Impact of Physical Activity on Obesity and Health

Overview:

The Journal of the American Medical Association reports that in 2003-2004, 17.1 percent of US children and adolescents were overweight, with the rates continuing to increase. These children are at an increased risk for developing health problems such as heart disease, diabetes, cancer, and hypertension. Activity levels for many children have declined because of a built environment that is unsafe for walking and bicycling, the low percentage of children who take physical education in school, and the popularity of sedentary leisure-time activities.

Using Safe Routes to School as way to create environment, policy, and behavioral changes is one way to increase physical activity and promote the health of both children and adults. This section highlights academic literature that speaks to the overall health benefits of physical activity, specifically walking to and from school, as well as the impact that increased physical activity opportunities have on current obesity and health trends in the US. The implications of this research are valuable as they guide policy-makers and practitioners to implement effective strategies for improving physical activity opportunities and overall health.

Research Highlights:

  • Walking and bicycling are far more common in European countries than in the United States, Australia, and Canada, where active transportation is inversely related to obesity (Bassett, et al., 2008).
  • Research demonstrates that children who walk or bicycle to school have higher daily levels of physical activity and better cardiovascular fitness than do children who do not actively commute to school (Davison, et al., 2008).
  • Two small lifestyle changes in diet (to eliminate 100 kcal/day) and physical activity (to walk an additional 2000 steps/day) could be useful for addressing childhood obesity by preventing excess weight gain in families (Hill, et al., 2007)
  • Consistent behavioral changes averaging 110 to 165 kcal/day may be sufficient to counterbalance the energy gap resulting in excessive weight gain (Wang, et al., 2006).
  • In one study, researchers report that 100% of the students that walk both to and from school accumulate an average of 60 or more minutes of MVPA on weekdays (Alexander, et al., 2005)
  • One study suggests that a 5% increase in neighborhood walkability is associated with 32.1% more minutes devoted to physically active travel and about one-quarter point lower BMI (0.228) (Frank, et al., 2006).
  • Also available is our short fact sheet on the research linking Safe Routes to School to increases in physical activity.

See 2011 Archived Articles
See 2010 Archived Articles
See 2009 Archived Articles
See 2008 and Earlier Archived Articles

Academic Research Articles and Findings:

“Health implications of transport planning, development and operations” (2014)

  • This paper is an overview of impacts of transport on health for transport researchers and practitioners not familiar with them.
  • Transport is linked to physical ill-health, mental illness and stress, inequality and associated health outcomes, and safe road environments.
  • Health Impact Assessment (HIA) is recommended as a method to maximise benefits and mitigate disbenefits of transport schemes and policies.
  • The links between transport and health are well documented, but the extent of these benefits and disbenefits is not widely understood by non-health professionals. Additionally, there are less obvious, indirect ways in which transport and health are linked.
  • This paper provides a broad overview of the literature, compiling empirical evidence that describes, and where possible quantifies, the health effects of transport planning for the reference of transport professionals.
  • The paper makes the case for considering health alongside the environment when assessing a policy or development's sustainability, and provides empirical evidence to assist transport professionals in considering benefits or disbenefits involved.

Judith M. Cohena, Sadie Bonifaceb, Stephen Watkinsc. (2014). Health implications of transport planning, development and operations. Journal of Transport & Health(4 Feb 2014). 

”Prevalence of Childhood and Adult Obesity in the United States, 2011-2012” (2014)

 

  • More than one-third of adults and 17% of youth in the United States are obese, although the prevalence remained stable between 2003-2004 and 2009-2010.
  • The study’s objective was to provide the most recent national estimates of childhood obesity, analyze trends in childhood obesity between 2003 and 2012, and provide detailed obesity trend analyses among adults.
  • Weight and height or recumbent length were measured in 9120 participants in the 2011-2012 nationally representative National Health and Nutrition Examination Survey.
  • In 2011-2012, 8.1% (95% CI, 5.8%-11.1%) of infants and toddlers had high weight for recumbent length, and 16.9% (95% CI, 14.9%-19.2%) of 2- to 19-year-olds and 34.9% (95% CI, 32.0%-37.9%) of adults (age-adjusted) aged 20 years or older were obese.
  • Overall, there was no significant change from 2003-2004 through 2011-2012 in high weight for recumbent length among infants and toddlers, obesity in 2- to 19-year-olds, or obesity in adults. Tests for an interaction between survey period and age found an interaction in children (P = .03) and women (P = .02).
  • There was a significant decrease in obesity among 2- to 5-year-old children (from 13.9% to 8.4%; P = .03) and a significant increase in obesity among women aged 60 years and older (from 31.5% to 38.1%; P = .006).
  • Overall, there have been no significant changes in obesity prevalence in youth or adults between 2003-2004 and 2011-2012. Obesity prevalence remains high and thus it is important to continue surveillance.

Cynthia L. Ogden, PhD1; Margaret D. Carroll, MSPH1; Brian K. Kit, MD, MPH1,2; Katherine M. Flegal, PhD1. (2014). Prevalence of Childhood and Adult Obesity in the United States, 2011-2012. JAMA,, 311(8), 806-814. doi: 10.1001/jama:.2014.732.

Trends in physical activity, sedentary behavior, diet, and BMI among US adolescents, 2001-2009 (2013)

  • The high prevalence of adolescent obesity in the United States has been attributed to population changes in physical activity (PA), sedentary behaviors, and dietary behaviors. This study examines 8-year trends in these behaviors in US adolescents ages 11 to 16.
  • Nationally representative samples of US students in grades 6 to 10 were recruited during the 2001-2002 (N = 14607), 2005-2006 (N = 9150), and 2009-2010 (N = 10848) school years by using multistage stratified designs, with census regions and grades as strata, and school districts as the primary sampling units. African-American and Hispanic students were oversampled to obtain better estimates for those groups. Using the Health Behavior in School-aged Children quadrennial surveys, identical questions assessed BMI, PA, and sedentary and dietary behaviors at each school year. Logistic and linear regression analyses were conducted taking into account the sampling design and controlling for age, gender, race/ethnicity, and family affluence.
  • Across the quadrennial surveys, significant increases were identified in number of days with at least 60 minutes of PA, daily consumption of fruits and vegetables, eating breakfast on weekdays and weekends, and BMI. Television viewing and consumption of sweets and sweetened beverages decreased across this same period. These same patterns were seen in all racial/ethnic groups.
  • These patterns suggest that public health efforts to improve the obesity-related behaviors of US adolescents may be having some success. However, alternative explanations for the increase in BMI over the same period need to be considered.

