Physical fitness in relation to transport to school in adolescents: the Danish youth and sports study

Mobility Infrastructures and Health: Scoping Review of studies in Europe

Objectives

Movement-friendly environments with infrastructure favouring active mobility are important for promoting physical activity. This scoping literature review aims at identifying the current evidence for links between mobility infrastructures and (a) behaviour regarding active mobility, (b) health outcomes and (c) co-benefits.

Method

This review was conducted in accordance with the PRISMA scoping review guidelines using PubMed and EMBASE databases. Studies included in this review were conducted in Europe, and published between 2000 and March 2023.

Results

146 scientific articles and grey literature reports were identified. Connectivity of sidewalks, walkability, and accessibility of shops, services and work are associated with walking. Cycling is positively associated with cycle-paths, separation of cycling from traffic and proximity to greenspaces, and negatively associated with traffic danger. Increased active transportation has a protective effect on cardiovascular and respiratory health, obesity, fitness, and quality of life. Co-benefits result from the reduction of individual motorized transportation including reduced environmental pollution and projected healthcare expenditure.

Conclusion

Mobility infrastructure combined with social and educational incentives are effective in promoting active travel and reducing future healthcare expenses. A shift to active transportation would increase both individual and community health and decrease greenhouse gas emissions.

Parent perceptions of cycle training for children with special education needs and disabilities: What drives intention to cycle?

Background

Young people with Special Educational Needs and Disabilities (SEND) are especially vulnerable to physical inactivity. Research has demonstrated the effectiveness of tailored cycle training for children with SEND, however, it is unclear whether this then results in a greater uptake of cycling.

Aims

To determine parent based perceptions of a SEND cycle training programme, factors which predict intention to cycle more and ongoing barriers to cycling.

Methods

A tailored questionnaire was distributed to parents of children who took part in the cycle training.

Results

Parents reported increased confidence in their child's ability to cycle independently with many also highlighting improvements in confidence and resilience. The outcome of the cycle training (level of enjoyment and change in cycling ability) had a positive influence on intention to cycle more while cycling frequency prior to training had a negative influence. Continuing barriers to cycling were identified which included difficulties accessing specialised equipment and a need for additional on-road cycle training.

Conclusions and implications

This study demonstrates the success of a specialised cycle training programme for children with SEND in terms of improvement to cycling and influences on the intention to cycle more.

Associations among Active Commuting to School and Prevalence of Obesity in Adolescents: A Systematic Review

Active commuting to school (ACS) seems to be one of the means to increase physical activity (PA) levels in youth, but it is unclear if ACS reduces the prevalence of obesity, protecting and improving their health. Most of the previous research has been conducted on children or youth (i.e., children with adolescents together), and there is a paucity of research in adolescents only. The purpose of this review was to assess the association between ACS with overweight/obesity parameters in adolescents aged 11 to 19 years. We used PubMed, WOS and SPORTDiscus as electronics databases. All steps of the process followed the recommendations of the PRISMA flow-diagram. Fifteen articles (68.18%) found a consistent association between ACS and body composition and seven studies (31.82%) showed no differences in body composition between active and passive commuters to school. Fourteen studies observed that active commuters to school had a more favorable body composition and one study reported that ACS was associated with unfavourable body composition. ACS could be the steppingstone to improve PA promotion in adolescence but whether ACS is associated with improved body composition and prevention of obesity requires further research.

The Contribution of Walking to School in Students' Physical Activity and Its Effect on Being Overweight

Results

The findings of this research showed that being overweight is a concerning issue even in a small-sized and lightly populated city such as Bandar-Turkmen, Iran. Most students (90%) did not perform the required minimum daily activity when commuting to school. Further, overweight could be found even among those students who walked more than one hour to commute to school. The contribution of walking to school to the MVPA of overweight students was found to be low on school days and throughout the year. Counterintuitively, the situation is even worse for nonoverweight students.

Conclusion

The population of overweight students was more active compared to nonoverweight students in general, although they still suffered from excess weight since walking distances were short and not all days were school days. Thus, encouraging students to walk to school is necessary, while it is not sufficient alone as a single measure. Moreover, we recommend that all students should perform extra PA at home, school, or other places, on both school days and all other days of the year.

Active Commuting to University Is Positively Associated with Physical Activity and Perceived Fitness

Background: Fitness is a powerful marker of health associated with physical activity (PA) in university students. However, insufficient PA is a serious health concern among university students. Active commuting provides an opportunity for increased PA levels. Therefore, the aims of this study were (a) to describe the mode of commuting, PA and fitness in university students; (b) to analyze the associations of mode of commuting with PA and fitness; and c) to analyze the relationship between mode of commuting, PA recommendations and fitness. Methods: This was a cross-sectional study. A total of 1257 university students (52.4% women) participated (22.4 ± 5.6 years old). Results: Public commuting was the main mode to and from university. Active and public commuters were more likely to meet the PA recommendations and reported higher muscular strength than those using private commuting. Active and public commuters who met PA recommendations present the highest fitness in most of its components. Conclusions: Achieving the PA recommendations was more relevant than adopting an active mode of commuting in order to have better fitness. Further research targeting a broader understanding of the mode of commuting, PA levels and fitness in university students is needed.

Active Commuting and Healthy Behavior among Adolescents in Neighborhoods with Varying Socioeconomic Status: The NESLA Study

(1) Background: The World Health Organization recommends active commuting as a source of physical activity. Active commuting is determined by various factors, including the socioeconomic status (SES) of families and neighborhoods, distance to schools, perceived neighborhood safety, lifestyles and availability of walkways and biking paths. This study aimed to assess factors associated with modes of transportation to and from school among adolescents aged 16–19 living in a middle-sized city in Sweden. (2) Method: Three hundred and fourteen students, of whom 55% were females, from schools in the city of Västerås participated in the study. Printed as well as web-based self-administered questionnaires were used to collect the data. (3) Results: Adolescents living in high SES neighborhoods were 80% more likely to bike or walk to school (OR = 1.80; CI: 1.01, 3.20) than adolescents living in low SES neighborhoods. Furthermore, active commuting was associated with higher consumption of fruits and vegetables (OR = 1.77; CI: 1.05, 2.97) and less consumption of junk foods (OR = 0.43; CI: 0.26, 0.71), as compared to passive commuting. (4) Conclusions: Active commuting is a cost-effective and sustainable source of regular physical activity and should be encouraged at a societal level.

Compliance with a physical activity guideline among junior high school students

BACKGROUND

There were no nationwide moderate- to vigorous-intensity physical activity (MVPA) data relating to Japanese adolescents. This study assessed compliance with an MVPA guideline by adolescents, using a random sampling survey in Japan. The factors associated with compliance with the guideline were also examined.

METHODS

Participants were first- to third-grade Japanese junior high school students (307 boys and 255 girls). We analyzed data from the National Sports-Life Survey of Teens 2019, which used the Japanese version of physical activity (PA) questions in the World Health Organization Health Behavior in School-aged Children survey and potential correlates of MVPA.

RESULTS

Compliance with the PA guideline by the World Health Organization for Japanese students was 19.0% (95% confidence interval (CI), 15.8-22.3). The compliance of boys was significantly higher than that of girls (23.1%; 95% CI, 18.4-27.8; vs 14.1%; 95% CI, 9.8-18.4). The odds of meeting the PA guideline were significantly higher for boys in the second grade than boys in the first grade (odds ratio (OR) 1.78; 95% CI, 1.02-3.09), liking PA (for all: OR: 2.97; 95% CI, 1.32-6.69; for girls: OR: 2.99; 95% CI, 1.01-8.81), and sports participation (for all: OR: 4.77; 95% CI, 2.32-9.80; for boys: OR: 6.00; 95% CI, 1.81-19.89; for girls: OR: 4.08; 95% CI, 1.63-10.21).

CONCLUSIONS

The results suggest that more than 80% of junior high school students were insufficiently physically active in Japan. Preferences for PA and sports participation may be important correlates of sufficient PA.

