The review protocol was registered with PROSPERO (International database of prospectively registered systematic reviews in health and social care) PROSPERO 2013: CRD42013004266. Public health approaches would have the biggest impact if they are able to increase walking and cycling levels in the groups that have the lowest levels of these activities. The analysis shows that walking and cycling have population-level health benefits even after adjustment for other PA. The dose-response analysis showed that walking or cycling had the greatest effect on risk for ACM in the first (lowest) exposure interval. The shape of the dose-response relationship was modelled through meta-analysis of pooled relative risks within three exposure intervals. The estimates for walking are based on 280,000 participants and 2.6 million person-years and for cycling they are based on 187,000 individuals and 2.1 million person-years. For a standardised dose of 11.25 MET.hours per week (or 675 MET.minutes per week), the reduction in risk for ACM was 11% (95% CI = 4 to 17%) for walking and 10% (95% CI = 6 to 13%) for cycling. Walking (18 results from 14 studies) and cycling (8 results from 7 studies) were shown to reduce the risk of all-cause mortality, adjusted for other PA. We used random-effects meta-analyses to investigate the beneficial effects of regular walking and cycling. Study appraisal and synthesis methodsĮxtracted data included study population and location, sample size, population characteristics (age and sex), follow-up in years, walking or cycling exposure, mortality outcome, and adjustment for other co-variables. Only cohorts of individuals healthy at baseline were considered eligible. Study eligibility criteria and participantsĮligible studies were prospective cohort design and reporting walking or cycling exposure and mortality as an outcome. We also searched reference lists of relevant texts and reviews. Searches were conducted in November 2013 using the following health databases of publications: Embase (OvidSP) Medline (OvidSP) Web of Knowledge CINAHL SCOPUS SPORTDiscus. We conducted a systematic review to identify relevant studies. This paper aims to review the evidence and quantify these effects, adjusted for other physical activity (PA).
Walking and cycling have shown beneficial effects on population risk of all-cause mortality (ACM).
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