Iannotti RJ, Wang J. (2013). Trends in physical activity, sedentary behavior, diet, and BMI among US adolescents, 2001-2009. Pediatrics, 132(4), 606-614. doi: 10.1542/peds.

Physical fitness, academic achievement, and socioeconomic status in school-aged youth” (2013)

  • This study examined the association between physical fitness and academic achievement and determined the influence of socioeconomic status (SES) on the association between fitness and academic achievement in school-aged youth.
  • Overall, 1,701 third-, sixth-, and ninth-grade students from 5 school districts participated in the assessments. Fitness was assessed using FITNESSGRAM (aerobic fitness, muscular strength, muscular endurance, flexibility, and body composition). Results were used to determine individual fitness scores. Academic achievement was measured by standardized tests for Math (all grades), English (all grades), and Social Studies (sixth and ninth grades only). The SES was determined using eligibility for free and reduced lunch program.
  • There were no significant differences between fitness groups for Math and English in third-grade students. Sixth- and ninth-grade students with high fitness scored significantly better on Math and Social Studies tests compared with less fit students. Lower SES students scored significantly worse on all tests. Muscular strength and muscular endurance were significantly associated with academic achievement in all grades.
  • Compared with all other variables, SES appears to have the strongest association with academic achievement. However, it also appears that high fitness levels are positively associated with academic achievement in school-aged youth.

Coe DP, Peterson T, Blair C, Schutten MC, Peddie H. (2013). Physical fitness, academic achievement, and socioeconomic status in school-aged youth. J Sch Health, 83(7), 500-507. doi: 10.1111/josh

“Business Performance in Walkable Shopping Areas” (2013)

  • The study consisted of a meta-analysis of 70 studies and articles. However, as there have been few studies that address economic performance directly, the author also conducted an exploratory study of 15 walkable shopping areas judged as successful to examine the sources of success.
  • This literature review shows there is great enthusiasm for walkable shopping areas among retail experts, developers and many residents of urban and suburban areas. They have a potential to prosper as a result of demographics, increased gas prices, public policies encouraging higher densities and changing life style preferences. Businesses can be successful if such areas reach a critical mass, cater to diverse needs, are located in higher density areas or have good mass transit service, and have a supermarket as an anchor. With success, enterprises in walkable shopping areas are able to pay higher rents for their space, and housing near walkable commercial areas commonly sells for higher prices than in more distant areas.
  • While the economic performance of walkable shopping areas is worthy of continued empirical research, including interviewing merchants, all the evidence seems to suggest that walkable retail is on the upswing, and likely to grow over the next several decades. Since 45% of daily trips, on average, are made for shopping and running errands, encouraging walking is an important strategy in reducing obesity and improving health. It is also important to reducing energy usage and carbon emissions.

Hack, G. (2013). Business Performance in Walkable Shopping Areas. Princeton, NJ: Active Living Research, a National Program of the Robert Wood Johnson Foundation.

“Educating the student body: Taking physical activity and physical education to school.” (2013)

  • This downloadable report from the Institute of Medicine is a compilation of information around increasing physical activity in K-12 schools.
  • The report is the product of the IOM’s Committee on Physical Activity and Physical Education in the School Environment, which was formed to review the current status of physical activity and physical education in the school environment and to examine the influences of physical activity and physical education on the short- and long-term physical, cognitive and brain, and psychosocial health and development of children and adolescents.
  • The report includes a great deal of evidence about the impacts of physical activity on children’s health and academic performance.
  • The report also concludes with a chapter of recommendations, that is inclusive of many areas supportive of Safe Routes to School, including shared use agreements to open school facilities to the communities, school siting policies that encourage locating schools within neighborhoods, and ensuring safe active travel routes for students.

National Research Council. Educating the Student Body: Taking Physical Activity and Physical Education to School. Washington, DC: The National Academies Press, 2013.

"Possible Mechanisms Explaining the Association Between Physical Activity and Mental Health: Findings From the 2001 Dutch Health Behaviour in School-Aged Children Survey" (2013)

  • More physical activity is associated with fewer mental health problems among adolescents, but the underlying mechanisms are not clear. The aim of this article is to investigate whether the association between physical activity and mental health is mediated by body-weight perception (self-image) or the social aspects of participation in organized sports (social interaction).
  • Data from 7,304 adolescents were drawn from the Dutch Health Behaviour in School-Aged Children survey. Logistic regression analyses showed that, compared with respondents who were physically active, inactive respondents were at higher risk for both internalizing (odds ratio [OR] = 1.52, p < .001) and externalizing (OR = 1.34, p < .05) problems. The inclusion of body- weight perception and sports-club membership variables reduced the strength of the association to an OR of 1.35 (p < .05) for internalizing problems and an OR of 1.20 (p = .132) for externalizing problems.
  • This study found some support for the self-image and social interaction hypotheses and thereby confirms the importance of the psychological and sociological aspects of physical activity.

Karin Monshouwer, Margreet ten Have, Mireille van Poppel, Han Kemper, and Wilma Vollebergh. (2013). Possible Mechanisms Explaining the Association Between Physical Activity and Mental Health: Findings From the 2001 Dutch Health Behaviour in School-Aged Children Survey. Clinical Psychological Science, 1(January), 67-74. doi: 10.1177/2167702612450485

Obesity Prevention Programs: Comparative Effectiveness Review and Meta-Analysis

  • Researchers assessed the effectiveness of childhood obesity prevention programs by reviewing all interventional studies that aimed to improve diet, physical activity, or both and that were conducted in schools, homes, primary care clinics, childcare settings, the community, or combinations of these settings in high-income countries, as well as consumer health informatics interventions. Researchers compared the effects of the interventions on weight-related outcomes (e.g., body mass index [BMI], waist circumference, percent body fat, skinfold thickness, prevalence of obesity and overweight); intermediate outcomes (e.g., diet, physical activity); and obesity-related clinical outcomes (e.g., blood pressure, blood lipids).
  • Researchers included 131 articles describing 124 interventional studies. The majority of the interventions (104 studies) were school based, although many of them included components delivered in other settings. Most were conducted in the United States and in the past decade.
  • Conclusions:  The evidence is moderate about the effectiveness of school-based interventions for childhood obesity prevention. Physical activity interventions in a school-based setting with a family component or diet and physical activity interventions in a school-based setting with home and community components have the most evidence for effectiveness. More research is needed to test interventions in other settings, such as those testing policy, environmental, and consumer health informatics strategies.
  • This extensive review and meta-analysis was carefully executed then reviewed by a panel of experts.  Their conclusions support the SRTS program strategy of physical activity through active travel as a school based program with home and community components being part of one of the most effective prevention strategies for pediatric obesity.