Substitutability and Complementarity of Municipal Electric Bike Sharing Systems against Other Forms of Urban Transport

The current quantitative and qualitative development of bike-sharing systems worldwide involves particular implications regarding the level of sustainability of urban development and city residents’ quality of life. To make these implications as large as possible as well as the most positive, it is essential that the people who use municipal bikes on a regular basis to the largest extent possible abandon car travel at the same time. Thanks to their operational characteristics, electric bikes should enable meeting the transport needs of a wider group of city residents compared with traditional bicycles. The main aim of this study was therefore to check whether the municipal electric bike system (MEVO) in Gdańsk-Gdynia-Sopot metropolitan area of Poland lived up to the hopes placed upon it by policymakers. Therefore, the article tests the hypothesis indicating that the municipal electric bike systems constitute a substitutable form of transportation against passenger cars to a larger extent than against collective urban transport and walking trips. The analysis was performed based on the results of primary studies conducted among the users of MEVO. The data show that the MEVO was a substitutable form of transportation against collective transport and walking trips to a larger extent than against passenger cars. Through logistic regression analysis, the variables concerning the probability of replacing car trips by MEVO bicycles were determined. Among the analyzed variables, the following turned out to be statistically significant: age, the number of people in the household, the number of cars in the household, the distance from work, and gender. The results therefore indicate that substituting in favor of electro bikes was more probable for younger people with fewer people in the household and a distance to travel below 3 km, whereas it was less probable for people with more cars in the household or traveling a distance longer than 10 km. Additionally, females were more likely to choose the bike system.

Effects of School-Based Exercise Program on Obesity and Physical Fitness of Urban Youth: A Quasi-Experiment

(1) Purpose: The purpose of this study was to evaluate if an after-school intervention program could prevent obesity and promote the physical fitness of urban sedentary school children. (2) Methods: A 16-week after-school physical fitness program was provided to 36 middle school students (7th, 8th, and 9th graders) recruited from a middle school for three days a week. They were high-risk youth showing poor health status (level 4 or 5) in the regular physical fitness evaluation conducted. Their body mass index (BMI), cardiovascular endurance, muscular strength and endurance, quickness, and flexibility were evaluated. (3) Results: A paired sample t-test was used (α = 0.05). There were statistical differences ((x ± s), p < 0.05) between the pre-Progressive Aerobic Cardiovascular Endurance Run (PACER) (13.36 ± 4.98 (# of laps)) and post-PACER (18.64 ± 6.31 (# of laps)) (p < 0.001), between the pre-sit-up (18.06 ± 7.22 (# of sit-ups)) and post-sit-up (24.89 ± 7.52 (# of sit-ups)) (p < 0.001), and between the pre-Trunk Flexion (2.64 ± 3.49 ((cm))) and post-Trunk Flexion (5.97 ± 2.78 ((cm)) (p < 0.001). There was no statistical difference between the pre-50m-Run (10.74 ± 1.30 ((sec))) and post-50m-Run results (10.69 ± 1.25 (sec)) (p = 0.063) or between the pre-BMI (24.84 ± 3.97 (kg/m2)) and post-BMI (24.76 ± 3.61 (kg/m2)) (p = 0.458). Overall, the physical fitness measures improved, whereas BMI did not change after 16 weeks. (4) Conclusion: Sixteen weeks of the school-based Health-related Physical Fitness (HrPF) program can be effective in improving overall physical fitness levels of adolescents, although additional treatments would be required to change BMI, which showed no improvement in the present study. It is concluded that in order for adolescents to maintain and promote physical fitness and health, participation in a school-based HrPF program is recommended for at least 30 min a day, three days a week. In addition, schools should provide high-risk youth with easy access to physical activities that are similar to the objectives of the physical education curriculum. In order to promote the health of school-age children, each school should establish and operate school-based systematic intervention programs.

Associations of mode and distance of commuting to school with cardiorespiratory fitness in Slovenian schoolchildren: a nationwide cross-sectional study

Background

It is unclear whether active commuting has the potential to improve children’s health. This study examined the association of commuting mode and distance with children’s cardiorespiratory fitness (CRF).

Methods

We conducted a cross-sectional study, including 713 Slovenian schoolchildren aged 12 to 15 years. Commuting modes were self-reported, and four commuting groups were constructed, while CRF was determined with a 20-m shuttle run test. The distance from home to school was calculated using the Geographic Information System. Effects of commuting mode and distance, controlling for age, gender and amount of total physical activity, were evaluated using general two linear models (one for each direction of commuting to/from school).

Results

The main effect of commuting group on CRF and its interaction with distance were significant in the direction from school to home (P = 0.013 and P = 0.028, respectively), but not in the opposite direction. Predicted differences in CRF between commuting groups were moderate and generally higher in males than in females. When comparing commuting group median distance from home to school, males driven by car had around 4 ml/min/kg lower predicted CRF than those who walked (P = 0.01) or used wheels commuting (e.g., bicycle, skateboard).

Conclusions

The distance of commuting had a small effect on CRF, except in the Car group where children who live close to school had significantly lower CRF than those living further away. Children driven by car who live within wheels or walk distance from school should be targeted by interventions promoting active transport.

Physical Activity in the Daily Life of Adolescents: Factors Affecting Healthy Choices from a Discrete Choice Experiment

Physical activity improves peoples’ well-being and can help in preventing weight gain, obesity, and related non-communicable diseases. Promoting healthy behaviors in the daily travels and transport choices of adolescents is very important in early establishing healthy habits that imply routine physical activity. For designing and developing effective strategies, it is relevant to study adolescents’ preferences for physical activity and what factors in the social and environmental contexts affect their preferences. The paper investigates these aspects by means of a discrete choice experiment, using data from more than 4300 16–17 year-old adolescents in Italy. The results show that adolescents generally prefer walking for long time alone. However, females prefer cycling, while adolescents from lower educated families prefer motorized means of transport. Environmental factors affect the adolescents’ preferences: living nearby a green area is associated with more active and healthier choices in their short daily travels. Conversely, adolescents living closer to an industrial or high traffic area prefer to use motorized vehicles. Such findings have been discussed and policy implications presented, in order to support policymakers in designing cross-sectoral policies to promote healthy choices related to physical activity in adolescence.

Active Commuting and Physical Fitness: A Systematic Review

Physical fitness (PF) is considered an excellent biomarker of health. One possible strategy to improve PF levels is active commuting. This review, performed accordingly to the Preferred Reporting Items for Systematic Reviews guidelines includes scientific articles published in peer-reviewed journals up to December 2019 that aim at examining the relationship between active travel/commuting and PF. The search was performed in three databases (PubMed, Scopus, and Web of Science). Sixteen studies were included in this review. Findings from the 16 studies were unclear. From the eleven studies on children and adolescents screened, eight were cross-sectional, one prospective cohort, one quasi-experimental, and one experimental. From the five studies on adults, four were experimental and one cross-sectional. Body mass, waist circumference, skinfolds, fat mass, cardiorespiratory fitness, upper and lower strength tests were performed in children, adolescents, and adults. Agility and speed tests were performed only in the young age groups. Majority of the investigations on young ages and adults have shown positive effects or relationships between active commuting and several attributes of PF. However, to avoid misconceptions, there is a need for future robust investigation to identify potential mediators or confounders in this relationship. More robust investigations are essential to understand how and whether decision-makers and public health authorities can use active travel/commuting as a strategy to improve PF in all ages.

Changes in and the mediating role of physical activity in relation to active school transport, fitness and adiposity among Spanish youth: the UP&DOWN longitudinal study

Background

Longitudinal changes in child and adolescent active school transport (AST), and the mediating role of different intensities of daily physical activity (PA) levels in relation to AST and physical fitness and adiposity indicators is unclear. This study aimed to: 1) describe longitudinal changes in AST, light PA (LPA), moderate- to vigorous-intensity PA (MVPA), physical fitness and adiposity indicators over three time-points; and 2) investigate the mediating role of LPA and MVPA levels on associations between AST and physical fitness and adiposity indicators over three time-points among children and adolescents.

