Associations between Recreational and Commuter Cycling, Changes in Cycling, and Type 2 Diabetes Risk: A Cohort Study of Danish Men and Women

Abstract

BackgroundCycling is a recreational activity and mode of commuting with substantial potential to improve public health in many countries around the world. The aim of this study was to examine prospective associations between recreational and commuter cycling, changes in cycling habits, and risk of type 2 diabetes (T2D) in Danish adults from the Diet, Cancer and Health cohort study.Methods and FindingsAt baseline from 1993 to 1997, 24,623 men and 27,890 women from Denmark, 50–65 y of age and free of T2D and other chronic diseases, underwent a number of assessments, including completing a lifestyle questionnaire also addressing cycling habits. Approximately 5 y later, at a second examination, participants completed a new, updated lifestyle questionnaire. Cox regression was used to estimate hazard ratios (HRs) of incident T2D registered in the Danish National Diabetes Registry, according to recreational and commuter cycling and changes in cycling habits, with adjustment for a priori known T2D risk factors. During 743,245.4 person-years of follow-up (mean follow-up 14.2 y), 6,779 incident cases of T2D were documented. Multivariable adjusted HRs (95% confidence interval [CI]) were 1, 0.87 (0.82, 0.93), 0.83 (0.77, 0.89), 0.80 (0.74, 0.86) and 0.80 (0.74, 0.87) (p for trend = <0.001) for 0, 1–60, 61–150, 151–300, and >300 min/wk of total cycling (recreational and commuter cycling), respectively. In analysis of seasonal cycling, multivariable adjusted HRs (95% CI) were 1, 0.88 (0.83, 0.94), and 0.80 (0.76, 0.85) for non-cyclists, seasonal cyclists (those cycling only in summer or winter), and those cycling during both summer and winter, respectively. How changes in total cycling from baseline to the second examination affected risk was also investigated, and multivariable adjusted HRs (95% CI) were 1, 0.88 (0.78, 1.01), 0.80 (0.69, 0.91), and 0.71 (0.65, 0.77) for non-cyclists and for those who ceased, initiated, or continued cycling between baseline and the second examination, respectively. Lastly, in the analysis of commuter cycling, multivariable HRs (95% CI) were 1, 0.72 (0.60, 0.87), 0.83 (0.69, 1.00), and 0.70 (0.57, 0.85) (p for trend = <0.001) for cycling 0, 1–60, 61–150, and >150 min/wk to work, respectively. The main limitation of the current study is the use of self-reported physical activity.ConclusionsCommuter and recreational cycling was consistently associated with lower risk of T2D in Danish adults. Our results also provide evidence that late-in-life initiation of or continued engagement in cycling lowers risk of T2D.

Bicycling to Work and Primordial Prevention of Cardiovascular Risk: A Cohort Study Among Swedish Men and Women

“…A study in Chinese women and a study conducted among Danish men and women each reported bicycling to work and for other reasons being inversely associated with the risk of all‐cause mortality compared with passive travel. Another recent published study of Danish middle‐aged and older adults reports that bicycling to work is related to lower risk of type 2 diabetes mellitus . In a Dutch cohort study, engagement in nonspecific bicycling was associated with lower risk of cardiovascular disease .…”

“…Another recent published study of Danish middle-aged and older adults reports that bicycling to work is related to lower risk of type 2 diabetes mellitus. 22 In a Dutch cohort study, engagement in nonspecific bicycling was associated with lower risk of cardiovascular disease. 23 Furthermore, in a nested case-control study, we have previously reported that compared with bicycling to work, commuting by car was associated with greater risk of myocardial infarction, 24 and this relationship was to a large extent explained by inflammatory and hemostatic biomarkers.…”

Does Environmental Walkability Matter? The Role of Walkable Environment in Active Commuting

“…Reduced car use due to active commuting can lead to a decrease in air pollution and traffic congestion, and more efficient use of urban land due to a reduction in parking lots [2][3][4]. Moreover, active commuting has several health benefits, including increasing physical activity [5] and promoting mental health [6][7][8], and reducing obesity [9], cardiovascular diseases [10][11][12], type 2 diabetes [13], cancers [10,12], and all-cause mortality [10,14,15]. Avila-Palencia et al have examined the relationship between bicycle commuters and perceived stress in Barcelona, Spain.…”

“…They conducted their studies in Danish adults and collected data from the prospective cohort study, "Diet, Cancer, and Health". They found that cycling was associated with lower risks of coronary heart disease [11] and type 2 diabetes [13]. Andersen and colleagues have also focused on cycling as active commuting in Copenhagen, Denmark, and found cycling to work was associated with a lower risk of mortality [14].…”

Active commuting is beneficial for health

“…2 Since then, many studies have consistently reported lower rates of cardiovascular disease, 3 4 type 2 diabetes, 5 cancers, 4 and mortality 6 associated with cycling compared with not cycling. Other studies have shown that walking is also associated with health benefits, including a lower risk of cardiovascular disease, type 2 diabetes, and all cause mortality.…”