Car use and cardiovascular disease risk: Systematic review and implications for transport research

• Published in: Journal of transport & health Vol. 19; p. 100930
• Main Authors: Sugiyama, Takemi, Chandrabose, Manoj, Homer, Ashleigh R., Sugiyama, Masaaki, Dunstan, David W., Owen, Neville
• Format: Journal Article
• Language: English
• Published: Elsevier Ltd 01.12.2020
• Subjects: Driving; Obesity; Private motor vehicle use; Sedentary behaviour; Private motor vehicle use; Driving; Obesity; Sedentary behaviour
• ISSN: 2214-1405; 2214-1413
• DOI: 10.1016/j.jth.2020.100930

Time spent sitting in cars is a prevalent form of sedentary behaviour. Overall time spent sitting and specific sedentary behaviours such as TV viewing have been shown to be associated with cardiovascular disease – a major contributor to premature death. A previous review found that motor vehicle use (including public transport) was associated with obesity. We update the relevant evidence base, focusing specifically on car use as the risk exposure, and expanding the outcomes to relevant indices of cardiovascular disease risk including obesity. The initial search using four databases (Web of Science, Scopus, Medline, and Transport Research International Documentation) produced 3481 hits. After screening and excluding articles included in the previous review, nine articles were found eligible for review. Of these, five examined cross-sectional associations, three examined longitudinal associations, and one examined both. One study found longer car use to be related to higher risk of cardiovascular disease as a cause of death. Six out of six cases examining relationships of car use duration with obesity-related outcomes reported significant detrimental associations. However, car use frequency was associated with obesity outcomes in only one out of four cases. Findings were mixed or null for other cardiovascular disease risk markers (blood glucose, blood lipids, blood pressure and composite risk indices. Studies examining effect modification by gender and age found associations of car use with obesity to be more pronounced in men and working-age adults, relative to women and older adults. This review found strong evidence supporting detrimental associations of prolonged car use with obesity. However, none of the studies used device-measured time spent sitting in cars. Robust evidence of health risk associated with car use can inform initiatives to lower high levels of car dependency, which is an important goal of the transport and health sectors. •Nine studies examining associations of car use with cardiovascular risk were identified.•Strong evidence supports detrimental associations of prolonged car use with obesity.•The car use-obesity association was more pronounced in men and working-age adults.•Studies did not use devices to measure time spent sitting in cars objectively.