Does an Increase in Walking and Cycling Translate into a Higher Overall Physical Activity Level?

Abstract

Background Physical inactivity is the fourth leading cause of global mortality. Hence, the Physical Activity through Sustainable Transport Approaches (PASTA) study aims to promote active mobility (i.e. walking and cycling) as an innovative measure to increase physical activity levels. Studying the health benefits of an increase in active mobility is challenging as we lack understanding of its relation with overall physical activity. Therefore, we studied the association between changes in overall physical activity level and changes in the amount of active mobility and leisure-time physical activity. Methods A set of online questionnaires was deployed in seven European cities to collect data on travel and physical activity behaviour. After completing a baseline questionnaire, follow-up questionnaires were sent every thirteen days, alternating a short and a longer version (every third follow-up). The amount of total and domain-specific (i.e. transport and leisure-time) physical activity was reported in the Global Physical Activity Questionnaire (GPAQ) (separating cycling and walking for transport). The GPAQ was incorporated in the baseline questionnaire and the longer version of the follow-up. To analyse the association between a change in overall physical activity and a change in active mobility and leisure-time physical activity, a mixed effect model was used. This model included sex, age and season as covariates and all interaction terms for active mobility and leisure-time physical activity. We used random participant effects nested in city effects to account for repeated measures. Results 3083 participants completed at least two GPAQs. The maximum number of GPAQs collected per participant was 14 and the median amount of time between two questionnaires was 51 days (IQR:44-86 days). A one-minute increase in daily active mobility or leisure-time physical activity was associated with an increase of 1.14 (p 0.05), so participants who increased their active mobility did not decrease their leisure-time physical activity accordingly. Changes in overall physical activity were not affected by sex, age and season (p>0.05). However, the increase in total physical activity per unit increase in active mobility depended on sex (p Conclusions Our findings provide evidence that an increase in active mobility translated into an increase in overall physical activity, while the amount of leisure-time physical activity was not modified.