Research article
Commuting Distance, Cardiorespiratory Fitness, and Metabolic Risk

https://doi.org/10.1016/j.amepre.2012.02.020Get rights and content

Background

Limited evidence exists on the metabolic and cardiovascular risk correlates of commuting by vehicle, a habitual form of sedentary behavior.

Purpose

To examine the association between commuting distance, physical activity, cardiorespiratory fitness (CRF), and metabolic risk indicators.

Methods

This cross-sectional study included 4297 adults who had a comprehensive medical examination between 2000 and 2007 and geocoded home and work addresses in 12 Texas metropolitan counties. Commuting distance was measured along the road network. Outcome variables included weekly MET-minutes of self-reported physical activity, CRF, BMI, waist circumference, triglycerides, plasma glucose, high-density lipoprotein cholesterol, systolic and diastolic blood pressure, and continuously measured metabolic syndrome. Outcomes were also dichotomized using established cut-points. Linear and logistic regression models were adjusted for sociodemographic characteristics, smoking, alcohol intake, family history of diabetes, and history of high cholesterol, as well as BMI and weekly MET-minutes of physical activity and CRF (for BMI and metabolic risk models). Analyses were conducted in 2011.

Results

Commuting distance was negatively associated with physical activity and CRF and positively associated with BMI, waist circumference, systolic and diastolic blood pressure, and continuous metabolic score in fully adjusted linear regression models. Logistic regression analyses yielded similar associations; however, of the models with metabolic risk indicators as outcomes, only the associations with elevated blood pressure remained significant after adjustment for physical activity and CRF.

Conclusions

Commuting distance was adversely associated with physical activity, CRF, adiposity, and indicators of 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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