Impact of changes in mode of travel to work on changes in body mass index: evidence from the British Household Panel Survey

BACKGROUND Active commuting is associated with various health benefits, but little is known about its causal relationship with body mass index (BMI). METHODS We used cohort data from three consecutive annual waves of the British Household Panel Survey, a longitudinal study of nationally representative households, in 2004/05 (n=15,791), 2005/06 and 2006/07. Participants selected for the analyses (n=4,056) reported their usual main mode of travel to work at each time point. Self-reported height and weight were used to derive BMI at baseline and after two years. Multivariable linear regression analyses were used to assess associations between switching to and from active modes of travel (over one and two years) and change in BMI (over two years) and to assess dose-response relationships. RESULTS After adjustment for socioeconomic and health-related covariates, the first analysis (n=3,269) showed that switching from private motor transport to active travel or public transport (n=179) was associated with a significant reduction in BMI compared to continued private motor vehicle use (n=3,090) (-0.32kg/m2, 95% CI: -0.60 to -0.05). Larger adjusted effect sizes were associated with switching to active travel (n=109) (-0.45kg/m2, -0.78 to -0.11), particularly among those who switched within the first year and those with the longest journeys. The second analysis (n=787) showed that switching from active travel or public transport to private motor transport was associated with a significant increase in BMI (0.34kg/m2, 0.05 to 0.64). CONCLUSION Interventions to enable commuters to switch from private motor transport to more active modes of travel could contribute to reducing population mean BMI

Cycling and Diabetes Prevention: Practice-Based Evidence for Public Health Action.

Panter and Ogilvie describe findings that link recreational and commuter cycling with reduced incidence of diabetes

Walking and cycling to work despite reporting an unsupportive environment: insights from a mixed-method exploration of counterintuitive findings.

BACKGROUND: Perceptions of the environment appear to be associated with walking and cycling. We investigated the reasons for walking and cycling to or from work despite reporting an unsupportive route environment in a sample of commuters. METHODS: This mixed-method analysis used data collected as part of the Commuting and Health in Cambridge study. 1164 participants completed questionnaires which assessed the travel modes used and time spent on the commute and the perceived environmental conditions on the route to work. A subset of 50 also completed qualitative interviews in which they discussed their experiences of commuting. Participants were included in this analysis if they reported unsupportive conditions for walking or cycling on their route (e.g. heavy traffic) in questionnaires, walked or cycled all or part of the journey to work, and completed qualitative interviews. Using content analysis of these interviews, we investigated their reasons for walking or cycling. RESULTS: 340 participants reported walking or cycling on the journey to work despite unsupportive conditions, of whom 15 also completed qualitative interviews. From these, three potential explanations emerged. First, some commuters found strategies for coping with unsupportive conditions. Participants described knowledge of the locality and opportunities for alternative routes more conducive to active commuting, as well as their cycling experience and acquired confidence to cycle in heavy traffic. Second, some commuters had other reasons for being reliant on or preferring active commuting despite adverse environments, such as childcare arrangements, enjoyment, having more control over their journey time, employers' restrictions on car parking, or the cost of petrol or parking. Finally, some survey respondents appeared to have reported not their own environmental perceptions but those of others such as family members or 'the public', partly to make a political statement regarding the adversity of active commuting in their setting. CONCLUSIONS: Participants report walking and cycling to work despite adverse environmental conditions. Understanding this resilience might be just as important as investigating 'barriers' to cycling. These findings suggest that developing knowledge of safe walking and cycling routes, improving cycling confidence and restricting workplace parking may help to encourage walking and cycling to and from work.RIGHTS : This article is licensed under the BioMed Central licence at http://www.biomedcentral.com/about/license which is similar to the 'Creative Commons Attribution Licence'. In brief you may : copy, distribute, and display the work; make derivative works; or make commercial use of the work - under the following conditions: the original author must be given credit; for any reuse or distribution, it must be made clear to others what the license terms of this work are

Longitudinal associations of active commuting with wellbeing and sickness absence.

