collapse
Affiliation(s)
- Aparna Bole
- Department of Pediatrics, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Aaron Bernstein
- Department of General Pediatrics, Boston Children's Hospital, and Center for Climate, Health and the Global Environment, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Michelle J White
- Department of Pediatrics, Duke University Medical Center, Durham, North Carolina
| |
Collapse
|
4
|
Logan G, Somers C, Baker G, Connell H, Gray S, Kelly P, McIntosh E, Welsh P, Gray CM, Gill JMR. Benefits, risks, barriers, and facilitators to cycling: a narrative review. Front Sports Act Living 2023; 5:1168357. [PMID: 37795314 PMCID: PMC10546027 DOI: 10.3389/fspor.2023.1168357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 09/05/2023] [Indexed: 10/06/2023] Open
Abstract
There is large potential to increase cycling participation worldwide. Participation in cycling is associated with lower risk of mortality from any cause, and incidence of cardiovascular disease and type 2 diabetes, as well as positive mental health and well-being. The largest potential for health gains likely to come from increasing participation amongst those who do not currently cycle regularly, rather than encouraging those who already cycle regularly to cycle more. Replacing car journeys with cycling can lead to reductions in air pollution emissions and lower pollutant exposure to the general population. Important gaps and uncertainties in the existing evidence base include: the extent to which the health benefits associated with cycling participation are fully causal due to the observational nature of much of the existing evidence base; the real-world economic cost-benefits of pragmatic interventions to increase cycling participation; and the most effective (combination of) approaches to increase cycling participation. To address these uncertainties, large-scale, long-term randomised controlled trials are needed to: evaluate the effectiveness, and cost-effectiveness, of (combinations of) intervention approaches to induce sustained long-term increases in cycling participation in terms of increases in numbers of people cycling regularly and number of cycling journeys undertaken, across a range of population demographic groups; establish the effects of such interventions on relevant outcomes related to health and wellbeing, economic productivity and wider societal impacts; and provide more robust quantification of potential harms of increasing cycling participation, such as collision risks.
Collapse
Affiliation(s)
- Greig Logan
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, United Kingdom
| | - Camilla Somers
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Graham Baker
- Physical Activity for Health Research Centre, University of Edinburgh, Edinburgh, United Kingdom
| | - Hayley Connell
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Stuart Gray
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, United Kingdom
| | - Paul Kelly
- Physical Activity for Health Research Centre, University of Edinburgh, Edinburgh, United Kingdom
| | - Emma McIntosh
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Paul Welsh
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, United Kingdom
| | - Cindy M. Gray
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Jason M. R. Gill
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, United Kingdom
| |
Collapse
|
5
|
Alareeki A, Awad SF, Critchley JA, El-Nahas KG, Al-Hamaq AO, Alyafei SA, Al-Thani MHJ, Abu-Raddad LJ. Epidemiological impact of public health interventions against diabetes in Qatar: mathematical modeling analyses. Front Public Health 2023; 11:1167807. [PMID: 37404285 PMCID: PMC10315912 DOI: 10.3389/fpubh.2023.1167807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 05/30/2023] [Indexed: 07/06/2023] Open
Abstract
Aims To predict the epidemiological impact of specific, and primarily structural public health interventions that address lifestyle, dietary, and commuting behaviors of Qataris as well as subsidies and legislation to reduce type 2 diabetes mellitus (T2DM) burden among Qataris. Methods A deterministic population-based mathematical model was used to investigate the impact of public health interventions on the epidemiology of T2DM among Qataris aged 20-79 years, which is the age range typically used by the International Diabetes Federation for adults. The study evaluated the impact of interventions up to 2050, a three-decade time horizon, to allow for the long-term effects of different types of interventions to materialize. The impact of each intervention was evaluated by comparing the predicted T2DM incidence and prevalence with the intervention to a counterfactual scenario without intervention. The model was parameterized using representative data and stratified by sex, age, T2DM risk factors, T2DM status, and intervention status. Results All intervention scenarios had an appreciable impact on reducing T2DM incidence and prevalence. A lifestyle management intervention approach, specifically applied to those who are categorized as obese and ≥35 years old, averted 9.5% of new T2DM cases by 2050. An active commuting intervention approach, specifically increasing cycling and walking, averted 8.5% of new T2DM cases by 2050. Enhancing consumption of healthy diets including fruits and vegetables, specifically a workplace intervention involving dietary modifications and an educational intervention, averted 23.2% of new T2DM cases by 2050. A subsidy and legislative intervention approach, implementing subsidies on fruits and vegetables and taxation on sugar-sweetened beverages, averted 7.4% of new T2DM cases by 2050. A least to most optimistic combination of interventions averted 22.8-46.9% of new T2DM cases by 2050, respectively. Conclusions Implementing a combination of individual-level and structural public health interventions is critical to prevent T2DM onset and to slow the growing T2DM epidemic in Qatar.
Collapse
Affiliation(s)
- Asalah Alareeki
- Infectious Diseases Epidemiology Group, Weill Cornell Medical College–Qatar, Cornell University, Doha, Qatar
- World Health Organization Collaborating Centre for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine–Qatar, Doha, Qatar
| | - Susanne F. Awad
- Infectious Diseases Epidemiology Group, Weill Cornell Medical College–Qatar, Cornell University, Doha, Qatar
- World Health Organization Collaborating Centre for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine–Qatar, Doha, Qatar
- Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York, NY, United States
| | - Julia A. Critchley
- Population Health Research Institute, St George's, University of London, London, United Kingdom
| | | | | | - Salah A. Alyafei
- Public Health Department, Ministry of Public Health, Doha, Qatar
| | | | - Laith J. Abu-Raddad
- Infectious Diseases Epidemiology Group, Weill Cornell Medical College–Qatar, Cornell University, Doha, Qatar
- World Health Organization Collaborating Centre for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine–Qatar, Doha, Qatar
- Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York, NY, United States
- Department of Public Health, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
- College of Health and Life Sciences, Hamad Bin Khalifa University, Doha, Qatar
| |
Collapse
|
6
|
Sugiyama T, Cole R, Hadgraft N, Owen N, Thompson RG, Chandrabose M. Area-level associations of travel behaviour metrics with waist circumference: findings from linkage of travel and health surveys. Sci Rep 2023; 13:8136. [PMID: 37208412 DOI: 10.1038/s41598-023-35335-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 05/16/2023] [Indexed: 05/21/2023] Open
Abstract
Individual-level analyses have consistently shown associations of travel behaviours with obesity-related measures. However, transport planning policies often target areas rather than individuals. To better inform transport-related policies and initiatives for obesity prevention, area-level relationships need to be investigated. This study linked data from two travel surveys with data from the Australian National Health Survey at the level of Population Health Areas (PHAs) and examined to what extent area-level travel behaviours metrics (prevalence of active travel, mixed travel and sedentary travel, diversity of travel modes) were associated with the rate of high waist circumference. Data from 51,987 travel survey participants were aggregated into 327 PHAs. Bayesian conditional autoregressive models were used to account for spatial autocorrelation. It was found that statistically replacing participants who relied on cars for travel (without walking/cycling) with those engaging in 30+ min/d of walking/cycling (without car use) was associated with a lower rate of high waist circumference. Areas with greater diversity of travel modes (mix of walking/cycling, car use, public transport use) also had lower prevalence of high waist circumference. This data-linkage study suggests that area-level transport planning strategies addressing car dependency, shifting car use to walking/cycling over 30 min/d, may help to reduce obesity.
Collapse
Affiliation(s)
- Takemi Sugiyama
- Centre for Urban Transitions, Swinburne University of Technology, Melbourne, John Street, Hawthorn, VIC, 3122, Australia.
- Baker Heart and Diabetes Institute, Melbourne, Australia.
| | - Rachel Cole
- School of Health and Behavioural Sciences, University of the Sunshine Coast, Sippy Downs, Australia
| | - Nyssa Hadgraft
- Centre for Urban Transitions, Swinburne University of Technology, Melbourne, John Street, Hawthorn, VIC, 3122, Australia
- Baker Heart and Diabetes Institute, Melbourne, Australia
| | - Neville Owen
- Centre for Urban Transitions, Swinburne University of Technology, Melbourne, John Street, Hawthorn, VIC, 3122, Australia
- Baker Heart and Diabetes Institute, Melbourne, Australia
| | - Russel G Thompson
- Department of Infrastructure Engineering, The University of Melbourne, Melbourne, Australia
| | - Manoj Chandrabose
- Centre for Urban Transitions, Swinburne University of Technology, Melbourne, John Street, Hawthorn, VIC, 3122, Australia
- Baker Heart and Diabetes Institute, Melbourne, Australia
| |
Collapse
|
7
|
Kaseva K, Lounassalo I, Yang X, Kukko T, Hakonen H, Kulmala J, Pahkala K, Rovio S, Hirvensalo M, Raitakari O, Tammelin TH, Salin K. Associations of active commuting to school in childhood and physical activity in adulthood. Sci Rep 2023; 13:7642. [PMID: 37169787 PMCID: PMC10175542 DOI: 10.1038/s41598-023-33518-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 04/13/2023] [Indexed: 05/13/2023] Open
Abstract
This study examined whether active commuting to school in childhood and adolescence predicted active commuting to work and overall physical activity (PA) in adulthood. Participants from the Young Finns Study (N = 2436) were aged 9-18 years in 1980 and followed up until 2018/2020. Their commuting modes to school were assessed with a self-reported questionnaire in 1980. Adulthood PA was assessed through self-reports regarding commuting modes to work (2001-2018), leisure-time physical activity (LTPA) (2001-2018), and objectively measured daily steps (2007-2018/2020). Associations between childhood commuting and adulthood PA were evaluated using regression analyses and multilevel models. Demographic, socioeconomic and environmental covariates were adjusted for in the analyses. Active commuting to school in childhood contributed favourably to LTPA in 2001 (B = .38, p < .001), in 2007 (B = .35, p < .001), and in 2018 (B = .28, p < .01). Active commuting in childhood was associated with higher number of daily aerobic steps (B = 299.00, p = .03) and daily aerobic steps during weekdays in 2011 (B = 312.15, p = .03). In 2018, active commuting associated favourably with daily aerobic steps (B = 370.42, p < .01), daily aerobic steps during weekdays (B = 347.65, p = .01), daily steps during weekends (B = 628.49, p = .02), and daily aerobic steps during weekends (B = 402.69, p = .03). Covariate adjustments attenuated the associations excluding the one between active commuting and LTPA in 2007 (B = .36, p = .01) and daily steps during weekends in 2018 (B = 782.25, p = .04). Active commuting to school in childhood might be one of the PA modes that contribute to PA in adulthood and is therefore encouraged to be promoted from an early age.
Collapse
Affiliation(s)
- Kaisa Kaseva
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.
- Faculty of Education Sciences, University of Helsinki, Helsinki, Finland.
| | - Irinja Lounassalo
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Xiaolin Yang
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
- School of Health and Social Studies, Jamk University of Applied Sciences, Jyväskylä, Finland
| | - Tuomas Kukko
- School of Health and Social Studies, Jamk University of Applied Sciences, Jyväskylä, Finland
| | - Harto Hakonen
- School of Health and Social Studies, Jamk University of Applied Sciences, Jyväskylä, Finland
| | - Janne Kulmala
- School of Health and Social Studies, Jamk University of Applied Sciences, Jyväskylä, Finland
| | - Katja Pahkala
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
- Paavo Nurmi Centre & Unit for Health and Physical Activity, University of Turku, Turku, Finland
| | - Suvi Rovio
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
| | - Mirja Hirvensalo
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Olli Raitakari
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
- Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland
| | - Tuija H Tammelin
- School of Health and Social Studies, Jamk University of Applied Sciences, Jyväskylä, Finland
| | - Kasper Salin
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| |
Collapse
|
8
|
Bourne JE, Leary S, Page A, Searle A, England C, Thompson D, Andrews RC, Foster C, Cooper AR. Electrically assisted cycling for individuals with type 2 diabetes mellitus: a pilot randomized controlled trial. Pilot Feasibility Stud 2023; 9:60. [PMID: 37072802 PMCID: PMC10111297 DOI: 10.1186/s40814-023-01283-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 03/28/2023] [Indexed: 04/20/2023] Open
Abstract
BACKGROUND Type 2 diabetes mellitus (T2DM) and its associated complications puts considerable strain on healthcare systems. With the global incidence of T2DM increasing, effective disease management is essential. Physical activity (PA) is a key component of T2DM management; however, rates of PA engagement are low in this population. Developing effective and sustainable interventions that encourage PA is a high priority. Electrically assisted bicycles are becoming increasingly popular and may increase PA in healthy adults. This study aimed to provide evidence of the feasibility of conducting a randomized controlled trial to evaluate the efficacy of an e-cycling intervention to increase PA and improve health in individuals with T2DM. METHODS A parallel-group two-arm randomized, waitlist-controlled pilot study was conducted. Individuals were randomized to either an e-bike intervention or standard care. The intervention incorporated two one-to-one e-bike skills training and behavioural counselling sessions delivered by a community-based cycling charity, followed by a 12-week e-bike loan with two further sessions with the instructors. Feasibility was assessed via measures related to recruitment, retention and intervention implementation. Post-intervention interviews with instructors and participants explored the acceptability of the study procedures and intervention. Clinical, physiological and behavioural outcomes were collected at baseline and post-intervention to evaluate the intervention's potential. RESULTS Forty participants (Mage = 57) were randomized, of which 34 were recruited from primary care practices. Thirty-five participants were retained in the trial. The intervention was conducted with high fidelity (> 80% content delivered). E-bike training provided participants with the skills, knowledge and confidence needed to e-bike independently. Instructors reported being more confident delivering the skills training than behavioural counselling, despite acknowledging its importance. The study procedures were found to be acceptable to participants. Between-group differences in change during the intervention were indicative of the interventions potential for improving glucose control, health-related quality of life and cardiorespiratory fitness. Increases in overall device measured moderate-to-vigorous PA behaviour following the intervention were found, and there was evidence that this population self-selected to e-cycle at a moderate intensity. CONCLUSIONS The study's recruitment, retention, acceptability and potential efficacy support the development of a definitive trial subject to identified refinements. TRIAL REGISTRATION ISRCTN, ISRCTN67421464 . Registered 17/12/2018.
Collapse
Affiliation(s)
- Jessica E Bourne
- Centre for Exercise, Nutrition and Health Sciences, School of Policy Studies, University of Bristol, 8 Priory Road, Bristol, BS8 1TZ, UK.
