title: Bicycling policy indirectly associated with overweight/obesity.
abstract: BACKGROUND
  Policies to enhance bicycling are correlated with health outcomes. Research has yet to provide an adequate, empirically derived explanation for this finding.
  
  
  OBJECTIVE
  To examine a comprehensive model of a pathway potentially linking bicycle policies to overweight/obesity.
  
  
  METHODS
  Data representing multiple years between 2006 and 2012 from CDC, U.S. Census Bureau, U.S. Department of Transportation, and the Alliance for Biking and Walking were subjected to bivariate and multivariate analyses in 2013. A path model was created to explain the relationship between bicycle policies and overweight/obesity in the 48 largest U.S. cities.
  
  
  RESULTS
  Zero-order correlations were significant between the number of bicycle policies and the percentage of workers bicycling to work and rates of overweight/obesity. These relationships did not remain statistically significant in the multivariate analysis. However, more bicycle policies were associated with a greater number of bicycle infrastructure components (p<0.005). In turn, bicycling infrastructure components were positively related to the percentage of workers bicycling to work (p<0.001), which was inversely associated with overweight/obesity rates (p<0.05).
  
  
  CONCLUSIONS
  The results of this study suggest that large cities with more policies aimed at promoting bicycling have fewer overweight/obese residents, partially because the policies are related to supportive bicycling infrastructures that promote bicycling to work.
authors.affiliation: Department of Physiology, Kansas City University of Medicine and Biosciences, Kansas City, Missouri. Electronic address: rsuminski@kcumb.edu.
authors.forename: Richard R
authors.initials: RR
authors.lastname: Suminski
authors.affiliation: Department of Biomedical Sciences, William Beaumont School of Medicine, Oakland University, Rochester Hills, Michigan.
authors.forename: Jason A
authors.initials: JA
authors.lastname: Wasserman
authors.affiliation: Division of Research, Kansas City University of Medicine and Biosciences, Kansas City, Missouri.
authors.forename: Carlene A
authors.initials: CA
authors.lastname: Mayfield
authors.affiliation: College of Osteopathic Medicine, Kansas City University of Medicine and Biosciences, Kansas City, Missouri.
authors.forename: Emily
authors.initials: E
authors.lastname: Freeman
authors.affiliation: College of Osteopathic Medicine, Kansas City University of Medicine and Biosciences, Kansas City, Missouri.
authors.forename: Rachel
authors.initials: R
authors.lastname: Brandl
mesh_terms: D000328:Adult; D001642:Bicycling / Q000523:psychology / Q000706:statistics & numerical data; D002958:City Planning / Q000379:methods / Q000592:standards; D003430:Cross-Sectional Studies; D005260:Female; D006293:Health Promotion / Q000379:methods / Q000458:organization & administration; D006801:Humans; D008297:Male; D009765:Obesity / Q000453:epidemiology / Q000517:prevention & control / Q000523:psychology; D011640:Public Policy; D014186:Transportation / Q000379:methods / Q000706:statistics & numerical data; D014481:United States / Q000453:epidemiology