title: Effect of E-Bike Versus Bike Commuting on Cardiorespiratory Fitness in Overweight Adults: A 4-Week Randomized Pilot Study Pedelecs as a physically active transportation mode Effects of exercise intensity on postprandial improvement in glucose disposal and insulin sensitivity in prediabetic adults. Association between active commuting and incident cardiovascular disease, cancer, and mortality: prospective cohort study Demands of Simulated Commuting Using an Electrically Assisted Bicycle Effects of high-intensity interval exercise versus continuous moderate-intensity exercise on postprandial glycemic control assessed by continuous glucose monitoring in obese adults.
abstract: Objective : To assess if active commuting with an electrically assisted bicycle ( e-bike ) during a 4-week period can induce increases in cardiorespiratory fitness measured as peak oxygen uptake ( V[Combining Dot Above]O2peak ) in untrained , overweight individuals , and if these changes are comparable with those induced by a conventional bicycle . Design : Four-week r and omized pilot study . Setting : Controlled laboratory . Participants : Thirty-two volunteers ( 28 men ) participated . Seventeen { median age 37 years [ interquartile range ( IQR ) 34 , 45 ] , median body mass index [ BMI ] 29 kg/m2 [ IQR 27 , 31 ] } were r and omized to the E-Bike group and 15 [ median age 43 years ( IQR 38 , 45 ) , median BMI 28 kg/m2 ( IQR 26 , 29 ) ] to the Bike group . Interventions : Participants in both groups were instructed to use the bicycle allocated to them ( e-bike or conventional bicycle ) for an active commute to work in the Basel ( Switzerl and ) area at a self-chosen speed on at least 3 days per week during the 4-week intervention period . Main Outcome Measures : V[Combining Dot Above]O2peak was assessed before and after the intervention in an all-out exercise test on a bicycle ergometer . Results : V[Combining Dot Above]O2peak increased by an average of 3.6 mL/(kg·min ) [ SD 3.6 mL/(kg·min ) ] in the E-Bike group and by 2.2 mL/(kg·min ) [ SD 3.5 mL/(kg·min ) ] in the Bike group , with an adjusted difference between the 2 groups of 1.4 mL/(kg·min ) [ 95 % confidence interval , −1.4 - 4.1 ; P = 0.327 ] . Conclusions : E-bikes may have the potential to improve cardiorespiratory fitness similar to conventional bicycles despite the available power assist , as they enable higher biking speeds and greater elevation gain Introduction Pedelecs are bicycles that provide electric assistance only when a rider is pedaling and have become increasingly popular . Purpose Our purpose was to quantify usage patterns over 4 weeks of real-world commuting with a pedelec and to determine if pedelec use would improve cardiometabolic risk factors . Methods Twenty sedentary commuters visited the laboratory for baseline physiological measurements [ body composition , maximum oxygen consumption ( $ $ \dot{V}{\text{O } } _ { 2 } { \hbox{max } } $ $ V˙O2max ) , mean arterial blood pressure ( MAP ) , blood lipid profile , and 2-h oral glucose tolerance test ( OGTT ) ] . The following 4 weeks , participants were instructed to commute using a pedelec at least 3 days week−1 for 40 min day−1 while wearing a heart rate monitor and a GPS device . Metabolic equivalents ( METS ) were estimated from heart rate data . Following the intervention , we repeated the physiological measurements . Results Average total distance and time were 317.9 ± 113.8 km and 15.9 ± 3.4 h , respectively . Participants averaged 4.9 ± 1.2 METS when riding . Four weeks of pedelec commuting significantly improved 2-h post-OGTT glucose ( 5.53 ± 1.18–5.03 ± 0.91 mmol L−1 , p < 0.05 ) , $ $ \dot{V}{\text{O } } _ { 2 } { \hbox{max } } $ $ V˙O2max ( 2.21 ± 0.48–2.39 ± 0.52 L min−1 , p < 0.05 ) , and end of $ $ \dot{V}{\text{O } } _ { 2 } { \hbox{max } } $ $ V˙O2max test power output ( 165.1 ± 37.1–189.3 ± 38.2 W , p < 0.05 ) . There were trends for improvements in MAP ( 84.6 ± 10.5–83.2 ± 9.4 mmHg , p = 0.15 ) and fat mass ( 28.6 ± 11.3–28.2 ± 11.4 kg , p = 0.07 ) . Conclusion  Participants rode a pedelec in the real world at a self-selected moderate intensity , which helped them meet physical activity recommendations . Pedelec commuting also result ed in