Methods

This longitudinal study comprised 1646 Spanish children and adolescents (48.8% girls, mean age 12.5 years ±2.5) at baseline, recruited from schools in Cádiz and Madrid. Mode of commuting to school was self-reported at baseline (T0, 2011–12), 1-year (T1) and 2-year follow-up (T2). PA was assessed using accelerometers. Handgrip strength, standing long jump and cardiorespiratory fitness (CRF) assessed physical fitness. Height, weight, body mass index, waist circumference, and triceps and subscapular skinfold thickness were measured. Multilevel linear regression analyses assessed changes in AST, PA levels, physical fitness and adiposity indicators over three time-points (T0-T1-T2). Additionally, longitudinal path analysis (n = 453; mean age [years] 12.6 ± 2.4) was used to test the mediating effects of LPA and MVPA levels on the association between AST and physical fitness and adiposity indicators.

Results

Multilevel analyses observed decreases in LPA between T0-T1 (β = − 11.27; p < 0.001) and T0-T2 (β = − 16.27; p < 0.001) and decreases in MVPA between T0-T2 (β = − 4.51; p = 0.011). Moreover, changes over time showed increases in handgrip between T0-T1 (β = 0.78; p = 0.028) and T0-T2 (β = 0.81; p = 0.046).

Path analyses showed that AST was directly positively associated with MVPA at T1 (all, β ≈ 0.33; p < 0.001). MVPA at T1 mediated associations between AST and CRF at T2 (β = 0.20; p = 0.040), but not the other outcomes. LPA did not mediate any associations.

Conclusions

Results from longitudinal path analysis suggest that participation in more AST may help attenuate declines in MVPA that typically occur with age and improve CRF. Therefore, we encourage health authorities to promote AST, as a way to increase MVPA levels and CRF among youth.

Cycling but not walking to work or study is associated with physical fitness, body composition and clustered cardiometabolic risk in young men

Introduction

Active commuting is an inexpensive and accessible form of physical activity and may be beneficial to health. The aim of this study was to investigate the association of active commuting and its subcomponents, cycling and walking, with cardiometabolic risk factors, physical fitness and body composition in young men.

Methods

Participants were 776 Finnish young (26±7 years), healthy adult men. Active commuting was measured with self-report. Waist circumference was measured and body mass index (BMI) calculated. Aerobic fitness was measured with bicycle ergometer and muscular fitness with maximal leg and bench press, sit-ups, push-ups and standing long jump. Cardiometabolic risk factors were analysed from blood samples and selected variables (glucose, insulin, triglycerides, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, as well as systolic and diastolic blood pressure) were further converted to z-score to form clustered cardiometabolic risk.

Results

A total of 24% used active commuting consisting of 10% of walkers and 14% of cyclists. After adjustments for age, smoking, time of year, leisure-time and occupational physical activities, cycling was inversely associated with the clustered cardiometabolic risk (β=−0.11, 95% CI −0.22 to −0.01), while walking was not (β=−0.04, 95% CI −0.16 to 0.08). However, further adjustment for waist circumference attenuated the associations to non-significant. Moreover, cycling but not walking was inversely associated with BMI, waist circumference and maximal strength, while a positive association was observed with aerobic fitness (p<0.05).

Conclusion

This study shows that cycling to work or study has beneficial associations to clustered cardiometabolic risk, body composition and aerobic fitness in young, healthy adult men.

Physical Activity and Commuting to School in Spanish Nine-Year-Old Children: Differences by Gender and by Geographical Environment

Children’s health status is related to their physical activity levels. Active commuting is associated with higher physical activity and reduced risk of all-cause mortality, cardiovascular disease incidence, and diabetes. The objective of this research was to study the levels of physical activity and the commuting to school (active vs. passive) in Spanish nine-year-old children, analyzing the differences by gender and by the geographical environment where they live (rural or urban environment). Accelerometry was used for the measurement of physical activity: Sedentary time (min/day), vigorous physical activity (min/day), moderate to vigorous physical activity (min/day), intensity (counts/min), steps (number). The questionnaire of the European Youth Heart Study (EYHS) was used to determine the geographical environment (city/urban, residential area/outside city, rural/village) and the modes of transport (active: Walking and bicycle, passive: Car, motorcycle, public transport). A total of 455 Spanish nine-year-old children (247 girls and 208 boys) belonging to the EYHS participated in this study. The results showed that boys were significantly more physically active than girls (p ≤ 0.001). Results also showed that active commuting to school was positively correlated with the levels of physical activity (r = 0.324, p ≤ 0.001). The geographical environment influenced the way in which children went to school, being active commuting to school significantly (p ≤ 0.001) less frequent in those children who lived in a rural environment (22.4%) than in those who lived in the city (57.1%) or in a residential area (62.7%). As active commuting to school means increasing levels of physical activity in both sexes, strategies should be implemented in order to encourage active commuting to schools, contributing at the same time to better health and sustainability of future generations.

Cycling and cardiovascular disease risk factors including body composition, blood lipids and cardiorespiratory fitness analysed as continuous variables: Part 2—systematic review with meta-analysis

Objectives

We aimed to examine the relationship between cycling (particularly commuter cycling) and risk factors associated with cardiovascular diseases (CVDs) including body composition, blood lipids and cardiorespiratory fitness. This study differed from our recent (Part 1) systematic review in that risk factors for CVD were analysed as continuous variables rather than being present or absent.

Design

Systematic review and meta-analysis.

Eligibility criteria

We searched four databases (Web of Science, MEDLINE, SPORTDiscus and Scopus). All quantitative studies, published until August 2017, were included when a general population was investigated, cycling was assessed either in total or as a transportation mode, and CVD risk factors were reported.

Methods

We analysed body composition, physical activity (PA), cardiorespiratory fitness (CRF), blood lipids and blood pressure (BP). Skinfold, waist circumference and body mass index were analysed and prioritised in that order when more than one measure were available. PA included measures of counts per minutes, moderate-to-vigorous PA or minutes per week. CRF included results of maximal tests with or without expired air or submaximal test. For blood lipids and BP, separate analyses were run for low-density and high-density lipoprotein, triglycerides, total cholesterol, systolic BP and diastolic BP. Studies were excluded when reporting dichotomous outcomes or when cycling and walking were combined. Heterogeneity was investigated using I2.

Results

Fifteen studies were included; the majority reported commuter cycling. In total, we included 5775 cyclists and 39 273 non-cyclists. Cyclists had more favourable risk factor levels in body composition −0.08 (95% CI −0.13 to −0.04), PA 0.13 (95% CI 0.06 to 0.20), CRF 0.28 (95% CI 0.22 to 0.35) and blood lipids compared with non-cyclists. There was no sex difference in risk reduction.

Conclusion/implication

Cycling mitigated the risk factor profile for CVD. A strength of this systematic review is that all the risk factors were analysed as continuous variables. These data provide evidence for practitioners, stakeholders, policy-makers and city planners to accommodate and promote cycling.

Systematic review registration

PROSPERO CRD42016052421.

No Association Between Active Commuting to School, Adiposity, Fitness, and Cognition in Spanish Children: The MOVI-KIDS Study

BACKGROUND

Walking and bicycling (active commuting) to school may be a useful strategy to increase the daily amount of physical activity, and, potentially, improve children's health. However, it is unclear whether active commuting to school (ACS) has the potential to improve physical health and cognitive performance in children. Our aim was to examine the relationship between ACS with adiposity indicators, physical fitness, and cognitive performance in 4- to 7-year-old children.

METHODS

We conducted a cross-sectional study with 1159 children from the provinces of Cuenca and Ciudad Real, Spain. ACS was self-reported by parents. Adiposity (body mass index, waist circumference, body fat mass, and triceps skinfold thickness) and physical fitness (cardiorespiratory and muscular fitness) were measured by standard procedures. Cognitive performance was assessed using the Battery of General and Differential Aptitudes. Data analysis included analysis of covariance.

