Research articleCommuting Distance, Cardiorespiratory Fitness, and Metabolic Risk
Introduction
Physical inactivity is a leading public health issue in the U.S.1 and internationally2 and has increased over time.3 Accumulating evidence suggests that time spent sitting has adverse effects on cardiovascular and metabolic health, distinct from time spent being physically active.4, 5, 6 Health risks associated with sedentary behavior may be attributed to the physiologic effects of muscle inactivity on glucose uptake, cardiac function, and lipid metabolism, as well as sedentary behavior displacing light-to-moderate activity and thus reducing energy expenditure.7, 8, 9
Although most research on sedentary behavior has focused on TV viewing, the metabolic and cardiovascular health impacts of long commutes by automobile are less well understood.5, 10, 11, 12, 13, 14, 15 Travel by motorized vehicle is the most common light activity reported in the U.S.,16 and commuting to work is an especially important purpose of travel to study because it is part of people's routine and constitutes the largest share of annual vehicle miles traveled per household in the U.S.17
Although active commuting has documented health benefits,18, 19 it may be infeasible for many adults. Understanding the health effects of passive commuting is also important given that commuting by vehicle is prevalent and has increased in recent decades. In the U.S. between 1960 and 2000, the number of workers commuting by private vehicle increased from 41.4 million to 112.7 million.20, 21 Moreover, average commuting distances and time by private vehicle have increased from 8.9 miles and 17.6 minutes in 1983 to 12.1 miles and 22.5 minutes in 2001.17 These trends parallel population shifts from urban to suburban settings, with the proportion of people living in suburbs having increased from 23% to 50% between 1950 and 2000.20
This study examined the association between commuting distance from home to work with cardiorespiratory fitness (CRF), physical activity levels, and metabolic risk indicators among men and women without known diabetes. By examining biomarkers and using objective home-to-work route distance, this study illuminates possible mechanisms for the increased risk of cardiovascular disease death associated with time driving in an automobile among men in this study population.15
Section snippets
Study Design and Population
The study population included participants in the Cooper Center Longitudinal Study (CCLS) who were seen at the Cooper Clinic in Dallas TX for a preventive medical examination. Most patients were referred by their personal physician or employer, or were self-referred. Patients signed an informed consent for the clinical examinations. This study was approved by the IRBs of the Cooper Institute and Washington University.
The current cross-sectional analysis, conducted in 2011, included data from
Results
Of the 7181 participants with geocoded addresses in the study areas, exclusions were made based on the following criteria: working from home (n=700); being unemployed, a housewife, student, or fully retired (n=62); being sick for more than 6 weeks in the past year (n=1870); history of heart attack (n=38), stroke (n=23), or diabetes (n=121); or currently pregnant (n=3). Of the remaining 6225 participants, 1003 were excluded with missing data on at least one outcome variable. An additional 925
Discussion
This study yielded new information about biological outcomes and commuting distance, an understudied and habitual source of sedentary behavior that is prevalent among employed adults and important for individuals with the additional exposure of occupational sitting. The findings suggest that commuting distance is adversely associated with moderate-to-vigorous physical activity, CRF, adiposity, and blood pressure but not blood lipids or fasting glucose. This information provides important
Conclusion
This study contributed additional information about possible mechanisms underlying the increased risk of obesity, hypertension, and poor physical health observed among adults living in more-sprawling communities.63, 64, 65 Multilevel strategies in the home, worksite, and community settings will be needed to mitigate the negative health consequences of long commutes faced by a substantial segment of the U.S. population.41
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