OBJECTIVE: Our aim was to explore longitudinal associations of active commuting (cycling to work and walking to work) with physical wellbeing (PCS-8), mental wellbeing (MCS-8) and sickness absence. METHOD: We used data from the Commuting and Health in Cambridge study (2009 to 2012; n=801) to test associations between: a) maintenance of cycling (or walking) to work over a one year period and indices of wellbeing at the end of that one year period; and b) associations between change in cycling (or walking) to work and change in indices of wellbeing. Linear regression was used for testing associations with PCS-8 and MCS-8, and negative binomial regression for sickness absence. RESULTS: After adjusting for sociodemographic variables, physical activity and physical limitation, those who maintained cycle commuting reported lower sickness absence (0.46, 95% CI: 0.14-0.80; equivalent to one less day per year) and higher MCS-8 scores (1.50, 0.10-2.10) than those who did not cycle to work. The association for sickness absence persisted after adjustment for baseline sickness absence. No significant associations were observed for PCS-8. Associations between change in cycle commuting and change in indices of wellbeing were not significant. No significant associations were observed for walking. CONCLUSIONS: This work provides some evidence of the value of cycle commuting in improving or maintaining the health and wellbeing of adults of working age. This may be important in engaging employers in the promotion of active travel and communicating the benefits of active travel to employees.The Commuting and Health in Cambridge study was developed by David Ogilvie, Simon Griffin, Andy Jones and Roger Mackett and initially funded under the auspices of the Centre for Diet and Activity Research (CEDAR), a UKCRC Public Health Research Centre of Excellence. Funding from the British Heart Foundation, Economic and Social Research Council, Medical Research Council, National Institute for Health Research and the Wellcome Trust, under the auspices of the UK Clinical Research Collaboration, is gratefully acknowledged. The study is now funded by the National Institute for Health Research (NIHR) Public Health Research programme (project number 09/3001/06: see http://www.nets.nihr.ac.uk/projects/phr/09300106). David Ogilvie is supported by the Medical Research Council [Unit Programme number MC_UP_12015/6]. Jenna Panter is supported by an NIHR post-doctoral fellowship [PDF-2012-05-157] and Oliver Mytton by a Welcome Trust clinical doctoral fellowship. The views and opinions expressed herein are those of the authors and do not necessarily reflect those of the NIHR, the NHSor the Department of Health. The funders had no role in study design, data collection and analysis, the decision to publish, or the preparation of the manuscript. We thank all staff from the MRC Epidemiology Unit Functional Group Team, in particular for study coordination and data collection (led by Cheryl Chapman and Fiona Whittle) and data management (Lena Alexander). We also thank Emma Coombes for linking postcodes to deprivation indices and Louise Foley for her contribution to preparing the questionnaire data for analysis.This is the final version of the article. It first appeared from Elsevier via http://dx.doi.org/10.1016/j.ypmed.2015.12.01

Longitudinal associations of active commuting with body mass index.

