Is active commuting the answer to population health?

This brief review examines whether active commuting is an effective method of controlling the current obesity epidemic and enhancing the cardiovascular health of the population. Of the many potential methods of active commuting, walking and cycling are the usual choices. Children and adolescents prefer cycling, but for adults issues of safety, cycle storage and company dress codes make walking the preferred option, particularly in North American cities, where urban design and weather conditions often do not favour cycling. Active transportation is more frequent in some European countries with dedicated cycle and pedestrian paths, but in most developed societies, active transportation has declined in recent years.Attempts to increase walking behaviour in the sedentary population have had only limited success to date. A weekly gross energy expenditure of at least 4 MJ is recommended to reduce all-cause and cardiovascular mortality. This can be achieved by walking 1.9 km in 22 minutes twice per day, 5 days per week, or by cycling at 16 km/h for 11 minutes twice per day, 5 days per week. When engaged in level walking, the intensity of effort may be adequate for cardiovascular benefit in older adults, but in fit young workers, it is necessary to either increase the pace or choose a hilly route in order to induce cardio-respiratory benefit; in contrast, cycling is likely to provide an adequate cardiovascular stimulus even for young adults.Empirical data to date have yielded mixed results: a reduced all-cause and cardiovascular mortality has been observed more frequently in cyclists than in walkers, and more frequently in women and older men than in young active commuters. More information is needed concerning the typical weekly dose of activity provided by active commuting, and the impact of such commuting on overall attitudes towards physical activity. It is also necessary to find better methods of involving the sedentary population, through both counselling and changes in urban design.