- NIHR Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, UK.
| | - Sam Leary
- NIHR Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, UK
| | - Angie Page
- Centre for Exercise, Nutrition and Health Sciences, School of Policy Studies, University of Bristol, 8 Priory Road, Bristol, BS8 1TZ, UK
- NIHR Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, UK
| | - Aidan Searle
- NIHR Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, UK
| | - Clare England
- NIHR Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, UK
| | - Dylan Thompson
- Department for Health, University of Bath, Bath, BA2 7PB, UK
| | - Robert C Andrews
- Institute of Biomedical and Clinical Sciences, Medical Research, University of Exeter Medical School, RILD Level 3, Barrack Road, Exeter, EX2 5DW, Devon, UK
| | - Charlie Foster
- Centre for Exercise, Nutrition and Health Sciences, School of Policy Studies, University of Bristol, 8 Priory Road, Bristol, BS8 1TZ, UK
| | - Ashley R Cooper
- Centre for Exercise, Nutrition and Health Sciences, School of Policy Studies, University of Bristol, 8 Priory Road, Bristol, BS8 1TZ, UK
- NIHR Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, UK
| |
Collapse
|
9
|
Hu HY, Ma YH, Deng YT, Ou YN, Cheng W, Feng JF, Tan L, Yu JT. Residential greenness and risk of incident dementia: A prospective study of 375,342 participants. ENVIRONMENTAL RESEARCH 2023; 216:114703. [PMID: 36334822 DOI: 10.1016/j.envres.2022.114703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Revised: 10/25/2022] [Accepted: 10/28/2022] [Indexed: 06/16/2023]
Abstract
INTRODUCTION Incorporation of greenspace may be a novel environmental policy that might result in positive health effects; hence, this study aimed to investigate the association between residential greenness and dementia incidence. The effects of particulate air pollution on mediating dementia were also determined. METHODS A prospective cohort study involving 375,342 UK biobank participants was conducted, in which Cox regression models were used to determine the association of greenspace exposure with the risks of all-cause dementia (ACD), Alzheimer's disease (AD) and vascular dementia (VD). Sociodemographic variables, lifestyle or dietary characteristics and apolipoprotein E4 status were controlled using two levels of adjusted models. Mediation analyses were performed to determine the mediation effects of PMs. RESULTS The results indicated that there were 4929 ACD, 2132 AD, and 1184 VD incidents throughout the 8-year study. In the multi-adjusted model, each interquartile increment in greenspace (buffer 300m) conferred the lower risks of ACD (HR = 0.968, 95% confidence intervals [CI]: 0.938-1.000]) and VD (HR = 0.926, 95% CI: 0.867-0.989). The fourth greenspace quartile conferred also reduced risks of ACD (HR = 0.891, 95% CI: 0.804-0.989) and VD (HR = 0.778, 95% CI: 0.630-0.960) in reference to the first quartile. With regard to 1000m catchment, each interquartile increment conferred a 5.0% (95% CI: 1.8-8.1) lower risk of ACD, and the fourth greenspace quartile conferred a 10.9% (95% CI: 0.9-19.8) lower risk of ACD compared to the first quartile. The protective effect of greenness might be mediated based on the reduction of PM2.5 and PM10 (Pindirect effect<0.05). CONCLUSIONS Increasing greenness reduces the risk of dementia. This study suggests that greenspace is an environmental strategy that helps prevent dementia.
Collapse
Affiliation(s)
- He-Ying Hu
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China.
| | - Ya-Hui Ma
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China.
| | - Yue-Ting Deng
- Department of Neurology and National Center for Neurological Disorders, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, China.
| | - Ya-Nan Ou
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China.
| | - Wei Cheng
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China.
| | - Jian-Feng Feng
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China.
| | - Lan Tan
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China.
| | - Jin-Tai Yu
- Department of Neurology and National Center for Neurological Disorders, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, China.
| |
Collapse
|
10
|
Abstract
In recent decades, the prevalence of obesity and diabetes has risen substantially in North America and worldwide. To address these dual epidemics, researchers and policymakers alike have been searching for effective means to promote healthy lifestyles at a population level. As a consequence, there has been a proliferation of research examining how the "built" environment in which we live influences physical activity levels, by promoting active forms of transportation, such as walking and cycling, over passive ones, such as car use. Shifting the transportation choices of local residents may mean that more members of the population can participate in physical activity during their daily routine without structured exercise programs. Increasingly, this line of research has considered the downstream metabolic consequences of the environment in which we live, raising the possibility that "healthier" community designs could help mitigate the rise in obesity and diabetes prevalence. This review discusses the evidence examining the relationship between the built environment, physical activity, and obesity-related diseases. We also consider how other environmental factors may interact with the built environment to influence metabolic health, highlighting challenges in understanding causal relationships in this area of research.
Collapse
Affiliation(s)
| | - Gillian L Booth
- Department of Medicine, University of Toronto, Toronto, ON, Canada
- MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, ON, Canada
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- ICES, Toronto, ON, Canada
| |
Collapse
|
11
|
Pindek S, Shen W, Andel S. Finally, some “me time”: A new theoretical perspective on the benefits of commuting. ORGANIZATIONAL PSYCHOLOGY REVIEW 2022. [DOI: 10.1177/20413866221133669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Most research on commuting has focused on its negative aspects and consequences (i.e., stress). However, some work has also begun to recognize that there may be positive aspects to commuting. In this paper, we develop a perspective that has so far received limited attention, highlighting how the commute can be experienced as desired and beneficial “me time”, due to the fact that it inhabits a “third space” that is less associated with work or home role requirements. Drawing upon and integrating theories and research on commuting, leisure, recovery, and identity, we first define this construct and then develop a theoretical model that aims to address key questions regarding predicting motivation to engage in “me time”, beneficial outcomes of “me time”, and potential moderators of these effects. Consequently, our proposed model offers both research and practical implications for commuting employees as well as their employers, families, and society. Plain Language Summary The majority of research on commuting has focused on its negative aspects and consequences (i.e., stress). However, increasingly, some work has also begun to recognize that there may be some positive aspects of commuting. Despite some scholars acknowledging the potential benefits of commuting, most still conceptualize the commute as simply a necessary transition between domains (i.e., work and home). In this paper, we seek to bring a new perspective to the literature, highlighting how the commute can be experienced as desired “time to myself”. We therefore develop a theoretical model that aims to address key questions surrounding this phenomenon, including what is “me time” during the commute, who is more likely to uses the commute for “me time”, what are the situational factors that facilitate or inhibit choosing “me time”, what positive outcomes can be expected when engaging in “me time”, and what conditions are likely to affect this process. We also discuss the underlying mechanisms for this process. As a result, our proposed model presents both research and practical implications for commuting employees as well as their employers, families, and society.
Collapse
Affiliation(s)
| | - Winny Shen
- Schulich School of Business, York University, Canada
| | | |
Collapse
|
12
|
Dadashova B, Park ES, Mousavi SM, Dai B, Sanders R. Assessment of inequity in bicyclist crashes using bivariate Bayesian copulas. JOURNAL OF SAFETY RESEARCH 2022; 82:221-232. [PMID: 36031249 DOI: 10.1016/j.jsr.2022.05.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Revised: 11/27/2021] [Accepted: 05/25/2022] [Indexed: 06/15/2023]
Abstract
INTRODUCTION Physical activity associated with active transport modes such as bicycling has major health benefits and can help to reduce health concerns related to sedentary lifestyles, such as cardiovascular disease, Type II diabetes, and obesity, as well as risks of colon and breast cancer, high blood pressure, lipid disorders, osteoporosis, depression, and anxiety. However, as a vulnerable user group, bicyclists experience negative health impacts of transportation policies and infrastructure, such as traffic crashes and exposure to air and noise pollution that is disproportionately distributed within low-income and underserved areas. METHOD This study used aggregated (block-group) bicyclist crash data from Harris County, Texas, to analyze how various equity measures are associated with both fatal and injury (FI) and no injury (property damage only) bicyclist crashes that occurred from 2010 to 2017. We used Bayesian bivariate copula-based random effects regression analysis to evaluate these associations. In contrast to more traditional univariate analysis, this novel methodology can consider the effects of factors of interest across different severity levels or crash types to fully understand their effects and how they may differ across categories. RESULTS The analysis results indicate that the bicyclist exposure, vehicle exposure, population demographics, population density, the percentage of African-Americans, and households below the poverty level are associated with both FI and PDO bicyclist crashes. CONCLUSIONS Although more location and context-specific analyses are required, this study's overall results once again conform with the findings and assumptions in bicycling safety literature that the low-income and racially diverse communities are prone to experience more bicyclist crashes. PRACTICAL APPLICATIONS The findings of this study may have implications for future transportation and planning policies. These findings can be used to guide the policies and strategies targeting the elimination of inequity in transportation-related health concerns.
Collapse
Affiliation(s)
- Bahar Dadashova
- Texas A&M Transportation Institute, 1111 Rellis Pkwy, Bryan, TX 77807, United States.
| | - Eun Sug Park
- Texas A&M Transportation Institute, 1111 Rellis Pkwy, Bryan, TX 77807, United States
| | | | - Boya Dai
- Texas A&M Transportation Institute, 1111 Rellis Pkwy, Bryan, TX 77807, United States
| | - Rebecca Sanders
- Safe Streets Research & Consulting, 2641 SE Harrison Street, Portland, OR 97214, United States
| |
Collapse
|
13
|
Jepson R, Baker G, Cleland C, Cope A, Craig N, Foster C, Hunter R, Kee F, Kelly MP, Kelly P, Milton K, Nightingale G, Turner K, Williams AJ, Woodcock J. Developing and implementing 20-mph speed limits in Edinburgh and Belfast: mixed-methods study. PUBLIC HEALTH RESEARCH 2022. [DOI: 10.3310/xazi9445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background
Transport initiatives such as 20-mph (≈30-km/h) speed limits are anticipated to result in fewer road casualties and improve perceptions of safety, leading to increases in active travel. Lower speeds may also lead to more pleasant environments in which to live, work and play.
Objectives
The main objective was to evaluate and understand the processes and effects of developing and implementing 20-mph speed limits in Edinburgh and Belfast. The focus was on health-related outcomes (casualties and active travel) that may lead to public health improvements. An additional objective was to investigate the political and policy factors (conditions) that led to the decision to introduce the new speed limits.
Design
This was a mixed-methods study that comprised an outcome, process, policy and economic evaluation of two natural experiments.
Setting
The study was set in Edinburgh, Scotland, and Belfast, Northern Ireland, from 2000 to 2018.
Participants
The whole population of each city were participants, as well as stakeholders involved in implementation and decision-making processes.
Intervention
The intervention was the implementation of 20-mph legislation, signage, enforcement, and education and awareness-raising in Edinburgh (citywide) and Belfast (city centre).
Main outcome measures
The main outcomes measured were speed; number, type and severity of road collisions; perceptions; and liveability.
Data sources
The following data sources were used – routinely and locally collected quantitative data for speed, volume of traffic, casualties and collisions, and costs; documents and print media; surveys; interviews and focus groups; and Google Street View (Google Inc., Mountain View, CA, USA).
Results
Collisions and casualties – the overall percentage reduction in casualty rates was 39% (the overall percentage reduction in collision rates was 40%) in Edinburgh. The percentage reduction for each level of severity was 23% for fatal casualties, 33% for serious casualties and 37% for minor casualties. In Belfast there was a 2% reduction in casualties, reflecting differences in the size, reach and implementation of the two schemes. Perceptions – in Edinburgh there was an increase in two factors (support for 20 mph and rule-following after implementation) supported by the qualitative data. Liveability – for both cities, there was a small statistical increase in liveability. Speed – mean and median speeds reduced by 1.34 mph and 0.47 mph, respectively, at 12 months in Edinburgh, with no statistically significant changes in Belfast. History, political context, local policy goals, local priorities and leadership influenced decision-making and implementation in the two cities.
Limitations
There was no analysis of active travel outcomes because the available data were not suitable.
Conclusions
The pre-implementation period is important. It helps frame public and political attitudes. The scale of implementation and additional activities in the two cities had a bearing on the impacts. The citywide approach adopted by Edinburgh was effective in reducing speeds and positively affected a range of public health outcomes. The city-centre approach in Belfast (where speeds were already low) was less effective. However, the main outcome of these schemes was a reduction in road casualties at all levels of severity.
Future work
Future work should develop a statistical approach to public health interventions that incorporates variables from multiple outcomes. In this study, each outcome was analysed independently of each other. Furthermore, population measures of active travel that can be administered simply, inexpensively and at scale should be developed.
Study registration
This study is registered as ISRCTN10200526.
Funding
This project was funded by the National Institute for Health and Care Research (NIHR) Public Health Research programme and will be published in full in Public Health Research; Vol. 10, No. 9. See the NIHR Journals Library website for further project information.
Collapse
Affiliation(s)
- Ruth Jepson
- Scottish Collaboration for Public Health Research and Policy, University of Edinburgh, Edinburgh, UK
| | - Graham Baker
- Physical Activity for Health Research Centre, University of Edinburgh, Edinburgh, UK
| | - Claire Cleland
- School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, UK
| | | | | | - Charlie Foster
- Centre for Exercise, Nutrition and Health Sciences, University of Bristol, Bristol, UK
| | - Ruth Hunter
- School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, UK
| | - Frank Kee
- School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, UK
| | - Michael P Kelly
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Paul Kelly
- Physical Activity for Health Research Centre, University of Edinburgh, Edinburgh, UK
| | - Karen Milton
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - Glenna Nightingale
- Scottish Collaboration for Public Health Research and Policy, University of Edinburgh, Edinburgh, UK
| | - Kieran Turner
- Scottish Collaboration for Public Health Research and Policy, University of Edinburgh, Edinburgh, UK
- Physical Activity for Health Research Centre, University of Edinburgh, Edinburgh, UK
| | | | - James Woodcock
- Centre for Diet and Activity Research, University of Cambridge, Cambridge, UK
| |
Collapse
|
14
|
Ferrari G, Drenowatz C, Kovalskys I, Gómez G, Rigotti A, Cortés LY, García MY, Pareja RG, Herrera-Cuenca M, Del'Arco AP, Peralta M, Marques A, Leme ACB, Sadarangani KP, Guzmán-Habinger J, Chaves JL, Fisberg M. Walking and cycling, as active transportation, and obesity factors in adolescents from eight countries. BMC Pediatr 2022; 22:510. [PMID: 36042429 PMCID: PMC9426250 DOI: 10.1186/s12887-022-03577-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Accepted: 08/24/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Evidence has shown that active transportation decreases obesity rates, but considering walking or cycling as separate modes could provide additional information on the health benefits in adolescents. This study aimed to examine the associations between walking and cycling as form active transportation and obesity indicators in Latin American adolescents. METHODS Population-based study with 671 adolescents (mean age: 15.9 [standard deviation: 0.8] years) from eight countries participating in the Latin American Study of Nutrition and Health/Estudio Latino Americano Nutrition y Salud (ELANS). Walking and cycling for active transportation were measured using the International Physical Activity Questionnaire long version. Body mass index, waist circumference, neck circumference, and relative fat mass were used as obesity indicators. Associations were estimated using logistic regression models for the pooled data adjusted for country, sex, age, socio-economic levels, race/ethnicity, leisure-time physical activity and energy intake. RESULTS Mean time spent walking and cycling was 22.6 (SD: 33.1) and 5.1 (SD: 24.1) min/day, respectively. The median values were 12.8 (IQR: 4.2; 25.7) and 0 (IQR: 0; 6.2) for walking and cycling. Participants reporting ≥ 10 min/week of walking or cycling for active transportation were 84.2% and 15.5%, respectively. Costa Rica (94.3% and 28.6%) showed the highest prevalence for walking and cycling, respectively, while Venezuela (68.3% and 2.4%) showed the lowest prevalence. There was no significant association between walking for active transportation and any obesity indicator. In the overall sample, cycling for ≥ 10 min/week was significantly associated with a lower likelihood of overweight/obesity based on BMI (OR: 0.86; 95%CI: 0.88; 0.94) and waist circumference (OR: 0.90; 95%CI: 0.83; 0.97) adjusted for country, sex, age, socio-economic level, race/ethnicity, leisure-time physical activity and energy intake compared to cycling for < 10 min/week. There were no significant associations between cycling for active transportation and neck circumference as well as relative fat mass. CONCLUSIONS Cycling for active transportation was negatively associated with obesity indicators, especially body mass index and waist circumference. Programs for promoting cycling for active transportation could be a feasible strategy to tackle the high obesity rates in adolescents in Latin America. TRIAL REGISTRATION ClinicalTrials.Gov NCT02226627. Retrospectively registered on August 27, 2014.