significant improvements in 2-h post-OGTT glucose , $ $ \dot{V}{\text{O } } _ { 2 } { \hbox{max } } $ $ V˙O2max , and power output . Pedelecs are an effective form of active transportation that can improve some cardiometabolic risk factors within only 4 weeks BACKGROUND A single bout of exercise improves postpr and ial glycemia and insulin sensitivity in prediabetic patients ; however , the impact of exercise intensity is not well understood . The present study compared the effects of acute isocaloric moderate ( MIE ) and high-intensity ( HIE ) exercise on glucose disposal and insulin sensitivity in prediabetic adults . METHODS Subjects ( n=18 ; age 49±14 y ; fasting glucose 105±11 mg/dL ; 2 h glucose 170±32 mg/dL ) completed a peak O2 consumption/lactate threshold ( LT ) protocol plus three r and omly assigned conditions : 1 ) control , 1 hour of seated rest , 2 ) MIE ( at LT ) , and 3 ) HIE ( 75 % of difference between LT and peak O2 consumption ) . One hour after exercise , subjects received an  oral glucose tolerance test  ( OGTT ) . Plasma glucose , insulin , and C-peptide concentrations were sample d at 5- to 10-minute intervals at baseline , during exercise , after exercise , and for 3 hours after glucose ingestion . Total , early-phase , and late-phase area under the glucose and insulin response curves were compared between conditions . Indices of insulin sensitivity ( SI ) were derived from OGTT data using the oral minimal model . RESULTS Compared with control , SI improved by 51 % ( P=.02 ) and 85 % ( P<.001 ) on the MIE and HIE days , respectively . No differences in SI were observed between the exercise conditions ( P=.62 ) . Improvements in SI corresponded to significant reductions in the glucose , insulin , and C-peptide area under the curve values during the late phase of the OGTT after HIE ( P<.05 ) , with only a trend for reductions after MIE . CONCLUSION These results suggest that in prediabetic adults  , acute exercise has an immediate and intensity-dependent effect on improving postpr and ial glycemia and insulin sensitivity Objective To investigate the association between active commuting and  incident cardiovascular disease ( CVD ) , cancer , and all cause mortality .  Design Prospect i ve population based study . Setting UK Biobank . Participants 263 450 participants ( 106 674 ( 52 % ) women ; mean age 52.6 ) , recruited from 22 sites across the UK . The exposure variable was the mode of transport used ( walking , cycling , mixed mode v non-active ( car or public transport ) ) to commute to and from work on a typical day . Main outcome measures Incident ( fatal and non-fatal ) CVD and cancer , and deaths from CVD , cancer , or any causes . Results 2430 participants died ( 496 were related to CVD and 1126 to cancer ) over a median of 5.0 years ( interquartile range 4.3 - 5.5 ) follow-up . There were 3748 cancer and 1110 CVD events . In maximally adjusted models , commuting by cycle and by mixed mode including cycling were associated with lower risk of all cause mortality ( cycling hazard ratio 0.59 , 95 % confidence interval 0.42 to 0.83 , P=0.002 ; mixed mode cycling 0.76 , 0.58 to 1.00 , P<0.05 ) , cancer incidence ( cycling 0.55 , 0.44 to 0.69 , P<0.001 ; mixed mode cycling 0.64 , 0.45 to 0.91 , P=0.01 ) , and cancer mortality ( cycling 0.60 , 0.40 to 0.90 , P=0.01 ; mixed mode cycling 0.68 , 0.57 to 0.81 , P<0.001 ) . Commuting by cycling and walking were associated with a lower risk of CVD incidence ( cycling 0.54 , 0.33 to 0.88 , P=0.01 ; walking 0.73 , 0.54 to 0.99 , P=0.04 ) and CVD mortality ( cycling 0.48 , 0.25 to 0.92 , P=0.03 ; walking 0.64 , 0.45 to 0.91 , P=0.01 ) . No statistically significant associations were observed for walking commuting and all cause mortality or cancer outcomes . Mixed mode commuting including walking was not noticeably associated with any of the measured outcomes . Conclusions Cycle commuting was associated with a lower risk of CVD , cancer , and all cause mortality .  