Memorandum by Working for Cycling (OB
1. CTC the national cyclists' organisation,
welcomes the opportunity to contribute to this inquiry. CTC has
over 70,000 members and supporters, including both recreational
and "utility" cycle users, who join for a wide range
of benefits: information on all aspects of cycling, insurance,
legal advice & support, organised rides tours and other local
and national events, and to support our campaigns to promote better
conditions for cycling, and to encourage more people to cycle
2. Our submission details our knowledge
and experience of the issue of obesity, discusses the role which
cycling could play as part of the answer to the problem, and recommends
actions to Government to maximise its potential benefits in this
respect. We focus particularly on the role of cycle training as
a uniquely powerful tool both for giving children the life skills
of being able to cycle competently and safely (thereby reducing
the risks of developing obesity), and as a means of gaining or
regaining health and fitness for those in later life.
3. Throughout this submission the word "cycling"
is used to mean use of a pedal cycle including bicycles, tricycles
and tandems. It does not refer to the phenomenon of cyclical weight
loss and gain.
4. We would be happy to give oral evidence
to the Committee to expand further on the ideas contained in this
submission. We are aware that a submission covering complementary
issues is being prepared by the English Regional Cycling Development
Team, with whom we work closely.
5. Obesity is considered to be a medical
condition that causes significant morbidity and decreased life
expectancy (1). At the upper extremes of body mass index, health
risk increases significantly. Obesity is defined as having a body
mass index (BMI) over 30 kg/m2(2), although significant risk of
health begins at a BMI of about 27.3 kg/m2(3).
6. Body mass index, as an expression of
fatness, is positively related to excess mortality. More specifically,
obesity is associated with non-insulin-dependent diabetes mellitus,
hypertension, hyperlipidaemia, osteoarthritis, psoriasis, respiratory
insufficiency (including sleep apnea), gallstones, and biliary
tract disease (4).
7. Although obesity is frequently associated
with atherogenic factors such as diabetes, hypertension, and hyperlipedaemia,
a direct relationship between obesity and cardiovascular disease
is debated by some authorities (5). However obesity is known to
contribute to other risk factors for coronary heart disease such
as hypertension and inactivity and is therefore implicated as
8. For obese people, spending on hospital
and outpatient care is 36% higher and medication costs are 77%
higher than for people in the normal weight range, according to
a study carried out in USA. People with high BMIs (>35) can
experience lost years of life of nine to 13 years. White men in
their 20s with a BMI of >45 had 13 years of life lost (YLL)
compared to those with a BMI of 24. A white woman of the same
age and BMI category lost eight years due to obesity. Among black
people in USA there was not a consistent reduction in life expectancy
until BMIs of 37 for women and 32 for men were reached (6).
9. A National Audit Office (NAO) report
(7) estimates that obesity in England costs £ ½ billion
a year in NHS treatment costs, and that the costs to the wider
economy may exceed £2 billion.
10. The previously-mentioned NAO report
records over half of the adult population in England was overweight
in 1998, and around one in five was obese (21% of men and 17%),
following a doubling in the number of obese adults in the preceding
18 years (this was a much higher rate of increase than for other
European countries, where growth rates were between 10% and 40%)
(8). There are also signs of a growing epidemic of obesity among
childrenby 1997, 20% of four year olds in England were
overweight and 8% obese (9).
What are the causes of the rise in obesity in
11. Reduced physical activity has been identified
as the dominant factor causing the trend of increasing obesity
in Britain (10). A table in the recently published National Cycling
Strategy advice note graphically illustrates the apparent relationship
between cycling levels in different European countries and the
levels of childhood obesity (11).
12. Recent decreases in physical activity
among children are cause for concern. A report from Sport England
claims that the emphasis on "back-to-basics" in primary
schools means that children are not getting enough time for PE
and games (12). In 1994, 32% of six to eight year olds were getting
the recommended two hours of exercise a week. Last year, that
figure was down to just 11%. For nine to 11 year olds, the report
shows a fall from 46% to 21% in the same period.
13. The Scottish Health Survey of 1998 (13)
revealed that young Scots, particularly girls, are taking less
exercise than did previous generations. The amount of exercise
taken by boys stays roughly steady through the childhood years,
at 15 hours a week; girls only manage seven hours by the time
they reach 14 or 15. Professor Marmot, an author of the survey
report, said that the drop in exercise should be looked at in
broad terms. "Taking the issue of obesity and exercise,
it is not enough to say to people: `you must take more exercise'.