Collapse
Affiliation(s)
- Gerson Ferrari
- Sciences of Physical Activity, Sports and Health School, University of Santiago of Chile (USACH), Santiago, Chile. .,Faculty of Health Sciences, Universidad Autónoma de Chile, Av. Pedro de Valdivia 425, 7500912, Providencia, Santiago, Chile.
| | - Clemens Drenowatz
- Division of Sport, Physical Activity and Health, University of Education Upper Austria, 4020, Linz, Austria
| | - Irina Kovalskys
- Nutrition Career, Faculty of Medical Sciences, Pontificia Universidad Católica Argentina, AAZ, C1107, Buenos Aires, Argentina
| | - Georgina Gómez
- Department of Biochemistry, School of Medicine, Universidad de Costa Rica, San José, 11501-2060, Costa Rica
| | - Attilio Rigotti
- Department of Nutrition, Diabetes and Metabolism, School of Medicine, Pontificia Universidad Católica, 8330024, Santiago, Chile
| | - Lilia Yadira Cortés
- Department of Nutrition and Biochemistry, Pontificia Universidad Javeriana, 110231, Bogotá, Colombia
| | - Martha Yépez García
- College of Health Sciences, San Francisco de Quito University, Quito, Ecuador
| | | | - Marianella Herrera-Cuenca
- Center for Development Studies, Central University of Venezuela (CENDES/UCV) Bengoa Foundation, Caracas, Venezuela
| | - Ana Paula Del'Arco
- Pediatric Department, Escola Paulista de Medicina, Federal University of Sao Paulo, Brazil - UNIFESP, São Paulo, Brazil
| | - Miguel Peralta
- CIPER, Faculty of Human Kinetics, University of Lisbon, 1499-002 Cruz Quebrada, Lisbon, Portugal.,ISAMB, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - Adilson Marques
- CIPER, Faculty of Human Kinetics, University of Lisbon, 1499-002 Cruz Quebrada, Lisbon, Portugal.,ISAMB, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - Ana Carolina B Leme
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Kabir P Sadarangani
- School of Kinesiology, Faculty of Health and Dentistry, Universidad Diego Portales, 8370057, Santiago, Chile.,School of Kinesiology, Faculty of Dentistry and Rehabilitation Sciences, Universidad San Sebastián, Bío Bío, Chile
| | - Juan Guzmán-Habinger
- Sports Medicine and Physical Activity Specialty, Science Faculty, Universidad Mayor, Santiago, Chile
| | | | - Mauro Fisberg
- Pediatric Department, Escola Paulista de Medicina, Federal University of Sao Paulo, Brazil - UNIFESP, São Paulo, Brazil.,Pensi Institute, José Luiz Egydio Setúbal Foundation- Sabará Children's Hospital, São Paulo, Brazil
| |
Collapse
|
15
|
Quist J, Winther J, Friis A, Gram A, Blond M, Rosenkilde M, Jespersen A, Stallknecht B. Maintenance of cardiorespiratory fitness, body composition, and a physically active lifestyle after structured exercise interventions in individuals with overweight and obesity: A mixed-method follow-up study. PUBLIC HEALTH IN PRACTICE 2022; 4:100293. [PMID: 36570402 PMCID: PMC9773044 DOI: 10.1016/j.puhip.2022.100293] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 06/17/2022] [Accepted: 07/01/2022] [Indexed: 12/27/2022] Open
Abstract
Objectives The aim of this mixed-method study was to explore maintenance of physical activity and health effects one year after completion of exercise interventions in transport and leisure-time domains of everyday life. We hypothesised that routinisation of active commuting would lead to better maintenance of physical activity and health effects compared with leisure-time exercise. Study design Mixed-methods follow-up study. Methods Individuals with overweight/obesity, who completed a 6-month exercise intervention (active commuting by bike (BIKE), moderate (MOD) or vigorous intensity leisure-time exercise (VIG)), were after one year invited to participate in a follow-up visit which included measurements of cardiorespiratory fitness during an incremental bicycle test and body composition using dual-energy X-ray absorptiometry. Variability in maintenance practices was assessed in a sub-sample of participants who experienced the greatest improvements ('VO2peak improvers') and reductions ('VO2peak reducers'), respectively, in cardiorespiratory fitness. Semi-structured interviews were conducted (15-30 min) and analysed using systematic text condensation to identify barriers and facilitators associated with maintenance of physical activity. Results Out of the 74 participants completing an exercise intervention, 46 (62%) completed follow-up (BIKE: n = 14; MOD: n = 14; VIG: n = 18). Improvements in VO2peak and reductions in fat mass were maintained in BIKE and VIG. Body weight decreased in BIKE and fat free mass increased in VIG. Changes in VO2peak and anthropometry at follow-up did not differ between BIKE and MOD + VIG. Fat mass decreased and recreational physical activity increased in 'VO2peak improvers'. Findings from the interviews suggested that self-monitoring, collective exercising, and new personal exercise challenges facilitate maintenance of a physically active lifestyle. Conclusion Completion of a structured exercise intervention consisting of 6 months of active commuting or vigorous intensity leisure-time exercise was associated with long-term maintenance of improvements in VO2peak and body composition, whereas moderate intensity leisure-time exercise was not. In contrast to our hypothesis, active commuting was not associated with better maintenance of physical activity and health effects after the intervention compared with leisure-time exercise.
Collapse
Affiliation(s)
- J.S. Quist
- Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark,Clinical Research, Copenhagen University Hospital - Steno Diabetes Center Copenhagen, Herlev, Denmark,Corresponding author. Department of Biomedical Sciences, University of Copenhagen, Blegdamsvej 3, DK, 2200, Copenhagen, Denmark.
| | - J. Winther
- Department of Social Education, University College Copenhagen, Copenhagen, Denmark,Copenhagen Centre for Health Research in the Humanities, Saxo Institute, University of Copenhagen, Copenhagen, Denmark
| | - A.L. Friis
- Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - A.S. Gram
- Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - M.B. Blond
- Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark,Clinical Research, Copenhagen University Hospital - Steno Diabetes Center Copenhagen, Herlev, Denmark
| | - M. Rosenkilde
- Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - A.P. Jespersen
- Copenhagen Centre for Health Research in the Humanities, Saxo Institute, University of Copenhagen, Copenhagen, Denmark
| | - B.M. Stallknecht
- Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| |
Collapse
|
16
|
den Braver NR, Lakerveld J, Gozdyra P, van de Brug T, Moin JS, Fazli GS, Rutters F, Brug J, Moineddin R, Beulens JWJ, Booth GL. Development of a neighborhood drivability index and its association with transportation behavior in Toronto. ENVIRONMENT INTERNATIONAL 2022; 163:107182. [PMID: 35306254 DOI: 10.1016/j.envint.2022.107182] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 03/08/2022] [Accepted: 03/09/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Car driving is a form of passive transport that is associated with an increase in physical inactivity, obesity, air pollution and noise. Built environment characteristics may influence transport mode choice, but comprehensive indices for built environment characteristics that drive car use are still lacking, while such an index could provide tangible policy entry points. OBJECTIVE We developed and validated a neighbourhood drivability index, capturing combined dimensions of the neighbourhood environment in the City of Toronto, and investigated its association with transportation choices (car, public transit or active transport), overall, by trip length, and combined for residential neighbourhood and workplace drivability. METHODS We used exploratory factor analysis to derive distinct factors (clusters of one or more environmental characteristics) that reflect the degree of car dependency in each neighbourhood, drawing from candidate variables that capture density, diversity, design, destination accessibility, distance to transit, and demand management. Area-level factor scores were then combined into a single composite score, reflecting neighbourhood drivability. Negative binomial generalized estimating equations were used to test the association between driveability quintiles (Q) and primary travel mode (>50% of trips by car, public transit, or walking/cycling) in a population-based sample of 63,766 Toronto residents enrolled in the Transportation Tomorrow Survey (TTS) wave 2016, adjusting for individual and household characteristics, and accounting for clustering of respondents within households. RESULTS The drivability index consisted of three factors: Urban sprawl, pedestrian facilities and parking availability. Relative to those living in the least drivable neighbourhoods (Q1), those in high drivability areas (Q5) had a significantly higher rate of car travel (adjusted Risk Ratio (RR): 1.80, 95%CI: 1.77-1.88), and lower rate of public transit use (RR: 0.90, 95%CI: 0.85-0.94) and walking/cycling (RR: 0.22, 95%CI: 0.19-0.25). Associations were strongest for short trips (<3 km) (RR: 2.72, 95%CI: 2.48-2.92), and in analyses where both residential and workplace drivability was considered (RR for car use in high/high vs. low/low residential/workplace drivability: 2.18, 95%CI: 2.08-2.29). CONCLUSION This novel neighbourhood drivability index predicted whether local residents drive or use active modes of transportation and can be used to investigate the association between drivability, physical activity, and chronic disease risk.
Collapse
Affiliation(s)
- Nicolette R den Braver
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands; Upstream Team, www.upstreamteam.nl, Amsterdam, the Netherlands.
| | - Jeroen Lakerveld
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Peter Gozdyra
- MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada; ICES, Toronto, Canada
| | - Tim van de Brug
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - John S Moin
- MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada
| | - Ghazal S Fazli
- MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada
| | - Femke Rutters
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Johannes Brug
- National Institute for Public Health and the Environment, Bilthoven, the Netherlands; Faculty of Social and Behavioural Sciences, University of Amsterdam, Amsterdam, the Netherlands
| | - Rahim Moineddin
- ICES, Toronto, Canada; Department of Family and Community Medicine, Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Joline W J Beulens
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands; Upstream Team, www.upstreamteam.nl, Amsterdam, the Netherlands; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Gillian L Booth
- MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada; ICES, Toronto, Canada; Department of Medicine, University of Toronto, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Canada
| |
Collapse
|
17
|
Clark S, Lomax N, Birkin M, Morris M. A foresight whole systems obesity classification for the English UK biobank cohort. BMC Public Health 2022; 22:349. [PMID: 35180877 PMCID: PMC8856870 DOI: 10.1186/s12889-022-12650-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 01/18/2022] [Indexed: 12/20/2022] Open
Abstract
Background The number of people living with obesity or who are overweight presents a global challenge, and the development of effective interventions is hampered by a lack of research which takes a joined up, whole system, approach that considers multiple elements of the complex obesity system together. We need to better understand the collective characteristics and behaviours of those who are overweight or have obesity and how these differ from those who maintain a healthy weight. Methods Using the UK Biobank cohort we develop an obesity classification system using k-means clustering. Variable selection from the UK Biobank cohort is informed by the Foresight obesity system map across key domains (Societal Influences, Individual Psychology, Individual Physiology, Individual Physical Activity, Physical Activity Environment). Results Our classification identifies eight groups of people, similar in respect to their exposure to known drivers of obesity: ‘Younger, urban hard-pressed’, ‘Comfortable, fit families’, ‘Healthy, active and retirees’, ‘Content, rural and retirees’, ‘Comfortable professionals’, ‘Stressed and not in work’, ‘Deprived with less healthy lifestyles’ and ‘Active manual workers’. Pen portraits are developed to describe the characteristics of these different groups. Multinomial logistic regression is used to demonstrate that the classification can effectively detect groups of individuals more likely to be living with overweight or obesity. The group identified as ‘Comfortable, fit families’ are observed to have a higher proportion of healthy weight, while three groups have increased relative risk of being overweight or having obesity: ‘Active manual workers’, ‘Stressed and not in work’ and ‘Deprived with less healthy lifestyles’. Conclusions This paper presents the first study of UK Biobank participants to adopt this obesity system approach to characterising participants. It provides an innovative new approach to better understand the complex drivers of obesity which has the potential to produce meaningful tools for policy makers to better target interventions across the whole system to reduce overweight and obesity. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-12650-x.
Collapse
Affiliation(s)
- Stephen Clark
- Consumer Data Research Centre and School of Geography, University of Leeds, LEEDS, LS2 9JT, UK.
| | - Nik Lomax
- School of Geography and Consumer Data Research Centre, University of Leeds, LEEDS, LS2 9JT, UK
| | - Mark Birkin
- Consumer Data Research Centre and School of Geography, University of Leeds, LEEDS, LS2 9JT, UK
| | - Michelle Morris
- School of Medicine and Consumer Data Research Centre, University of Leeds, LEEDS, UK
| |
Collapse
|
18
|
Green S. Cycling for health: Improving health and mitigating the climate crisis. CANADIAN FAMILY PHYSICIAN MEDECIN DE FAMILLE CANADIEN 2021; 67:739-742. [PMID: 34649896 PMCID: PMC8516176 DOI: 10.46747/cfp.6710739] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To review the literature about cycling and health, and to provide an overview and discussion of the available evidence. SOURCES OF INFORMATION The MeSH terms bicycle and transportation were searched in PubMed. Clinical trials, practice reviews, and systematic reviews were included. All reference lists were reviewed for additional articles. MAIN MESSAGE Climate change is a threat to health. In Canada alone, transportation is the second largest source of greenhouse gas emissions. Active transportation, which is any form of human-powered transportation, can mitigate the health effects of the climate crisis while simultaneously improving the health of people. Physical activity improves overall well-being, as well as physical and mental health. Active transportation, particularly cycling, is a convenient way to meet physical activity targets, reduce risk of disease and all-cause mortality, and derive mental health and social benefits. Family physician advocacy for active transportation has been shown to increase cycling levels in patients compared with no physician advocacy. CONCLUSION Family physicians can help to increase the level of active transportation at the individual patient level through patient education and behaviour change counseling; at the community level through community education and political advocacy; and at the policy level through partnerships with larger organizations.
Collapse
Affiliation(s)
- Samantha Green
- Family physician at St Michael’s Hospital in Toronto, Ont, and Faculty Lead in Climate Change and Health in the Department of Family and Community Medicine at the University of Toronto
| |
Collapse
|
19
|
Wu J, Li Q, Feng Y, Bhuyan SS, Tarimo CS, Zeng X, Wu C, Chen N, Miao Y. Active commuting and the risk of obesity, hypertension and diabetes: a systematic review and meta-analysis of observational studies. BMJ Glob Health 2021; 6:bmjgh-2021-005838. [PMID: 34172487 PMCID: PMC8237743 DOI: 10.1136/bmjgh-2021-005838] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Accepted: 05/21/2021] [Indexed: 11/18/2022] Open
Abstract
Active commuting may hold a potential for preventing adverse health outcomes. However, evidence of the association of active commuting and the risk of health outcomes remains debatable. The current study systematically and quantitatively summarised research findings on the association between active commuting and the risk of the mentioned health outcomes. We comprehensively searched four databases (PubMed, EMBASE, Web of Science and Open Grey) from inception to 2 August 2020 for observational studies investigating the associations among adult population. Summary relative risks (RRs) and 95% CIs were estimated for the association. Heterogeneity was investigated using Cochran’s Q test and the I2 statistic. Restricted cubic splines were used to evaluate linear and nonlinear relations. The search yielded 7581 initial references. We included 28 articles in the meta-analysis. Compared with inactive commuting, active commuting reduced the risk of obesity (RR=0.88, 95% CI 0.83 to 0.94, I2=69.1%), hypertension (RR=0.95, 95% CI 0.87 to 1.04, I2=82.2%) and diabetes (RR=0.82, 95% CI 0.76 to 0.90, I2=44.5%). Restricted cubic splines showed linear associations between active commuting and obesity, hypertension and diabetes (Pnonlinearity=0.640; Pnonlinearity=0.886; Pnonlinearity=0.099). As compared with the lowest active commuting group, the risk of obesity, hypertension and diabetes in the highest active commuting group were reduced by 13% (95% CI 0.82 to 0.93, I2=65.2%); 6% (95% CI 0.86 to 1.02, I2=75.2%) and 19% (95% CI 0.73 to 0.91, I2=49.8%) respectively. Active commuting seemed to be associated with lower risk of obesity, hypertension and diabetes. However, the results should be interpreted cautiously because this meta-analysis was based solely on observational studies. PROSPERO registration number CRD42020202723.
