title: Cycling and sports, but not walking, are associated with 10-year cardiovascular disease incidence: the MORGEN Study.
abstract: BACKGROUND
  Physical activity is inversely related to cardiovascular diseases. However, the type of activities that contribute most to these beneficial effects remain unclear. For this reason, we investigated self-reported leisure time physical activities in relation to fatal/nonfatal cardiovascular disease incidence.
  
  
  METHODS
  The Dutch Monitoring Project on Risk Factors for Chronic Diseases Study, carried out between 1993 and 1997, is a prospective cohort study of over 23000 men and women aged 20–65 years from the general Dutch population.
  
  
  METHODS
  From 1994 till 1997 physical activity was assessed with a questionnaire in 7451 men and 8991 women who were followed for an average of 9.8 years. Cox proportional hazards models were used adjusting for age, sex, other physical activities, smoking, alcohol consumption, and educational level.
  
  
  RESULTS
  Almost the entire study population (97%) was engaged in walking, about 75% in regular cycling, and about half the population in sports or gardening. Cycling [hazard ratio (HR): 0.82, 95% confidence interval (CI): 0.71–0.95] and sports (HR: 0.74, 95% CI: 0.64–0.87) were both inversely related to cardiovascular disease incidence, whereas walking and gardening were not. For sports (P < 0.001), but not for cycling (P = 0.06), we found a dose - response relationship with respect to cardiovascular disease incidence. Engaging in both cycling and sports resulted in an even greater risk reduction (HR: 0.64, 95% CI: 0.52–0.77).
  
  
  CONCLUSIONS
  In this relatively active population, types of activities of at least moderate intensity, such as cycling and sports were associated with lower CVD incidence, whereas activities of lower intensity, such as walking and gardening, were not.
authors.affiliation: Centre for Prevention and Health Services Research, National Institute for Public Health and the Environment, Bilthoven, The Netherlands. marieke.hoevenaar@rivm.nl
authors.forename: Marieke P
authors.initials: MP
authors.lastname: Hoevenaar-Blom
authors.forename: G C W
authors.initials: GC
authors.lastname: Wendel-Vos
authors.forename: Annemieke M W
authors.initials: AM
authors.lastname: Spijkerman
authors.forename: Daan
authors.initials: D
authors.lastname: Kromhout
authors.forename: W M M
authors.initials: WM
authors.lastname: Verschuren
mesh_terms: D000328:Adult; D000368:Aged; D001642:Bicycling; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000401:mortality / Q000517:prevention & control; D005260:Female; D006306:Health Surveys; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D016016:Proportional Hazards Models; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D040242:Risk Reduction Behavior; D057566:Self Report; D013177:Sports; D013997:Time Factors; D016138:Walking; D055815:Young Adult