RESULTS

We found no differences in adiposity, physical fitness, and cognitive performance between active commuters and nonactive commuters.

CONCLUSIONS

Walking to school had no positive impact on adiposity, physical fitness, and cognition in 4- to 7-year-old children. Future studies should examine the intensity and duration of walking to school needed to provide benefits in health and cognitive performance.

Do Not Forget About Public Transportation: Analysis of the Association of Active Transportation to School Among Washington, DC Area Children With Parental Perceived Built Environment Measures

BACKGROUND

Although the active transportation (AT) indicator received an F grade on the 2016 US Report Card on Physical Activity for Children and Youth, this AT assessment excluded public transportation. An objective of the Built Environment and Active Play Study was to assess youth AT, including public transportation, among Washington, DC area children in relation to parental perceptions of neighborhood built environment (BE) variables.

METHODS

Questionnaires were mailed to 2000 parents of children aged 7-12 years. AT to school (ATS) was assessed with the question: "In an average school week, how many days does your child use each of the following ways to get to and from school? (a) Walk; (b) Bike; (c) Car; (d) Bus or Metro." Parental perceived BE data were obtained through questionnaire items, and logistic regression was conducted to determine if BE variables were associated with youth ATS.

RESULTS

The sample included 144 children (50% female; average age 9.7 years; 56.3% white; 23.7% African American; 10.4% Asian American). Over 30% used ATS-public transportation 5 days per week, and nearly 13% used ATS-walking daily. Parental perceived BE variables significantly predicted youth ATS-walking and ATS-public transportation.

CONCLUSIONS

ATS-public transportation is common among Washington, DC area youth, and parental perceptions of BE can significantly predict ATS.

Parental perceptions of barriers to active commuting to school in Spanish children and adolescents

Background

: Understanding parental barriers is crucial to promote active commuting to school since the parental perceptions influence how young people commute. This study examined parental barriers to active commuting to school among Spanish children and adolescents, and their association with their gender and the usual mode of commuting. Parents of children ( n = 628) and parents of adolescents ( n = 151) from Granada (Spain) completed a paper-based questionnaire about perceived parental barriers to active commuting to school and mode of commuting. Data were analyzed using the Chi-square test. Among Spanish parents, the most common barriers reported by parents of children were traffic volume and dangerous intersections, whereas the most frequent barriers reported by parents of adolescents were distance to school and dangerous intersections. Compared to parents of children, a greater proportion of parents of adolescents reported distance to school and crime and smaller proportion reported traffic volume as barriers to active commuting to school. Among parents of children, crime was a more commonly reported as a barrier by parents of girls. Although some barriers reported by parents of passive commuters were similar for children and adolescents (such as distance to school and absence of a policeman at crosswalks), other barriers were specific to parents of children. The main parental barriers to active commuting in children were traffic volume and dangerous intersections whereas for adolescents were distance and dangerous intersections. Among Spanish parents, parental barriers to active commuting are influenced by children's age, gender and mode of commuting to school.

Examining the Influence of a New Light Rail Line on the Health of a Demographically Diverse and Understudied Population within the Washington, D.C. Metropolitan Area: A Protocol for a Natural Experiment Study

Approximately two-thirds of adults and youth in Prince George's County, Maryland, a suburb of Washington, D.C. are overweight or obese and less than half are achieving daily physical activity recommendations. Active transportation (AT), such as walking, biking or using public transportation (PT), is a strategic pathway to improving physical activity levels and thus reducing excess weight. Utilizing an expansion of the Washington, D.C. area transportation system with a new light rail line, the Purple Line Outcomes on Transportation (PLOT) Study will exam pre- and post-Purple Line PT use, AT behaviors and attitudes and physical activity among Prince George's County adults and youth. The PLOT Study will take advantage of this natural experiment in an area enduring significant racial/ethnic and gender-based overweight or obesity and physical inactivity disparities. While similar natural experiments on AT have been conducted in other U.S. cities, those studies lacked diverse and representative samples. To effectively evaluate these physical activity outcomes among this population, efforts will be used to recruit African American and Latino populations, the first and second most common racial/ethnic groups in Prince George's County. Finally, the PLOT Study will also examine how contextual effects (e.g., neighborhood built environment) impact PT, AT and physical activity.

Cycling to School and Body Composition, Physical Fitness, and Metabolic Syndrome in Children and Adolescents

OBJECTIVE

To evaluate the association between cycling to/from school and body composition, physical fitness, and metabolic syndrome among a sample of Colombian children and adolescents.

STUDY DESIGN

During the 2014-2015 school year, we examined a cross-sectional component of the Association for muscular strength with early manifestation of cardiovascular disease risk factors among Colombian children and adolescents (FUPRECOL) study. Participants included 2877 youths (54.5% girls) from Bogota, Colombia. A self-reported questionnaire was used to measure the frequency and mode of commuting to school. Four components of physical fitness were measured: (1) anthropometric (height, weight, body mass index, and waist circumference); (2) musculoskeletal (handgrip and standing long jump test); (3) motor (speed-agility test; 4 × 10-meter shuttle run); and (4) cardiorespiratory (20-m shuttle run test [20mSRT]). The prevalence of metabolic syndrome was determined by the definitions provided by the International Diabetes Federation.

RESULTS

Twenty-three percent of the sample reported commuting by cycle. Active commuting boys had a likelihood of having an unhealthy 4 × 10 m value (OR, 0.72; 95% CI, 0.53-0.98; P = .038) compared with the reference group (passive commuters). Active commuting girls showed a lower likelihood of having unhealthy a 20mSRT value (OR, 0.81; 95% CI, 0.56-0.99; P = .047) and metabolic syndrome (OR, 0.61; 95% CI, 0.35-0.99; P = .048) compared with passive commuters.

CONCLUSION

Regular cycling to school may to be associated with better physical fitness and a lower incidence of metabolic syndrome than passive transport, especially in girls.

Associations of commuting to school and work with demographic variables and with weight status in eight European countries: The ENERGY-cross sectional study

This study aims to assess the prevalence of different modes of commuting to school and work for 10-12year-olds and their parents; to assess the associations with demographic variables (country, sex, parental education and ethnicity) and with weight status in eight European countries. As part of the ENERGY project a cross-sectional survey was conducted in 2010 in which modes of commuting and socio-demographic variables for children (N=7903) and one of their parents (n=6455) were measured by questionnaires. Children's weight and height were objectively measured; parents self-reported their weight and height. Logistic multilevel regression analyses assessed the associations between mode of commuting and overweight. Differences between countries and differences in mode of commuting according to demographic variables were tested using χ²-test and Marascuilo's Post-hoc analysis. There were marked differences between countries, especially regarding cycling to school, which was common in The Netherlands and Norway and rare in Greece and Spain. Demographic variables were associated with mode of commuting in children and parents. Mode of commuting was not associated with being overweight in children, after adjustment for demographic variables. Bicycling to work, but not other modes of commuting, was significantly inversely associated with being overweight among parents (OR=0.74 (95%CI 0.57-0.97)). Interventions targeting active commuting may promote cycling, and should take into account the differences regarding demographic variables.

Effects of a school-based intervention on active commuting to school and health-related fitness

Background

Active commuting to school has declined over time, and interventions are needed to reverse this trend. The main objective was to investigate the effects of a school-based intervention on active commuting to school and health-related fitness in school-age children of Southern Spain.

Methods

A total of 494 children aged 8 to 11 years were invited to participate in the study. The schools were non-randomly allocated (i.e., school level allocation) into the experimental group (EG) or the control group (CG). The EG received an intervention program for 6 months (a monthly activity) focused on increasing the level of active commuting to school and mainly targeting children’s perceptions and attitudes. Active commuting to school and health-related fitness (i.e., cardiorespiratory fitness, muscular fitness and speed-agility), were measured at baseline and at the end of the intervention. Children with valid data on commuting to school at baseline and follow-up, sex, age and distance from home to school were included in the final analysis (n = 251). Data was analyzed through a factorial ANOVA and the Bonferroni post-hoc test.

