E-cycling and health benefits: A systematic literature review with meta-analyses

publishedVersio

Bicycling in the right direction? : Two systematic literature reviews with meta-analyses of cycling and cardiovascular disease, followed by national correlates of commuter cycling and the presentation of a novel bike tra c index to describe trends in cycling over the years.

Background: The world population needs to be more physically active. Cardiovascular disease (CVD) is one of the leading causes of death and can be prevented by physical activity. Cycling as transportation may be a means of improving the health of the general population. To facilitate and evaluate interventions to increase cycling in Norway, we need more information about factors associated with cycling and a method to follow future trends. Main aims: To investigate the relationship between cycling and CVD and its associated risk factors and to investigate individual and environmental factors that may affect Norwegian people’s choice to travel by bicycle. We also aimed to develop a sensitive method to describe cycling trends in Norway over the years at the local, regional, and national levels. Materials and methods: This thesis is based on two systematic reviews and meta-analyses of CVD and associated risk factors in more than one million individuals, as well as a crosssectional study of Norwegian public-sector employees in Sogn og Fjordane, Aust Agder and West Agder counties that used a web-based questionnaire combined with objective measurement by a geographical information system. Finally, the thesis is based on opensource data from 89 stationary cycle trips counters in Norway describing the trends in counted trips from 2017 to 2020. Main results: Based on the systematic review, we found that cycling was associated with a 22% lower risk of CVD mortality, CVD incidence, and associated CVD risk factors compared with passive transport (Study I). Being a cyclist was also associated with beneficial risk factor levels, except for blood pressure, compared with non-cyclists (Study II). In the Norwegian environment, we found both individual and environmental factors associated with a higher likelihood of commuter cycling. Travel distance below 5 km and living in a highly populated area increased the probability of cycling. Having good health, being physically active, and owing an e-bike also increased the likelihood of cycling (Study III). Finally, we observed an 11% increase in counted cycle trips from 2018 to 2020, with large geographical differences (Study IV). Conclusions: Cyclists were at lower risk of CVD incidence, CVD mortality, and some CVD risk factors. Health professionals, city planners, and stakeholders can recommend cycling to prevent CVD and should aim to increase the amount of cycling. Both individual and environmental factors were associated with likelihood of being a cyclist. Characteristics of cyclists seemed to be similar regardless of whether they lived in areas with smaller or larger numbers of cyclists. Nationally, we observed a significant increase in counted trips, while the regional and local indices indicated geographical differences. The indices may highlight effects related to local and national bicycling strategies

Endrer motivasjonen seg i løpet av de fire første ukene av livsstilsendringskurset EasyLife?

Vi har undersøkt motivasjonsregulering hos deltagere i et livsstilsendringsprogram. Teoretisk har vi benyttet oss av Helseoppfatningsmodellen (The Health Belief Model; Rosenstock, 1966), Den transteoretiske modellen (The Transtheoretical Model; DiClemente & Prochaska, 1982; Marcus & Simkin, 1994), Selvbestemmelsesteorien (Self-Determination Theory; Deci & Ryan, 2000) og Rosenstocks fire modeller for ansvar. For å kartlegge motivasjonsregulering har vi benyttet oss av BREQ-2 (Markland & Tobin 2004). Vi fant ingen signifikante forskjeller i motivasjonen ved dag én og etter fire uker, verken for kjønn, alder eller prosentvis vektnedgang. Uteblivelse av forandring er diskutert opp mot de ulike teoriene for å se om forklaringen ligger i kursets struktur eller hos deltagerne selv