There is also the whole question about where that fits into people's
lives. Are there sports facilities available, is it safe for people
to ride bikes?"
14. In 1997, only 55% of boys and 39% of
girls in England were doing the 60 minutes of at least moderate
activity (eg feeling warm and slightly out of breath) as recommended
by the Department of Health (14). Activity levels have been declining,
partly due to a fall in the levels of walking and cycling, particularly
for the journey to and from school. Data on school travel show
that the proportion of five to 10 year olds being driven to school
has increased from 22% in 1985-86 to 39 % in 1999-2001, with corresponding
decreases in the proportions walking and cycling. The number of
11-16 year olds cycling to school has declined from 6% to 2% in
the same period (15).
The role of physical activity in tackling obesity
15. There is evidence that physical activity,
with the aim of increasing calorie expenditure, is an important
part of the solution to the current rise in obesity. In two studies
in 1976 (16) (17) researchers compared changes in body composition
between three groups of study participants; the first group reduced
their dietary intake, the second increased their calorie expenditure,
and the third did a bit of both. The three groups achieved comparable
reductions in body weight, but the first group (diet only) did
so by loosing muscle mass, whereas the other two did so by loosing
body fat whilst gaining in muscle mass.
16. A multifaceted weight reduction program,
including diet, exercise and behaviour modification, has been
shown to be more effective than other weight reduction programs
(18). The balance between intensity and duration should be struck
to give a high total caloric expenditure. Approximately, 300 to
500 Calories each period of exercise and 1,000 to 2,000 Calories
per week for adults is recommended. Since many obese individuals
are at an increased risk for injury to joints and soft tissues,
non-weight-bearing activities may be recommended. An intensity
of 60% or less of maximal heart rate may be maintained to improve
cardiorespiratory endurance (19).
17. It has been found that obese people
could loose a considerable amount of weight by walking or cycling
for a mile or two each day for a year (20). Moreover, obese people
who exercise regularly have been found to reduce their risks of
suffering heart attacks or other related illnesses even if they
remain overweight. The risk of heart attacks for obese people
who exercise regularly are no higher than the norm for those who
take exercise, whereas for sedentary obese people the risk is
five times higher than the equivalent norm (21).
The role of cycling in tackling obesity
18. Cycling is close to being an ideal form
of exercise for the following reasons:
It is aerobicit uses major
muscle groups (in the legs) and causes the heart rate and respiration
to increase in order to supply the muscles.
It is low weight bearingbecause
the cycle takes the weight of the body off the legs, much less
pressure is exerted on the joints than in running for example.
Cycling is therefore a good form of exercise for people with joint
It is a low skill activity (by contrast
with ballet for example)although navigating today's roads
may sometimes seem very skilled, it is essentially a skill that
can be once acquired and never forgotten.
Those who eschew sports orientated
recreational activity, such as women, may find, commuter cycling
acceptable (22). Cycling can take people out into green space
and the countryside which has in itself been shown to have health
19. A UK study found that people who took
up cycling as a new activity gained the greatest benefits at the
outset of the trial, but fitness continued to improve as they
increased their cycle use. Reduced body fat was also noted, particularly
among those who were overweight or obese at the outset of the
Cycling is healthy, not dangerous
20. Proposals to encourage increased cycle
use on health grounds sometimes prompt the concern that this could
increase the number of cyclist casualties. We do not accept that
this is a valid concern, for a number of reasons:
The risks of cycling are easily overestimated.
It takes around 21,000 years of average cycling to suffer a fatal
The number of cyclists killed in
road traffic crashes in 2000 was 125. Deaths from heart disease
attributable to physical inactivity that year were 46,250 (26).
One could reasonably argue that the risks of cycling are dwarfed
by the risks of not doing so.
The British Medical Association recognises
that, "Even in the current hostile traffic environment,
the benefits gained from regular cycling are likely to outweigh
the loss of life through cycling accidents for the current population
of regular cyclists." (27) The author of this report
subsequently estimated that the life years gained due to the health
and fitness benefits of cycling outweighed the life-years lost
through injuries by a factor of around 20:1 (28).