Results

At follow up, the EG had higher rates of cycling to school than CG for boys only (p = 0.04), but not for walking to school for boys or girls. The EG avoided increases in the rates of passive commuting at follow up, which increased in the CG among girls for car (MD = 1.77; SE = 0.714; p = 0.010) and bus (MD = 1.77; SE = 0.714; p = 0.010) modes. Moreover, we observed significant interactions and main effects between independent variables (study group, sex and assessment time point) on health-related fitness (p < 0.05) over the 6-month period between groups, with higher values in the control group (mainly in boys).

Conclusion

A school-based intervention focused on increasing active commuting to school was associated with increases in rates of cycling to school among boys, but not for walking to school or health-related fitness. However, the school-based intervention avoided increases in rates of passive commuting in the experimental group, which were significantly increased in girls of the control group.

Active commuting to school in Finland, the potential for physical activity increase in different seasons

Background

Active commuting to school (ACS) can be a significant source of physical activity and provide many health benefits.

Objective

This study identified the potential to increase physical activity levels by promoting ACS in Finnish schools and evaluated the effects of season, distance and age on ACS.

Design

Data were collected with a questionnaire from 5,107 students, aged 10–16, in 45 comprehensive schools in Finland. The distance and the mode of transport to school in different seasons were self-reported.

Results

The prevalence of ACS was over 80% during spring/fall for those living 0–5 km from school. ACS was inversely associated with the distance to school and was lower in winter compared to spring and fall. Cycling is less common in winter, especially among girls and younger students. The potential for increasing students’ physical activity levels via ACS seems to be largest in winter, especially among students living 1–5 km from school. The variation in the prevalence of ACS between schools was large, especially in winter.

Conclusions

When planning interventions to promote ACS, one is encouraged to acknowledge and evaluate the potential in the selected target schools in different seasons. The potential varies largely between schools and seasons and is highly dependent on students’ commuting distances.

Factors associated with active commuting to school by bicycle from Bogotá, Colombia: The FUPRECOL study

Background

Active commuting to school (ACS) can contribute to daily physical activity (PA) levels in children and adolescents. The aim of the study was to analyze the characteristics of active commuting to and from school by bicycle and to identify the factors associated with the use of bicycles for active commuting to school based in a sample of schoolchildren in Bogotá, Colombia.

Methods

A cross-sectional study was conducted in 8,057 children and adolescents. A self-reported questionnaire was used to measure frequency and mode of commuting to school and the time it took them to get there. Weight, height, and waist circumference measurements were obtained using standardized methods, and mothers and fathers self-reported their highest level of educational attainment and household level. Multivariate analyses using unordered multinomial logistic regression models were conducted in the main analysis.

Results

21.9 % of the sample reported commuting by bicycle and 7.9 % reported commuting for more than 120 min. The multivariate logistic regression showed that boys, aged 9–12 years, and those whose parents had achieved higher levels of education (university/postgraduate) were the factors most strongly associated with a use bicycles as a means of active commuting to and from school.

Conclusion

The findings of this study suggest that it’s necessary to promote ACS from childhood and to emphasize its use during the transition to adolescence and during adolescence itself in order to increase its continued use by students.

Pyschosocial factors associated with children's cycling for transport: A cross-sectional moderation study

Promoting children's cycling for transport is a useful strategy to increase their physical activity levels. No studies have examined to which extent children's psychosocial characteristics play a role in their transportation cycling. Furthermore, insights into the association between children's independent mobility (IM) and transportation cycling is lacking in Europe. This study examined (1) the association of children's psychosocial characteristics with transportation cycling and its moderating effect of child's gender, parents' educational attainment and IM, and (2) the association between children's IM and transportation cycling. Children (n=1232, aged 10-12yrs) completed an online questionnaire at school assessing their psychosocial characteristics related with transportation cycling. Parents reported child's usual transportation cycling and the distance their child is allowed to cycle unsupervised (IM). Hurdle models were used to estimate associations between independent variables and odds of being a cyclist and with minutes of transportation cycling among those cycling. Data were collected during November-December 2014 across Flanders, Belgium. Children's perceived parental modeling, parental norm, peers' co-participation, self-efficacy and IM were positively related to the odds of being a cyclist, perceived benefits were negatively associated. Parental modeling, siblings' modeling, self-efficacy and parental norm were more strongly related to the odds of being a cyclist among children with a low IM. Friends' modeling was significantly related with odds of being a cyclist among boys. IM and parental norm (only among boys) were positively related to the time spent cycling. Targeting children, their friends and parents seems therefore most appropriate when aiming to increase children's transportation cycling.

Creating Cycling-Friendly Environments for Children: Which Micro-Scale Factors Are Most Important? An Experimental Study Using Manipulated Photographs

BACKGROUND

Increasing participation in transportation cycling represents a useful strategy for increasing children's physical activity levels. Knowledge on how to design environments to encourage adoption and maintenance of transportation cycling is limited and relies mainly on observational studies. The current study experimentally investigates the relative importance of micro-scale environmental factors for children's transportation cycling, as these micro-scale factors are easier to change within an existing neighborhood compared to macro-scale environmental factors (i.e. connectivity, land-use mix, …).

METHODS

Researchers recruited children and their parents (n = 1232) via 45 randomly selected schools across Flanders and completed an online questionnaire which consisted of 1) demographic questions; and 2) a choice-based conjoint (CBC) task. During this task, participants chose between two photographs which we had experimentally manipulated in seven micro-scale environmental factors: type of cycle path; evenness of cycle path; traffic speed; traffic density; presence of speed bumps; environmental maintenance; and vegetation. Participants indicated which route they preferred to (let their child) cycle along. To find the relative importance of these micro-scale environmental factors, we conducted Hierarchical Bayes analyses.

RESULTS

Type of cycle path emerged as the most important factor by far among both children and their parents, followed by traffic density and maintenance, and evenness of the cycle path among children. Among parents, speed limits and maintenance emerged as second most important, followed by evenness of the cycle path, and traffic density.

CONCLUSION

Findings indicate that improvements in micro-scale environmental factors might be effective for increasing children's transportation cycling, since they increase the perceived supportiveness of the physical environment for transportation cycling. Investments in creating a clearly designated space for the young cyclist, separated from motorized traffic, appears to be the most effective way to increase perceived supportiveness. Future research should confirm our laboratory findings with experimental on-site research.

Effectiveness and implementation of interventions to increase commuter cycling to school: a quasi-experimental study

Background

Active transportation to school has been positively associated with various health parameters whereas only sparse evidence exists on risk of injury while commuting to school. This study investigated the overall effectiveness of cycling promotion combined with structural changes on cycling to school.

Methods

Interventions at public schools in three different regions in Denmark were based on planned infrastructural changes near schools (e.g. road surface and traffic regulation) and school-motivation for promoting commuter cycling. Participants were pupils from control schools (n = 12) or intervention schools (n = 13). All children (n = 2415) from the 4^th and 5^th grade were measured at baseline during spring 2010 and at follow-up one year later.

Results

No significant differences in commuter cycling were detected in the adjusted analyses comparing the intervention with the control group neither when assessed as changes in short term (beta: 0.15 trips/week, p = 0.463) nor when assessed as changes in long term school cycling (beta: −0.02 units, p = 0.485). No differences were observed neither in the incidence of traffic injuries nor in the characteristics of injuries when comparing the control group and the intervention group. Approximately 50 % of all traffic injuries occurred during school transport with most injuries categorized as solo injuries. The only significant predictor of future traffic injuries was previous school transport injuries.

Conclusion

This multifaceted school cycling promotion programme did not affect school cycling behaviour or the health parameters assessed. Implementation issues relevant in the planning of future school cycling interventions are discussed in the article. The one year incidence of being involved in a traffic injury was approximately 25 % with almost 50 % of all traffic injuries occurred during school transport. Previous school transport injury predicted future school traffic injuries.

