Bicycling for Transportation and Recreation in Cardiovascular Disease Prevention

Purpose of Review: Bicycling as a mode of transportation can be an easy and inexpensive way of integrating health enhancing physical activity into everyday life. In the present paper, we summarize the evidence from studies on bicycling for transportation and recreation in relation to cardiovascular disease prevention. We also estimate the population impact of increasing bicycling as a mode of transportation. Recent Findings: The overall evidence from prospective cohort studies supports that bicycling for transportation or recreation is related to lower risk of development of fatal or non-fatal cardiovascular disease and premature mortality. The decreased risk of cardiovascular disease and all-cause mortality from regular bicycling is estimated to outweigh risk from additional exposure to air pollution during outdoor exercise. Also, based on experimental studies on the effect of bicycling to school or work, we report an average increase (summary effect) on cardiorespiratory fitness of 3.56 ml O₂/min/kg (95% CI 2.79 to 4.32) compared with control. Extrapolating the size of this average difference, approximately equivalent to 1 MET, then a right shift in the fitness distribution among adults in the general population would lead to substantial reductions in cases of fatal and non-fatal cardiovascular disease and type 2 diabetes. Furthermore, we estimate a significant impact on cardiovascular mortality under plausible public health intervention scenarios increasing the percentage of the population bicycling to work. Summary: Bicycling remains an underutilized alternative to motorized transport in most countries, and promoting bicycling could be a viable approach in primordial and primary prevention of cardiovascular diseases.