National Trends in Cycling in Light of the Norwegian Bike Traffic Index

National and international strategies and recommendations are intended to increase physical activity in the general population. Active transportation is included in interdisciplinary strategies to meet these recommendations. Cycling seems to be more health enhancing than walking for transportation since cycling seems to reduce the risk of cardiovascular disease and associated risk factors. Furthermore, the health benefits of cycling are proven to outrun the risk of injuries and mortality. Politicians seem to approve costly infrastructure strategies to increase the amount of cycling in the population to improve public health and shift to more sustainable travel habits. A linear relationship between cycle-friendly infrastructure and the amount of commuter cycling has been demonstrated. However, in Norway and on a global level, there is a lack of robust evaluations of actions and sensitive monitoring systems to observe possible change. Therefore, we aimed to develop the Norwegian bike traffic index and describe the national, regional, and local trends in counted cycle trips. We used a transparent methodology so that the index can be used, developed, and adapted in other countries. We included 89 stationary counters from the whole country. Counters monitored cycling from 2018 onward. The index is organized at local, regional, and national levels. Furthermore, the index is adjusted for population density at the counter level and presented as ratio of counted cycle trips, comparing 2018 to subsequent years. The index is presented as a percentage change with 95% confidence intervals. In Norway, counted cycle trips increased by 11% from 2018 (100, 100–100) to 2020 (111.0, 106.2–115.1), with large geographical differences. In Southern Norway, there was a significant increase of 23%, and in Northern Norway, there was a nonsignificant decrease by 8% from 2018 to 2020. The indices may indicate possible related effects of local to national cycling strategies and how the COVID-19 pandemic has affected Norwegian travel habits in urban areas

Correlates of Commuter Cycling in Three Norwegian Counties

Globally, there is an increasing challenge of physical inactivity and associated diseases. Commuter cycling is an everyday physical activity with great potential to increase the health status in a population. We aimed to evaluate the association of self-reported factors and objectively measured environmental factors in residence and along commuter routes and assessed the probability of being a commuter cyclist in Norway. Our study included respondents from a web-based survey in three Norwegian counties and we used a Geographic Information Systems (GIS) to evaluate the natural and built environment. Of the 1196 respondents, 488 were classified as commuter cyclists. Self-reported factors as having access to an e-bike (OR 5.99 [CI: 3.71–9.69]), being physically active (OR 2.56 [CI: 1.42–4.60]) and good self-rated health (OR 1.92 [CI: 1.20–3.07]) increased the probability of being a cyclist, while being overweight or obese (OR 0.71 [CI: 0.54–0.94]) reduced the probability. Environmental factors, such as high population density (OR 1.49 [CI: 1.05–2.12]) increased the probability, while higher slope (trend p = 0.020), total elevation along commuter route (trend p = 0.001), and >5 km between home and work (OR 0.17 [CI: 0.13–0.23]) decreased the probability of being a cyclist. In the present study, both self-reported and environmental factors were associated with being a cyclist. With the exception of being in good health, the characteristics of cyclists in Norway, a country with a low share of cyclists, seem to be similar to countries with a higher share of cyclists. With better knowledge about characteristics of cyclists, we may design better interventions and campaigns to increase the share of commuter cyclists

Correlates of Commuter Cycling in Three Norwegian Counties

Globally, there is an increasing challenge of physical inactivity and associated diseases. Commuter cycling is an everyday physical activity with great potential to increase the health status in a population. We aimed to evaluate the association of self-reported factors and objectively measured environmental factors in residence and along commuter routes and assessed the probability of being a commuter cyclist in Norway. Our study included respondents from a web-based survey in three Norwegian counties and we used a Geographic Information Systems (GIS) to evaluate the natural and built environment. Of the 1196 respondents, 488 were classified as commuter cyclists. Self-reported factors as having access to an e-bike (OR 5.99 [CI: 3.71–9.69]), being physically active (OR 2.56 [CI: 1.42–4.60]) and good self-rated health (OR 1.92 [CI: 1.20–3.07]) increased the probability of being a cyclist, while being overweight or obese (OR 0.71 [CI: 0.54–0.94]) reduced the probability. Environmental factors, such as high population density (OR 1.49 [CI: 1.05–2.12]) increased the probability, while higher slope (trend p = 0.020), total elevation along commuter route (trend p = 0.001), and >5 km between home and work (OR 0.17 [CI: 0.13–0.23]) decreased the probability of being a cyclist. In the present study, both self-reported and environmental factors were associated with being a cyclist. With the exception of being in good health, the characteristics of cyclists in Norway, a country with a low share of cyclists, seem to be similar to countries with a higher share of cyclists. With better knowledge about characteristics of cyclists, we may design better interventions and campaigns to increase the share of commuter cyclists

