Physical inactivity is now identified as the fourth leading risk factor for global mortality, representing six per cent of deaths globally. Levels of physical inactivity are rising in many countries and this has major implications for the prevalence of non-communicable diseases (such as obesity and cardiovascular and other chronic degenerative diseases) as well as the general health of the global population. Physical inactivity is estimated to cause around 21-25 per cent of breast and colon cancer burden, 27 per cent of diabetes and about 30 per cent of ischaemic heart disease burden. International groups, including the World Health Organization, have thus recommended policy changes to combat physical inactivity. In addition, there is a growing recognition that reduced levels of physical activity can partly be explained by the dominance of the private car as a mode of transport in urban society, as well as the role it plays in inhibiting both walking and cycling. Although the importance of physical activity is recognized by most people, the ever-growing benefits of physical activity for health are often weighed against the barriers people face in being active, such as a lack of time or motivation. Active transport (that is walking and cycling) is one way to overcome some of these barriers. When active transport becomes part of one's daily routine, it does not require much additional time or effort. Substantial physical activity can be accumulated through active transport, and over time, it also contributes to greater total physical activity. Cycling is recognized as an important potential means to promote public health. Research has shown that cycling on a regular basis (at least three times per week) with a conventional bicycle positively influences one's physical fitness. It also decreases the risk of coronary heart disease and improves health-related causality of life for untrained healthy adults. Moreover, cycling to work is associated with a reduction in absence at work due to sickness. However, cycling on a conventional bicycle faces its own challenges, which include the topography of certain urban environments, roads that are not adapted for cyclists and increasing distances from living to working places. In the past decades, a new type of bicycle has emerged that comes with a small electrical motor to help cyclists pedal with less effort: the pedelec. When using a pedelec, human pedaling is assisted with a speed of up to 25 km/h (16 mph). Pedelecs have the advantage of reducing the problems associated with cycling on hilly terrains and they make longer distances more accessible by bike, since they can be travelled in the same amount of time and effort as with a conventional bicycle. By decreasing the cycling intensity (by reducing fatigue), pedelecs can provide new motivation for those interested in starting to cycle. Further, it can also increase the likelihood that those users will continue using their pedelecs in the future. In the Netherlands, for example, it has been shown that the mean commuting distance with a pedelec is 1.5 times as high as with a conventional bicycle. Pedelecs are also becoming increasingly popular. The 27 countries of the European Union imported a total of 551,782 pedelecs and speed-pedelecs in 2012, according to the Eurostat data. The majority (67.5 per cent) of those imports were regular 250 Watt/25 km/h electric pedal-power assisted bicycles (pedelecs). Nevertheless, this new kind of bicycle raises (1uestions about whether or not it would be good for large proportions of the population to use pedelecs. This includes questions such as: will there be increases in health benefits if people switch from car to pedelecs, and what is the effect on the fitness level of people who exchange their conventional bicycle for a pedelec? In this chapter, the health benefits of physical activity, and cycling for transport in particular, are discussed. Subsequently, barriers of bicycle use for transport are considered and the potential of pedelecs to reduce those barriers are described. The available literature on the possible health effects of pedelec use is enumerated and some safety aspects related to the use of pedelecs are discussed. The chapter concludes with a discussion of future research challenges and recommendations for policy makers. (Author/publisher)
Samenvatting