There is some evidence to suggest
that the risk per kilometre cycled goes down as cycle use goes
up at the population level. It has been estimated that a doubling
of cycle use would result in only a 25-30% increase in cycle fatalities,
representing a 35-40% reduction in risk per cyclist (29). It is
assumed that this is partly because drivers become more "cycle
aware" with more cyclists on the road, and partly because
a greater proportion of the driving population would themselves
be sometime cycle users. Improving cycle facilities and/or reducing
traffic speeds can achieve even better resultsLondon and
York are both among several European towns and cities which has
increased cycle use while at the same time reducing casualties
in absolute terms.
Compared with motorised traffic,
cyclists impose very little danger on other road users. Typically
about three to seven third parties are killed in fatal crashes
involving a cycle, compared with around 1,600 third party fatalities
involving cars. "More cycling would almost certainly reduce
road deaths", to quote one author (30).
A policy framework to promote cycling
21. This is not the place for a full discussion
of the range of policies and initiatives that are necessary or
desirable to promote increased cycle use. Nevertheless, we feel
it is useful to provide a brief overview of some key points in
the paragraph below, before proceeding to discuss specifically
how to promote cycling among children and young people (in order
to prevent the onset of weight problems), and how the health sector
could promote projects to assist people in tackling obesity.
22. A strategy to promote cycling would
include the following features:
Tackling traffic growth. People
are known to travel for a little over one hour every day. Yet
the Government's 10 Year Plan for transport predicted that, in
the period 2000 to 2010, there will be 17% growth in road vehicle-km.
It also set growth targets for 50% more rail passenger-km, 10%
more bus passenger-journeys a doubling of light rail journeys
as well as a trebling of cycling trips (31). We estimate that
these targets and predictions, taken together, amount to around
15% extra time spent travelling. This is an implausible over a
10-year period, and is certainly undesirable. It is also in conflict
with the government's own policy objective (set out in planning
policy guidance on transport) to "reduce the need to travel"
Tackling vehicle speeds and other
forms of dangerous driving. A combination of physical measures
(eg traffic calming or the reallocation of road space or junction
capacity in favour of pedestrians, cyclists and buses), regulatory
measures (eg lower speed limits, more stringent penalties for
offences) and awareness campaigns is required to create a road
user culture which is more conducive not only to cycling, but
also to walking, outdoor children's play and other community activity
(all of which involve physical activity).
Cycle facilities, including cycle
parking. We have followed the example of the "hierarchy
of solutions" in the official guidance on "Cycle Friendly
Infrastructure" (33) in prioritising cycle facilities below
measures to reduce the volume and speed of traffic, and to reallocate
road space. The aim ultimately should be to create a comprehensive
cycle-friendly highway networkcyclists' journey patterns
will never be adequately catered for by networks of dedicated
cycle facilities which are more limited than the network available
for motorised traffic. Nevertheless, well-designed cycle facilities
can prove useful, either as protection from more dangerous locations
(especially for less confident or experienced riders, including
children) or to provide off-road routes which are more direct
than the on-road equivalent. Cyclists also need good, secure and
well-located parking facilities at the ends of their journeys
(34). Lockers and shower facilities, particularly at workplaces,
can make a significant difference to some people's willingness
to cycles (35), (36).
Land use policies to promote local
travel. Planning policies should support the objective of
reducing the need to travel (see reference 32) by seeking to locate
developments (especially those which generate the greatest concentrations
of travel demand) where they are easily accessible by walking,
cycling and public transport. Opportunities should be taken to
secure useful cycle facilities in conjunction with Travel Plans
required as part of the development control processalthough
this is advocated in Planning Policy Guidance on Transport (PPG
13), it has been found that few authorities are doing this (37).
Integration of cycling with public
transport. There is much that could be done to enable people
to make journeys by combining cycle travel with public transport.
Such combinations can involve cycle carriage on trains, buses
and other public transport services; cycle parking at one or both
ends of the public transport leg of the journey; or cycle hire
facilities (38), (39).
Integration of cycling with other
policy areas. Policies on sustainable communities, crime reduction,
air pollution, noise and climate change should provide supporting
justification for promoting cycle use. Other aspects of transport,
such as highway maintenance and development control, need to be
undertaken in ways which reflect cyclists' needs and support efforts
to increase cycle use. Cycling should be integrated with policies
on urban regeneration, rural economy, leisure and recreation,
sustainable tourism. Finally, there are some vital links to be
made with policies on health, education and social inclusionthese
last three are discussed more fully in the following sections.
