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Clinical Articles, Lead Article

Walking or cycling to work improves wellbeing

Walking or cycling to work is better for people’s mental health than driving to work, according to a study published recently1 in Preventive Medicine.

The report from health economists at the University of East Anglia and the Centre for Diet and Activity Research (CEDAR) reveals that people who stopped driving and started walking or cycling to work benefited from improved wellbeing. In particular, active commuters felt better able to concentrate and were less under strain than if they travelled by car. These benefits come on top of the physical health benefits of walking and cycling that are already widely documented.

Experts also found that travelling on public transport is better for people’s psychological wellbeing than driving. Lead researcher Adam Martin, from UEA’s Norwich Medical School, said:  “One surprising finding was that commuters reported feeling better when travelling by public transport, compared to driving. You might think that things like disruption to services or crowds of commuters might have been a cause of considerable stress. But as buses or trains also give people time to relax, read, socialise, and there is usually an associated walk to the bus stop or railway station, it appears to cheer people up.”

The research team studied 18 years of data on almost 18,000 18–65-year-old commuters in Britain. The data allowed them to look at multiple aspects of psychological health including feelings of worthlessness, unhappiness, sleepless nights, and being unable to face problems. The researchers also accounted for numerous factors known to affect wellbeing, including income, having children, moving house or job, and relationship changes.

The study also shows commute time to be important. Adam Martin said: “Our study shows that the longer people spend commuting in cars, the worse their psychological wellbeing. And correspondingly, people feel better when they have a longer walk to work.”

Data from the 2011 Census (England and Wales) shows that 67.1% of commuters use cars or vans as their usual main commute mode compared to 17.8% who use public transport, 10.9% who walk and just 3.1% who cycle.

“This research shows that if new projects such as London’s proposed segregated cycleways, or public transport schemes such as Crossrail, were to encourage commuters to walk or cycle more regularly, then there could be noticeable mental health benefits.”

…cardiorespiratory fitness can delay male, age-associated blood pressure hikes

A man’s cardiorespiratory fitness can drastically delay the natural, age-associated increase of his blood pressure over his adult life span, according to a study published recently in the Journal of the American College of Cardiology.1

The study examined whether a man’s improved fitness level delays the age ranges for naturally-occurring systolic blood pressure (SBP) and diastolic blood pressure (DBP) hypertension in males. Study co-author Dr Junxiu Liu (University of South Carolina, Columbia) said: “Since regular physical activity is the primary and most modifiable determinant of fitness level, our results underscore the importance for a man to increase his regular physical activity to prevent his natural, aging-related rise in blood pressure”.

Data analysis reveals that the average low fit male’s SBP begins to increase to pre-hypertension levels (120 mmHg) about the age of 46 while his DBP begins to increase to pre-hypertension levels (80 mmHg) about the age of 42. However, this study suggests that those men with a high fitness level are likely to reach the age at which normal SBP increases about a decade later, approximately at age 54, while the DBP does not reach prehypertension level until advanced ages (approximately at age 90). This implies that improving fitness levels may reduce the duration of elevated blood pressure.

Researchers studied 13,953 men between the ages of 20 and 90 who were free of hypertension, cardiovascular disease and cancer over a 36-year period (1970–2006) to determine whether there is a relationship between cardiorespiratory fitness and the increase in blood pressure with age. This data was drawn from the Aerobics Center Longitudinal Study where the participants completed from three to 28 follow-up medical examinations during the specified time frame (the mean was 3.8).

Fitness was measured by a strenuous cardiovascular treadmill exercise stress test. A cardiovascular exercise stress testing in conjunction with ECG has been established as one of the focal points in the diagnosis and prognosis of cardiovascular disease.

…and high-intensity exercise found safe and effective in long-term heart transplant recipients

High-intensity exercise can help stable heart transplant patients reach higher levels of exercise capacity, and gain better control of their blood pressure than moderate intensity exercise, according to a study published recently in the American Journal of Transplantation.3

Recent research shows that high-intensity interval exercise – training for a few minutes at close to the maximum heart rate – is safe and more efficient than moderate exercise for improving exercise capacity in different groups of patients with heart disease. Researchers led by Dr Christian Dall (Bispebjerg Hospital, University of Copenhagen, Denmark) investigated whether people who have received a new heart gain similar benefits from high-intensity interval training, or whether they should exercise at moderate intensity as currently recommended.

The team compared the effects of 12 weeks of high-intensity interval training versus continued moderate training in 16 stable heart transplant recipients who had been living with their new heart for more than one year.

The trial revealed that high-intensity interval training is safe in heart transplant patients, and the effect on exercise capacity and blood pressure control is superior to moderate intensity training. VO2 max, or maximal oxygen uptake, increased by 17% in patients performing high-intensity interval training compared with 10% in patients performing continued moderate training. Systolic blood pressure decreased significantly in patients in the high-intensity group, while it remained unchanged in patients in the moderate intensity group. Peak heart rate also increased in the high-intensity group but not in the moderate intensity group. Heart rate recovery improved in both groups.

“Today, people who have been given a new heart experience increased physical function, quality of life, and overall life span; however, most patients continue to have limitations in their physical function and reduced quality of life compared to the general population due to side-effects from anti-rejection medications and because heart rate regulation is impaired after heart transplantation,” said Dr Dall.

“The impaired heart rate response has been considered a hindrance for more demanding high-intensity training, but this new study documents that stable heart transplant recipients benefit from this type of training more than from the moderate training that has been recommended so far. Importantly, the training is also safe and well received by patients,” he added.


1. Martin A, Goryakin Y, Suhrcke M. Does active commuting improve psychological wellbeing? Longitudinal evidence from eighteen waves of the British Household Panel Survey. Preventive Medicine 2014.

2. Liu J, Sui X, Lavie CJ, et al. Effects of cardiorespiratory fitness on blood pressure trajectory with aging in a cohort of healthy men. J Am Coll Cardiol 2014;64:1245–53.

3. Dall CH, Snoer M, Christensen S, et al. Effect of high-intensity training versus moderate training on peak oxygen uptake and chronotropic response in heart transplant recipients: a randomized crossover trial. American Journal of Transplantation 2014.

Published on: September 26, 2014

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