Dose-response relationship of active commuting to work: Results of the GISMO study.

The positive health benefits of regular exercise, particularly regarding cardiovascular risk and diseases, are well recognized and scientifically evident. However, a sedentary lifestyle is one of the most important cardiovascular risk factors that are still insufficiently addressed. Leisure-time active commuting like walking and biking is an ideal way to improve exercise behavior in the general population. The purpose of this substudy of the GISMO study was to assess dose-response relations in all commuters and the three subgroups of commuters (physically active by bicycle and/or walking, physically active by using public transportation (PT), and the controls using their own vehicles). As such, a positive dose-response relationship could be confirmed in all physically active commuters compared to the control group. Whether the commuters cycled, walked, or traveled by PT -the more the physical exercise they performed (measured in metabolic equivalent [MET]-hours), the larger their gain in physical fitness (measured in gained or "Delta" Watt during a maximal exercise test), and their physical fitness at the end of the study was P = .016 and P = .003, respectively. Health-related quality of life correlated in two out of eight subdomains of the SF-36 questionnaire with MET-hours achieved during the study period (General Health and Physical Functioning). No clearly significant dose-response could be observed regarding HDL(high-density lipoprotein)-cholesterol or body composition. Our results indicate a dose-response pattern of healthy commuting in exercise capacity and health-related quality of life to increase doses of physically active commuting.