{
  "abstract": "Objective To investigate the relationship between active commuting and atherosclerosis in middle age using state-of-the-art coronary CT angiography (CCTA).Methods This cross-sectional study used data from the Swedish CArdioPulmonary bioImage Study (SCAPIS) and included 23 722 randomly recruited individuals aged 50–64 years from six different regions in Sweden. The exposure was commuting mode, assessed using self-reported questionnaires and categorised as year-round walking and/or cycling (active commuting), commuting by bus/train, commuting by car or mixed commuting patterns. The outcome was atherosclerosis, evaluated using CCTA for coronary stenosis and coronary artery calcium (CAC) score and ultrasound for carotid plaques. Associations were analysed using multivariate binomial logistic regression models.Results After adjusting for confounders (age, sex, SCAPIS site, education, occupational physical activity and leisure time exercise habits, sleep, diet and smoking habits), active commuting was associated with lower odds of coronary stenosis (OR 0.87; 95% CI 0.80 to 0.94) and a CAC score ≥1 Agatston units (OR 0.93; 95% CI 0.86 to 1.00), as compared with car commuting. No associations were observed between active commuting and the presence of carotid plaques (OR 0.97; 95% CI 0.90 to 1.03). When stratified, the inverse association with coronary stenosis appeared to be somewhat stronger for cycling (OR 0.86; 95% CI 0.78 to 0.95) than for walking (OR 0.89; 95% CI 0.79 to 1.01).Conclusion Using advanced CCTA imaging in a large, randomly selected sample of middle-aged adults, we show for the first time that coronary atherosclerosis is less common in active commuters, particularly those cycling, compared with car commuters. While this indicates that active commuting might be a potential preventive measure to reduce atherosclerosis and subsequent cardiovascular disease, further causal analyses are needed to confirm our findings.",
  "authors": [
    {
      "affiliations": [
        "Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden",
        "Department of Environmental and Bioscience, Halmstad University, Halmstad, Sweden"
      ],
      "name": "Peter Edholm"
    },
    {
      "affiliations": [
        "Department of Public Health and Clinical Medicine, Umeå Universitet, Umeå, Västerbotten County, Sweden"
      ],
      "name": "Patrik Wennberg"
    },
    {
      "affiliations": [
        "Department of Public Health and Caring Sciences, Clinical Geriatrics, Uppsala Universitet, Uppsala, Sweden"
      ],
      "name": "Marcel Ballin"
    },
    {
      "affiliations": [
        "Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden",
        "Centre of Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Östergötland, Sweden"
      ],
      "name": "Carl-Johan Östgren"
    },
    {
      "affiliations": [
        "School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Goteborg, Sweden"
      ],
      "name": "Bledar Daka"
    },
    {
      "affiliations": [
        "Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden",
        "Center for Wellbeing, Welfare and Happiness, Stockholm School of Economics, Stockholm, Stockholm County, Sweden"
      ],
      "name": "Daniel Berglind"
    },
    {
      "affiliations": [
        "Department of Clinical Sciences in Malmö, Centre for Primary Health Care Research, Lund University, Lund, Sweden"
      ],
      "name": "Cecilia Lenander"
    },
    {
      "affiliations": [
        "Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden",
        "Department of Biomedicine, Aarhus Universitet, Aarhus, Central Denmark Region, Denmark"
      ],
      "name": "Viktor H. Ahlqvist"
    },
    {
      "affiliations": [
        "Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden",
        "The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia"
      ],
      "name": "Karin Rådholm"
    },
    {
      "affiliations": [
        "Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden"
      ],
      "name": "Pontus Henriksson"
    },
    {
      "affiliations": [
        "Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden"
      ],
      "name": "Ángel Herraiz-Adillo"
    }
  ],
  "title": "Active commuting and atherosclerosis in a population-based sample of middle-aged adults: the Swedish CArdioPulmonary bioImage study (SCAPIS)",
  "uid": "4b899a31-ee6b-5bf0-a0f4-7f4606235b8e"
}