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Background  There is comprehensive evidence of the positive health effects of physical activity, and transport authorities can enable this by developing infrastructure for cycling and walking. In particular, cycling to work or to school can be a relatively high intensity activity that by itself might suffice for maximum health gain. In this paper, we present estimates of net health effects that can be assumed for demand responses to infrastructure development. The estimation was based on comparing current cyclists/pedestrians against potential cyclists/pedestrians, applying the  international physical activity questionnaire , which is a survey-based method for estimating  metabolic equivalent task  levels from self-reported types of physical activity, and their frequency, duration and level of intensity (moderate or vigorous).. By comparing between shares of individuals with medium or high intensity levels, within the segments of current cyclists/pedestrians and potential cyclists/pedestrians, we estimate the possible net health effects of potential new users of improved cycling/walking infrastructure. For an underpinning of the estimates, we also include the respondents' assessments of the extent to which cycling/walking for transport replaces other physical activity, and we carry out a regression of cycling/walking activity levels on individual characteristics and cycle/walk facility features.    Results  The estimated share of new regular cyclists obtaining net health gains was ca. 30%, while for new regular pedestrians this was only ca. 15%. These estimates are based on the assumption that the new users of improved cycle/walk facilities are best represented by self-declared potential users of such improved facilities. For potential cyclists/pedestrians, exercise was stated as the main motivation for physical active transport, but among current regular cyclists "fast and flexible" was just as important as exercising. Measured intensity levels from physically active transport increased with separate cycling/walking facilities, and were higher for those with higher education and living in urban areas, while they were lower for those with higher BMI and higher age.    Conclusions  Since the share obtaining net health gains might have a huge impact on cost-benefit analysis of new or improved infrastructure for cyclists/pedestrians, it is of importance to estimate this share. A main limitation of our estimation is the cross-sectional design. There is a need for more case studies combining surveys and objective measurement of physical activity changes, preferably before and after the construction of new infrastructure.

Cycling and walking for transport: Estimating net health effects from comparison of different transport mode users' self-reported physical activity