Is active commuting associated with metabolic syndrome in adults, adolescents, and children? a systematic review and meta-analysis.

Aims: The prevalence of metabolic syndrome (MetS) is increasing annually across all age groups, raising the risk of morbidity, mortality, diabetes and cardiovascular disease in adults, adolescents, and children. Active commuting (AC) provides an opportunity to increase physical activity and reduce the MetS risk. The purpose of this study was to synthesize the available evidence on the prevalence of MetS and MetS risk factors in relation to AC vs non-active commuting among adults, adolescents, and children.

Data Synthesis: PubMed and Web of Science databases were searched for studies investigating the relationship between MetS and AC, conducted following the PRISMA statement. The quality of the included studies was assessed using the Newcastle-Ottawa Scale and the AXIS tool. Meta-analyses were conducted using random-effects model. Eleven studies were included: seven studies in adults and one study in adolescents indicated that active commuters had lower odds of MetS prevalence compared to non-active commuters. This finding was supported by the ten studies included in the meta-analysis (Odds Ratio (OR) = 0.88; 95 % Confidence Interval (CI) = 0.83-0.94; p < 0.001; Q = 33.16; I = 72.86). Additionally, five studies in adults and one study in adolescents showed that active commuters had lower odds of abdominal obesity, a key MetS risk factor. This was corroborated by the six studies included in the meta-analysis (OR = 0.72; 95 %CI = 0.61-0.84; p < 0.001; Q = 20.48; I = 75.59).

Conclusion: The prevalence of MetS and abdominal obesity seems to be lower among adults who engage in AC. However, generalization to younger populations is limited. Future intervention and longitudinal studies with objective and standardized measures are needed.