Youfa Wang, M.D., Ph.D. Yang Wu, M.S., Renee F. Wilson, M.S. Sara Bleich, Ph.D., Larry Cheskin, M.D., Christine Weston, Ph.D., Nakiya Showell, M.D., M.P.H. Oluwakemi Fawole, M.D., M.P.H. Brandyn Lau, M.P.H., & Jodi Segal, M.D., M.P.H. (2013). Childhood Obesity Prevention Programs: Comparative Effectiveness Review and Meta-Analysis. In M. Johns Hopkins University Evidence-based Practice Center Baltimore (Ed.), (Comparative Effectiveness Review No. 115. (Prepared by the Johns Hopkins University Evidence-based Practice Center under Contract No. 290-2007-10061-I.) AHRQ Publication No. 13-EHC081-EF. Rockville, MD: Agency for Healthcare Research and Quality; June 2013.

Cardiometabolic Risk Factors in Children: The Importance of Physical Activity

  • Considerable evidence has accrued that cardiovascular disease (CVD) has its beginnings during childhood, with some reports of endothelial damage occurring in early adolescence. Thus, early prevention and intervention on developing cardiometabolic risk factors is important.
  • Presently, diet and exercise are strategic parts of any CVD prevention or treatment program. Although diet is important, the effects of exercise training or regular moderate-to-vigorous intensity physical activity go beyond simply modifying the traditional risk factors.
  • For children, the majority of studies show that regular physical activity can lower elevated blood pressure, positively influence lipid profiles, reduce inflammation, and improve vascular functioning. These changes are most evident in children who exercise and lose weight.
  • Despite these potential benefits of physical activity, not all studies on children have found positive effects of habitual physical activity on CVD risk factors. Reasons for these differences are discussed throughout this review. The literature also suggests that habitual physical activity, although meeting guidelines may not be sufficient for all individuals to bring about changes; thus, to be an effective modality physical activity needs to increase beyond habitual levels or be of a moderate to vigorous intensity.
  • This review provides recent evidence (since 2008) regarding the influence of physical activity on the cardiometabolic risk factors in children.

Robert G. McMurray, PhD, & Kristin S. Ondrak, PhD. (2013). Cardiometabolic Risk Factors in Children: The Importance of Physical Activity. Am J Lifestyle Med, 7(3), 292-303. doi: 10.1177/1559827613481429

Childhood obesity task forces established by state legislatures

  • States and communities are considering policy and environmental strategies, including enacting legislation, to reduce and prevent childhood obesity. One legislative approach has been to create task forces to understand key issues and develop a course of action. The goal of this study was to describe state-level, childhood obesity task forces in the United States created by legislation from 2001 through 2010.
  • Researchers used the Center for Disease Control and Prevention's Division of Nutrition, Physical Activity, and Obesity database to identify state-level childhood obesity task forces created through legislation from 2001 through 2010.
  • They identified 21 states that had enacted legislation creating childhood obesity task forces of which 6 had created more than one task force. Most task forces were charged with both gathering and reviewing information and making recommendations for obesity-prevention actions in the state. Most legislation required that task forces include representation from the state legislature, state agencies, community organizations, and community members.
  • CONCLUSION:  Evaluation of the effectiveness of obesity-prevention task forces and the primary components that contribute to their success may help to determine the advantages of the use of such strategies in obesity prevention.  

May AL, Kim SA, Sherry B, Blanck HM. (2013). Childhood obesity task forces established by state legislatures, 2001-2010. Prev Chronic Dis., 10(E144). doi: 10.5888/pcd10.120153

Lifestyle Approach for Increasing Physical Activity in Youth

Summary:

  • Although physical activity (PA) provides children with various health benefits, many children do not engage in regular PA.
  • This commentary recommends that health care professionals can effectively encourage children and their families to participate in more PA through lifestyle changes.
  • The strategies that clinicians can employ to promote PA are discussed in this article, including encouraging health care professionals to include the entire family, support lifestyle physical activity (such as walking or biking to school), promote self-efficacy, and encourage self-monitoring.

Craig A. Johnston, PhD, & Maria A. Papaioannou, BS. (2013). Lifestyle Approach for Increasing Physical Activity in Youth. Am J Lifestyle Med, 7(5), 307-309.

Trends in Physical Activity, Sedentary Behavior, Diet, and BMI Among US Adolescents, 2001–2009

  •  The high prevalence of adolescent obesity in the United States has been attributed to population changes in physical activity (PA), sedentary behaviors, and dietary behaviors. This study examines 8-year trends in these behaviors in US adolescents ages 11 to 16.
  • Nationally representative samples of US students in grades 6 to 10 were recruited during the 2001–2002 (N = 14 607), 2005–2006 (N = 9150), and 2009–2010 (N = 10 848) school years by using multistage stratified designs, with census regions and grades as strata, and school districts as the primary sampling units. African-American and Hispanic students were oversampled to obtain better estimates for those groups.
  • Using the Health Behavior in School-aged Children quadrennial surveys, identical questions assessed BMI, PA, and sedentary and dietary behaviors at each school year. Logistic and linear regression analyses were conducted taking into account the sampling design and controlling for age, gender, race/ethnicity, and family affluence.
  • RESULTS: Across the quadrennial surveys, significant increases were identified in number of days with at least 60 minutes of PA, daily consumption of fruits and vegetables, eating breakfast on weekdays and weekends, and BMI. Television viewing and consumption of sweets and sweetened beverages decreased across this same period. These same patterns were seen in all racial/ethnic groups.
  • CONCLUSIONS: These patterns suggest that public health efforts to improve the obesity-related behaviors of US adolescents may be having some success. However, alternative explanations for the increase in BMI over the same period need to be considered.