Collapse
Affiliation(s)
- Jian Wu
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Quanman Li
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Yu Feng
- Department of Social Medicine and Health Service Management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Soumitra S Bhuyan
- Edward J. Bloustein School of Planning and Public Policy, Rutgers University New Brunswick, New Brunswick, New Jersey, USA
| | - Clifford Silver Tarimo
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China.,Department of Science and Laboratory Technology, Dar es salaam Institute of Technology, P.O. Box 2958, Dar es Salaam, Tanzania
| | - Xin Zeng
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Cuiping Wu
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Ning Chen
- School of Politics and Public Administration, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Yudong Miao
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| |
Collapse
|
20
|
Peruzzi M, Sanasi E, Pingitore A, Marullo AG, Carnevale R, Sciarretta S, Sciarra L, Frati G, Cavarretta E. An overview of cycling as active transportation and as benefit for health. Minerva Cardioangiol 2021; 68:81-97. [PMID: 32429627 DOI: 10.23736/s0026-4725.20.05182-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Active transportation is defined as travelling on foot, by bicycle or other non-motorized means, sometimes in combination with other forms of public transportation, in contrast with the use of motor vehicles. The prevalence of sedentary lifestyle and physical inactivity is a growing epidemic in most developed countries that spread over the last three decades; active transportation may be a promising approach to increase physical activity and reduce the risk of non-communicable diseases improving cardiorespiratory fitness and cardiometabolic health. The health benefits of physical activity in reducing mortality and morbidity have been proved by several publications. Cardiorespiratory fitness can be improved by regular physical activity with an amelioration of insulin sensitivity, blood lipid profile, body composition, inflammation, and blood pressure. Active transportation as a daily physical activity is less expensive compared to motor vehicle use. The advantages are remarkable in terms of contrasting obesity and sedentary lifestyle, decrease motor traffic congestion and mitigate climate change. Massive investments in policies and interventions aimed to increase active transportation are not generally promoted and there are differences in the prevalence of active transportation in the daily routine among different areas. As in the literature several studies as randomized trials or observational studies have been published, with different end-points, in order to investigate if active commuting may be the right answer to improve cardiorespiratory fitness and cardiometabolic health, we aimed to review the available evidences of cycling as an active transportation and to consider its benefits on health.
Collapse
Affiliation(s)
| | - Elena Sanasi
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University, Latina, Italy
| | | | - Antonino G Marullo
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University, Latina, Italy
| | - Roberto Carnevale
- Mediterranea Cardiocentro, Naples, Italy.,Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University, Latina, Italy
| | - Sebastiano Sciarretta
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University, Latina, Italy.,Department of Angio-Cardio-Neurology, IRCCS NeuroMed, Pozzilli, Isernia, Italy
| | - Luigi Sciarra
- Division of Cardiology, Policlinico Casilino, Rome, Italy
| | - Giacomo Frati
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University, Latina, Italy.,Department of Angio-Cardio-Neurology, IRCCS NeuroMed, Pozzilli, Isernia, Italy
| | - Elena Cavarretta
- Mediterranea Cardiocentro, Naples, Italy - .,Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University, Latina, Italy
| |
Collapse
|
21
|
Alessio HM, Bassett DR, Bopp MJ, Parr BB, Patch GS, Rankin JW, Rojas-Rueda D, Roti MW, Wojcik JR. Climate Change, Air Pollution, and Physical Inactivity: Is Active Transportation Part of the Solution? Med Sci Sports Exerc 2021; 53:1170-1178. [PMID: 33986228 DOI: 10.1249/mss.0000000000002569] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Active transportation is defined as self-propelled, human-powered transportation modes, such as walking and bicycling. In this article, we review the evidence that reliance on gasoline-powered transportation is contributing to global climate change, air pollution, and physical inactivity and that this is harmful to human health. Global climate change poses a major threat to human health and in the future could offset the health gains achieved over the last 100 yr. Based on hundreds of scientific studies, there is strong evidence that human-caused greenhouse gas emissions are contributing to global climate change. Climate change is associated with increased severity of storms, flooding, rising sea levels, hotter climates, and drought, all leading to increased morbidity and mortality. Along with increases in atmospheric CO2, other pollutants such as nitrogen dioxide, ozone, and particulate matter (e.g., PM2.5) are released by combustion engines and industry, which can lead to pulmonary and cardiovascular diseases. Also, as car ownership and vehicle miles traveled have increased, the shift toward motorized transport has contributed to physical inactivity. Each of these global challenges has resulted in, or is projected to result in, millions of premature deaths each year. One of the ways that nations can mitigate the health consequences of climate change, air pollution, and chronic diseases is through the use of active transportation. Research indicates that populations that rely heavily on active transportation enjoy better health and increased longevity. In summary, active transportation has tremendous potential to simultaneously address three global public health challenges of the 21st century.
Collapse
Affiliation(s)
- Helaine M Alessio
- Department of Kinesiology, Nutrition, and Health, Miami University, Miami, OH
| | - David R Bassett
- Department of Kinesiology, Recreation, and Sport Studies, University of Tennessee, Knoxville, TN
| | - Melissa J Bopp
- Department of Kinesiology, Pennsylvania State University, State College, PA
| | - Brian B Parr
- Department of Exercise and Sports Science, University of South Carolina, Aiken, SC
| | | | - Janet W Rankin
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA
| | - David Rojas-Rueda
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO
| | - Melissa W Roti
- Movement Science, Sport, and Leisure Studies Department, Westfield State University, Westfield, MA
| | - Janet R Wojcik
- Department of Physical Education, Sport, and Human Performance, Winthrop University, Rock Hill, SC
| |
Collapse
|
22
|
Crist K, Benmarhnia T, Zamora S, Yang JA, Sears DD, Natarajan L, Dillon L, Sallis JF, Jankowska MM. Device-Measured and Self-Reported Active Travel Associations with Cardiovascular Disease Risk Factors in an Ethnically Diverse Sample of Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:3909. [PMID: 33917841 PMCID: PMC8068223 DOI: 10.3390/ijerph18083909] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 03/25/2021] [Accepted: 04/02/2021] [Indexed: 01/13/2023]
Abstract
Active travel (AT) provides an opportunity to alleviate the physical inactivity and climate crises contributing to the global chronic disease burden, including cardiovascular diseases (CVD). Though AT shows promising links to reduced CVD risk, prior studies relied on self-reported AT assessment. In the present study, device-measured and self-reported AT were compared across population subgroups and relationships with CVD risk biomarkers were evaluated for both measures. The study recruited an ethnically diverse sample (N = 602, mean age 59 years, 42% Hispanic/Latino ethnicity) from neighborhoods that varied by walkability and food access. AT was assessed using concurrently collected accelerometer and GPS data and self-report data from a validated survey. Relationships with body mass index (BMI), triglycerides, high-density lipoprotein (HDL) cholesterol, blood pressure (BP), and moderate-to-vigorous physical activity (MVPA) were modeled using multivariable linear regression. Devices captured more AT than did self-report. We found differences in AT measures by population subgroups, including race, ethnicity, education, income, vehicle access, and walkability. Men had more accelerometer-measured MVPA, though women self-reported more daily minutes. Both device and survey AT measures were positively associated with total accelerometer-measured MVPA, though the relationship was stronger with device-measured AT. Device-measured AT was associated with lower BMI. No other CVD risk biomarker was associated with either AT measure. No effect modification by Hispanic/Latino ethnicity was detected. Further studies with device-based measures are warranted to better understand the relationship between AT and cardiovascular health.
Collapse
Affiliation(s)
- Katie Crist
- Department of Family Medicine, UC San Diego, La Jolla, CA 92093, USA;
| | - Tarik Benmarhnia
- Herbert Wertheim School of Public Health and Human Longevity Science, UC San Diego, La Jolla, CA 92093, USA; (T.B.); (L.N.); (L.D.); (J.F.S.)
- Scripps Institution of Oceanography, UC San Diego, La Jolla, CA 92093, USA
| | - Steven Zamora
- Qualcomm Institute/Calit2, UC San Diego, La Jolla, CA 92093, USA; (S.Z.); (J.-A.Y.)
| | - Jiue-An Yang
- Qualcomm Institute/Calit2, UC San Diego, La Jolla, CA 92093, USA; (S.Z.); (J.-A.Y.)
| | - Dorothy D. Sears
- Department of Family Medicine, UC San Diego, La Jolla, CA 92093, USA;
- Department of Medicine, UC San Diego, La Jolla, CA 92093, USA
- College of Health Solutions, Arizona State University, 550 N 3rd Street, Phoenix, AZ 85004, USA
| | - Loki Natarajan
- Herbert Wertheim School of Public Health and Human Longevity Science, UC San Diego, La Jolla, CA 92093, USA; (T.B.); (L.N.); (L.D.); (J.F.S.)
| | - Lindsay Dillon
- Herbert Wertheim School of Public Health and Human Longevity Science, UC San Diego, La Jolla, CA 92093, USA; (T.B.); (L.N.); (L.D.); (J.F.S.)
| | - James F. Sallis
- Herbert Wertheim School of Public Health and Human Longevity Science, UC San Diego, La Jolla, CA 92093, USA; (T.B.); (L.N.); (L.D.); (J.F.S.)
- Mary MacKillop Institute for Health Research, Australian Catholic University, Fitzroy, VIC 3065, Australia
| | - Marta M. Jankowska
- Population Sciences, Beckman Research Institute, City of Hope, 1500 E Duarte Rd, Duarte, CA 91010, USA;
| |
Collapse
|
23
|
Nonnenmacher L, Baumann M, le Bihan E, Askenazy P, Chauvel L. Cross-border mobility in European countries: associations between cross-border worker status and health outcomes. BMC Public Health 2021; 21:588. [PMID: 33761912 PMCID: PMC7992783 DOI: 10.1186/s12889-021-10564-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 03/05/2021] [Indexed: 12/04/2022] Open
Abstract
Background Mobility of workers living in one country and working in a different country has increased in the European Union. Exposed to commuting factors, cross-border workers (CBWs) constitute a potential high-risk population. But the relationships between health and commuting abroad are under-documented. Our aims were to: (1) measure the prevalence of the perceived health status and the physical health outcomes (activity limitation, chronic diseases, disability and no leisure activities), (2) analyse their associations with commuting status as well as (3) with income and health index among CBWs. Methods Based on the ‘Enquête Emploi’, the French cross-sectional survey segment of the European Labour Force Survey (EU LFS), the population was composed of 2,546,802 workers. Inclusion criteria for the samples were aged between 20 and 60 years and living in the French cross-border departments of Germany, Belgium, Switzerland and Luxembourg. The Health Index is an additional measure obtained with five health variables. A logistic model was used to estimate the odds ratios of each group of CBWs, taking non-cross border workers (NCBWs) as the reference group, controlling by demographic background and labour status variables. Results A sample of 22,828 observations (2456 CBWs vs. 20,372 NCBWs) was retained. The CBW status is negatively associated with chronic diseases and disability. A marginal improvement of the health index is correlated with a wage premium for both NCBWs and CBWs. Commuters to Luxembourg have the best health outcomes, whereas commuters to Germany the worst. Conclusion CBWs are healthier and have more income. Interpretations suggest (1) a healthy cross-border phenomenon steming from a social selection and a positive association between income and the health index is confirmed; (2) the existence of major health disparities among CBWs; and (3) the rejection of the spillover phenomenon assumption for CBWs. The newly founded European Labour Authority (ELA) should take into account health policies as a promising way to support the cross-border mobility within the European Union. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-10564-8.
Collapse
Affiliation(s)
- Lucas Nonnenmacher
- Institute for Research on Sociology and Economic Inequalities. Department of Social Sciences, University of Luxembourg, Belval Campus, L-4366, Esch-sur-Alzette, Luxembourg.,Centre Maurice Halbwachs, CNRS-ENS-PSL, 48 Boulevard Jourdan, 75014, Paris, France
| | - Michèle Baumann
- Institute for Research on Sociology and Economic Inequalities. Department of Social Sciences, University of Luxembourg, Belval Campus, L-4366, Esch-sur-Alzette, Luxembourg.
| | - Etienne le Bihan
- Institute for Research on Sociology and Economic Inequalities. Department of Social Sciences, University of Luxembourg, Belval Campus, L-4366, Esch-sur-Alzette, Luxembourg
| | - Philippe Askenazy
- Centre Maurice Halbwachs, CNRS-ENS-PSL, 48 Boulevard Jourdan, 75014, Paris, France
| | - Louis Chauvel
- Institute for Research on Sociology and Economic Inequalities. Department of Social Sciences, University of Luxembourg, Belval Campus, L-4366, Esch-sur-Alzette, Luxembourg.
| |
Collapse
|
24
|
Yu W, Rohli KE, Yang S, Jia P. Impact of obesity on COVID-19 patients. J Diabetes Complications 2021; 35:107817. [PMID: 33358523 PMCID: PMC7690270 DOI: 10.1016/j.jdiacomp.2020.107817] [Citation(s) in RCA: 62] [Impact Index Per Article: 20.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 10/29/2020] [Accepted: 11/11/2020] [Indexed: 02/08/2023]
Abstract
With the increasing prevalence of obesity, there is a growing awareness of its impact on infectious diseases. In past epidemics of influenza A and Middle East respiratory syndrome (MERS) coronavirus, obesity has been identified as a risk factor influencing the severity of illness in infected persons. The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is responsible for a large number of deaths and health damages worldwide. Increasing numbers of reports have linked obesity to more severe COVID-19 disease and death. This review focuses on the impact of obesity on patients with COVID-19. We comprehensively analyzed the various mechanisms of obesity affecting the severity of the disease. In addition, on the basis of the vulnerability of people with obesity during the COVID-19 epidemic, we summarized both individual-level and hospital-level prevention and management measures for COVID-19 patients with obesity and discussed the impact of isolation on people with obesity.
Collapse
Affiliation(s)
- Wanqi Yu
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China; International Institute of Spatial Lifecourse Epidemiology (ISLE), Hong Kong, China
| | - Kristen E Rohli
- Carver College of Medicine, University of Iowa, Iowa City, IA, USA; International Institute of Spatial Lifecourse Epidemiology (ISLE), Hong Kong, China
| | - Shujuan Yang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China; International Institute of Spatial Lifecourse Epidemiology (ISLE), Hong Kong, China.
| | - Peng Jia
- Department of Land Surveying and Geo-Informatics, The Hong Kong Polytechnic University, Hong Kong, China; International Institute of Spatial Lifecourse Epidemiology (ISLE), Hong Kong, China.
| |
Collapse
|
25
|
Schäfer C, Mayr B, Fernandez La Puente de Battre MD, Reich B, Schmied C, Loidl M, Niederseer D, Niebauer J. Health effects of active commuting to work: The available evidence before GISMO. Scand J Med Sci Sports 2021; 30 Suppl 1:8-14. [PMID: 32297362 PMCID: PMC7540011 DOI: 10.1111/sms.13685] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2019] [Revised: 01/27/2020] [Accepted: 04/03/2020] [Indexed: 11/28/2022]
Abstract
Sedentary lifestyle is a major modifiable risk factor for many chronic diseases. Global guidelines recommend for maintaining health in adults, at least 150 minutes of moderate intensity of physical activity throughout the week, but compliance is insufficient and health problems arise. One obvious way to overcome this is to integrate physical activity into the daily routine for example by active commuting to work. Scientific evidence, however, is scarce and therefore we set out to perform this systematic review of the available literature to improve understanding of the efficiency of active commuting initiatives on health. Literature searches were performed in PubMed and Cochrane database. Altogether, 37 studies were screened. Thereof, eight publications were reviewed, which included 555 participants. The mean study duration of the reviewed research was 36 ± 26 (8-72) weeks. Overall, active commuting in previously untrained subjects of both sexes significantly improved exercise capacity, maximal power, blood pressure, lipid parameters including cholesterol, high-density lipoprotein, and waist circumference. Improvement was independent of the type of active commuting. Despite relatively few studies that were previously performed, this review revealed that active commuting has health beneficial effects comparable to those of moderate exercise training.