Public employees in South-Western Norway using an e-bike or a regular bike for commuting – A cross-sectional comparison on sociodemographic factors, commuting frequency and commuting distance

Large-scale analyses on the travel behavior of e-bikes are scarce, and current knowledge regarding who the e-bike owners are is inconsistent. Also, commuters represent a relevant user group with an unexploited potential. Therefore, the purpose of the present study was to examine (i) associations between type of bike (e-bike vs. regular bike) with place of residence (county), sociodemographic variables (age, sex, educational level, income and ethnicity) and habitual physical activity level, and (ii) if public employees possessing an e-bike cycle more often and longer distances to work. A cross-sectional survey was conducted in 2017 among 1977 (5.2% of eligible subjects) public employees in Southern and Western Norway. Binary and multinomial logistic regression analyses were conducted. Respondents possessing an e-bike were less likely to perform high levels of leisure time physical activity (OR 0.56 (CI 0.39-0.82)), compared to those possessing a regular bike only. For those residing in Agder, the likelihood of possessing an e-bike (vs. regular bike) was almost 4 times higher (OR 3.98 (CI 2.53-6.26)), compared with participants residing in Sogn og Fjordane. Compared with those possessing a regular bike only, e-bike users cycled more frequently to work, both occasionally (OR 3.71 (CI 2.44-5.65)) and most of the time (OR 4.28 (CI 2.79-6.55)), and they had higher odds of cycling medium distances to the workplace (OR 1.74 (CI 1.04-2.90)). In conclusion, e-bike access could result in increased commuter cycling, both in terms of cycling frequency and cycling distance, which in turn could contribute to enhanced physical activity levels. Keywords: E-bike, Bicycle, Active travel, Active commuting, Public employees, Southern Norway, Western Norwa

Public employees in South-Western Norway using an e-bike or a regular bike for commuting – A cross-sectional comparison on sociodemographic factors, commuting frequency and commuting distance

Large-scale analyses on the travel behavior of e-bikes are scarce, and current knowledge regarding who the e-bike owners are is inconsistent. Also, commuters represent a relevant user group with an unexploited potential. Therefore, the purpose of the present study was to examine (i) associations between type of bike (e-bike vs. regular bike) with place of residence (county), sociodemographic variables (age, sex, educational level, income and ethnicity) and habitual physical activity level, and (ii) if public employees possessing an e-bike cycle more often and longer distances to work. A cross-sectional survey was conducted in 2017 among 1977 (5.2% of eligible subjects) public employees in Southern and Western Norway. Binary and multinomial logistic regression analyses were conducted. Respondents possessing an e-bike were less likely to perform high levels of leisure time physical activity (OR 0.56 (CI 0.39-0.82)), compared to those possessing a regular bike only. For those residing in Agder, the likelihood of possessing an e-bike (vs. regular bike) was almost 4 times higher (OR 3.98 (CI 2.53-6.26)), compared with participants residing in Sogn og Fjordane. Compared with those possessing a regular bike only, e-bike users cycled more frequently to work, both occasionally (OR 3.71 (CI 2.44-5.65)) and most of the time (OR 4.28 (CI 2.79-6.55)), and they had higher odds of cycling medium distances to the workplace (OR 1.74 (CI 1.04-2.90)). In conclusion, e-bike access could result in increased commuter cycling, both in terms of cycling frequency and cycling distance, which in turn could contribute to enhanced physical activity levels