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Health benefits of leisure time and commuting physical activity: a meta-analysis of effects on morbidity
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Sustainable Health.
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Sustainable Health.
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Sustainable Health.ORCID iD: 0000-0002-0159-6657
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Sustainable Health.ORCID iD: 0000-0002-8854-498x
2020 (English)In: Journal of Transport & Health, ISSN 2214-1405, E-ISSN 2214-1413, Vol. 18, article id 100873Article in journal (Refereed) Published
Abstract [en]

Introduction: A protective role of leisure time physical activity with regard to non-communicable chronic diseases (NCDs) is well established. However, shapes of dose-response relationships and the extent of BMI mediation between physical activity and disease risk are not well known. Furthermore, the knowledge about risk reductions from active commuting is limited. Methods: Meta-analyses of prospective cohort studies published from January 1990 to June 2019 were conducted, 1) to assess the effect of leisure time and commuting physical activity on cardiovascular disease (CVD), type 2 diabetes, breast cancer and colon cancer, and 2) to quantify the extent to which adjustment for BMI affect these relations. Results: Random effect meta-analyses of 59 prospective cohort studies estimated that individuals who engaged in 11.25 MET-hours/week of active commuting had a decreased risk of myocardial infarction (MI) by 18% (95% CI: 1-33%) and type 2 diabetes by 22% (95% CI: 4-37%) compared with non-commuters. Corresponding risk reductions for leisure-time physical activity (LTPA) were 22% for MI, 26% for CVD, 27% for heart failure, 23% for stroke, 22% for type 2 diabetes, 15% for colon cancer and 7% for breast cancer. Except for breast cancer, adjustment for BMI reduced the benefit of physical activity. Conclusion: Both active commuting and LTPA are associated with lower risk for NCD. Currently, available data is insufficient to establish detail and reliable dose-response curves.

Place, publisher, year, edition, pages
Elsevier, 2020. Vol. 18, article id 100873
Keywords [en]
Leisure time physical activity, Active commuting, Non communicable chronic diseases, Meta-analysis, Dose-response relation, Metabolic equivalent of task
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:umu:diva-175846DOI: 10.1016/j.jth.2020.100873ISI: 000571103400022Scopus ID: 2-s2.0-85085926435OAI: oai:DiVA.org:umu-175846DiVA, id: diva2:1476456
Available from: 2020-10-14 Created: 2020-10-14 Last updated: 2024-07-04Bibliographically approved
In thesis
1. Impacts of Active Transport on Health: with a focus on physical activity, air pollution, and cardiovascular disease
Open this publication in new window or tab >>Impacts of Active Transport on Health: with a focus on physical activity, air pollution, and cardiovascular disease
2021 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background: There are increasing number of health impact assessment studies investigating the health effects by transferring trips made by motorised transport to active commuting; however, air pollution exposure during active commuting and its impact on health has been less thoroughly assessed. It is furthermore uncertain whether there is any interaction effect between air pollution and physical activity for the risk of cardiovascular diseases. The overall aim of the thesis was to improve the knowledge base for assessments of the total impact on health of a mode shift resulting in both increased physical activity and increased air pollution exposure, especially regarding combined effects on cardiovascular risks.

Methods: The thesis is based on four studies. In Study I, methodological issues related to the assessment of air pollution in previous studies on the health impact of changes in transport mode were critically reviewed. In Study II, the effect of leisure time and active commuting physical activity, on chronic diseases was quantified by conducting a random-effect meta-analysis. In two prospective cohort studies, participants of the Västerbotten Intervention Programme living in the Umeå region were studied to assess the impact as well as interaction effect of physical activity and air pollution on the incidence (Study III) and recurrence (Study IV) of cardiovascular diseases.

Results: In previous studies on the health impact of changes in transport mode, there was a large methodological discrepancy between studies due to different assumptions for air pollution exposure assessments in general populations and commuters as well as methods for estimation of impacts. Randomeffect meta-analyses showed a beneficial effect of leisure time physical activity and active commuting on morbidity among individuals performing these activities at the minimum level of physical activity recommended by WHO, equivalent to 11.25 MET-hours per week. Beneficial effects of exercise on firstincident ischemic heart disease (IHD) were observed among individuals with high residential PM10/PM2.5 concentrations, but not among individuals with low concentrations. Adverse effects associated with high residential PM10 and PM2.5 concentrations were only observed among the individuals whom less frequently exercised. A statistically significant interaction effect was found between air pollution and exercise in training clothes for first-incident IHD but not for recurrence of IHD/stroke.

Conclusions: The results in this thesis strengthen the public health message that physical activity is beneficial for cardiovascular health, even in areas with air pollution. Therefore, public health and transport policies should be designed to improve population health through promotion of active transport and mitigation of air pollution.

Place, publisher, year, edition, pages
Umeå: Umeå University, 2021. p. 86
Series
Umeå University medical dissertations, ISSN 0346-6612 ; 2132
Keywords
Health impact assessment, Air pollution, Active commuting, Exercise, Interaction. Cardiovascular diseases, Ischemic heart diseases, Stroke
National Category
Public Health, Global Health, Social Medicine and Epidemiology Occupational Health and Environmental Health
Research subject
Public health; Occupational and Environmental Medicine
Identifiers
urn:nbn:se:umu:diva-183309 (URN)978-91-7855-533-8 (ISBN)978-91-7855-532-1 (ISBN)
Public defence
2021-06-15, Triple Helix, Universitetsledningshuset/Zoom, Umeå, 13:00 (English)
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Supervisors
Note

Zoom: https://umu.zoom.us/j/62645020569

Passcode: 223344

Available from: 2021-05-25 Created: 2021-05-21 Last updated: 2021-06-22Bibliographically approved

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Raza, WasifKrachler, BennoForsberg, BertilNilsson Sommar, Johan

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