Walking commuting was associated with a lower risk of CVD independent of major measured confounding factors . Initiatives to encourage and support active commuting could reduce risk of death and the burden of important chronic conditions The American College of Sports Medicine ( ACSM ) recommends adults participate in weekly aerobic activity for a minimum of 30 minutes moderate intensity exercise 5 days per week or 20 minutes of vigorous activity 3 days per week . The electrically assisted bicycle may help individuals achieve the ACSM ’s aerobic recommendations and introduce inactive individuals to physical activity . To compare the physiological requirements of riding a bicycle with electric pedal assist versus non-assist among healthy active young adults . 6 males and 6 females completed two r and omized cycling trials using electric pedal assist ( PAB ) and non-assist ( NON ) . Cycling trials were completed over a 3.54 km course with varying terrain . Time to completion was faster in the PAB ( 12.5 ± 0.3 min ) than the NON ( 13.8 ± 0.3 min , p=0.01 ) . Rating of Perceived Exertion ( RPE ) was lower in the PAB ( 12.0 ± 0.4 ) than the NON ( 14.8 ± 0.5 , p < 0.001 ) . There was no difference in mean VO2 between PAB ( 2.3 ± 0.1 L·min−1 ) and NON ( 2.5 ± 0.1 L·min−1 , p=0.45 ) . There was no difference in mean power output when comparing PAB ( 115 ± 11 Watts ) to NON ( 128 ± 11 Watts , p=0.38 ) . There was no difference in heart rate between PAB ( 147 ± 5 bpm ) and NON ( 149 ± 5 bpm , p=0.77 ) . Recreationally active younger ( college age ) individuals may self-select a similar physiological intensity of physical activity regardless of mechanical assistance , result ing in quicker completion of a commuting task with PAB . Both the PAB and NON exercise bouts met ACSM criteria for vigorous exercise The purpose of this study was to examine the impact of acute high-intensity interval training ( HIIT ) compared with continuous moderate-intensity ( CMI ) exercise on postpr and ial hyperglycemia in overweight or obese adults . Ten inactive , overweight or obese adults ( 41 ± 11 yrs , BMI = 36 ± 7 kg/m(2 ) ) performed an acute bout of HIIT ( 10 × 1 min at approximately 90 % peak heart rate ( HRpeak ) with 1-min recovery periods ) or matched work CMI ( 30 min at approximately 65 % HRpeak ) in a r and omized , counterbalanced fashion . Exercise was performed 2 h after breakfast , and glucose control was assessed by continuous glucose monitoring under st and ardized dietary conditions over 24 h. Postpr and ial glucose ( PPG ) responses to lunch , dinner , and the following day 's breakfast were analyzed and compared with a no-exercise control day . Exercise did not affect the PPG responses to lunch , but performing both HIIT and CMI in the morning significantly reduced the PPG incremental area under the curve ( AUC ) following dinner when compared with control ( HIIT = 110 ± 35 , CMI = 125 ± 34 , control = 162 ± 46 mmol/L × 2 h , p < 0.05 ) . The PPG AUC ( HIIT = 125 ± 53 , CMI = 186 ± 55 , control = 194 ± 96 mmol/L × 2 h ) and the PPG spike ( HIIT = Δ2.1 ± 0.9 , CMI = Δ3.0 ± 0.9 , control = Δ3.0 ± 1.5 mmol/l ) following breakfast on the following day were significantly lower following HIIT compared with both CMI and control ( p < 0.05 ) . Absolute AUC and absolute glucose spikes were not different between HIIT , CMI , or control for any meal ( p > 0.05 for all ) . We conclude that a single session of HIIT has greater and more lasting effects on reducing incremental PPG when compared with CMI
target: There was moderate evidence that  e-cycling provided physical activity of at least moderate intensity , which was lower than the intensity elicited during conventional cycling , but higher than that during walking .
  There was also moderate evidence that  e-cycling can improve cardiorespiratory fitness in physically inactive individuals .
  Evidence of the impact of e-cycling  on metabolic and psychological health outcomes was inconclusive .
  Conclusion E-cycling can contribute to meeting physical activity recommendations and increasing physical fitness .
  As such , e-bikes offer a potential alternative to conventional cycling .
background: Background Electrically assisted bicycles ( e-bikes ) have been highlighted as a method of active travel that could overcome some of the commonly reported barriers to cycle commuting .
  The objective of this systematic review was to assess the health benefits associated with e-cycling .