Promoting cycle use for children and teenagers
23. Sport England also asked young people
what they do most in their leisure time (40) and 48% of them reported
cycling. Yet other evidence suggests that few of them do so for
travel. One survey found that, although 90% of junior school pupils
and 67% of senior school pupils owned cycles, three quarters of
the juniors and a quarter of seniors were not allowed to cycle
on roads. Very few of the seniors cycled to school even though
about three in five of the cycle owners had journeys of less than
2 km, an easily cyclable distance (41).
24. There is already a wealth of advice
from Government and other sources about encouraging cycle use
for school journeys (42), (43), and many examples of good practice
and success stories (44). Yet most of these best practice examples
rest on the enthusiasm and commitment of individual teachers/head-teachers,
parents or governorsthe encouragement of cycling for school
travel is far from universal and many schools still actively discourage
it, often due to fears about road danger.
25. Moreover, there is a lack of effort
to promote cycling activities for children and young people for
purposes other than the school journey. More needs to be done
to provide children and teenagers with spaces where they can develop
their cycling skills in a safe environment, and enjoy cycling
as a free-time activity. For instance, properly funded and managed
Kids Cycling Clubs, based in local parks, could offer cycle training
and excursions in the neighbourhood, nearby rural areas or further
afield. The provision of facilities such as BMX parks can encourage
participation in a healthy activity among teenagers, and can often
be provided inexpensively on otherwise underused landthis
is particularly true in deprived areas, where there is often a
lack facilities and activities to engage teenagers' interest.
The importance of cycle training
26. We have already argued that the risks
of cycling are a good deal lower than is widely realised. Nevertheless,
the perception that "cycling is dangerous" is a significant
barrier to realising the benefits of increasing cycle use. We
would undoubtedly argue that action is needed to improve cycling
conditionsboth by improving the physical infrastructure
and by improving driver awareness of the need to respect the vulnerability
of pedestrians and cyclists. However, we have also argued that
there are overwhelming health benefits to be gained from encouraging
greater cycle use even in existing conditions. Moreover, the presence
of more cyclists will of itself affect driver attitudes and awareness.
27. So the question is one of how to start
this "cycle of benefits". We believe that cycle training
has a large part to play in the solution.
28. All unfamiliar activities with an element
of risk are "too dangerous" for people who have not
gained the confidence and skill to undertake them safely. In this
respect, cycling is no different from canoeing, horse-riding or
indeed driving. Yet most young people in Britain never have the
opportunity to learn how to handle real traffic conditions confidently,
competently and safely, and many do not gain cycle training at
all. Those cycle training schemes which do exist typically give
young children the skill to balance, signal and make basic turning
movements, often in playground conditions only. As they progress
through teenage years and into adulthood, they are unlikely to
encounter any opportunity to develop their cycling skills further,
and particularly to develop the confidence and skills necessary
to handle real traffic conditions. A recent survey of cycle training
provision found that:
Fewer than 30% of children receive
some form of training before primary school and only 25% learn
Less than 20% receive professional
instruction and only 10% are definitely trained by instructors
who are experienced cyclists;
Only 4% receive on-road training
carried out by professional instructors who are cyclists and have
been trained on a structured instructor training course;
Only 1% of secondary school pupils
receive any cycle training (45).
29. It is unsurprising then that, by adulthood,
people often use the shorthand "it's too dangerous"
to explain why they do not cycle. It is an understandable statement,
however its true explanation is more complex, and yet at the same
time it is a totally surmountable problem. 99% of men and 87%
of women aged over 15 say they can cycle (46). With adequate training,
they could be cycling for regular day-to-day local journeys, thereby
gaining health and fitness benefits without needing to set any
special time aside to undertake physical exercise for its own
sake (eg visit a gym).
30. CTC has been working with the Department
for Transport and the Department of Health to develop national
frameworks and standards for cycle training schemes and their
providers. The aim of this project is to raise standards of cycle
training schemes, by:
defining various levels of cycle
training to meet varying needs, from beginners through to competent
cyclists who need to gain roadcraft skills; and
supporting providers in delivering
cycle training courses which meet best practice standards.