Ronald J. Iannotti, PhD and Jing Wang, PhD. (2013). Trends in Physical Activity, Sedentary Behavior, Diet, and BMI Among US Adolescents, 2001–2009. Pediatrics, 132(4), 606-614. doi: 10.1542/peds.2013-1488

Evaluation of School Transportation Patterns and the Associated Impact on BMI in 2 Midwestern Communities

  • The decline in active commuting to and from school in the United States is, in part, due to urban design standards and public policies that promote automobile travel and discourage pedestrian activity.
  • The study examines active commuting at neighborhood schools and how it is altered by distance to school, student age and its potential impact on Body Mass Index.
  • Methods: Demographic and transportation datasets were obtained for 5367 elementary students (K-5th grade) and middle school students (6th-8th grade) in 2 Midwestern communities.
  • Results:
  1. 4379 (81.6%) students were successfully geocoded and 21.9% actively commute to school at least half of the time meeting the Healthy People 2010 objective 22-14.
  2. Of those students who could potentially actively commute to school (0.5 mile for grades K-5 and 1 mile for grades 6-8) 36.6% are passive commuters.
  3. No significant negative associations were found between BMI z-score or BMI percentile with accumulation of activity through active commuting (frequency × distance) for elementary (r = -0.04, P = .27) or middle school students (r = .027, P = .56).
  • Conclusion: Many elementary students living within 0.3-0.4 miles are being driven to school. Promoting pedestrian-friendly communities and making healthy and sustainable transportation choices should be priorities for community leaders and school administrators.

Heelan K, Combs HJ, Abbey BM, Burger P, Bartee T. . (2013). Evaluation of School Transportation Patterns and the Associated Impact on BMI in 2 Midwestern Communities. J Phys Act Health, 10(5), 632-640. 

Behaviors Related to Physical Activity and Nutrition Among U.S. High School Students

  • Purpose:   National data related to physical activity (PA) and nutrition among adolescents are needed to help develop effective obesity prevention programs. The 2010 National Youth Physical Activity and Nutrition Study (NYPANS) was conducted to provide nationally representative data on behaviors and behavioral correlates related to healthy eating and PA.
  • Methods:   NYPANS used a three-stage cluster sample design to obtain data representative of public- and private-school students in grades 9 through 12 in the United States (n= 11,429). Students completed an anonymous, self-administered questionnaire in their classrooms during a regular class period. Trained data collectors directly measured the students’ height and weight at school using a standard protocol.
  • Results: Analyses revealed that 19.0% of students were obese and 17.8% were overweight. Students participated in a range of physical activities during the 12 months before the survey; prevalence ranged from 5.0% for ice hockey to 83.9% for walking. In addition, 52.5% of students enjoyed the physical education classes they took at school. During the 7 days before the survey, 74.8% of students ate at least one meal or snack from a fast food restaurant, with black students more likely than white and Hispanic students to have done so. Forty-one percent of students always or most of the time have a TV on while eating dinner at home.
  • Conclusions:   These and other NYPANS results can be used to develop obesity prevention programs that address specific behaviors and behavioral correlates, and target subgroups in which behaviors and behavioral correlates related to obesity are most prevalent.

Nancy D. Brener, Ph.D. a, *, Danice K. Eaton, Ph.D. b, Laura K. Kann, Ph.D. a, Tim S. McManus, M.S. a, Sarah M. Lee, Ph.D. c, Kelley S. Scanlon, Ph.D., R.D. d, Janet E. Fulton, Ph.D. d, and Terry P. O’Toole, Ph.D. d. (2013). Behaviors Related to Physical Activity and Nutrition Among U.S. High School Students. Journal of Adolescent Health, 1e8.

Tracking Physical Activity and Sedentary Behavior in Childhood (2013)

  • To date, no reviews have investigated the evidence of tracking of physical activity and sedentary behavior specifically during early childhood (aged 0–5.9 years) or from early childhood to middle childhood (aged 6–12 years). It is important to review the evidence of tracking of these behaviors to determine their stability during the foundational early years of life.
  • A literature search of studies was conducted in seven electronic databases (January 1980 to April 2012). Studies were compared on methodologic quality and evidence of tracking of physical activity or sedentary behavior. Tracking was defined as the stability (or relative ranking within a cohort) of behaviors, such as physical activity and sedentary behavior, over time.
  • Eleven studies met the inclusion criteria. All studies reporting physical activity outcomes had high methodologic quality; 71% of studies reporting sedentary behavior outcomes had high methodologic quality. Of the tracking coefficients for physical activity, 4% were large, 60% were moderate, and 36% were small. Of the tracking coefficients for sedentary behavior, 33% were large, 50% were moderate, and 17% were small. Overall, there was evidence of moderate tracking of physical activity during early childhood, and from early childhood to middle childhood, and of moderate-to-large tracking of sedentary behavior during early childhood and from early childhood to middle childhood.
  • This review highlights the importance of establishing recommended levels of physical activity and sedentary behavior during the early years of life. Based on this review, the following recommendations are made: (1) early childhood should be targeted as a critical time to promote healthy lifestyle behaviors through methodologically sound prevention studies; and (2) future tracking studies should assess a broad range of sedentary behaviors using objective measures.

The first recommendation aligns well with the Safe Routes to School mission and practice.

Jones, Rachel A., PhD. Trina Hinkley, PhD. Anthony D. Okely, EdD. Jo Salmon, PhD. (2013). Tracking Physical Activity and Sedentary Behavior in Childhood: A Systematic Review. American Journal of Preventive Medicine, 44(6), 651-658.

Active Travel and Physical Activity across the School Transition: the PEACH Project (2012)

  • Physical activity in youth decreases with age, with the transition from primary to secondary school being a key period for change. Active travel to school has been associated with higher physical activity in youth compared with those who travel by car. This study investigated whether change in travel mode to/from school was associated with change in physical activity among young people transitioning from primary to secondary school.
  • One thousand three hundred and seven final year UK primary school children (11.0 ± 0.4 yr) were recruited, of whom 953 (72.9%) were followed-up 1 year later in their first year of secondary school. Physical activity was measured by accelerometer, and travel mode to/from school was self-reported. Change in moderate-to-vigorous physical activity (MVPA) associated with change in travel mode between primary and secondary school was measured in 500 children who provided valid accelerometer data and used a consistent travel mode to/from school at each time point.
  • Total MVPA was slightly higher in secondary school than primary school (60.6 ± 21.6 vs. 63.1 ± 23.6 min, respectively, P = 0.017). Daily MVPA increased by 11.4% in children who walked both to primary and secondary school (63.4 ± 22.0 vs. 70.6 ± 23.0 min, P < 0.001). In those who changed from walking to car travel, MVPA decreased by 15.5% (62.5 ± 22.0 vs. 52.8 ± 21.5 min, P = 0.003), whereas adoption of bus travel was associated with smaller reductions. A change from car travel to walking was associated with 16.1% more daily MVPA (50.1 ± 14.3 vs. 58.2 ± 20.6 min, P = 0.038).
  • Change from active to passive transportation to school may contribute to the decline in physical activity seen between primary and secondary school.

