Active commuting and the risk of obesity, hypertension and diabetes: a systematic review and meta-analysis of observational studies

doi:10.1136/bmjgh-2021-005838

Meta-Analysis

. 2021 Jun;6(6):e005838.

doi: 10.1136/bmjgh-2021-005838.

Active commuting and the risk of obesity, hypertension and diabetes: a systematic review and meta-analysis of observational studies

Jian Wu^#¹, Quanman Li^#¹, Yu Feng², Soumitra S Bhuyan³, Clifford Silver Tarimo^{1

4}, Xin Zeng¹, Cuiping Wu¹, Ning Chen⁵, Yudong Miao⁶

Affiliations

¹ Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China.
² Department of Social Medicine and Health Service Management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China.
³ Edward J. Bloustein School of Planning and Public Policy, Rutgers University New Brunswick, New Brunswick, New Jersey, USA.
⁴ Department of Science and Laboratory Technology, Dar es salaam Institute of Technology, P.O. Box 2958, Dar es Salaam, Tanzania.
⁵ School of Politics and Public Administration, Zhengzhou University, Zhengzhou, Henan, People's Republic of China.
⁶ Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China meldon@zzu.edu.cn.

^# Contributed equally.

PMID: 34172487
PMCID: PMC8237743
DOI: 10.1136/bmjgh-2021-005838

Meta-Analysis

Active commuting and the risk of obesity, hypertension and diabetes: a systematic review and meta-analysis of observational studies

Jian Wu et al. BMJ Glob Health. 2021 Jun.

. 2021 Jun;6(6):e005838.

doi: 10.1136/bmjgh-2021-005838.

Authors

Jian Wu^#¹, Quanman Li^#¹, Yu Feng², Soumitra S Bhuyan³, Clifford Silver Tarimo^{1

4}, Xin Zeng¹, Cuiping Wu¹, Ning Chen⁵, Yudong Miao⁶

Affiliations

¹ Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China.
² Department of Social Medicine and Health Service Management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China.
³ Edward J. Bloustein School of Planning and Public Policy, Rutgers University New Brunswick, New Brunswick, New Jersey, USA.
⁴ Department of Science and Laboratory Technology, Dar es salaam Institute of Technology, P.O. Box 2958, Dar es Salaam, Tanzania.
⁵ School of Politics and Public Administration, Zhengzhou University, Zhengzhou, Henan, People's Republic of China.
⁶ Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China meldon@zzu.edu.cn.

^# Contributed equally.

PMID: 34172487
PMCID: PMC8237743
DOI: 10.1136/bmjgh-2021-005838

Abstract

Active commuting may hold a potential for preventing adverse health outcomes. However, evidence of the association of active commuting and the risk of health outcomes remains debatable. The current study systematically and quantitatively summarised research findings on the association between active commuting and the risk of the mentioned health outcomes. We comprehensively searched four databases (PubMed, EMBASE, Web of Science and Open Grey) from inception to 2 August 2020 for observational studies investigating the associations among adult population. Summary relative risks (RRs) and 95% CIs were estimated for the association. Heterogeneity was investigated using Cochran's Q test and the I ² statistic. Restricted cubic splines were used to evaluate linear and nonlinear relations. The search yielded 7581 initial references. We included 28 articles in the meta-analysis. Compared with inactive commuting, active commuting reduced the risk of obesity (RR=0.88, 95% CI 0.83 to 0.94, I²=69.1%), hypertension (RR=0.95, 95% CI 0.87 to 1.04, I²=82.2%) and diabetes (RR=0.82, 95% CI 0.76 to 0.90, I²=44.5%). Restricted cubic splines showed linear associations between active commuting and obesity, hypertension and diabetes (P_nonlinearity=0.640; P_nonlinearity=0.886; P_nonlinearity=0.099). As compared with the lowest active commuting group, the risk of obesity, hypertension and diabetes in the highest active commuting group were reduced by 13% (95% CI 0.82 to 0.93, I²=65.2%); 6% (95% CI 0.86 to 1.02, I²=75.2%) and 19% (95% CI 0.73 to 0.91, I²=49.8%) respectively. Active commuting seemed to be associated with lower risk of obesity, hypertension and diabetes. However, the results should be interpreted cautiously because this meta-analysis was based solely on observational studies.PROSPERO registration numberCRD42020202723.