Electronic supplementary material

The online version of this article (doi:10.1186/s12889-015-2536-1) contains supplementary material, which is available to authorized users.

Associations between Active Commuting to School and Health-Related Physical Fitness in Spanish School-Aged Children: A Cross-Sectional Study

Active commuting (walking or cycling) to school has been positively associated with improved fitness among adolescents. However, current evidence lacks information on whether this association persists in children. The aim of this study was to examine the association of active commuting to school with different fitness parameters in Spanish school-aged children. A total of 494 children (229 girls) from five primary schools in Granada and Jaén (Spain), aged between eight and 11 years, participated in this cross-sectional study. Participants completed the Assessing Levels of Physical Activity (ALPHA) fitness test battery and answered a self-reported questionnaire regarding the weekly travel mode to school. Active commuting to school was significantly associated with higher levels of speed-agility in boys (p= 0.048) and muscle strength of the lower body muscular fitness in girls (p= 0.016). However, there were no significant associations between active commuting to school and cardiorespiratory fitness and upper body muscular fitness. Our findings suggest that active commuting to school was associated with higher levels of both speed-agility and lower body muscular fitness in boys and girls, respectively. Future studies should confirm whether increasing active commuting to school increases speed-agility and muscle strength of the lower body.

A Scoping Review of Observational Studies Examining Relationships between Environmental Behaviors and Health Behaviors

Individual lifestyles are key drivers of both environmental change and chronic disease. We undertook a scoping review of peer-reviewed studies which examined associations between environmental and health behaviors of individuals in high-income countries. We searched EconLit, Medline, BIOSIS and the Social Science Citation Index. A total of 136 studies were included. The majority were USA-based cross-sectional studies using self-reported measures. Most of the evidence related to travel behavior, particularly active travel (walking and cycling) and physical activity (92 studies) or sedentary behaviors (19 studies). Associations of public transport use with physical activity were examined in 18 studies, and with sedentary behavior in one study. Four studies examined associations between car use and physical activity. A small number included other environmental behaviors (food-related behaviors (n = 14), including organic food, locally-sourced food and plate waste) and other health behaviors ((n = 20) smoking, dietary intake, alcohol). These results suggest that research on individual environmental and health behaviors consists largely of studies examining associations between travel mode and levels of physical activity. There appears to be less research on associations between other behaviors with environmental and health impacts, and very few longitudinal studies in any domain.

A systematic review of active transportation research in Africa and the psychometric properties of measurement tools for children and youth

Background

Previous systematic reviews indicate that active transportation (AT; the use of non-motorized travel modes such as walking, running and cycling) is an important source of daily physical activity (PA). However, no previous systematic review has examined travel behaviours among African children and youth or the psychometric properties of measurement tools used among children and youth worldwide.

Methods

Studies on AT among African children and youth (aged 5–17 years) were identified through 1) the MEDLINE and Embase databases; 2) manual searches of six African journals that are not indexed in these databases; and 3) the articles included in a previous systematic review on PA among children and youth in Sub-Saharan Africa. Second, literature on the psychometric properties of measurement tools for children and youth was searched using the MEDLINE, Embase, Cochrane Central Register of Controlled Trials, PsycInfo, SportDiscus, and Health and Psychosocial Instruments databases. Study quality was assessed with a modified version of the Downs and Black checklist.

Results

Twenty studies reported original data on AT among African children and youth. This evidence suggests that rates of AT to/from school are lower in urban areas and in youth attending higher SES schools. Two population-based studies reported rates of AT ranging between 19.8% and 66.6% in multiple countries. Studies conducted in Africa seldom examined non-school travel and only one reported data on the psychometric properties of their measures of travel behaviours. Nineteen studies conducted predominantly in high-income countries provided psychometric data. Child and parent reports were used in 17 studies, and these measures generally showed substantial to almost perfect test-retest reliability and convergent validity for school trips. Limited information was available regarding non-school trips. Objective measures of travel behaviours have been used much less often, and further validity and reliability assessments are warranted.

Conclusion

These findings emphasize a need for more research examining travel behaviours among African children and youth, particularly for non-school travel. Further research is needed to develop valid and reliable measures of non-school travel and to examine their psychometric properties in the African context. These measures could then be used to evaluate AT promotion interventions.

Association between habitual school travel and muscular fitness in youth

OBJECTIVE

To determine whether active school travel is associated with muscular fitness, which is an emerging marker of youth health.

METHODS

Handgrip strength, vertical jump and vertical jump peak power were measured in n=6829 English schoolchildren (53% males, age 12.9 ± 1.2 years) between 2007 and 2011. Participants were grouped according to self-reported habitual school travel modality.

RESULTS

Cyclists had greater handgrip strength than passive travelers. Vertical jump height was greater in walkers and cyclists compared with passive travelers. Jump peak power was also higher in walkers than in the passive travel group. Compared with passive travelers, cyclists had a higher (age, sex and BMI-adjusted) likelihood of good handgrip strength (OR 1.42, 95%CI;1.14-1.76) and walkers were more likely to have good measures for vertical jump peak power (OR 1.14, 95%CI;1.00-1.29). Cyclists' likelihood of having good handgrip strength remained significantly higher when adjusted for physical activity (OR 1.29, 95%CI;1.08-1.46).

CONCLUSION

Muscular fitness differs according to school travel habits. Cycling is independently associated with better handgrip strength perhaps due to the physical demands of the activity. Better muscular fitness may provide another health-related reason to encourage active school travel.

Active commuting throughout adolescence and central fatness before adulthood: prospective birth cohort study

BACKGROUND

Active commuting is a good opportunity to accumulate physical activity (PA) across the lifespan that potentially might influence central body fat. We aimed to examine the prospective associations of active commuting at 11, 15 and 18 years of age with central body fat at 18 years.

METHODS

Participants were part of a large birth cohort study in Pelotas, Brazil (n = 3,649 participants). Active commuting, leisure-time PA and income were self-reported at 11, 15 and 18 years. Waist circumference and trunk fat mass were collected at 18 years with the use of a 3-dimensional photonic scanner and dual-energy X-ray absorptiometry, respectively.

RESULTS

Active commuting at 11 years was not prospectively associated with central body fat. However, we found that active commuting at 15 and 18 years were prospectively and cross-sectionally associated with central body fat variables, respectively, in boys but not in girls. Also, boys in the highest tertile of accumulated active commuting (i.e., average of active commuting at 11, 13 and 18 years) were associated with -2.09 cm (95%CI: -3.24; -0.94) of waist circumference and -1.11 kg (95%CI: -1.74; -0.48) of trunk fat mass compared to boys in the lowest tertile. Analyses on changes in tertiles of active commuting from 11 and 15 years to 18 years with central body fat variables at 18 years showed that boys who remained consistently in the highest tertile or moved to a higher tertile had lower levels of central body fat compared to those consistently in the lowest tertile.

CONCLUSIONS

Active commuting throughout adolescence in boys, especially during middle and late adolescence, is associated with lower levels in central fatness before adulthood.

Active transportation and adolescents' health: the Canadian Health Measures Survey

BACKGROUND

Active transportation (AT; e.g., walking and cycling) is increasingly promoted to increase youth physical activity (PA). Most previous research focused solely on school trips, and associations among AT and cardiovascular risk factors have seldom been examined in adolescents.

PURPOSE

To address these important research gaps using data from the nationally representative 2007-2009 Canadian Health Measures Survey.

METHODS

A total of 1,016 adolescents aged 12-19 years reported their weekly time spent utilitarian walking and cycling, and wore an Actical accelerometer for 7 days. They underwent a series of physical tests (measures of fitness, body composition, blood pressure, and blood sampling) following standardized protocols. In 2013, differences in PA and health-related outcomes across levels of walking and cycling were assessed with ANCOVA analyses adjusted for age, gender, parental education, and usual daily PA.