Collapse
Affiliation(s)
- Christine Schäfer
- University Institute of Sports Medicine, Prevention and Rehabilitation and Research Institute of Molecular Sports Medicine and Rehabilitation, Paracelsus Medical University, Salzburg, Austria
| | - Barbara Mayr
- University Institute of Sports Medicine, Prevention and Rehabilitation and Research Institute of Molecular Sports Medicine and Rehabilitation, Paracelsus Medical University, Salzburg, Austria
| | - Maria Dolores Fernandez La Puente de Battre
- University Institute of Sports Medicine, Prevention and Rehabilitation and Research Institute of Molecular Sports Medicine and Rehabilitation, Paracelsus Medical University, Salzburg, Austria
| | - Bernhard Reich
- University Institute of Sports Medicine, Prevention and Rehabilitation and Research Institute of Molecular Sports Medicine and Rehabilitation, Paracelsus Medical University, Salzburg, Austria
| | - Christian Schmied
- Department of Cardiology, University Heart Centre, University Hospital Zurich, Zürich, Switzerland
| | - Martin Loidl
- Department of Geoinformatics, Paris Lodron University of Salzburg, Salzburg, Austria
| | - David Niederseer
- Department of Cardiology, University Heart Centre, University Hospital Zurich, Zürich, Switzerland
| | - Josef Niebauer
- University Institute of Sports Medicine, Prevention and Rehabilitation and Research Institute of Molecular Sports Medicine and Rehabilitation, Paracelsus Medical University, Salzburg, Austria
| |
Collapse
|
26
|
Jacob N, Munford L, Rice N, Roberts J. Does commuting mode choice impact health? HEALTH ECONOMICS 2021; 30:207-230. [PMID: 33145835 DOI: 10.1002/hec.4184] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 09/23/2020] [Accepted: 10/12/2020] [Indexed: 06/11/2023]
Abstract
Governments around the world are encouraging people to switch away from sedentary modes of travel towards more active modes, including walking and cycling. The aim of these schemes is to improve population health and to reduce emissions. There is considerable evidence on the latter, but relatively little on the former. This paper investigates the impact of mode choice on physical and mental health. Using data from the UK Household Longitudinal Study, we exploit changes in mode of commute to identify health outcome responses. Individuals who change modes are matched with those whose mode remains constant. Overall we find that mode switches affect both physical and mental health. When switching from car to active travel we see an increase in physical health for women and in mental health for both genders. In contrast, both men and women who switch from active travel to car are shown to experience a significant reduction in their physical health and health satisfaction, and a decline in their mental health when they change from active to public transport.
Collapse
Affiliation(s)
- Nikita Jacob
- Centre for Health Economics, University of York, York, UK
| | - Luke Munford
- School of Health Sciences, University of Manchester, Manchester, UK
| | - Nigel Rice
- Centre for Health Economics & Department of Economics and Related Studies, University of York, York, UK
| | | |
Collapse
|
27
|
Lai S, Zhou Y, Yuan Y. Associations between Community Cohesion and Subjective Wellbeing of the Elderly in Guangzhou, China-A Cross-Sectional Study Based on the Structural Equation Model. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18030953. [PMID: 33499175 PMCID: PMC7908095 DOI: 10.3390/ijerph18030953] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 01/13/2021] [Accepted: 01/18/2021] [Indexed: 01/06/2023]
Abstract
Population aging has become one of the most prominent population trends in China and worldwide. Given the retirement and physical limitation of the elderly, the neighborhood has gradually become the center of their daily lives and communication. Community cohesion plays an essential role in improving the elderly’s subjective wellbeing. However, most present studies on the concept and relationship between different dimensions of community cohesion are mainly in western countries. Meanwhile, most of the studies on the relationship between community cohesion and subjective wellbeing only focused on one aspect of community cohesion such as community interaction. To address this research gap, this study sampled 20 communities in Guangzhou, conducted a questionnaire survey on 969 elderly people, and explored the relationship between four aspects of community cohesion (community interaction, environmental satisfaction, belonging, and participation) and their associations with subjective wellbeing using the Structural Equation Model (SEM). In addition, we performed multi-group analysis to study the association differences among older individuals in communities with different socioeconomic types. We found that: (1) The conceptual relationship between different aspects of community cohesion among older adults is significant; (2) Community environmental satisfaction, interaction, and belonging associate with the elderly’s subjective wellbeing, whereas there is no significant association between community participation and subjective wellbeing; (3) Mental health is an important mediating factor connecting community cohesion and subjective wellbeing, whereas physical health is not. (4) The association pattern of older adults in communities with different socio-economic status are identical, whereas the association strengths are different. In high Socio-Economic Status Index (SESI) communities (communities where older adults with relatively high socioeconomic attributes gather, such as high income and education level), community belonging and participation are significantly associated with community environmental satisfaction and interaction, respectively. In low SESI communities (communities in which older adults with relatively low socioeconomic attributes gather, such as low income and education level), community interaction, belonging, and participation considerably link to community environmental satisfaction, interaction, and belonging, respectively. Regarding the association between community cohesion and subjective wellbeing, community interaction has stronger linkage with the elderly’s subjective wellbeing of in high-SESI aging community than low-SESI aging community. While community environmental satisfaction has stronger association with the elderly’s subjective wellbeing of the elderly in low-SESI aging community than high-SESI aging community. Therefore, it is sensible for community planning to focus on community environment improvement and vibrant community activities organization.
Collapse
Affiliation(s)
- Shulin Lai
- School of Geography and Planning, Sun Yat-sen University, Guangzhou 510275, China;
- Guangzhou Urban Planning & Design Survey Research Institute, Guangzhou 510060, China
| | - Yuquan Zhou
- Department of City and Regional Planning, College of Environmental Design, University of California, Berkeley, CA 94720, USA
- Correspondence: (Y.Z.); (Y.Y.)
| | - Yuan Yuan
- School of Geography and Planning, Sun Yat-sen University, Guangzhou 510275, China;
- Correspondence: (Y.Z.); (Y.Y.)
| |
Collapse
|
28
|
Fritsche LG, Patil S, Beesley LJ, VandeHaar P, Salvatore M, Ma Y, Peng RB, Taliun D, Zhou X, Mukherjee B. Cancer PRSweb: An Online Repository with Polygenic Risk Scores for Major Cancer Traits and Their Evaluation in Two Independent Biobanks. Am J Hum Genet 2020; 107:815-836. [PMID: 32991828 PMCID: PMC7675001 DOI: 10.1016/j.ajhg.2020.08.025] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Accepted: 08/28/2020] [Indexed: 02/06/2023] Open
Abstract
To facilitate scientific collaboration on polygenic risk scores (PRSs) research, we created an extensive PRS online repository for 35 common cancer traits integrating freely available genome-wide association studies (GWASs) summary statistics from three sources: published GWASs, the NHGRI-EBI GWAS Catalog, and UK Biobank-based GWASs. Our framework condenses these summary statistics into PRSs using various approaches such as linkage disequilibrium pruning/p value thresholding (fixed or data-adaptively optimized thresholds) and penalized, genome-wide effect size weighting. We evaluated the PRSs in two biobanks: the Michigan Genomics Initiative (MGI), a longitudinal biorepository effort at Michigan Medicine, and the population-based UK Biobank (UKB). For each PRS construct, we provide measures on predictive performance and discrimination. Besides PRS evaluation, the Cancer-PRSweb platform features construct downloads and phenome-wide PRS association study results (PRS-PheWAS) for predictive PRSs. We expect this integrated platform to accelerate PRS-related cancer research.
Collapse
Affiliation(s)
- Lars G Fritsche
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA; Center for Statistical Genetics, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA; Center for Precision Health Data Science, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA; University of Michigan Rogel Cancer Center, University of Michigan, Ann Arbor, MI 48109, USA.
| | - Snehal Patil
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA; Center for Statistical Genetics, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA
| | - Lauren J Beesley
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA; Center for Precision Health Data Science, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA
| | - Peter VandeHaar
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA; Center for Statistical Genetics, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA
| | - Maxwell Salvatore
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA; Center for Precision Health Data Science, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA
| | - Ying Ma
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA; Center for Statistical Genetics, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA
| | - Robert B Peng
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA; Center for Precision Health Data Science, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA; Department of Statistics, Northwestern University, Evanston, IL 60208, USA
| | - Daniel Taliun
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA; Center for Statistical Genetics, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA
| | - Xiang Zhou
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA; Center for Statistical Genetics, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA; Center for Precision Health Data Science, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA
| | - Bhramar Mukherjee
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA; Center for Statistical Genetics, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA; Center for Precision Health Data Science, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA; Michigan Institute for Data Science, University of Michigan, Ann Arbor, MI 48109, USA; Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA; University of Michigan Rogel Cancer Center, University of Michigan, Ann Arbor, MI 48109, USA.
| |
Collapse
|
29
|
Active Transportation and Obesity Indicators in Adults from Latin America: ELANS Multi-Country Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17196974. [PMID: 32987637 PMCID: PMC7579005 DOI: 10.3390/ijerph17196974] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 09/19/2020] [Accepted: 09/21/2020] [Indexed: 12/26/2022]
Abstract
PURPOSE The aim of this study was to determine the association between active transportation and obesity indicators in adults from eight Latin American countries. METHODS Data from the ELANS study, an observational multi-country study (n: 8336; 18-65 years), were used. Active transportation (walking and cycling) and leisure time physical activity was assessed using the International Physical Activity Questionnaire (long version). The obesity indicators considered were: body mass index, and waist and neck circumference. RESULTS In the total sample, the average time dedicated to active transportation was 24.3 min/day, with the highest amount of active transportation being Costa Rica (33.5 min/day), and the lowest being Venezuela (15.7 min/day). The countries with the highest proportion of active transportation were Ecuador (71.9%), and the lowest was Venezuela (40.5%). Results from linear regression analyses suggest that active transportation was significantly and independently associated with a lower body mass index (β: -0.033; 95% CI: -0.064; -0.002), but not with waist circumference (β: -0.037; 95% CI: -1.126; 0.390 and neck circumference (β: -0.007; 95% CI: -0.269; 0.130). CONCLUSIONS Active transportation is significantly associated with a lower body mass index. Governments should incentivize this type of transportation as it could help to reduce the obesity pandemic in Latin America.
Collapse
|
30
|
Patterson R, Webb E, Millett C, Laverty AA. Physical activity accrued as part of public transport use in England. J Public Health (Oxf) 2020; 41:222-230. [PMID: 29893886 DOI: 10.1093/pubmed/fdy099] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Revised: 05/18/2018] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Walking and cycling for transport (active travel) is an important source of physical activity with established health benefits. However, levels of physical activity accrued during public transport journeys in England are unknown. METHODS Using the English National Travel Survey 2010-14 we quantified active travel as part of public transport journeys. Linear regression models compared levels of physical activity across public transport modes, and logistic regression models compared the odds of undertaking 30 min a day of physical activity. RESULTS Public transport users accumulated 20.5 min (95% confidence interval=19.8, 21.2) a day of physical activity as part of public transport journeys. Train users accumulated 28.1 min (26.3, 30.0) with bus users 16.0 min (15.3, 16.8). Overall, 34% (32%, 36%) of public transport users achieved 30 min a day of physical activity in the course of their journeys; 21% (19%, 24%) of bus users and 52% (47%, 56%) of train users. CONCLUSION Public transport use is an effective way to incorporate physical activity into daily life. One in three public transport users meet physical activity guidelines suggesting that shifts from sedentary travel modes to public transport could dramatically raise the proportion of populations achieving recommended levels of physical activity.
Collapse
Affiliation(s)
- R Patterson
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London, UK
| | - E Webb
- Department of Epidemiology and Public Health, University College London, London, UK
| | - C Millett
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London, UK
| | - A A Laverty
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London, UK
| |
Collapse
|
31
|
Medina I, Petermann-Rocha F, Waddell H, Díaz-Martínez X, Matus-Castillo C, Cigarroa I, Concha-Cisternas Y, Salas-Bravo C, Martínez-Sanguinetti MA, Celis-Morales C. Association between Different Modes of Travelling and Adiposity in Chilean Population: Findings from the Chilean National Health Survey 2016-2017. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17103731. [PMID: 32466197 PMCID: PMC7277509 DOI: 10.3390/ijerph17103731] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 05/19/2020] [Accepted: 05/22/2020] [Indexed: 01/14/2023]
Abstract
BACKGROUND Active travel has been suggested as a feasible way of increasing physical activity levels. Although international studies have demonstrated its effect over different health outcomes and adiposity, there is still limited evidence on this topic in developing countries, such as Chile. AIM To investigate the associations between different types of travelling and markers of obesity in the Chilean adult population. METHODS 5411 participants from the Chilean National Health Survey 2016-2017 (CNHS) were included in this study. Active travel was assessed using a questionnaire. Car commuters, public transport (PT), walking and cycling were the four forms of travelling assessed. Bodyweight, body mass index and waist circumference were used as markers of adiposity. RESULTS Compared to car travellers, body weight, WC and BMI levels were lower for PT walking and cycling travellers. The odds for obesity (Odds ratio (OR): 0.41 (95% CI: 0.28; 0.61 p ≤ 0.001) were lower for walking and the odds (OR: 0.56 (95%CI: 0.35; 0.89 p = 0.014) for central obesity were significantly lower for cyclist in comparison to car travellers. Additionally, participation in any form of active travel (walking or cycling) was low, with only 20.9% of the population reporting being active travellers. CONCLUSION Active travel, such as walking and cycling, was associated with lower adiposity levels in the Chilean adult population. Promoting active travel could be a feasible strategy to tackle the high prevalence of obesity and physical inactivity in the Chilean population.
Collapse
Affiliation(s)
- Ignacio Medina
- British Heart Foundation Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow G12 8TA, UK; (I.M.); (F.P.-R.); (H.W.)
| | - Fanny Petermann-Rocha
- British Heart Foundation Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow G12 8TA, UK; (I.M.); (F.P.-R.); (H.W.)
- Institute of Health and Wellbeing, University of Glasgow, Glasgow G12 8RZ, UK
| | - Heather Waddell
- British Heart Foundation Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow G12 8TA, UK; (I.M.); (F.P.-R.); (H.W.)
- Institute of Health and Wellbeing, University of Glasgow, Glasgow G12 8RZ, UK
- Medical Research Council Centre for Inflammation Research, The Queen’s Medical Research Institute, The University of Edinburgh, Edinburgh EH16 4TJ, UK
| | - Ximena Díaz-Martínez
- Grupo de Investigación en Calidad de Vida, Departamento de Ciencias de la Educación, Facultad de Educación y Humanidades, Universidad del Biobío, Chillán 378000, Chile
| | - Carlos Matus-Castillo
- Departamento de Ciencias del Deporte y Acondicionamiento Físico, Universidad Católica de la Santísima Concepción, Concepción 4090541, Chile;
| | - Igor Cigarroa
- Escuela de Kinesiología, Facultad de Salud, Universidad Santo Tomás, Santiago 8370003, Chile; (I.C.); (Y.C.-C.)
| | - Yeny Concha-Cisternas
- Escuela de Kinesiología, Facultad de Salud, Universidad Santo Tomás, Santiago 8370003, Chile; (I.C.); (Y.C.-C.)
- Pedagogía en Educación Física, Facultad de Educación, Universidad Autónoma de Chile, Talca 3467987, Chile
| | - Carlos Salas-Bravo
- Departamento de Educación Física, Facultad de Educación, Universidad de Concepción, Concepción 4070386, Chile
| | | | - Carlos Celis-Morales
- British Heart Foundation Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow G12 8TA, UK; (I.M.); (F.P.-R.); (H.W.)
