Introduction

Time spent sitting in cars is a prevalent form of sedentary behaviour. Overall time spent sitting and specific sedentary behaviours such as TV viewing have been shown to be associated with cardiovascular disease – a major contributor to premature death. A previous review found that motor vehicle use (including public transport) was associated with obesity. We update the relevant evidence base, focusing specifically on car use as the risk exposure, and expanding the outcomes to relevant indices of cardiovascular disease risk including obesity.

Methods

The initial search using four databases (Web of Science, Scopus, Medline, and Transport Research International Documentation) produced 3481 hits. After screening and excluding articles included in the previous review, nine articles were found eligible for review. Of these, five examined cross-sectional associations, three examined longitudinal associations, and one examined both.

Results

One study found longer car use to be related to higher risk of cardiovascular disease as a cause of death. Six out of six cases examining relationships of car use duration with obesity-related outcomes reported significant detrimental associations. However, car use frequency was associated with obesity outcomes in only one out of four cases. Findings were mixed or null for other cardiovascular disease risk markers (blood glucose, blood lipids, blood pressure and composite risk indices. Studies examining effect modification by gender and age found associations of car use with obesity to be more pronounced in men and working-age adults, relative to women and older adults.

Conclusion

This review found strong evidence supporting detrimental associations of prolonged car use with obesity. However, none of the studies used device-measured time spent sitting in cars. Robust evidence of health risk associated with car use can inform initiatives to lower high levels of car dependency, which is an important goal of the transport and health sectors.

中文翻译：

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汽车使用和心血管疾病的风险：系统评价及其对交通研究的影响

介绍

坐在汽车上的时间是久坐行为的一种普遍形式。坐下来的总时间和特定的久坐行为（例如看电视）已被证明与心血管疾病有关-心血管疾病是导致过早死亡的主要原因。先前的一项审查发现，使用机动车辆（包括公共交通工具）与肥胖有关。我们更新了相关的证据基础，特别侧重于汽车使用作为暴露的风险，并将结果扩展到包括肥胖在内的心血管疾病风险的相关指标。

方法

使用四个数据库（Web of Science，Scopus，Medline和Transport Research International Documentation）的初始搜索产生了3481个匹配项。经过筛选并排除了先前评论中包含的文章，发现有9篇文章符合审查条件。其中，五个检查了截面关联，三个检查了纵向关联，一个检查了两个。

结果

一项研究发现，长时间使用汽车与导致死亡的心血管疾病风险更高有关。在检查汽车使用时间与肥胖相关结果之间关系的六个案例中，有六个报告了明显的有害关联。但是，在四分之一的病例中，汽车使用频率与肥胖结局相关。其他心血管疾病风险指标（血糖，血脂，血压和综合风险指数）的发现是混合的或无效的。研究按性别和年龄对效果的影响进行研究的研究发现，在男性和工作年龄段，汽车与肥胖的关联更为明显。成年人，相对于妇女和老年人。

结论

这项审查发现有力的证据支持长时间使用汽车与肥胖之间的有害联系。但是，没有一项研究使用设备测量的时间坐在汽车上。与使用汽车相关的健康风险的有力证据可以为降低高水平的汽车依赖度提供信息，这是运输和卫生部门的重要目标。