OBJECTIVE: To investigate the longitudinal associations between active commuting (walking and cycling to work) and body mass index (BMI). METHOD: We used self-reported data on height, weight and active commuting from the Commuting and Health in Cambridge study (2009 to 2012; n=809). We used linear regression to test the associations between: a) maintenance of active commuting over one year and BMI at the end of that year; and b) change in weekly time spent in active commuting and change in BMI over one year. RESULTS: After adjusting for sociodemographic variables, other physical activity, physical wellbeing and maintenance of walking, those who maintained cycle commuting reported a lower BMI on average at one year follow-up (1.14kg/m(2), 95% CI: 0.30 to 1.98, n=579) than those who never cycled to work. No significant association remained after adjustment for baseline BMI. No significant associations were observed for maintenance of walking. An increase in walking was associated with a reduction in BMI (0.32kg/m(2), 95% CI: 0.03 to 0.62, n=651, after adjustment for co-variates and baseline BMI) only when restricting the analysis to those who did not move. No other significant associations between changes in weekly time spent walking or cycling on the commute and changes in BMI were observed. CONCLUSIONS: This work provides further evidence of the contribution of active commuting, particularly cycling, to preventing weight gain or facilitating weight loss. The findings may be valuable for employees choosing how to commute and engaging employers in the promotion of active travel.The Commuting and Health in Cambridge study was developed by David Ogilvie, Simon Griffin, Andy Jones and Roger Mackett and initially funded under the auspices of the Centre for Diet and Activity Research (CEDAR), a UKCRC Public Health Research Centre of Excellence. Funding from the British Heart Foundation, Economic and Social Research Council, Medical Research Council, National Institute for Health Research and the Wellcome Trust, under the auspices of the UK Clinical Research Collaboration, is gratefully acknowledged. The study was then subsequently funded by the National Institute for Health Research Public Health Research programme (project number 09/3001/06). Oliver Mytton is supported by a Welcome Trust clinical doctoral fellowship. David Ogilvie and Jenna Panter are supported by the Medical Research Council [Unit Programme number MC_UP_12015/6]. Jenna Panter was supported by an NIHR post-doctoral fellowship [PDF-2012-05-157].This is the final version of the article. It first appeared from Elsevier via http://dx.doi.org/10.1016/j.ypmed.2016.06.01

Physical activity and the environment: conceptual review and framework for intervention research.

BACKGROUND: Changing the physical environment is one way to promote physical activity and improve health, but evidence on intervention effectiveness is mixed. The theoretical perspectives and conceptual issues discussed or used in evaluative studies and related literature may contribute to these inconsistencies. We aimed to advance the intervention research agenda by systematically searching for and synthesising the literature pertaining to these wider conceptual issues. METHODS: We searched for editorials, commentaries, reviews, or primary qualitative or quantitative studies in multiple disciplines by electronic searches of key databases (MEDLINE and MEDLINE In-Process, Web of Science, Cochrane Reviews, ProQuest for dissertations, Health Evidence, EPPI-Centre, TRID and NICE) and snowballing. We extracted theoretical and conceptual material and used thematic analysis in an in-depth, configurative narrative approach to synthesis. RESULTS: Our initial searches identified 2760 potential sources from fields including public health, sociology, behavioural science and transport, of which 104 were included. By first separating out and then drawing together this material, we produced a synthesis that identified five high-level conceptual themes: one concerning outcomes (physical activity as a behaviour and a socially embedded practice), one concerning exposures (environmental interventions as structural changes) and three concerning how interventions bring about their effects (the importance of social and physical context; (un) observable mechanisms linking interventions and changes in physical activity; and interventions as events in complex systems). These themes are inter-related but have rarely been considered together in the disparate literatures. Drawing on these insights, we present a more generalisable way of thinking about how environmental interventions work which could be used in future evaluation studies. CONCLUSIONS: Environmental and policy interventions are socially embedded and operate within a system. Evaluators should acknowledge this, and the philosophical perspective taken in their evaluation. Across disciplinary fields, future studies should seek to understand how interventions work through considering these systems, the context in which interventions take place, and the (un) observable mechanisms that may operate. This will help ensure that findings can be more easily interpreted and widely applied by policymakers. We hope that highlighting these conceptual issues will help others to interpret and improve upon a somewhat contested evidence base

Impact of New Transport Infrastructure on Walking, Cycling, and Physical Activity.

