People who walk or cycle to work have a significantly lower risk of death due to heart disease or stroke, compared to those who commute by car, a study has found.
Physical activity, including less vigorous forms such as walking and cycling, reduces the risk of cardiovascular disease, but despite this well-known benefit, levels of activity are still low in many countries.
There are concerns that many peoples' lives involve increasingly sedentary occupations and little opportunity for leisure time physical activity.
Researchers from the University of Cambridge, London School of Hygiene and Tropical Medicine, and Imperial College London in the UK set out to investigate the associations between using alternatives to the car which are more active for commuting and non-commuting purposes, and illness and mortality.
For the study published in the journal Heart, they used data on 358,799 participants collected between 2006 and 2010. People were followed up for an average of seven years.
They were asked about their commute and non-commute travel and to detail whether they relied exclusively on the car or used alternative modes of transport that were more active at least some of the time.
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Outcome measures used were incident and fatal cardiovascular disease (CVD), incident and fatal cancer, and all-cause mortality.
Approximately two-thirds of commuters relied exclusively on the car to travel to work, with more active travel patterns being more frequently reported for non-commuting travel.
Cycling was less prevalent, being mentioned by 8.5 per cent and 7 per cent of regular commuters for commuting and non-commuting travel, respectively, and by 4.8 per cent of other participants.
Analysis of the data showed that regular commuters with more active patterns of travel on the commute had a 11% lower risk of incident cardiovascular disease (CVD) and 30 per cent lower risk of fatal CVD.
Those regular commuters who also had more active patterns of commute and non-commute travel combined had an even lower risk of fatal CVD - 43 per cent less risk.
Among people who were not regular commuters, more active patterns of travel were associated with an 8 per cent lower risk of all-cause mortality.
Researchers concluded that interventions that encourage people to make more use of public transport, walking and cycling could be more widely promoted, including by clinicians.