Sports Medicine

, Volume 49, Issue 3, pp 437–452 | Cite as

Active Commuting and Multiple Health Outcomes: A Systematic Review and Meta-Analysis

  • Monica DinuEmail author
  • Giuditta Pagliai
  • Claudio Macchi
  • Francesco Sofi
Systematic Review



Active commuting is associated with greater physical activity, but there is no consensus on the actual beneficial effects of this type of physical activity on health outcomes.


To examine the association between active commuting and risk of all-cause mortality, incidence and mortality from cardiovascular diseases, cancer and diabetes through meta-analysis.


A comprehensive search of MEDLINE, Embase, Google Scholar, Web of Science, The Cochrane Library, Transport Research International Documentation database, and reference lists of included articles was conducted. Only prospective cohort studies were included.


Twenty-three prospective studies including 531,333 participants were included. Participants who engaged in active commuting had a significantly lower risk of all-cause mortality [relative risk (RR) 0.92, 95% CI 0.85–0.98] and cardiovascular disease incidence (RR 0.91; 95% CI 0.83–0.99). There was no association between active commuting and cardiovascular disease mortality and cancer. Participants who engaged in active commuting had a 30% reduced risk of diabetes (RR 0.70; 95% CI 0.61–0.80) in three studies after removal of an outlying study that affected the heterogeneity of the results. Subgroup analyses suggested a significant risk reduction (− 24%) of all-cause mortality (RR 0.76; 95% CI 0.63–0.94) and cancer mortality (− 25%; RR 0.75; 95% CI 0.59–0.895) among cycling commuters.


People who engaged in active commuting had a significantly reduced risk of all-cause mortality, cardiovascular disease incidence and diabetes.


Compliance with Ethical Standards


No sources of funding were used to assist in the preparation of this article.

Conflict of interest

Monica Dinu, Giuditta Pagliai, Claudio Macchi and Francesco Sofi declare that they have no conflicts of interest relevant to the content of this review.

Supplementary material

40279_2018_1023_MOESM1_ESM.doc (32 kb)
Supplementary material 1 (DOC 32 kb)
40279_2018_1023_MOESM2_ESM.doc (71 kb)
Supplementary material 2 (DOC 71 kb)


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Copyright information

© Springer Nature Switzerland AG 2018

Authors and Affiliations

  1. 1.Department of Experimental and Clinical MedicineUniversity of FlorenceFlorenceItaly
  2. 2.Clinical Nutrition UnitCareggi University HospitalFlorenceItaly
  3. 3.Don Carlo Gnocchi Foundation Italy, IRCCSFlorenceItaly

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