Cycle training: maintaining children's health
31. One respect in which British patterns
of cycle use are crucially different from countries such as Holland
are the degree to which cycle use in Britain drops off markedly
after passing the mid-teenage years (earlier for girls), whereas
Dutch males and females alike maintain healthy levels of cycle
use throughout adulthood and into old age (47). Cycle training
for children and teenagers therefore has a valuable role to play
in ensuring that children not only learn the basic skills of handling
their cycles, but continue to develop their skills as seek and
gain increasing freedom and independence to travel more extensively
on their own. Creating the habits of healthy travelor overcoming
the habits of physical inactivitycould play a significant
role in addressing the health effects of obesity, as well as other
conditions related to physical inactivity. It is also an ideal
form of exercise for children who already have weight problems.
The efficiency of cycling makes it attractive to children who
might be deterred by the difficulties they encounter with other
forms of exercise.
Cycle training: overcoming weight problems
32. There is growing recognition in the
health sector of the value of exercise on referral schemes as
a means to tackle a range of health problems, including obesity.
We have referred already to a project in which overweight adults
were found to loose weight and gain fitness rapidly through participation
in cycling (see paragraph 19). Despite this finding, we are not
aware of any projects that have been run specifically to enable
overweight or obese adults to gain these benefits. Nevertheless,
there have now been a number of "cycling on prescription"
projects run for people with a range of health and fitness problems.
For instance, CycleWest is providing cycling on prescription for
PCTs in Bristol and mid-Devon, while Cycle Project for the North
West is running a specific project for rehabilitation of post-cardiac
arrest patients run in conjunction with Stockport PCT. We believe
that similar projects could prove valuable in enabling overweight
people to loose weight in a way that can be maintained and which
will give them increasing confidence and quality of life benefits
33. The Department of Health's national
quality assurance framework for exercise referral schemes says
"Many patients entering a referral scheme
will not find leisure facilities such as gyms desirable or convenient
for maintaining an increased level of physical activity. It is
therefore imperative that exercise referral schemes are individualised
to provide an educational experience that motivates patients for
long-term change. Walking and cycling in the community may well
be the most popular options, particularly if they are convenient,
safe, affordable and can be sociable"
Cycle training: tackling health inequalities
34. The recent report Social Exclusion Unit
on Transport identified clearly how socially excluded individuals
and communities tend to suffer disproportionately from the poor
transport services and from other adverse effects of transport
(eg air pollution and danger from road traffic) (49). However
it was very disappointing in failing to identify the potential
role of cycling in enabling people to gain improved access to
schools and colleges, job interviews and employment opportunities,
healthcare facilities etc. Socially excluded communities are generally
more likely than the norm to suffer from deficiencies in public
transport services. Encouraging people in these communities to
cycle would not only enable them to break out of the sense of
powerlessness that exclusion can create, and give people in those
communities a sense of independence. At the same time, projects
to provide spaces in those communities where children and teenagers
can cycle would help to overcome the health risks that some children
in those communities face due to parental pressure to remain indoors,
for fear of the disproportionate dangers they face from road traffic
in their areas.
35. Responsibility for physical activity
and active transport in young people should be shared between
the education, health and transport sectors. We have already outlined
(in paragraph 22) the transport and land use policy framework
needed to foster a higher level of cycle use, in order to realise
its various health and other benefits. We would add specific recommendations
Primary Care Trusts should work with
highway authorities to ensure that the provision of cycle training
schemes for people of all ages is an integral part of and Local
Transport Plans and cycling strategies. Health promotion units
should work with those authorities to promote such schemes.
PCTs should work with local authorities
and/or independent cycle training providers to make cycling on
prescription available as part of all exercise on prescription
Cycle training courses, provided
by accredited cycle training providers and including tuition in
on-road riding skills, should be made available for all children.
Training should be made available for teenagers as well as younger
Recreation (with links to social inclusion/regeneration
Funding should be allocated to each
local authority area, without competition, for children's cycling
clubs. These should be run by trained and qualified adults and
could take place in local parks, schools and leisure centres where
a tarmac cycle track and additional hard surfaced area has been
Funding should be allocated to each
local authority area, without competition, for provision of sufficient
tarmac cycle tracks and additional hard surfaced areas in schools
with large grounds to meet the demand for children's cycling clubs.
The National Cycle Network should
be completed, enhanced and maintained by local authorities through
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