- Institute of Health and Wellbeing, University of Glasgow, Glasgow G12 8RZ, UK
- Centro de Investigación en Fisiología del Ejercicio (CIFE), Universidad Mayor, Santiago 7510041, Chile
- Laboratorio de Rendimiento Humano, Grupo de Estudio en Educación, Actividad Física y Salud (GEEAFyS), Universidad Católica del Maule, Talca 3480112, Chile
- Correspondence: ; Tel.: +562-2518-9701
| | | |
Collapse
|
32
|
Munyombwe T, Lovelace R, Green M, Norman P, Walpole S, Hall M, Timmis A, Batin P, Brownlee A, Brownlee J, Oliver G, Gale CP. Association of prevalence of active transport to work and incidence of myocardial infarction: A nationwide ecological study. Eur J Prev Cardiol 2020; 27:822-829. [PMID: 31851832 DOI: 10.1177/2047487319876228] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/21/2024]
Abstract
BACKGROUND There is a paucity of population-based geospatial data about the association between active transport and myocardial infarction. We investigated the association between active transport to work and incidence of myocardial infarction. DESIGN This ecological study of 325 local authorities in England included 43,077,039 employed individuals aged 25-74 years (UK Census, 2011), and 117,521 individuals with myocardial infarction (Myocardial Ischaemia National Audit Project, 2011-2013). METHODS Bayesian negative binomial regression models were used to investigate the association of active transport to work and incidence of myocardial infarction adjusting for local levels of deprivation, obesity, smoking, diabetes and physical activity. RESULTS In 2011, the prevalence of active transportation to work for people in employment in England aged 25-74 years was 11.4% (4,531,182 active transporters; 8.6% walking and 2.8% cycling). Active transport in 2011 was associated with a reduced incidence of myocardial infarction in 2012 amongst men cycling to work (incidence rate ratio (95% credible interval) 0.983 (0.967-0.999); and women walking to work (0.983 (0.967-0.999)) after full adjustments. However, the prevalence of active transport for men and women was not significantly associated with the combined incidence of myocardial infarction between 2011-2013 after adjusting for physical activity, smoking and diabetes. CONCLUSIONS In England, the prevalence of active transportation was associated with a reduced incidence of myocardial infarction for women walking and men cycling to work in corresponding local geographic areas. The overall association of active transport with myocardial infarction was, however, explained by local area levels of smoking, diabetes and physical activity.
Collapse
Affiliation(s)
- Theresa Munyombwe
- Leeds Institute for Cardiovascular and Metabolic Medicine, University of Leeds, UK
- Leeds Institute for Data Analytics, University of Leeds, UK
| | - Robin Lovelace
- Leeds Institute for Data Analytics, University of Leeds, UK
- Institute for Transport Studies, University of Leeds, UK
| | - Mark Green
- Department of Geography and Planning, University of Liverpool, UK
| | - Paul Norman
- School of Geography, University of Leeds, UK
| | | | - Marlous Hall
- Leeds Institute for Cardiovascular and Metabolic Medicine, University of Leeds, UK
- Leeds Institute for Data Analytics, University of Leeds, UK
| | - Adam Timmis
- NIHR Cardiovascular Biomedical Research Unit, Barts Heart Centre, UK
| | - Phil Batin
- Department of Cardiology, Mid Yorkshire Hospitals NHS Trust, UK
| | | | | | | | - Chris P Gale
- Leeds Institute for Cardiovascular and Metabolic Medicine, University of Leeds, UK
- Leeds Institute for Data Analytics, University of Leeds, UK
| |
Collapse
|
33
|
Do the Walkability and Urban Leisure Amenities of Neighborhoods Affect the Body Mass Index of Individuals? Based on a Case Study in Seoul, South Korea. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17062060. [PMID: 32244911 PMCID: PMC7142730 DOI: 10.3390/ijerph17062060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 02/29/2020] [Accepted: 03/14/2020] [Indexed: 11/17/2022]
Abstract
This study investigates the impact of neighborhood-built environments on obesity in interrelationship with socioeconomic status (SES)—controlling for dietary patterns and physical activities of residents—using structural equation modeling (SEM). A total of 577 samples who are between 19 and 64 years old and reside in Seoul are extracted from Korea National Health and Nutrition Examination Survey (KNHNES), 2015. Neighborhood environments are represented as the two latent constructs—walkability and leisure amenities—composited with indicators such as density of intersections, density of mixed-use area, and the area of open spaces and are aggregated by jurisdictional unit in Seoul. We found that greater walkability in a neighborhood explained a lower body mass index (BMI) among residents, whereas more urban leisure amenities in a neighborhood explained a higher BMI. The finding suggests that a walking-friendly environment is more effective than active recreational amenities in inducing people to engage in daily physical activities to the level that reduces obesity rate. SES exerted a negative impact on BMI of a greater magnitude than the impact of either of the environmental living conditions, reinforcing the importance of general wealth and education level in leading to a healthy lifestyle. Our research contributes to growing evidence of a relationship between obesity and the built environment in the context of Asian countries where the prevalence of obesity is becoming a serious issue and requires immediate attention.
Collapse
|
34
|
Mirzaei M, Dastgiri S, Aminisani N, Asghari-Jafarabadi M. Sociodemographic Pattern of Physical Activity in the Northwest of Iran: Results of the Pilot Phase of the Azar Cohort Study. Int J Prev Med 2020; 10:154. [PMID: 32133072 PMCID: PMC6826577 DOI: 10.4103/ijpvm.ijpvm_472_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Accepted: 01/22/2018] [Indexed: 11/13/2022] Open
Abstract
Background: Sedentary lifestyle plays a key role in the emergence of many noncommunicable diseases. Given the importance of physical activity (PA) in population-based studies, the present study was conducted to investigate the pattern of PA and its correlates in the pilot phase of Azar cohort study. Methods: In the pilot phase of Azar cohort study, 1236 individuals aged 35–70 years in Khameneh, a city in East Azarbaijan, Iran, were invited to participate in the study. A total of 952 individuals completed the overall and the PA questionnaire, a response rate of 82%. The PA level was evaluated using the classified PA questionnaire based on the equivalent metabolic activities. The general linear model was used to determine the factors affecting PA. Results: The overall mean score of PA was 36.54 (standard deviation = 5.3). In multivariate analysis, after adjustment for sociodemographic variables, total PA score was associated with gender (adjusted β = 0.014, confidence interval [CI] 95% = [0.01–0.82]), occupation (adjusted βs ranged over 0.015–0.059, (CI 95% = 0.01–0.079), level of education (adjusted βs ranged over 0.010–0.018, CI 95% = 0.001–0.026). In other word, sex (mean ranged over 35.49–36.81), educational level (mean ranged over 35.01–36.73) and occupation status (mean ranged over 34.62–39.62) were predictors of PA (all P < 0.05). This variable could also predict 20% of the variance of the PA. Conclusions: The current study identifies that gender, occupation and level of education could be factors that influence on PA level in the study population.
Collapse
Affiliation(s)
- Maryam Mirzaei
- Department of Radiology and Nuclear Medicine, School of Allied Medical Sciences, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Saeed Dastgiri
- Tabriz Health Services Management Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Nayyereh Aminisani
- Noncommunicable Diseases Research Center, Neyshabur University of Medical Sciences, Neyshabur, Iran
| | - Mohammad Asghari-Jafarabadi
- Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.,Department of Statistics and Epidemiology, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran
| |
Collapse
|
35
|
Vaara JP, Vasankari T, Fogelholm M, Koski H, Kyröläinen H. Cycling but not walking to work or study is associated with physical fitness, body composition and clustered cardiometabolic risk in young men. BMJ Open Sport Exerc Med 2020; 6:e000668. [PMID: 32153983 PMCID: PMC7047505 DOI: 10.1136/bmjsem-2019-000668] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/06/2020] [Indexed: 11/14/2022] Open
Abstract
Introduction Active commuting is an inexpensive and accessible form of physical activity and may be beneficial to health. The aim of this study was to investigate the association of active commuting and its subcomponents, cycling and walking, with cardiometabolic risk factors, physical fitness and body composition in young men. Methods Participants were 776 Finnish young (26±7 years), healthy adult men. Active commuting was measured with self-report. Waist circumference was measured and body mass index (BMI) calculated. Aerobic fitness was measured with bicycle ergometer and muscular fitness with maximal leg and bench press, sit-ups, push-ups and standing long jump. Cardiometabolic risk factors were analysed from blood samples and selected variables (glucose, insulin, triglycerides, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, as well as systolic and diastolic blood pressure) were further converted to z-score to form clustered cardiometabolic risk. Results A total of 24% used active commuting consisting of 10% of walkers and 14% of cyclists. After adjustments for age, smoking, time of year, leisure-time and occupational physical activities, cycling was inversely associated with the clustered cardiometabolic risk (β=−0.11, 95% CI −0.22 to −0.01), while walking was not (β=−0.04, 95% CI −0.16 to 0.08). However, further adjustment for waist circumference attenuated the associations to non-significant. Moreover, cycling but not walking was inversely associated with BMI, waist circumference and maximal strength, while a positive association was observed with aerobic fitness (p<0.05). Conclusion This study shows that cycling to work or study has beneficial associations to clustered cardiometabolic risk, body composition and aerobic fitness in young, healthy adult men.
Collapse
Affiliation(s)
- Jani P Vaara
- The Department of Leadership and Military Pedagogy, National Defence University, Helsinki, Finland
| | - Tommi Vasankari
- UKK Institute for Health Promotion Research, Tampere, Finland
| | - Mikael Fogelholm
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Harri Koski
- Training Division, Defence Command, Finnish Defence Forces, Helsinki, Finland
| | - Heikki Kyröläinen
- University of Jyväskylä, Faculty of Sports and Health Sciences, Jyvaskyla, Finland
| |
Collapse
|
36
|
Liu Y, Tao L, Zhang J, Liu J, Li H, Liu X, Luo Y, Zhang J, Wang W, Guo X. Impact of Commuting Mode on Obesity Among a Working Population in Beijing, China: Adjusting for Air Pollution. Diabetes Metab Syndr Obes 2020; 13:3959-3968. [PMID: 33122932 PMCID: PMC7591004 DOI: 10.2147/dmso.s265537] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 09/16/2020] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Few studies have considered the interplay between commuting mode and air pollution on obesity. The aim of this study was to examine whether workplace air pollutants exposure modifying the associations between different commuting mode and obesity. METHODS A cross-sectional study of workers in Beijing was conducted in 2016. The study sample comprised 10,524 participants aged 18 to 65 years old. Outcomes were defined as overall obesity (BMI≥ 28 kg/m2) and abdominal obesity (WC ≥ 85 cm in men and WC ≥ 80 cm in women). Commuting modes were divided into walking, cycling, bus, subway, and car or taxi. Logistic regression models were used to estimate odds ratios relating commuting mode to overall and abdominal obesity and stratified by gender, controlling for covariates. RESULTS The association between commuting mode and obesity was more strongly in men than women. In the fully adjusted models, compared with car or taxi commuters, cycling (men: OR=0.37, 95% CI=0.20 to 0.68) or bus (men: OR=0.58, 95% CI=0.36 to 0.94) counterparts had a lower risk of overall obesity. Compared with car or taxi commuters, walking (men: OR=0.57, 95% CI=0.36 to 0.91), bus (men: OR=0.59, 95% CI=0.39 to 0.89), or subway (men: OR=0.59, 95% CI=0.39 to 0.89) counterparts had a lower risk of abdominal obesity. We observed significant interactions between exposure PM10 and cycling on overall obesity in men. After adjusting for air pollutants, the association between commuting mode and obesity was slightly strengthened. CONCLUSION This study findings indicate that active (walking or cycling) or public (bus or subway) commuting modes were protected factors for overall and abdominal obesity among men. Air pollutants do not obscure the benefits of active or public commuting for obesity. These associations support the policy for increasing active or public commuting as a strategy to reduce the prevalence of obesity.
Collapse
Affiliation(s)
- Yue Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, People’s Republic of China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, People’s Republic of China
| | - Lixin Tao
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, People’s Republic of China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, People’s Republic of China
| | - Jie Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, People’s Republic of China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, People’s Republic of China
| | - Jia Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, People’s Republic of China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, People’s Republic of China
| | - Haibin Li
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, People’s Republic of China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, People’s Republic of China
| | - Xiangtong Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, People’s Republic of China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, People’s Republic of China
| | - Yanxia Luo
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, People’s Republic of China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, People’s Republic of China
| | - Jingbo Zhang
- Beijing Physical Examination Center, Beijing, People’s Republic of China
| | - Wei Wang
- Global Health and Genomics, School of Medical Sciences and Health, Edith Cowan University, Perth, Western Australia, Australia
| | - Xiuhua Guo
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, People’s Republic of China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, People’s Republic of China
- Correspondence: Xiuhua Guo Email
| |
Collapse
|
37
|
Anderson ML, Lu F, Yang J. Physical activity and weight following car ownership in Beijing, China: quasi-experimental cross sectional study. BMJ 2019; 367:l6491. [PMID: 31852683 PMCID: PMC7190034 DOI: 10.1136/bmj.l6491] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/05/2019] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To determine the implications of car ownership for physical activity and weight in a global city. DESIGN Quasi-experimental cross sectional study. SETTING Beijing, China, 2011-15. PARTICIPANTS People aged 18 and older from a random sample of households who had entered a permit lottery to purchase a vehicle between January 2011 and November 2015. INTERVENTIONS Permit allowing purchase of a vehicle within six months of permit issuance. MAIN OUTCOME MEASURES Transit use (number of subway and bus rides each week), physical activity (minutes of walking or bicycling each day), and weight, measured once in early 2016. RESULTS Of 937 people analysed in total, 180 had won a permit to purchase a new vehicle. Winning the permit lottery resulted in the purchase of an additional vehicle 91% of the time (95% confidence interval 89% to 94%; P<0.001). About five years after winning, winners took significantly fewer weekly transit rides (-2.9 rides (-5.1 to -0.7); P=0.01) and walked and cycled significantly less (-24.2 minutes (-40.3 to -8.1); P=0.003) than those who did not win the lottery. Average weight did not change significantly between lottery winners and losers. Among those aged 50 and older, however, winners' weight had increased relative to that of losers (10.3 kg (0.5 to 20.2); P=0.04) 5.1 years after winning. CONCLUSIONS These data indicate that vehicle ownership in a rapidly growing global city led to long term reductions in physical activity and increase in weight. Continuing increases in car use and ownership in developing and middle income countries could adversely affect physical health and obesity rates.
Collapse
Affiliation(s)
- Michael L Anderson
- University of California, Berkeley, CA, USA, and National Bureau of Economic Research, Cambridge, MA, USA
| | - Fangwen Lu
- School of Economics, Renmin University of China, 59 Zhongguancun Street, Beijing 100872, China
| | - Jun Yang
- Beijing Transport Institute, Beijing, China
| |
Collapse
|
38
|
Bourne JE, Page A, Leary S, Andrews RC, England C, Cooper AR. Electrically assisted cycling for individuals with type 2 diabetes mellitus: protocol for a pilot randomized controlled trial. Pilot Feasibility Stud 2019; 5:136. [PMID: 31788322 PMCID: PMC6875029 DOI: 10.1186/s40814-019-0508-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Accepted: 10/01/2019] [Indexed: 01/06/2023] Open
Abstract
Background The global incidence of type 2 diabetes mellitus (T2DM) is increasing. Given the many complications associated with T2DM, effective management of the disease is crucial. Physical activity is considered to be a key component of T2DM management. However, people with T2DM are generally less physically active than individuals without T2DM and adherence to physical activity is often poor following completion of lifestyle interventions. As such, developing interventions that foster sustainable physical activity is of high priority. Electrically assisted bicycles (e-bikes) have been highlighted as a potential strategy for promoting physical activity in this population. E-bikes provide electrical assistance to the rider only when pedalling and could overcome commonly reported barriers to regular cycling. This paper describes the protocol of the PEDAL-2 pilot randomized controlled trial, an e-cycling intervention aimed at increasing physical activity in individuals with T2DM. Methods A parallel-group two-arm randomized waitlist-controlled pilot trial will be conducted. Forty individuals with T2DM will be randomly assigned, in a 1:1 allocation ratio, to an e-cycling intervention or waitlist control. Recruitment and screening will close once 20 participants have been randomized to each study arm. The intervention will involve e-bike training with a certified cycle instructor and provision of an e-bike for 12 weeks. Data will be collected at baseline, during the intervention and immediately post-intervention using both quantitative and qualitative methods. In this trial, the primary interests are determination of effective recruitment strategies, recruitment and consent rates, adherence and retention and delivery and receipt of the intervention. The potential impact of the intervention on a range of clinical, physiological and behaviour outcomes will be assessed to examine intervention promise. Data analyses will be descriptive. Discussion This paper describes the protocol for the PEDAL-2 pilot randomized controlled trial. Results from this trial will provide information on trial feasibility and identify the promise of e-cycling as a strategy to positively impact the health and behaviour of individuals with T2DM. If appropriate, this information can be used to design and deliver a fully powered definitive trial. Trial registration ISRCTN, ISRCTN67421464. Registered 03/01/2019.
