The results of these studies have been provided for outcomes for which pertinent systematic reviews and meta-analyses have been published. Evidence from more current research that have been published since these reviews were published has been added to these. We have made an effort to provide a representative summary of the evidence that is available in areas where a systematic review or meta-analysis has not yet been published. The sections below provide a summary of the research that is currently available on cycling and particular health outcomes.
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Cycling and mortality risk
Large prospective cohort studies have provided the data that suggests frequent cycling is linked to a decreased risk of death. A thorough systematic review and meta-analysis of data from all published studies in healthy people examining the relationship between cycling involvement and mortality risk was published in 2014 by Kelly et al (3). Data from seven large-scale studies—four from Denmark, two from the UK, and one from China—that encompassed over 2 million person-years of observation and almost 200,000 persons between the ages of 20 and 93 were included in this study. These studies measured the amount of cycling that individuals did, tracked them for a follow-up period ranging from 5.7 to 18 years, and reported the mortality outcomes throughout that time. Many possible confounding factors were taken into account when statistical adjustments were made to the data. Every study controlled for factors such as age, smoking, other physical activity that isn’t cycling, socioeconomic position, and various characteristics of health. They also either performed analyses in single-sex groups or adjusted for sex. BMI was also taken into account in four research, and alcohol use was taken into account in three investigations. Supplementary Table S1 lists the salient characteristics of the research that were part of the 2014 Kelly meta-analysis (3).
Higher levels of cycling were linked to a decreased risk of death throughout the follow-up period, according to all but one research. Regular cycling involvement was clearly related with a statistically significant decreased risk of death when data from all trials were pooled. The combined data from all of these studies, as shown in Figure 1, showed a curvilinear relationship between higher levels of cycling and a lower risk of mortality, with the greatest difference in mortality risk observed between those who reported cycling for no purpose at all and those who reported cycling for up to about 100 minutes per week. Analyses that controlled for significant confounding factors showed that a reduction in mortality risk of 17% was linked to cycling involvement of around 100 minutes per week.
Cycling levels over this threshold were linked to a somewhat smaller risk of death, albeit not as sharply. When compared to no riding, involvement in around 270 minutes per week was linked to a 24% lower risk of death; when compared to no cycling, participation in roughly 570 minutes per week was linked to a 30% lower risk of death. This has the obvious consequence that encouraging those who do not now ride often to start riding would have a greater positive impact on public health than encouraging those who do to increase their cycling frequency.
Ever since the Kelly et al. (2014) systematic review and meta-analysis (3) was published, more epidemiological research has looked at the relationship between riding a bicycle and mortality risk. Table 1 summarizes the main findings of these investigations, which are also discussed below.
In a study conducted over a median of 13.1 years, Koolhaas et al. investigated the relationship between cycling involvement and risk of all-cause death among 7,225 older persons (mean age 70 years) residing in Rotterdam (6). After controlling for confounders, they found that cycling at “medium” levels (median 13 minutes per day, or 91 minutes per week) was linked, after adjustment for variables, to a 28% lower risk of death compared to no cycling at all, and that cycling at “high” levels (median 51 minutes per day, or 357 minutes per week) was linked to a 35% lower risk of death.
Due to the fact that individuals with pre-existing conditions are more likely to pass away during the first few years of measurement, Koolhaas et al. conducted sensitivity analyses to reduce the possible contribution of reverse causality. The results were essentially unchanged (6). This study is significant because it examined older individuals, a population for whom there has been little prior research, and it demonstrates that there are still links between cycling involvement and a decreased risk of death even in this age group. Significantly, the results align with the meta-analysis conducted by Kelly et al., which indicated that the greatest decrease in mortality risk occurred when riding for 100 minutes a week instead of none at all, with the benefits decreasing from then on out.