Keywords: diabetes; epidemiology; public health.

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Conflict of interest statement

Competing interests: None declared.

Figures

**Figure 1**
Flowchart of study selection.

**Figure 2**
Association between active commuting and obesity, hypertension, and diabetes. (A) active/inactive; (B) high/low; (C) per 60 min/week increase.

**Figure 3**
Forest plot summary of associations between active commuting and obesity. (A) active/inactive; (B) high/low; (C) per 60 min/week increase.

**Figure 4**
Forest plot summary of associations between active commuting and hypertension. (A) active/inactive; (B) high/low; (C) per 60 min/week increase.

**Figure 5**
Forest plot summary of associations between active commuting and diabetes. (A) active/inactive; (B) high/low; (C) per 60 min/week increase.

See this image and copyright information in PMC

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References

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[1] GBD 2017 Causes of Death Collaborators . Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980-2017: a systematic analysis for the global burden of disease study 2017. Lancet 2018;392:1736–88. 10.1016/S0140-6736(18)32203-7 - DOI - PMC - PubMed

[2] GBD 2017 Causes of Death Collaborators . Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980-2017: a systematic analysis for the global burden of disease study 2017. Lancet 2018;392:1736–88. 10.1016/S0140-6736(18)32203-7 - DOI - PMC - PubMed

[3] Martinez R, Lloyd-Sherlock P, Soliz P, et al. . Trends in premature avertable mortality from non-communicable diseases for 195 countries and territories, 1990-2017: a population-based study. Lancet Glob Health 2020;8:e511–23. 10.1016/S2214-109X(20)30035-8 - DOI - PubMed

[4] Martinez R, Lloyd-Sherlock P, Soliz P, et al. . Trends in premature avertable mortality from non-communicable diseases for 195 countries and territories, 1990-2017: a population-based study. Lancet Glob Health 2020;8:e511–23. 10.1016/S2214-109X(20)30035-8 - DOI - PubMed

[5] Reddy KS. Measuring mortality from non-communicable diseases: broadening the band. Lancet Glob Health 2020;8:e456–7. 10.1016/S2214-109X(20)30064-4 - DOI - PubMed

[6] Reddy KS. Measuring mortality from non-communicable diseases: broadening the band. Lancet Glob Health 2020;8:e456–7. 10.1016/S2214-109X(20)30064-4 - DOI - PubMed

[7] The Lancet Global Health . Getting to the heart of non-communicable diseases. Lancet Glob Health 2018;6:e933. 10.1016/S2214-109X(18)30362-0 - DOI - PubMed

[8] The Lancet Global Health . Getting to the heart of non-communicable diseases. Lancet Glob Health 2018;6:e933. 10.1016/S2214-109X(18)30362-0 - DOI - PubMed

[9] Chowdhury R, Lawrence R, van Daalen K, et al. . Reducing NCDS globally: the under-recognised role of environmental risk factors. Lancet 2018;392:212. 10.1016/S0140-6736(18)31473-9 - DOI - PubMed

[10] Chowdhury R, Lawrence R, van Daalen K, et al. . Reducing NCDS globally: the under-recognised role of environmental risk factors. Lancet 2018;392:212. 10.1016/S0140-6736(18)31473-9 - DOI - PubMed

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Active commuting and the risk of obesity, hypertension and diabetes: a systematic review and meta-analysis of observational studies

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Active commuting and the risk of obesity, hypertension and diabetes: a systematic review and meta-analysis of observational studies

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Abstract

Conflict of interest statement

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