Cooper, A. R., Jago, R., Southward, E. F., & Page, A. S. (2012). Active Travel and Physical Activity across the School Transition: the PEACH Project. Medicine & Science in Sports & Exercise, 44(10), 1890-1897. doi: 10.1249/MSS.0b013e31825a3a1e 

Annual Motor Vehicle Travel Distance and Incident Obesity: A Prospective Cohort Study (2013)   

  • Obesity has become a major health and economic problem with increasing prevalence. Unfortunately, no country can act as public health exemplar for reduction of obesity. The fınding of associations between sedentary behaviors and obesity, independent of the level of physical activity, may offer new insights.
  • This study was a prospective evaluation of the relationship between annual distance traveled by motor vehicles and subsequent incidence of overweight or obesity in a Mediterranean cohort.
  • Data from a prospective cohort study (Seguimiento Universidad de Navarra Project, 1999 –2011) with a permanently open recruitment were analyzed. Self-administered questionnaires are mailed every 2 years, collecting information on dietary habits, lifestyle, risk factors, and medical conditions. Annual kilometers traveled by motor vehicles were grouped into three categories (<10,000; >10,000 to <20,000; and >20,000). Multivariate Cox regression analyses were used to assess the risk of overweight or obesity across categories of distance traveled annually.
  • In all, 9160 participants (58% female, average age 37 years) were followed up for a median of 6.4 years. During 39,175 person-years of follow-up, 1044 (15.3%) normal-weight participants at baseline became overweight or obese. Among participants who did not change their category of annual kilometers traveled during follow-up, an increased risk of overweight or obesity in the highest category of annual kilometers traveled was observed, compared with the lowest one (hazard ratio = 1.4, 95% CI=1.1, 1.7).
  • This study suggests a potential pernicious effect of the use of motor vehicles on the risk of overweight or obesity.

Nunez-Cordoba JM, Bes-Rastrallo M, Pollack KM, Segui-Gomez M, Beunza JJ, Syon-Orea C, Martinez-Gonzales MA. (2013).Annual motor vehicle travel distance and incident obesity: a prospective cohort study. American Journal of Preventive Medicine. 44(3), 254-259.

"Leveraging the Health Benefits of Active Transportation: Creating an Actionable Agenda for Transportation Professionals" (2012)

  • The authors are researchers at the University of North Carolina Highway Safety Research Center, Chapel Hil, North Carolina.  They provide a review of the health benefits of active transportation as a call to transportation planners to include health in the agenda for transportation planning, funding, and engineering considerations. 
  • They list many useful active transportation references (from TRB, Sustainable Communities Partnership, Federal Highway Administration, APHA, and the World Health Organization) and comment on the increasing dialog between the transportation and public health communities, highlighted by the formation of a new Health and Transportation Subcommittee of the TRB which will address active transportation and interface with other key groups such as the American Public Health Association’s Transportation, Health, and Equity Program.
  • The Center for Disease Control and Prevention (CDC) convened an expert panel: Measuring Walking and Cycling for Transportation in Feb 2012.  This meeting included representatives from state, local, and federal transportation agencies, and academia, including experts in public health, planning, environmental science, engineering and transportation.  The report of this meeting will be made availabe to the public.
  • Issues covered in the article overview include: benefits of walking and biking, addressing barriers, environments and facilities, connecting with transit, partnering with other agencies, and collaborative endeavors.

Sandt L, Pullen-Seufert N, Lejeunesse S Gelinne D. (2012). Leveraging the Health Benefits of Active Transportation:  Creating an Actionable Agenda for Transportation Professionals. TR News, May/June(280), 18-25.

“Effects of Locomotor Skill Program on Minority Preschoolers’ Physical Activity Levels” (2012)

  • This pilot study examined the effects of a teacher-taught, locomotor skill (LMS)-based physical activity (PA) program on the LMS and PA levels of minority preschooler-aged children.
  • Eight low-socioeconomic status preschool classrooms were randomized into LMS-PA (LMS-oriented lesson plans) or control group (supervised free playtime). Interventions were delivered for 30 min/day, five days/week for six months. Changes in PA (accelerometer) and LMS variables were assessed with MANCOVA.
  • LMS-PA group exhibited a significant reduction in during-preschool and total daily percent time spent in sedentary activity. LMS-PA group also exhibited significant improvement in leaping skills. No other, significant changes were observed. The implementation of a teacher-taught, LMS-based PA program could potentially improve LMS and reduce sedentary time of minority preschoolers.

Alhassan, S., O. Nwaokelemeh, et al. (2012). "Effects of locomotor skill program on minority preschoolers' physical activity levels." Pediatric Exercise Science 24(3): 435-449.

"Unwalkable Neighborhoods, Poverty, and the Risk of Diabetes Among Recent Immigrants to Canada Compared With Long-Term Residents” (2012)

  • This study was designed to examine whether residents living in neighborhoods that are less conducive to walking or other physical activities are more likely to develop diabetes and, if so, whether recent immigrants are particularly susceptible to such effects.
  • The authors conducted a population-based, retrospective cohort study to assess the impact of neighborhood walkability on diabetes incidence among recent immigrants (n = 214,882) relative to long-term residents (n = 1,024,380). Adults aged 30–64 years who were free of diabetes and living in Toronto, Canada, on March 31, 2005 were identified from administrative health databases and followed until March 31, 2010 for the development of diabetes, using a validated algorithm. Neighborhood characteristics, including walkability and income, were derived from the Canadian Census and other sources.
  • Neighborhood walkability was a strong predictor of diabetes incidence independent of age and area income, particularly among recent. Coexisting poverty accentuated these effects; diabetes incidence varied threefold between recent immigrants living in low-income/low walkability areas (16.2 per 1,000) and those living in high-income/high walkability areas (5.1 per 1,000).
  • Neighborhood walkability was inversely associated with the development of diabetes in our setting, particularly among recent immigrants living in low-income areas.