Collapse
Affiliation(s)
- Jessica E Bourne
- 1Centre for Exercise, Nutrition and Health Sciences, School of Policy Studies, University of Bristol, 8 Priory Road, Bristol, BS8 1TZ UK.,2NIHR Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, UK
| | - Angie Page
- 1Centre for Exercise, Nutrition and Health Sciences, School of Policy Studies, University of Bristol, 8 Priory Road, Bristol, BS8 1TZ UK.,2NIHR Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, UK
| | - Sam Leary
- 2NIHR Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, UK
| | - Robert C Andrews
- 3Institute of Biomedical and Clinical Sciences, Medical Research, University of Exeter Medical School, RILD Level 3, Barrack Road, Exeter, Devon EX2 5DW UK
| | - Clare England
- 1Centre for Exercise, Nutrition and Health Sciences, School of Policy Studies, University of Bristol, 8 Priory Road, Bristol, BS8 1TZ UK.,2NIHR Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, UK
| | - Ashley R Cooper
- 1Centre for Exercise, Nutrition and Health Sciences, School of Policy Studies, University of Bristol, 8 Priory Road, Bristol, BS8 1TZ UK.,2NIHR Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, UK
| |
Collapse
|
39
|
Steell L, Garrido-Méndez A, Petermann F, Díaz-Martínez X, Martínez MA, Leiva AM, Salas-Bravo C, Alvarez C, Ramirez-Campillo R, Cristi-Montero C, Rodríguez F, Poblete-Valderrama F, Floody PD, Aguilar-Farias N, Willis ND, Celis-Morales CA. Active commuting is associated with a lower risk of obesity, diabetes and metabolic syndrome in Chilean adults. J Public Health (Oxf) 2019; 40:508-516. [PMID: 28977515 DOI: 10.1093/pubmed/fdx092] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Accepted: 07/04/2017] [Indexed: 11/12/2022] Open
Abstract
Background There is limited evidence on how active commuting is associated with health benefits in developing countries. The aim of this study therefore was to investigate the associations between active commuting and markers of adiposity and cardiometabolic risk in the Chilean adult population. Methods In total, 5157 participants from the Chilean National Health Survey 2009-10 were included in this cross-sectional study. Active commuting was measured using the Global Physical Activity Questionnaire (GPAQ v2). Body mass index (BMI) and waist circumference (WC) were measured and used to define obesity and central obesity. Type 2 diabetes (T2D) and metabolic syndrome were determined using WHO and updated ATPIII-NCEP criteria, respectively. Results The main finding of this study is that a 30 min increase in active commuting is associated with lower odds for BMI > 25.0 kg m-2 (0.93 [95% CI: 0.88-0.98, P = 0.010]). Similarly, the odds for central obesity was 0.87 [0.82-0.92, P < 0.0001]. Similar associations were found for T2D (0.81 [0.75-0.88], P < 0.0001) and metabolic syndrome (OR: 0.86 [0.80-0.92], P < 0.0001). Conclusion Our findings show that active commuting is associated with lower adiposity and a healthier metabolic profile including lower risk for obesity, diabetes and metabolic syndrome.
Collapse
Affiliation(s)
- Lewis Steell
- BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Science, University of Glasgow, Glasgow, UK
| | | | - Fanny Petermann
- BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Science, University of Glasgow, Glasgow, UK
| | - Ximena Díaz-Martínez
- Grupo de Investigación Calidad de Vida, Departamento de Ciencias de la Educación, Facultad de Educación y Humanidades, Universidad del Bio-Bio, Chillan, Chile
| | - María Adela Martínez
- Instituto de Farmacia, Facultad de Ciencias, Universidad Austral de Chile, Valdivia, Chile
| | - Ana María Leiva
- Instituto de Anatomía, Histología y Patología, Facultad de Medicina, Universidad Austral de Chile, Valdivia, Chile
| | - Carlos Salas-Bravo
- Departamento de Educación Física, Facultad de Educación, Universidad de Concepción, Concepción, Chile
| | - Cristian Alvarez
- Department of Physical Activity Sciences, Research Nucleus in Health, Physical Activity and Sport, Universidad de Los Lagos, Osorno, Chile
| | - Rodrigo Ramirez-Campillo
- Department of Physical Activity Sciences, Research Nucleus in Health, Physical Activity and Sport, Universidad de Los Lagos, Osorno, Chile
| | - Carlos Cristi-Montero
- Grupo IRyS, Escuela de Educación Física, Pontificia Universidad Católica de Valparaíso, Valparaíso, Chile
| | - Fernando Rodríguez
- Grupo IRyS, Escuela de Educación Física, Pontificia Universidad Católica de Valparaíso, Valparaíso, Chile
| | | | - Pedro Delgado Floody
- Departamento de Educación Física, Deportes y Recreación, Universidad de La Frontera, Temuco, Chile
| | - Nicolás Aguilar-Farias
- Departamento de Educación Física, Deportes y Recreación, Universidad de La Frontera, Temuco, Chile
| | - Naomi D Willis
- Human Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - Carlos A Celis-Morales
- BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Science, University of Glasgow, Glasgow, UK.,Human Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK
| |
Collapse
|
40
|
Kuwahara K, Noma H, Nakagawa T, Honda T, Yamamoto S, Hayashi T, Mizoue T. Association of changes in commute mode with body mass index and visceral adiposity: a longitudinal study. Int J Behav Nutr Phys Act 2019; 16:101. [PMID: 31694716 PMCID: PMC6836489 DOI: 10.1186/s12966-019-0870-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Accepted: 10/22/2019] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Prospective data are sparse for active commuting to work and body weight in Asia. We assessed the association of 5-year changes in commuting mode with body mass index (BMI) and the indicators of abdominal obesity in Japanese working adults. METHODS In this longitudinal study, we studied 29,758 participants (25,808 men and 3950 women) in Japan aged 30 to 64 years at baseline who underwent further health examination 5 years after the baseline examination. Changes in BMI were calculated from objectively measured body height and weight at baseline and follow-up examination. Visceral and subcutaneous fat areas and waist circumference measured by computed tomography scans were used as indicators for abdominal adiposity. Linear regression was applied to estimate the association of changes in commuting mode with the obesity outcomes. RESULTS Within the 5-year study period, adults who maintained inactive commuting gained weight, and compared with this group, adults who switched to inactive commuting had higher weight gain; conversely, adults who switched to active or public transportation commuting and especially those who maintained active or public transportation commuting experienced less weight gain. Subgroup analysis showed similar tendency across the different transitions of leisure-time exercise or occupational physical activity. For example, among adults who maintained no exercise (n = 16,087), the adjusted mean (95% confidence intervals) of the BMI change over 5 years in kg/m2 were 0.27 (0.24 to 0.30) for maintained inactive commuting group (reference), 0.34 (0.30 to 0.38) for switching to inactive commuting group (P = 0.046), 0.20 (0.18 to 0.22) for switching to active commuting or public transportation group (P = 0.001), and 0.09 (0.06 to 0.13) for maintained active commuting or public transportation group (P < 0.001). Maintained inactive commuting tended to be associated with larger gain in abdominal adiposity indicators. CONCLUSION Switching from inactive commuting mode to more physically active commuting mode and maintaining active commuting can promote body weight control among working adults across different levels of occupational or leisure-time physical activity.
Collapse
Affiliation(s)
- Keisuke Kuwahara
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan. .,Teikyo University Graduate School of Public Health, 2-11-1 Kaga, Itabashi-ku, Tokyo, 173-8605, Japan.
| | - Hisashi Noma
- The Institute of Statistical Mathematics, Tokyo, Japan
| | - Tohru Nakagawa
- Hitachi Health Care Center, Hitachi, Ltd, Ibaraki, Japan
| | - Toru Honda
- Hitachi Health Care Center, Hitachi, Ltd, Ibaraki, Japan
| | | | | | - Tetsuya Mizoue
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| |
Collapse
|
41
|
Roever L, Tse G, Biondi-Zoccai G. Walking or cycling to work to prevent myocardial infarction: Hope or hype? Eur J Prev Cardiol 2019; 27:820-821. [PMID: 31610711 DOI: 10.1177/2047487319880365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- Leonardo Roever
- Department of Clinical Research, Federal University of Uberlândia, Brazil
| | - Gary Tse
- Xiamen Cardiovascular Hospital, P. R. China.,Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular disease, Second Hospital of Tianjin Medical University, P. R. China.,The First Affiliated Hospital of Dalian Medical University, P. R. China
| | - Giuseppe Biondi-Zoccai
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Italy.,Mediterranea Cardiocentro, Italy
| |
Collapse
|
42
|
Abstract
As the rate of obesity increases globally, so does the incidence of other non-communicable diseases such as diabetes, cardiovascular disease, cancer, osteoporosis, osteoarthritis, and dementia, which have been referred to as 'adiposity-based chronic disease'. With timely lifestyle modification such as behavioral changes, implementation of a healthy diet, and proper physical activity, many of these diseases can be prevented. Weight gain is one of the major health concerns of midlife. Midlife body changes are the result of aging, menopause, and other influences unique to menopausal women which interfere with adoption of a healthy lifestyle. Reduced metabolism levels lead to low energy levels, which discourage physical activity. In addition, with the onset of bone loss, menopausal women begin to lose muscle mass and gain more fat, resulting in osteopenic sarco-obesity. Adoption of a healthy lifestyle is a first-line option in the treatment for these midlife changes. Lifestyle medicine offers a broad set of network-based interventions, which need to be brought to the forefront in preventing and managing obesity at all stages. This review article focuses on evidence-based lifestyle changes and their benefits for reducing morbidity and mortality related to obesity and its complications prevalent at midlife and beyond.
Collapse
Affiliation(s)
- S Khandelwal
- Department of Obstetrics and Gynaecology, Fortis Escort Hospital, Jaipur, India
| |
Collapse
|
43
|
Smith MA, Boehnke JR, Graham H, White PCL, Prady SL. Associations between active travel and diet: cross-sectional evidence on healthy, low-carbon behaviours from UK Biobank. BMJ Open 2019; 9:e030741. [PMID: 31481378 PMCID: PMC6731823 DOI: 10.1136/bmjopen-2019-030741] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVES To examine whether there are associations between active travel and markers of a healthy, low-carbon (HLC) diet (increased consumption of fruit and vegetables (FV), reduced consumption of red and processed meat (RPM)). DESIGN Cross-sectional analysis of a cohort study. SETTINGS Population cohort of over 500 000 people recruited from 22 centres across the UK. Participants aged between 40 and 69 years were recruited between 2006 and 2010. PARTICIPANTS 412 299 adults with complete data on travel mode use, consumption of FV and RPM, and sociodemographic covariates were included in the analysis. EXPOSURE MEASURES Mutually exclusive mode or mode combinations of travel (car, public transport, walking, cycling) for non-work and commuting journeys. OUTCOME MEASURES Consumption of FV measured as portions per day and RPM measured as frequency per week. RESULTS Engaging in all types of active travel was positively associated with higher FV consumption and negatively associated with more frequent RPM consumption. Cycling exclusively or in combination with walking was most strongly associated with increased dietary consumption of FV and reduced consumption of RPM for both non-work and commuting journeys. Overall, the strongest associations were between non-work cycling and FV consumption (males: adjusted OR=2.18, 95% CI 2.06 to 2.30; females: adjusted OR=2.50, 95% CI 2.31 to 2.71) and non-work cycling and RPM consumption (males: adjusted OR=0.57, 95% CI 0.54 to 0.60; females: adjusted OR=0.54, 95% CI 0.50 to 0.59). Associations were generally similar for both commuting and non-work travel, and were robust to adjustment with sociodemographic and behavioural factors. CONCLUSIONS There are strong associations between engaging in active travel, particularly cycling, and HLC dietary consumption, suggesting that these HLC behaviours are related. Further research is needed to better understand the drivers and dynamics between these behaviours within individuals, and whether they share common underlying causes.
Collapse
Affiliation(s)
| | - Jan Rasmus Boehnke
- Department of Health Sciences, University of York, York, UK
- School of Nursing and Health Sciences, University of Dundee, Dundee, UK
| | - Hilary Graham
- Department of Health Sciences, University of York, York, UK
| | - Piran C L White
- Department of Environment and Geography, University of York, York, UK
| | | |
Collapse
|
44
|
Molina-García J, Menescardi C, Estevan I, Martínez-Bello V, Queralt A. Neighborhood Built Environment and Socioeconomic Status are Associated with Active Commuting and Sedentary Behavior, but not with Leisure-Time Physical Activity, in University Students. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16173176. [PMID: 31480418 PMCID: PMC6747177 DOI: 10.3390/ijerph16173176] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 08/23/2019] [Accepted: 08/29/2019] [Indexed: 12/18/2022]
Abstract
The role of neighborhood characteristics in promoting physical activity and sedentary behaviors (SB) has not been extensively studied in university students. The study purpose was to analyze the associations of neighborhood built environment and neighborhood socioeconomic status (SES) with active commuting, leisure-time physical activity (LTPA), and SB among university students. This is a cross-sectional study of 308 undergraduate students from two urban universities in Valencia, Spain. Participants' residential neighborhoods were classified according to walkability and SES levels. Walkability was defined as an index of three built environment attributes (i.e., residential density, land-use mix, and street connectivity) based on geographical information system data. Active commuting to and from university (ACU), active commuting in the neighborhood, LTPA, and SB were evaluated through a questionnaire. Mixed model regression analyses were performed. There were no significant SES-walkability interactions for any of the outcomes analyzed. However, university students living in more walkable areas reported two more ACU trips per week compared to those living in less walkable neighborhoods (p < 0.01). University students living in lower-SES neighborhoods reported more ACU trips per week than those living in higher-SES neighborhoods (p < 0.05). Regarding LTPA, there were no significant SES or walkability main effects. Neighborhood SES was negatively related to active commuting in the neighborhood and to time spent in SB (all p < 0.05). Participants living in lower-SES neighborhoods reported more active commuting per week and had the highest average minutes spent in SB. This study highlights the relevance of assessing university's residential environment when active transportation and SB are analyzed.
Collapse
Affiliation(s)
- Javier Molina-García
- Department of Teaching of Musical, Visual and Corporal Expression, University of Valencia, Avda. dels Tarongers, 4, 46022 Valencia, Spain.
