title: Projected effect of increased active travel in German urban regions on the risk of type 2 diabetes.
abstract: BACKGROUND
  Future transportation policy is likely to reduce emissions in the cities and urban regions by strengthening active travel. Increased walking and cycling are known to have positive effects on health outcomes. This work estimates effects of increased active travel on type 2 diabetes in Germany, where 64% of the population live in urban regions.
  
  
  METHODS
  Based on the effect size of an increased active travel scenario reported from a recent meta-analysis, we project the change in the life time risk, the proportion of prevented cases and the change in diabetes free life time in a German birth cohort (born 1985) compared to business as usual.
  
  
  RESULTS
  The absolute risk reduction of developing type 2 diabetes before the age of 80 is 6.4% [95% confidence interval: 3.7-9.7%] for men and 4.7% [2.2-7.7%] for women, respectively. Compared to business as usual, the increased active travel scenario prevents 14.0% [8.1-21.2%] of the future cases of diabetes in men and 15.8% [9.3-23.1%] in women. Diabetes free survival increases by 1.7 [1.0-2.7] years in men and 1.4 [0.6-2.3] in women.
  
  
  CONCLUSIONS
  Our projection predicts a substantial impact of increased active travel on the future burden of type 2 diabetes. The most striking effect may be seen in the number of prevented cases. In all urban regions with an increased active travel transport policy, about one out of seven male and one out of six female cases can be prevented.
authors: German Diabetes Center, Institute of Biometry and Epidemiology, Duesseldorf, Germany.
authors: Ralph
authors: R
authors: Brinks
authors: German Diabetes Center, Institute of Biometry and Epidemiology, Duesseldorf, Germany.
authors: Annika
authors: A
authors: Hoyer
authors: German Diabetes Center, Institute of Biometry and Epidemiology, Duesseldorf, Germany.
authors: Oliver
authors: O
authors: Kuss
authors: German Diabetes Center, Institute of Biometry and Epidemiology, Duesseldorf, Germany.
authors: Wolfgang
authors: W
authors: Rathmann
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D011640:Public Policy; D012306:Risk; D014195:Travel / Q000706:statistics & numerical data*; D014505:Urban Population / Q000706:statistics & numerical data*