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Back to Biking to Reduce Cardiovascular, Diabetes, and Cancer Risks

A new study found riding a bike to work associated with reduction in risk of cardiovascular disease, cancer risk, diabetes, and premature death over five years.

In five-year study, cyclists saw risk for heart disease, cancer, and early death cut by almost half according to a study published online April 19 in The BMJ.

Physical activity is declining worldwide, partly owing to reductions in active commuting (walking or cycling). Active commuting has been recommended as a practical way of incorporating more physical activity into daily life. A meta-analysis of 173, 146 participants reported that active commuting was associated with a lower risk of adverse cardiovascular outcomes, especially for women. However, the work was limited by a heterogeneous range of cardiometabolic endpoints (including hypertension, diabetes, stroke, coronary heart disease, and cardiovascular disease (CVD)), inconsistent adjustment for confounders, and no differentiation between walking and cycling. The authors of the study recommended further research on the association between active commuting and CVD. Evidence of the association of active commuting on mortality and cancer are equivocal, with available studies limited by relatively small numbers of participants.

Evidence is limited on the associations of mixed mode commuting (a combination of active and non-active) on health outcomes. We used UK Biobank, a large, prospective, population-based cohort study, to investigate the association between different types of active commuting and incident CVD, cancer, and all-cause mortality.

Jason Gill, Ph.D., of the University of Glasgow’s Institute of Cardiovascular and Medical Sciences in the United Kingdom, and colleagues looked at the commuting habits of 263,450 people in the United Kingdom and tracked their health over five years. Walking was also beneficial; it was associated with a 27 percent lower risk of cardiovascular disease and a 36 percent lower risk of dying from cardiovascular disease. However, it wasn’t linked with a lower risk of cancer or premature death. “Initiatives to encourage and support active commuting could reduce risk of death and the burden of important chronic conditions,” the authors write.

2,430 participants died (496 were related to CVD and 1126 to cancer) over a median of 5.0 years (interquartile range 4.3-5.5) follow-up. There were 3,748 cancer and 1,110 CVD events. In maximally adjusted models, commuting by cycle and by mixed mode, including cycling were associated with lower risk of all-cause mortality (cycling hazard ratio 0.59, 95% confidence interval 0.42 to 0.83, P=0.002; mixed mode cycling 0.76, 0.58 to 1.00, P<0.05), cancer incidence (cycling 0.55, 0.44 to 0.69, P<0.001; mixed mode cycling 0.64, 0.45 to 0.91, P=0.01), and cancer mortality (cycling 0.60, 0.40 to 0.90, P=0.01; mixed mode cycling 0.68, 0.57 to 0.81, P<0.001). Commuting by cycling and walking were associated with a lower risk of CVD incidence (cycling 0.54, 0.33 to 0.88, P=0.01; walking 0.73, 0.54 to 0.99, P=0.04) and CVD mortality (cycling 0.48, 0.25 to 0.92, P=0.03; walking 0.64, 0.45 to 0.91, P=0.01). No statistically significant associations were observed for walking commuting and all-cause mortality or cancer outcomes. Mixed mode commuting, including walking, was not noticeably associated with any of the measured outcomes.

From the results of the study, it was concluded that commuting undertaken totally or partially by bicycle was associated with a lower risk of a range of adverse health outcomes. Commuting by walking was associated with a lower risk of adverse CVD outcomes. The findings, if causal, suggest population health may be improved by policies that increase active commuting, particularly cycling, such as the creation of cycle lanes, cycle hire or purchase schemes, and better provision for cycles on public transport.

When it comes to preventing diabetes, in a current study they found that habitual cycling, whether as transportation to work or as a recreational activity, is associated with lower risk of developing type 2 diabetes (T2D), according to a study published  in PLOS Medicine. This cohort study, conducted by Martin Rasmussen of the University of Southern Denmark, and colleagues, included 24,623 men and 27,890 women from Denmark, recruited between the ages of 50 and 65, and compared the association between self-reported recreational and commuter cycling habits with T2D incidence measured in the Danish National Diabetes Registry. The authors found that participants who engaged in habitual cycling were less likely to develop T2D, and risk of developing T2D appeared to decrease with longer time spent cycling per week. Five years after they were initially recruited, participants were contacted for follow-up and their cycling habits were re-assessed. People who took up habitual cycling during this period were at 20% lower risk for T2D than non-cyclists.

Practice Pearls:

  • Biking was associated with a 46% reduced risk of cardiovascular disease.
  • Biking reduced the risk of cancer by 45%.
  • Biking lowered the risk of death by 41%.

BMJ 2017; 357 doi: https://doi.org/10.1136/bmj.j1456 (Published 19 April 2017)