Purpose
It is a need for public intervention aiming to make it easier to be physical active. To make it easier to walk and cycle (active transport) is such a public health intervention. The FACT-study is about what the researchers call “active transport” and “sustainable mobility”. During the last decade, both research areas have had an increasing interest in politics and academia. The study will provide new insight about whether commuter cycling may improve health and health, health related quality of life, and reduce social inequality in health. There is well known that physical activity benefits the health, but to increase the public level of physical activity in groups who are not interested in sports or other forms of physical activity during leisure time have been challenging.
The present project have three overall research questions:
- What is the CVD related benefits of commuter cycling?
- What individual and environmental factors is associated with commuter cycling in Norway?
- How can we follow trends in commuter cycling at local, regional, and national level?
Project description
The thesis is based on two systematic review and meta-analyses of cycling and cardiovascular disease (CVD) and its associated risk factors, one cross-sections study conducted in three Norwegian counties combined with objectively measures form a geographical information system. Finally, the thesis is based on a methodological study describing the methods of a new methods to describe and to evaluate trends of commuter cycling in Norway.
Results
Overall cycling was associated with 22% (95% CI: 0.74 to 0.82) lower risk of CVD mortality, CVD incidence and CVD risk factors combined, compared to non-cyclists (part I). Being a cyclist was also associated with more beneficial risk factor levels, except for blood pressure, compared with non-cyclists (part II). We observed no sex-difference. Neither did we observe any dose-response relationship of cycling and risk of CVD, except for WC for continuous outcome variables.
Further did we observe both individual and environmental factors associated with the probability of commuter cycling. Those living more than 5 km from workplace were unlikely of being commuter cyclists, while those living in an area of high population density had increased odds of being commuter cyclist. Among individual factors good self-reported health, higher level of education, having an active lifestyle and owning an e-bike were more likely to travel by bicycle.
Finally, we have developed a national bike-traffic index based on the actual number of passing bicyclists, independent of residence, age or recall bias. The continuous counting results in a model which is sensitive to actual changes.
From 2018 to 2020 the national index indicated a significant 11 % (111.0 [95% CI: 106.2 - 115.1]) increase in number of counted cycle trips. The national index was 97 in 2019 and 111 in 2020. However, there were regional differences in trend. Southern and Western Norway had a continuous increase in counted cycle trips, where Southern Norway had a 23% (123 [107-140]) increase over the last three years. The only region with a decrease in counted cycle trips was Northern Norway, where the number of counts were reduced by 8 % from 2018 to 2020 (92 [72 - 112]).
Paper 1: Cycling is associated with a lower incidence of cardiovascular diseases and death: Part 1–systematic review of cohort studies with meta-analysis.
Paper 2: Cycling and cardiovascular disease risk factors including body composition, blood lipids and cardiorespiratory fitness analysed as continuous variables: Part 2—systematic review with meta-analysis.
Paper 3: Correlates of commuter cycling in three Norwegian counties.