INTRODUCTION: Walking and cycling bring health and environmental benefits, but there is little robust evidence that changing the built environment promotes these activities in populations. This study evaluated the effects of new transport infrastructure on active commuting and physical activity. STUDY DESIGN: Quasi-experimental analysis nested within a cohort study. SETTING/PARTICIPANTS: Four hundred and sixty-nine adult commuters, recruited through a predominantly workplace-based strategy, who lived within 30 kilometers of Cambridge, United Kingdom and worked in areas of the city to be served by the new transport infrastructure. INTERVENTION: The Cambridgeshire Guided Busway opened in 2011 and comprised a new bus network and a traffic-free walking and cycling route. Exposure to the intervention was defined using the shortest distance from each participant's home to the busway. MAIN OUTCOME MEASURES: Change in weekly time spent in active commuting between 2009 and 2012, measured by validated 7-day recall instrument. Secondary outcomes were changes in total weekly time spent walking and cycling and in recreational and overall physical activity, measured using the validated Recent Physical Activity Questionnaire. Data were analyzed in 2014. RESULTS: In multivariable multinomial regression models--adjusted for potential sociodemographic, geographic, health, and workplace confounders; baseline active commuting; and home or work relocation-exposure to the busway was associated with a significantly greater likelihood of an increase in weekly cycle commuting time (relative risk ratio=1.34, 95% CI=1.03, 1.76) and with an increase in overall time spent in active commuting among the least active commuters at baseline (relative risk ratio=1.76, 95% CI=1.16, 2.67). The study found no evidence of changes in recreational or overall physical activity. CONCLUSIONS: Providing new sustainable transport infrastructure was effective in promoting an increase in active commuting. These findings provide new evidence to support reconfiguring transport systems as part of public health improvement strategies.JP is supported by a National Institute for Health Research (NIHR) post-doctoral fellowship (PDF- 2012-05-157). EH is supported by an NIHR Public Health Research project grant (see below) and DO is supported by the Medical Research Council [Unit Programme number MC_UP_12015/6]. RM is funded by the Higher Education Funding Council for England. The Commuting and Health in Cambridge Study was initially funded under the auspices of the Centre for Diet and Activity Research (CEDAR), a UKCRC Public Health Research Centre of Excellence. Funding from the British Heart Foundation, Economic and Social Research Council, Medical Research Council, National Institute for Health Research and the Wellcome Trust, under the auspices of the UK Clinical Research Collaboration, is gratefully acknowledged. The study is now funded by the National Institute for Health Research Public Health Research programme (project number 09/3001/06). The views and opinions expressed herein are those of the authors and do not necessarily reflect those of the NIHR PHR programme or the Department of HealthThis is the final version of the article. It was first available from Elsevier via http://dx.doi.org/10.1016/j.amepre.2015.09.02

Assessing the impact of road traffic on cycling for leisure and cycling to work.

BACKGROUND: To explore the relationship between leisure and commuter cycling with objectively measured levels of road traffic and whether any relationship was affected by traffic levels directly outside of home or in local neighbourhood. FINDINGS: We conducted a secondary analysis of data from the UK European Prospective Investigation of Cancer (EPIC) Norfolk cohort in 2009. We used a geographical information system (GIS) and gender specific multivariate models to relate 13 927 participants' reported levels of cycling with an index of road traffic volume (Road Traffic Volume Index Score--RTVIS). RTVIS were calculated around each participants home, using four distance based buffers, (0.5 km, 1 km, 2 km and 3.2 km). Models were adjusted for age, social status, education, car access and deprivation. Both genders had similar decreases in leisure cycling as traffic volumes increased at greater distances from home (OR 0.42, (95% CI 0.32-0.52, p < 0.001) for women and OR 0.41, (95% CI 0.33-0.50, p < 0.001) for men in the highest quartile at 3.2 km). There was no effect of traffic volumes at any distance on commuter cycling. CONCLUSIONS: Traffic volumes appear to have greater impact on leisure cycling than commuter cycling. Future research should investigate the importance of traffic on different types of cycling and include psychosocial correlates.RIGHTS : This article is licensed under the BioMed Central licence at http://www.biomedcentral.com/about/license which is similar to the 'Creative Commons Attribution Licence'. In brief you may : copy, distribute, and display the work; make derivative works; or make commercial use of the work - under the following conditions: the original author must be given credit; for any reuse or distribution, it must be made clear to others what the license terms of this work are