Using alternatives to the car and risk of all-cause, cardiovascular and cancer mortality

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Abstract: Objective: To investigate the associations between using alternatives to the car which are more active for commuting and non-commuting purposes and morbidity and mortality

Methods: We conducted a prospective study using 358799 participants aged 37-73 from UK Biobank. Commute and non-commute travel were assessed at baseline in 2006-2010. We classified participants according to whether they relied exclusively on the car, or used alternative modes of transport that were more active at least some of the time. Main outcome measures were incident CVD and cancer, and CVD, cancer and all-cause mortality. We excluded events in the first two years and conducted analyses separately for those who regularly commuted and those who did not.

Results: In maximally-adjusted models, regular commuters with more active patterns of travel on the commute had a lower risk of incident (HR 0.89, 95% CI 0.79 to 1.00) and fatal CVD (HR 0.70, 95% CI 0.51 to 0.95). Those regular commuters who also had more active patterns of non-commute travel had an even lower risk of fatal CVD (HR 0.57, 95% CI 0.39 to 0.85). Among those who were not regular commuters, more active patterns of travel were associated with a lower risk of all-cause mortality (HR 0.92, 95% CI 0.86 to 0.99).

Conclusions: More active patterns of travel are associated with a reduced risk of incident and fatal CVD and all-cause mortality in adults. This is an important message for clinicians advising people about how to be physically active and reduce their risk of disease.

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cardiac risk factors and prevention, coronary artery disease, epidemiology, hypertension, stroke, Adult, Aged, Bicycling, Cardiovascular Diseases, Cause of Death, Cross-Sectional Studies, Female, Humans, Male, Middle Aged, Neoplasms, Physical Fitness, Proportional Hazards Models, Risk Adjustment, Surveys and Questionnaires, Survival Analysis, Transportation, United Kingdom, Walking
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Wellcome Trust (087636/Z/08/Z)
Economic and Social Research Council (ES/G007462/1)
Medical Research Council (MR/K023187/1)
Medical Research Council (MC_UU_12015/6)
Medical Research Council (MC_UU_12015/1)
Medical Research Council (MC_UU_12015/3)
British Heart Foundation (None)
TCC (None)
JP, DO, SB and SS are supported by the Medical Research Council (Unit Programme Nos MC_UU_12015/1, MC_UU_12015/3 and MC_UU_12015/6) and KW is also supported by the British Heart Foundation (Intermediate Basic Science Research Fellowship grant No FS/12/58/29709). AAL is funded by the NIHR (RP 014-04-032), and the Public Health Policy Evaluation Unit are grateful for the support of the NIHR School of Public Health Research. This research was conducted using the UK Biobank resource (application No 20684). The work was also supported under the auspices of the Centre for Diet and Activity Research (CEDAR), a UKCRC Public Health Research Centre of Excellence at the University of Cambridge, for which 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 United Kingdom Clinical Research Collaboration, is gratefully acknowledged.