RESULTS

Greater walking and cycling time was associated with higher moderate-to-vigorous PA (MVPA). Compared to adolescents reporting walking 1-5 hours/week, those reporting <1 hour/week had lower waist circumference and total cholesterol/high-density lipoprotein (HDL) ratio and higher glycohemoglobin; those reporting >5 hours/week had better grip strength, lower total cholesterol, and total cholesterol/HDL ratio. Compared to adolescents reporting no cycling, those reporting ≥1 hour/week accumulated more light PA, had greater aerobic fitness, and lower BMI, waist circumference, and total cholesterol/HDL ratio; those who reported cycling <1 hour/week had lower total cholesterol.

CONCLUSIONS

Utilitarian walking and cycling were associated with higher daily MVPA in youth. Cycling was associated with a more consistent pattern of health benefits than walking.

Association between health behaviors and cardiorespiratory fitness in adolescents: results from the cross-sectional MoMo-study

PURPOSE

The aim of this study was to analyze the association between adolescent and familial health behavioral factors and cardiorespiratory fitness in German adolescent boys and girls.

METHODS

This study is based on a large nationwide cross-sectional study and its substudy on physical activity and fitness of children and adolescents ("Motorik-Modul"). For 1,328 adolescents between 11 and 17 years of age, data on cardiorespiratory fitness (Physical working capacity 170, PWC(170)) and familial and adolescent health behavioral factors were collected. Health behavior was assessed using psychometric questionnaires (socioeconomic status, pubertal stage, daily physical activity, sports-club time, parental physical activity habits, etc.). A hierarchical multiple regression model was used to quantify the association between relative PWC(170) values and health behavior.

RESULTS

The relationship between adolescents' health behavioral factors and cardiorespiratory fitness was stronger than the relationship between age, social status, familial health behavior and cardiorespiratory fitness. Familial health behavioral factors explained 4.1% and 2.1% of variance in cardiorespiratory fitness in girls and boys, respectively. Adolescents' health behavioral factors explained 15.2% of variance in girls and 25.7% of variance in boys. For both girls (β = .273) and boys (β = .400), being normal weight had the greatest effect on relative PWC(170) values.

CONCLUSIONS

The difference in explained variance in cardiorespiratory fitness by familial and adolescents' health behavioral factors between girls and boys indicates that different predictors for cardiorespiratory fitness are important for girls and boys. Hence, sex specific research and interventions aimed at improving familial and adolescent health behavior may be important.

Cross sectional analysis of the association between mode of school transportation and physical fitness in children and adolescents

Objective

To investigate the associations between body composition, cardiorespiratory and muscular fitness in relation to travel mode to school in children and adolescents.

Method

Children and adolescents from 40 elementary schools and 23 high schools representing all regions in Norway were invited to participate in the study. Anthropometry, cardiorespiratory and muscular fitness were tested at the school location. Questionnaires were used in order to register mode of transport to school, age, gender and levels of leisure time physical activity.

Results

A total of 1694 (i.e. 60% of all invited participants) children and adolescents at a mean age of 9.6 and 15.6 respectively (SD = 0.4 for both groups) were analyzed for associations with physical fitness variables. Males cycling to school had lower sum of skin folds than adolescents walking to school. Higher cardiorespiratory fitness in adolescents and male cyclists compared to walkers and passive commuters were observed. Among children, cycling and walking to school, higher isometric muscle endurance in the back extensors compared to passive commuters was observed.

Conclusion

Based on this national representative cross-sectional examination of randomly selected children and adolescents there is evidence that active commuting, especially cycling, is associated with a favourable body composition and better cardiorespiratory and muscular fitness as compared to passive commuting.

Bicycle guidelines and crash rates on cycle tracks in the United States

OBJECTIVES

We studied state-adopted bicycle guidelines to determine whether cycle tracks (physically separated, bicycle-exclusive paths adjacent to sidewalks) were recommended, whether they were built, and their crash rate.

METHODS

We analyzed and compared US bicycle facility guidelines published between 1972 and 1999. We identified 19 cycle tracks in the United States and collected extensive data on cycle track design, usage, and crash history from local communities. We used bicycle counts and crash data to estimate crash rates.

RESULTS

A bicycle facility guideline written in 1972 endorsed cycle tracks but American Association of State Highway and Transportation Officials (AASHTO) guidelines (1974-1999) discouraged or did not include cycle tracks and did not cite research about crash rates on cycle tracks. For the 19 US cycle tracks we examined, the overall crash rate was 2.3 (95% confidence interval = 1.7, 3.0) per 1 million bicycle kilometers.

CONCLUSIONS

AASHTO bicycle guidelines are not explicitly based on rigorous or up-to-date research. Our results show that the risk of bicycle-vehicle crashes is lower on US cycle tracks than published crashes rates on roadways. This study and previous investigations support building cycle tracks.

The relationships between active transport to work or school and cardiovascular health or body weight: a systematic review

To systematically examine the relationships between active transport to work or school and cardiovascular health, body weight, or other health outcomes, a systematic review of the literature was conducted in September 2012 using 3 electronic databases. A total of 3887 articles were screened, 30 full text articles were retrieved, and 19 articles were identified. Two reviewers independently assessed the quality of each article. The review found that active transport to work or school was significantly associated with improved cardiovascular health and lower body weight. However, the strength of the evidence varied from weak (mental health and cancer), moderate (body weight), to strong (cardiovascular health). The evidence was limited by lack of comparability of study outcomes, weak study designs, small sample sizes, and lack of experimental studies. Further research is needed to examine the effect of active transport on health using stronger research designs, including randomized controlled trials or longitudinal studies.

Bicycling to school is associated with improvements in physical fitness over a 6-year follow-up period in Swedish children

OBJECTIVE

To examine whether modes of commuting to school at baseline and changes in commuting were related to 6-year changes in cardiorespiratory fitness in youth.

METHODS

A total of 262 (142 girls) Swedish children (9 years at entry) were measured at baseline (1998/9) and follow-up (2004/5). Mode of commuting to school was assessed by questionnaire and fitness by a maximal bicycle test.

RESULTS

At baseline, 34% of children used passive modes of commuting (e.g., car, motorcycle, bus, train), 54% walked, and 12% bicycled to school. Six years later the percentage of bicyclists increased 19% and the percentage of walkers decreased 19%. On average, children who bicycled to school increased their fitness 13% (p=0.03) more than those who used passive modes and 20% (p=0.002) more than those who walked. Children who used passive modes or walked at baseline and bicycled to school at 6 years later increased their fitness 14% (p=0.001) more than those who remained using passive modes or walking at follow-up.

CONCLUSIONS

Implementing initiatives that encourage bicycling to school may be a useful strategy to increase cardiorespiratory fitness of children.

Global physical activity levels: surveillance progress, pitfalls, and prospects

To implement effective non-communicable disease prevention programmes, policy makers need data for physical activity levels and trends. In this report, we describe physical activity levels worldwide with data for adults (15 years or older) from 122 countries and for adolescents (13-15-years-old) from 105 countries. Worldwide, 31·1% (95% CI 30·9-31·2) of adults are physically inactive, with proportions ranging from 17·0% (16·8-17·2) in southeast Asia to about 43% in the Americas and the eastern Mediterranean. Inactivity rises with age, is higher in women than in men, and is increased in high-income countries. The proportion of 13-15-year-olds doing fewer than 60 min of physical activity of moderate to vigorous intensity per day is 80·3% (80·1-80·5); boys are more active than are girls. Continued improvement in monitoring of physical activity would help to guide development of policies and programmes to increase activity levels and to reduce the burden of non-communicable diseases.

Experiences from a randomised, controlled trial on cycling to school: Does cycling increase cardiorespiratory fitness?