- AFIPS research group, University of Valencia, 46022 Valencia, Spain.
| | - Cristina Menescardi
- Department of Teaching of Musical, Visual and Corporal Expression, University of Valencia, Avda. dels Tarongers, 4, 46022 Valencia, Spain
- AFIPS research group, University of Valencia, 46022 Valencia, Spain
| | - Isaac Estevan
- Department of Teaching of Musical, Visual and Corporal Expression, University of Valencia, Avda. dels Tarongers, 4, 46022 Valencia, Spain
- AFIPS research group, University of Valencia, 46022 Valencia, Spain
| | - Vladimir Martínez-Bello
- Department of Teaching of Musical, Visual and Corporal Expression, University of Valencia, Avda. dels Tarongers, 4, 46022 Valencia, Spain
- COS research group, University of Valencia, 46022 Valencia, Spain
| | - Ana Queralt
- AFIPS research group, University of Valencia, 46022 Valencia, Spain
- Department of Nursing, University of Valencia, Jaume Roig, s/n, 46010 Valencia, Spain
| |
Collapse
|
45
|
Celis-Morales CA, Lyall DM, Petermann F, Anderson J, Ward J, Iliodromiti S, Mackay DF, Welsh P, Bailey MES, Pell J, Sattar N, Gill JMR, Gray SR. Do physical activity, commuting mode, cardiorespiratory fitness and sedentary behaviours modify the genetic predisposition to higher BMI? Findings from a UK Biobank study. Int J Obes (Lond) 2019; 43:1526-1538. [PMID: 31168053 DOI: 10.1038/s41366-019-0381-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 03/01/2019] [Accepted: 03/10/2019] [Indexed: 12/15/2022]
Abstract
OBJECTIVE To investigate whether the association between a genetic profile risk score for obesity (GPRS-obesity) (based on 93 SNPs) and body mass index (BMI) was modified by physical activity (PA), cardiorespiratory fitness, commuting mode, walking pace and sedentary behaviours. METHODS For the analyses we used cross-sectional baseline data from 310,652 participants in the UK Biobank study. We investigated interaction effects of GPRS-obesity with objectively measured and self-reported PA, cardiorespiratory fitness, commuting mode, walking pace, TV viewing, playing computer games, PC-screen time and total sedentary behaviour on BMI. Body mass index (BMI) was the main outcome measure. RESULTS GPRS-obesity was associated with BMI (β:0.54 kg.m-2 per standard deviation (SD) increase in GPRS, [95% CI: 0.53; 0.56]; P = 2.1 × 10-241). There was a significant interaction between GPRS-obesity and objectively measured PA (P[interaction] = 3.3 × 10-11): among inactive individuals, BMI was higher by 0.58 kg.m-2 per SD increase in GPRS-obesity (p = 1.3 × 10-70) whereas among active individuals the relevant BMI difference was less (β:0.33 kg.m-2, p = 6.4 × 10-41). We observed similar patterns for fitness (Unfit β:0.72 versus Fit β:0.36 kg.m-2, P[interaction] = 1.4 × 10-11), walking pace (Slow β:0.91 versus Brisk β:0.38 kg.m-2, P[interaction] = 8.1 × 10-27), discretionary sedentary behaviour (High β:0.64 versus Low β:0.48 kg.m-2, P[interaction] = 9.1 × 10-12), TV viewing (High β:0.62 versus Low β:0.47 kg.m-2, P[interaction] = 1.7 × 10-11), PC-screen time (High β:0.82 versus Low β:0.54 kg.m-2, P[interaction] = 0.0004) and playing computer games (Often β:0.69 versus Low β:0.52 kg.m-2, P[interaction] = 8.9 × 10-10). No significant interactions were found for commuting mode (car, public transport, active commuters). CONCLUSIONS Physical activity, sedentary behaviours and fitness modify the extent to which a set of the most important known adiposity variants affect BMI. This suggests that the adiposity benefits of high PA and low sedentary behaviour may be particularly important in individuals with high genetic risk for obesity.
Collapse
Affiliation(s)
- Carlos A Celis-Morales
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, G12 8TA, UK.,Centro de Investigación en Fisiología del Ejercicio (CIFE), Universidad Mayor, Santiago, Chile
| | - Donald M Lyall
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, G12 8RZ, UK
| | - Fanny Petermann
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, G12 8TA, UK.,Institute of Health and Wellbeing, University of Glasgow, Glasgow, G12 8RZ, UK
| | - Jana Anderson
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, G12 8RZ, UK
| | - Joey Ward
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, G12 8RZ, UK
| | - Stamatina Iliodromiti
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, G12 8TA, UK
| | - Daniel F Mackay
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, G12 8RZ, UK
| | - Paul Welsh
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, G12 8TA, UK
| | - Mark E S Bailey
- School of Life Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, G12 8QQ, UK
| | - Jill Pell
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, G12 8RZ, UK
| | - Naveed Sattar
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, G12 8TA, UK
| | - Jason M R Gill
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, G12 8TA, UK
| | - Stuart R Gray
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, G12 8TA, UK.
| |
Collapse
|
46
|
Nordengen S, Andersen LB, Solbraa AK, Riiser A. Cycling and cardiovascular disease risk factors including body composition, blood lipids and cardiorespiratory fitness analysed as continuous variables: Part 2—systematic review with meta-analysis. Br J Sports Med 2019; 53:879-885. [DOI: 10.1136/bjsports-2018-099778] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/25/2018] [Indexed: 01/19/2023]
Abstract
ObjectivesWe aimed to examine the relationship between cycling (particularly commuter cycling) and risk factors associated with cardiovascular diseases (CVDs) including body composition, blood lipids and cardiorespiratory fitness. This study differed from our recent (Part 1) systematic review in that risk factors for CVD were analysed as continuous variables rather than being present or absent.DesignSystematic review and meta-analysis.Eligibility criteriaWe searched four databases (Web of Science, MEDLINE, SPORTDiscus and Scopus). All quantitative studies, published until August 2017, were included when a general population was investigated, cycling was assessed either in total or as a transportation mode, and CVD risk factors were reported.MethodsWe analysed body composition, physical activity (PA), cardiorespiratory fitness (CRF), blood lipids and blood pressure (BP). Skinfold, waist circumference and body mass index were analysed and prioritised in that order when more than one measure were available. PA included measures of counts per minutes, moderate-to-vigorous PA or minutes per week. CRF included results of maximal tests with or without expired air or submaximal test. For blood lipids and BP, separate analyses were run for low-density and high-density lipoprotein, triglycerides, total cholesterol, systolic BP and diastolic BP. Studies were excluded when reporting dichotomous outcomes or when cycling and walking were combined. Heterogeneity was investigated using I2.ResultsFifteen studies were included; the majority reported commuter cycling. In total, we included 5775 cyclists and 39 273 non-cyclists. Cyclists had more favourable risk factor levels in body composition −0.08 (95% CI −0.13 to −0.04), PA 0.13 (95% CI 0.06 to 0.20), CRF 0.28 (95% CI 0.22 to 0.35) and blood lipids compared with non-cyclists. There was no sex difference in risk reduction.Conclusion/implicationCycling mitigated the risk factor profile for CVD. A strength of this systematic review is that all the risk factors were analysed as continuous variables. These data provide evidence for practitioners, stakeholders, policy-makers and city planners to accommodate and promote cycling.Systematic review registrationPROSPERO CRD42016052421.
Collapse
|
47
|
Tao L, Li X, Zhang J, Liu J, Liu Y, Li H, Liu X, Luo Y, Guo X. Association of commuting mode with dyslipidemia and its components after accounting for air pollution in the working population of Beijing, China. BMC Public Health 2019; 19:622. [PMID: 31117979 PMCID: PMC6530144 DOI: 10.1186/s12889-019-6887-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Accepted: 04/24/2019] [Indexed: 11/10/2022] Open
Abstract
Background Evidence of the association between dyslipidemia and its components with commuting mode after adjusting for air pollution is limited. This study aimed to explore the association of dyslipidemia and its components with the modes used to commute to and from work after accounting for air pollution and other potential confounding factors. Methods This cross–sectional study was based on data collected from a working population of 69 functional communities in Beijing in 2016. A final sample of 8090 adults aged 18–65 years (mean age: 38.36 ± 9.75 years) was enrolled in the study. Risk estimates and their corresponding 95% confidence intervals (CIs) for the associations of dyslipidemia and its components with commuting mode were determined using multivariate logistic regression models. Results Of the 8090 subjects, 2419 (29.90%) met the criteria for dyslipidemia. Compared with car or taxi commuters, walking (OR 0.79, 95% CI 0.64 to 0.97), cycling (OR 0.71, 95% CI 0.58 to 0.86) and bus-riding commuters (OR 0.78, 95% CI 0.66 to 0.91) had a lower risk for dyslipidemia. Compared with car or taxi commuting, walking, cycling and bus-riding commuting were also associated with a lower risk for some components of dyslipidemia. Among the walking, cycling and bus-riding commuters, a dose-response trend of the association between dyslipidemia, some of its components and commuting mode by commuting time was also observed. Conclusions Walking, cycling and bus-riding commuting can reduce the risk for dyslipidemia and some of its components. Education on the prevention of dyslipidemia should be emphasized among higher-risk people who usually commute by car or taxi. Population-wide health may be improved by policies that encourage active commuting, particularly cycling and walking. Electronic supplementary material The online version of this article (10.1186/s12889-019-6887-x) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Lixin Tao
- School of Public Health, Capital Medical University, Beijing, China.,Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Xia Li
- Department of Mathematics and Statistics, La Trobe University, Melbourne, Australia
| | - Jie Zhang
- School of Public Health, Capital Medical University, Beijing, China.,Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Jia Liu
- School of Public Health, Capital Medical University, Beijing, China.,Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Yue Liu
- School of Public Health, Capital Medical University, Beijing, China.,Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Haibin Li
- School of Public Health, Capital Medical University, Beijing, China.,Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Xiangtong Liu
- School of Public Health, Capital Medical University, Beijing, China.,Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Yanxia Luo
- School of Public Health, Capital Medical University, Beijing, China.,Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Xiuhua Guo
- School of Public Health, Capital Medical University, Beijing, China. .,Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China.
| |
Collapse
|
48
|
Blond MB, Rosenkilde M, Gram AS, Tindborg M, Christensen AN, Quist JS, Stallknecht BM. How does 6 months of active bike commuting or leisure-time exercise affect insulin sensitivity, cardiorespiratory fitness and intra-abdominal fat? A randomised controlled trial in individuals with overweight and obesity. Br J Sports Med 2019; 53:1183-1192. [DOI: 10.1136/bjsports-2018-100036] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/13/2019] [Indexed: 12/23/2022]
Abstract
ObjectivesTo evaluate effects of active bike commuting or leisure-time exercise of two intensities on peripheral insulin sensitivity (primary outcome), cardiorespiratory fitness and intra-abdominal adipose tissue mass (secondary outcomes).Methods188 physically inactive, healthy women and men (20-45 years) with overweight or class 1 obesity were recruited. In the 6-month trial, 130 participants were randomised to either: no intervention (CON), active commuting (BIKE) or leisure-time exercise of moderate (MOD, 50% VO2peak) or vigorous (VIG, 70% VO2peak) intensity. 100 completed follow-up testing. Exercise prescription was 5 days/week with a weekly exercise energy expenditure of 1600 kcal for women and 2100 kcal for men. Testing was performed at baseline, 3 months and 6 months.ResultsPeripheral insulin sensitivity (ml/min/pmol insulin/L) increased (improved) by 24% (95% CI 6% to 46%, p=0.01) in VIG compared with CON at 3 months. Peripheral insulin sensitivity increased (improved) by 20% in BIKE (95% CI 1% to 43%, p=0.04) and 26% in VIG (95% CI 7% to 47%, p<0.01) compared with CON at 6 months. Cardiorespiratory fitness increased in all exercise groups compared with CON at 6 months; but the increase was higher in those that undertook vigorous exercise than those who did moderate exercise. Intra-abdominal adipose tissue mass diminished across all exercise groups in comparison to CON at 6 months.ConclusionsActive bike commuting improved cardiometabolic health; as did leisure-time exercise. Leisure-time exercise of vigorous intensity conferred more rapid effects on peripheral insulin sensitivity as well as additional effects on cardiorespiratory fitness than did moderate intensity exercise.Trial registrationNCT01962259
Collapse
|
49
|
Forbes CC, Yu ZM, Cui Y, DeClercq V, Grandy SA, Parker L, Sweeney E, Dummer TJB, Keats MR. Rural-Urban Disparities in Total Physical Activity, Body Composition, and Related Health Indicators: An Atlantic PATH Study. J Rural Health 2019; 36:111-119. [PMID: 30865321 DOI: 10.1111/jrh.12363] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
PURPOSE To describe and compare the sociodemographic and lifestyle characteristics of urban and rural residents in Atlantic Canada. METHODS Cross-sectional analyses of baseline data from the Atlantic Partnership for Tomorrow's Health cohort were conducted. Specifically, 17,054 adults (35-69 years) who provided sociodemographic characteristics, measures of obesity, and a record of chronic disease and health behaviors were included in the analyses. Multiple linear regression and logistic regression models were used to calculate the multivariable-adjusted beta coefficients (β), odds ratios (OR), and related 95% confidence intervals (CI). FINDINGS After adjusting for age, sex, and province, when compared to urban participants, rural residents were significantly more likely to: be classified as very active (OR: 1.19, CI: 1.11-1.27), be obese (OR: 1.13, 1.05-1.21), to present with abdominal obesity (OR: 1.08, CI: 1.01-1.15), and have a higher body fat percentage (β: 0.40, CI: 0.12-0.68) and fat mass index (β: 0.32, CI: 0.19-0.46). Rural residents were significantly less likely to be regular or habitual drinkers (OR: 0.83, CI: 0.78-0.89). Significant differences remained after further adjustment for confounding sociodemographic, lifestyle, and health characteristics. No significant differences in smoking behavior, fruit and vegetable intake, multimorbidity, or waist circumference were found. CONCLUSIONS As expected, obesity prevalence was higher in rural Atlantic Canadians. In contrast to much of the existing literature, we found that rural participants were more likely to report higher levels of total physical activity and lower alcohol consumption. Findings suggest that novel obesity prevention strategies may be needed for rural populations.
Collapse
Affiliation(s)
- Cynthia C Forbes
- Population Cancer Research Program, Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia, Canada.,Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Zhijie Michael Yu
- Population Cancer Research Program, Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Yunsong Cui
- Population Cancer Research Program, Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Vanessa DeClercq
- Population Cancer Research Program, Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Scott A Grandy
- School of Health and Human Performance, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Louise Parker
- Population Cancer Research Program, Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Ellen Sweeney
- Population Cancer Research Program, Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Trevor J B Dummer
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Melanie R Keats
- School of Health and Human Performance, Dalhousie University, Halifax, Nova Scotia, Canada
| |
Collapse
|
50
|
Booth GL, Creatore MI, Luo J, Fazli GS, Johns A, Rosella LC, Glazier RH, Moineddin R, Gozdyra P, Austin PC. Neighbourhood walkability and the incidence of diabetes: an inverse probability of treatment weighting analysis. J Epidemiol Community Health 2019; 73:287-294. [PMID: 30696690 DOI: 10.1136/jech-2018-210510] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Revised: 09/04/2018] [Accepted: 10/17/2018] [Indexed: 12/21/2022]
Abstract
BACKGROUND People living in highly walkable neighbourhoods tend to be more physically active and less likely to be obese. Whether walkable urban design reduces the future risk of diabetes is less clear. METHODS We used inverse probability of treatment weighting to compare 10-year diabetes incidence between residents living in high-walkability and low-walkability neighbourhoods within five urban regions in Ontario, Canada. Adults (aged 30-85 years) who were diabetes-free on 1 April 2002 were identified from administrative health databases and followed until 31 March 2012 (n=958 567). Within each region, weights reflecting the propensity to live in each neighbourhood type were created based on sociodemographic characteristics, comorbidities and healthcare utilisation and incorporated into region-specific Cox proportional hazards models. RESULTS Low-walkability areas were more affluent and had more South Asian residents (6.4%vs3.6%, p<0.001) but fewer residents from other minority groups (16.6%vs21.7%, p<0.001). Baseline characteristics were well balanced between low-walkability and high-walkability neighbourhoods after applying individual weights (standardised differences all <0.1). In each region, high walkability was associated with lower diabetes incidence among adults aged <65 years (overall weighted incidence: 8.2vs9.2 per 1000; HR 0.85, 95% CI 0.78 to 0.93), but not among adults aged ≥65 years (weighted incidence: 20.7vs19.5 per 1000; HR 1.01, 95% CI 0.91 to 1.12). Findings were consistent regardless of income and immigration status. CONCLUSIONS Younger adults living in high-walkability neighbourhoods had a lower 10-year incidence of diabetes than similarly aged adults living in low-walkability neighbourhoods. Urban designs that support walking may have important benefits for diabetes prevention.
Collapse
Affiliation(s)
- Gillian L Booth
- Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, Ontario, Canada.,The Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada.,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.,Department of Medicine, St. Michael's Hospital and the University of Toronto, Toronto, Ontario, Canada
| | - Maria I Creatore
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Jin Luo
- The Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
| | - Ghazal S Fazli
- Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, Ontario, Canada.,The Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada.,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Ashley Johns
- Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, Ontario, Canada
| | - Laura C Rosella
- The Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada.,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Richard H Glazier
- Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, Ontario, Canada.,The Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada.,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.,Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada.,Department of Family and Community Medicine, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Rahim Moineddin
- The Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada.,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.,Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Peter Gozdyra
- Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, Ontario, Canada.,The Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
| | - Peter C Austin
- The Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada.,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| |
Collapse
|