Booth, G. L., M. I. Creatore, et al. (2012). Unwalkable Neighborhoods, Poverty, and the Risk of Diabetes Among Recent Immigrants to Canada Compared With Long-Term Residents. Diabetes Care.

“Population Approaches to Improve Diet, Physical Activity, and Smoking Habits: A Scientific Statement From the American Heart Association” (2012)

  • Poor lifestyle behaviors, including suboptimal diet, physical inactivity, and tobacco use, are leading causes of preventable diseases globally. Although even modest population shifts in risk substantially alter health outcomes, the optimal population-level approaches to improve lifestyle are not well established.
  • In this paper, the authors systematically reviewed and graded the current scientific evidence for effective population approaches to improve dietary habits, increase physical activity, and reduce tobacco use.
  • Strategies were considered in 6 broad domains: (1) Media and educational campaigns; (2) labeling and consumer information; (3) taxation, subsidies, and other economic incentives; (4) school and workplace approaches; (5) local environmental changes; and (6) direct restrictions and mandates. The writing group also reviewed the potential contributions of healthcare systems and surveillance systems to behavior change efforts.
  • Several specific population interventions were identified, providing a set of specific evidence-based strategies that deserve close attention and prioritization for wider implementation. School-related interventions included increased availability and types of school playground spaces and equipment, increased number of PE classes, and revised PE curricula to increase time in at least moderate activity.
  • This systematic review identified and graded the evidence for a range of population-based strategies to promote lifestyle change. The findings provide a framework for policy makers, advocacy groups, researchers, clinicians, communities, and other stakeholders to understand and implement the most effective approaches. New strategic initiatives and partnerships are needed to translate this evidence into action.

Mozaffarian, D., A. Afshin, et al. (2012). Population Approaches to Improve Diet, Physical Activity, and Smoking Habits A Scientific Statement From the American Heart Association. Circulation 126(12):1514-1563.

“Does The Effect of a School Recess Intervention on Physical Activity Vary by Gender Or Race? Results from the Ready for Recess Pilot Study” (2012)

  • The recess environment in schools has been identified as an integral part of school-based programs to enhance physical activity (PA). The purpose of this study was to report pilot findings on the extent to which the Ready for Recess intervention was associated with a different amount of increase in moderate to vigorous PA (MPVA) during recess and the rest of the school day between girls and boys, and between nonwhites and whites.
  • The Ready for Recess intervention modified the recess environment of schools by providing staff training and recreational equipment. The MPVA levels of 3rd, 4th, and 5th grade students (n = 93) at 2 schools were measured pre- and post-intervention using ActiGraph accelerometers. Multiple regression models with robust variance were utilized to test for the interaction of intervention with gender and race/ethnicity.
  • The intervention was associated with an adjusted increase of 4.7 minutes (P <.001) in moderate/vigorous PA during recess. There was no evidence that this effect varied by gender (P = .944) or race (P = .731). The intervention was also associated with an adjusted increase of 29.6 minutes (P < .001) in moderate/vigorous PA during rest of the school day. While this effect did not vary by gender, there was some evidence (P = .034) that nonwhites benefited more from the intervention than whites.
  • Simple strategies such as staff training and recreational equipment may be an effective way to increase PA in children (despite gender or ethnicity) during recess time as well as during the rest of the school day.

Siahpush, M., J. L. Huberty, et al. (2012). Does the Effect of a School Recess Intervention on Physical Activity Vary by Gender or Race? Results From the Ready for Recess Pilot Study. Journal of Public Health Management and Practice 18(5): 416-422.

“The Healthy Afterschool Activity and Nutrition Documentation Instrument” (2012)

  • Policies call on afterschool programs to improve the physical activity and nutrition habits of youth attending. No tool exists to assess the extent to which the afterschool program environment meets physical activity and nutrition policies.
  • This paper seeks to describe the development of the Healthy Afterschool Activity and Nutrition Documentation (HAAND) instrument, which consists of two subscales: Healthy Afterschool Program Index for Physical Activity (HAPI-PA) and the HAPI-Nutrition (HAPI-N).
  • Thirty-nine afterschool programs took part in the HAAND evaluation during fall/spring 2010-2011. Inter-rater reliability data were collected at 20 afterschool programs during a single site visit via direct observation, personal interview, and written document review. Validity of the HAPI-PA was established by comparing HAPI-PA scores to pedometer steps collected in a subsample of 934 children attending 25 of the afterschool programs. Validity of the HAPI-N scores was compared against the mean number of times/week that fruits and vegetables (FV) and whole grains were served in the program.
  • Data were analyzed in June/July 2011. Inter-rater percent agreement was 85%-100% across all items. Increased pedometer steps were associated with the presence of a written policy related to physical activity, amount/quality of staff training, use of a physical activity curriculum, and offering activities that appeal to both genders. Higher servings of FV and whole grains per week were associated with the presence of a written policy regarding the nutritional quality of snacks.
  • The HAAND instrument is a reliable and valid measurement tool that can be used to assess the physical activity and nutritional environment of afterschool programs.

Ajja, R., Beets, M.W., Huberty, J., Kaczynski, A.T., Ward, D.S. (2012). The Healthy Afterschool Activity and Nutrition Documentation Instrument. American Journal of Preventive Medicine 43(3), 263-271.

“Philadelphia School District Reports Progress in Reducing Childhood Obesity Rates” (2012)

  • Epidemic increases in obesity negatively affect the health of US children, individually and at the population level. Although surveillance of childhood obesity at the local level is challenging, height and weight data routinely collected by school districts are valuable and often underused public health resources.
  • The authors analyzed data from the School District of Philadelphia for 4 school years (2006–2007 through 2009–2010) to assess the prevalence of and trends in obesity and severe obesity among public school children.
  • The prevalence of obesity decreased from 21.5% in 2006–2007 to 20.5% in 2009–2010, and the prevalence of severe obesity decreased from 8.5% to 7.9%. Both obesity and severe obesity were more common among students in grades 6 through 8 than among children in lower grades or among high school students. Hispanic boys and African American girls had the highest prevalence of obesity and severe obesity; Asian girls had much lower rates of obesity and severe obesity than any other group. Although obesity and severe obesity declined during the 4-year period in almost all demographic groups, the decreases were generally smaller in the groups with the highest prevalence, including high school students, Hispanic males, and African American females.
  • Although these data suggest that the epidemic of childhood obesity may have begun to recede in Philadelphia, unacceptably high rates of obesity and severe obesity continue to threaten the health and futures of many school children.