Aims: The objective of the present study was to investigate the effect of a 12-week randomised controlled cycling-to-school trial on cardiorespiratory fitness. Methods: A total of 53 10- to 13-year-old children from one public school were included. The children were randomised into either a cycling group or a control group. The cycling group was encouraged to cycle to and from school each day during a period of 12 weeks. Peak oxygen consumption (VO2peak) and anthropometrical data (weight and height) were measured at baseline and at the end of the 12-week period. Results: No significant differences were observed in VO2peak change over the 12-week period between the cycling group and the control group (49.7 ml O2/min/kg vs. 50.6 ml O2 /min/kg; effect size=−0.13, F=0.495, p=0.486). Within the intervention group, 69.2% (95% CI 50.1–88.2) started cycling, and within the control group 40.8% (95% CI 20.9–60.5) started cycling. Given that several children in both groups (intervention and control) started cycling to school, re-analyses were conducted between those starting cycling and those not starting cycling. At follow up, a significant difference between those starting cycling and those who did not starting cycling was observed in VO2peak (51.7 ml O2/min/kg vs. 47.9 ml O2/min/kg; effect size=0.49, F=8.145, p=0.007), after adjustment for baseline scores, gender and age. Conclusions: This study indicates that cycling to school improves cardiorespiratory fitness.

Screen time and passive school travel as independent predictors of cardiorespiratory fitness in youth

OBJECTIVE

The most prevalent sedentary behaviours in children and adolescents are engagement with small screen media (screen-time) and passive travel (by motorised vehicle). The objective of this research was to assess the independence of these behaviours from one another and from physical activity as predictors of cardiorespiratory fitness in youth.

METHODS

We measured cardiorespiratory fitness in n=6819 10-16 year olds (53% male) who self-reported their physical activity (7-day recall) school travel and screen time habits. Travel was classified as active (walking, cycling) or passive; screen time as <2 h, 2-4 h or >4 h.

RESULTS

The multivariate odds of being fit were higher in active travel (Boys: OR 1.32, 95% CI: 1.09-1.59; Girls: OR 1.46, 1.15-1.84) than in passive travel groups. Boys reporting low screen time were more likely to be fit than those reporting >4 h (OR 2.11, 95% CI: 1.68-2.63) as were girls (OR 1.66, 95% CI: 1.24-2.20). These odds remained significant after additionally controlling for physical activity.

CONCLUSION

Passive travel and high screen time are independently associated with poor cardiorespiratory fitness in youth, and this relationship is independent of physical activity levels. A lifestyle involving high screen time and habitual passive school travel appears incompatible with healthful levels of cardiorespiratory fitness in youth.

Bicycling to school improves the cardiometabolic risk factor profile: a randomised controlled trial

OBJECTIVES

To investigate whether bicycling to school improves cardiometabolic risk factor profile and cardiorespiratory fitness among children.

DESIGN

Prospective, blinded, randomised controlled trial.

SETTING

Single centre study in Odense, Denmark

PARTICIPANTS

43 children previously not bicycling to school were randomly allocated to control group (n=20) (ie, no change in lifestyle) or intervention group (ie, bicycling to school) (n=23).

PRIMARY AND SECONDARY OUTCOME MEASURES

Change in cardiometabolic risk factor score and change in cardiorespiratory fitness.

RESULTS

All participants measured at baseline returned at follow-up. Based upon intention-to-treat (ITT) analyses, clustering of cardiometabolic risk factors was lowered by 0.58 SD (95% CI -1.03 to -0.14, p=0.012) in the bicycling group compared to the control group. Cardiorespiratory fitness (l O(2)/min) per se did not increase significantly more in the intervention than in the control group (β=0.0337, 95% CI -0.06 to 0.12, p=0.458).

CONCLUSIONS

Bicycling to school counteracted a clustering of cardiometabolic risk factors and should thus be recognised as potential prevention of type 2 diabetes mellitus and cardiovascular disease (CVD). The intervention did, however, not elicit a larger increase in cardiorespiratory fitness in the intervention group as compared with the control group.

TRIAL REGISTRATION

Registered at http://www.clinicaltrials.gov (NCT01236222).

On your bike! a cross-sectional study of the individual, social and environmental correlates of cycling to school

Background

Active school transport (AST) has declined rapidly in recent decades. While many studies have examined walking, cycling to school has received very little attention. Correlates of cycling are likely to differ to those from walking and cycling enables AST from further distances. This study examined individual, social and environmental factors associated with cycling to school among elementary school-aged children, stratified by gender.

Methods

Children (n = 1197) attending 25 Australian primary schools located in high or low walkable neighborhoods, completed a one-week travel diary and a parent/child questionnaire on travel habits and attitudes.

Results

Overall, 31.2% of boys and 14.6% of girls cycled ≥ 1 trip/week, however 59.4% of boys and 36.7% of girls reported cycling as their preferred school transport mode. In boys (but not girls), school neighborhood design was significantly associated with cycling: i.e., boys attending schools in neighborhoods with high connectivity and low traffic were 5.58 times more likely to cycle (95% CI 1.11-27.96) and for each kilometer boys lived from school the odds of cycling reduced by 0.70 (95% CI 0.63-0.99). Irrespective of gender, cycling to school was associated with parental confidence in their child's cycling ability (boys: OR 10.39; 95% CI 3.79-28.48; girls: OR 4.03; 95% CI 2.02-8.05), parental perceived convenience of driving (boys: OR 0.42; 95% CI 0.23-0.74; girls: OR 0.40; 95% CI 0.20-0.82); and child's preference to cycle (boys: OR 5.68; 95% CI 3.23-9.98; girls: OR 3.73; 95% CI 2.26-6.17).

Conclusion

School proximity, street network connectivity and traffic exposure in school neighborhoods was associated with boys (but not girls) cycling to school. Irrespective of gender, parents need to be confident in their child's cycling ability and must prioritize cycling over driving.

Physical activity is inversely associated with high blood pressure independently of overweight in Brazilian adolescents

The purpose of this study was to assess the relationship between blood pressure (BP) levels and physical activity (PA) domains accounting for overweight/obesity. Adolescents aged 10 to 17 years old were recruited (n = 1021). International Obesity Task Force (IOTF) criteria were used to define overweight and obesity. High BP was defined using the Center of Disease Control and Prevention criteria. Different domains of PA (school activities, sport out of school, and leisure time PA) were assessed using a validated questionnaire. The prevalence of overweight/obesity was 21.9% for boys and 14.8% for girls. Some 13.4% of boys and 10.2% of girls, respectively, had high blood pressure (HBP). A strong and positive association was found between overweight and HBP. After adjustment for body mass index (BMI), total PA was inversely associated with BP. When all PA domains were entered simultaneously in a regression model, and after adjustment for BMI, only sport out of school was significantly and inversely associated with systolic BP [β: -0.82 (-1.50; -0.13)]. These findings open avenue for the early prevention of HBP by the prevention of obesity and promotion of PA.

Longitudinal associations between cycling to school and weight status

OBJECTIVE

The objective of the present study was to assess the longitudinal association between cycling to school and weight status in two cities where cycling to school is common - Kristiansand (Norway) and Rotterdam (The Netherlands).

METHODS

Data from two studies ENDORSE (Rotterdam) and YOUTH IN BALANCE (Kristiansand) were used. Both studies were longitudinal with two years between time (T) 1 and T2 measurements, and with mean age at T1 of 13.2 and 13.4 years, respectively. The sample was categorized into the following groups according to responses about main mode of commuting to school at the two time points: NO cycling, STARTED cycling, STOPPED cycling and CONTINUED cycling. Measured weight and height were obtained at both time points, and weight status (overweight vs. not overweight) was calculated using international classification criteria for BMI. The two datasets were analyzed separately and together.

RESULTS

In multilevel logistic regression models of the combined sample, adjusting for weight status at Time 1, those who stopped cycling had greater odds of being overweight at T2 (OR = 3.19; 95% CI = 1.41?7.24) while those continued cycling had lower odds of being overweight (OR = 0.44; 95% CI = 0.21?0.88), separately compared to the other three groups together. The same trend was observed in both study samples.

CONCLUSIONS

This study shows that there are longitudinal associations between cycling to school and weight status in two cities where cycling to school is common, implying that interventions aiming at reducing overweight/obesity among adolescents might consider the promotion of sustained cycling behaviour.