Robbins JM, Mallya G, Polansky M, Schwarz DF. (2012). Prevalence, Disparities, and Trends in Obesity and Severe Obesity Among Students in the Philadelphia, Pennsylvania, School District, 2006–2010. Preventing Chronic Disease 9:120118.

“Is There an Association Between Gasoline Prices and Physical Activity? Evidence from American Time Use Data” (2012)

  • A recent paper in the economics literature finds an inverse relationship between gasoline prices and obesity risk—suggesting that increased gasoline prices via higher gasoline taxes may have the effect of reducing obesity prevalence. This study builds upon that paper.
  • This study utilizes cross-sectional time series data from the American Time Use Survey (ATUS) over 2003–2008, utilizes the increases that occurred in gasoline prices in this period due to Hurricane Katrina and to the global spike in gasoline prices as a “natural experiment,” and explores how time spent by Americans on different forms of physical activity is associated with gasoline price levels.
  • Economic theory suggests that higher gasoline prices may alter individual behavior both via a “substitution effect” whereby people seek alternatives to motorized transportation, and an “income effect” whereby the effect of higher gasoline prices on the disposable family budget leads people to make various adjustments to what they spend money on. Thus, ultimately, the relationship between gasoline prices and physical activity must be empirically determined.
  • Results from multivariate regression models with state and time fixed effects indicate that higher gasoline prices are associated with an overall increase of physical activity that is at least moderately energy intensive. The increases are most pronounced in periods where gasoline prices fluctuate more sharply and unexpectedly. These results appear robust to a number of model specifications. One of the major components of this increase appears to be an increase in housework that is at least moderately energy intensive—such as interior and exterior cleaning, garden, and yard work.
  • The results from this study tentatively suggest that there is an income effect of higher gasoline prices, or a possible increase in prices of such services when gasoline prices increase. However, the increases in physical activity associated with increased gasoline prices are weaker among minorities and low socioeconomic status (SES) individuals.
  • Hence, while a policy that increases gasoline prices via raised gasoline taxes may have benefits in terms of increasing overall physical activity levels in the United States, these benefits may not accrue to low SES individuals to the same extent as to their higher SES counterparts. This suggests that if increasing physical activity is the primary goal, then it may be more efficient to use a tax that can exert an income effect on mid-to-high SES households, such as a targeted income tax. On the other hand, if gasoline taxes are imposed to address other negative externalities of gasoline use, then these taxes may have the added benefit of increasing physical activity at least among some segments of U.S. society.

Sen, B. (2012). Is There an Association Between Gasoline Prices and Physical Activity? Evidence from American Time Use Data. Journal of Policy Analysis and Management 31(2): 338-366.

“Walking to School in Japan and Childhood Obesity Prevention: New Lessons from an Old Policy” (2012)

  • The study analyzed the Japan’s walking-to-school practice implemented in 1953 for lessons useful to other cities and countries.
  • The authors reviewed background documents (gray literature, online government information, local policy documents, and regulations) for existing regulations in several urban settings. We also contacted boards of education.
  • Each municipality has a board of education in charge of public schools, which considers the geography, climate, and the transport situation to determine the method of commuting. Because there is high availability of schools in urban areas and most are located within walking range of the children’s homes, walking is the most common method. There are different safety initiatives depending on the district’s characteristics. Parents, school staff, and local volunteers are involved in supervision.
  • The walk-to-school practice has helped combat childhood obesity by providing regular physical activity. Recommendations to cities promoting walking to school are (1) base interventions on the existing network of schools and adapt the provision to other local organizations, (2) establish safety measures, and (3) respond specifically to local characteristics. Besides the well-established safety interventions, the policy's success may also be associated with Japan's low crime rate.

Mori, N., F. Armada, et al. (2012). Walking to School in Japan and Childhood Obesity Prevention: New Lessons from an Old Policy. American Journal of Public Health: e1-e6.

The Healthy Afterschool Activity and Nutrition Documentation Instrument (2012)

  • Policies call on afterschool programs to improve the physical activity and nutrition habits of youth attending. No tool exists to assess the extent to which the afterschool program environment meets physical activity and nutrition policies.
  • This paper seeks to describe the development of the Healthy Afterschool Activity and Nutrition Documentation (HAAND) instrument, which consists of two subscales: Healthy Afterschool Program Index for Physical Activity (HAPI-PA) and the HAPI-Nutrition (HAPI-N).
  • Thirty-nine afterschool programs took part in the HAAND evaluation during fall/spring 2010-2011. Inter-rater reliability data were collected at 20 afterschool programs during a single site visit via direct observation, personal interview, and written document review. Validity of the HAPI-PA was established by comparing HAPI-PA scores to pedometer steps collected in a subsample of 934 children attending 25 of the afterschool programs. Validity of the HAPI-N scores was compared against the mean number of times/week that fruits and vegetables (FV) and whole grains were served in the program.
  • Data were analyzed in June/July 2011. Inter-rater percent agreement was 85%-100% across all items. Increased pedometer steps were associated with the presence of a written policy related to physical activity, amount/quality of staff training, use of a physical activity curriculum, and offering activities that appeal to both genders. Higher servings of FV and whole grains per week were associated with the presence of a written policy regarding the nutritional quality of snacks.
  • The HAAND instrument is a reliable and valid measurement tool that can be used to assess the physical activity and nutritional environment of afterschool programs.

Ajja, R., Beets, M.W., Huberty, J., Kaczynski, A.T., Ward, D.S. (2012). The Healthy Afterschool Activity and Nutrition Documentation Instrument. American Journal of Preventive Medicine 43(3), 263-271.

Philadelphia School District Reports Progress in Reducing Childhood Obesity Rates (2012)

  • Epidemic increases in obesity negatively affect the health of US children, individually and at the population level. Although surveillance of childhood obesity at the local level is challenging, height and weight data routinely collected by school districts are valuable and often underused public health resources.
  • The authors analyzed data from the School District of Philadelphia for 4 school years (2006–2007 through 2009–2010) to assess the prevalence of and trends in obesity and severe obesity among public school children.
  • The prevalence of obesity decreased from 21.5% in 2006–2007 to 20.5% in 2009–2010, and the prevalence of severe obesity decreased from 8.5% to 7.9%. Both obesity and severe obesity were more common among students in grades 6 through 8 than among children in lower grades or among high school students. Hispanic boys and African American girls had the highest prevalence of obesity and severe obesity; Asian girls had much lower rates of obesity and severe obesity than any other group. Although obesity and severe obesity declined during the 4-year period in almost all demographic groups, the decreases were generally smaller in the groups with the highest prevalence, including high school students, Hispanic males, and African American females.
  • Although these data suggest that the epidemic of childhood obesity may have begun to recede in Philadelphia, unacceptably high rates of obesity and severe obesity continue to threaten the health and futures of many school children.

Robbins JM, Mallya G, Polansky M, Schwarz DF. (2012). Prevalence, Disparities, and Trends in Obesity and Severe Obesity Among Students in the Philadelphia, Pennsylvania, School District, 2006–2010. Preventing Chronic Disease 9:120118.

“Cycling to School Is Associated With Lower BMI and Lower Odds of Being Overweight or Obese in a Large Population-Based Study of Danish Adolescents” (2012)

  • Previous studies have been inconclusive concerning the effect of active transport on BMI. This study investigates the association between travel mode and BMI in a large community-based sample of Danish adolescents.
  • A cross-sectional survey on health and lifestyle was distributed to all pupils from the 7th to 9th grade (12–16 years of age) in the municipality of Odense, Denmark.
  • Cycling to school was associated with 0.38 lower BMI compared to passive travelers (P = .006) after multivariable adjustment. Cycling to school was associated with 0.55 lower odds of being overweight (P < .001) and 0.30 lower (P < .001) odds of being obese compared to individuals using passive transport. Walking to school was associated with 0.65 lower odds of being overweight (P = .006). Post hoc pairwise comparisons of ethnicity revealed that adolescents of foreign ethnicity were more likely to be walkers or passive commuters (75.14% vs. 29.72%) than cyclists (24.86% vs. 70.28%; P < .001) compared to subjects of Danish ethnicity.
  • Cycling to school was associated with lower BMI and lower odds of being overweight or obese compared to passive travel in Danish adolescents, whereas walking to school was associated with lower odds of being overweight.

Østergaard L, Grøntved A, et al. (2012). “Cycling to School Is Associated With Lower BMI and Lower Odds of Being Overweight or Obese in a Large Population-Based Study of Danish Adolescents.” Journal of Physical Activity & Health 9(5): 617-25.

“Influence of Sports, Physical Education, and Active Commuting to School on Adolescent Weight Status” (2012)

  • This study compares the associations between weight status and different forms of physical activity among adolescents.
  • The authors conducted telephone surveys with 1718 New Hampshire and Vermont high school students and their parents as part of a longitudinal study of adolescent health. They surveyed adolescents about their team sports participation, other extracurricular physical activity, active commuting, physical education, recreational activity for fun, screen time, diet quality, and demographics. Overweight/obesity (BMI for age ≥ 85th percentile) and obesity (BMI for age ≥ 95 percentile) were based on self-reported height and weight.
  • Overall, 29.0% (n = 498) of the sample was overweight/obese and 13.0% (n = 223) were obese. After adjustments, sports team participation was inversely related to overweight/obesity (relative risk [RR] = 0.73 [95% confidence interval (CI): 0.61, 0.87] for >2 sports teams versus 0) and obesity (RR = 0.61 [95% CI: 0.45, 0.81] for >2 sports teams versus 0). Additionally, active commuting to school was inversely related to obesity (RR = 0.67 [95% CI: 0.45, 0.99] for >3.5 days per week versus 0). Attributable risk estimates suggest obesity prevalence would decrease by 26.1% (95% CI: 9.4%, 42.8%) if all adolescents played on 2 sports teams per year and by 22.1% (95% CI: 0.1%, 43.3%) if all adolescents walked/biked to school at least 4 days per week.
  • Team sport participation had the strongest and most consistent inverse association with weight status. Active commuting to school may reduce the risk of obesity, but not necessarily overweight, and should be studied further. Obesity prevention programs should consider strategies to increase team sport participation among all students.

Drake, K. M., M. L. Beach, et al. (2012). “Influence of Sports, Physical Education, and Active Commuting to School on Adolescent Weight Status.” Pediatrics 130(2): e296-e304.

“Commuting Distance, Cardiorespiratory Fitness, and Metabolic Risk” (2012)

  • Limited evidence exists on the metabolic and cardiovascular risk correlates of commuting by vehicle, a habitual form of sedentary behavior.
  • To examine the association between commuting distance, physical activity, cardiorespiratory fitness (CRF), and metabolic risk indicators.
  • This cross-sectional study included 4297 adults who had a comprehensive medical examination between 2000 and 2007 and geocoded home and work addresses in 12 Texas metropolitan counties. Commuting distance was measured along the road network. Outcome variables included weekly MET-minutes of self-reported physical activity, CRF, BMI, waist circumference, triglycerides, plasma glucose, high-density lipoprotein cholesterol, systolic and diastolic blood pressure, and continuously measured metabolic syndrome. Outcomes were also dichotomized using established cut-points. Linear and logistic regression models were adjusted for sociodemographic characteristics, smoking, alcohol intake, family history of diabetes, and history of high cholesterol, as well as BMI and weekly MET-minutes of physical activity and CRF (for BMI and metabolic risk models). Analyses were conducted in 2011.
  • Commuting distance was negatively associated with physical activity and CRF and positively associated with BMI, waist circumference, systolic and diastolic blood pressure, and continuous metabolic score in fully adjusted linear regression models. Logistic regression analyses yielded similar associations; however, of the models with metabolic risk indicators as outcomes, only the associations with elevated blood pressure remained significant after adjustment for physical activity and CRF.
  • Commuting distance was adversely associated with physical activity, CRF, adiposity, and indicators of metabolic risk.

Hoehner, C. M., C. E. Barlow, et al. (2012). "Commuting Distance, Cardiorespiratory Fitness, and Metabolic Risk." American journal of preventive medicine 42(6): 571-578.

“Taking Up Cycling After Residential Relocation: Built Environment Factors” (2012)

  • To successfully stimulate cycling, it is necessary to understand the factors that facilitate or inhibit cycling. Little is known about how changes in the neighborhood environment are related to changes in cycling behavior.
  • This study aimed to identify environmental determinants of the uptake of cycling after relocation.
  • The RESIDential Environment Project (RESIDE) is a longitudinal natural experiment of people moving into new housing developments in Perth (Western Australia). Self-reported usual transport and recreational cycling behavior, as well as self-reported and objective built environmental factors were measured before and after residential relocation. Participants who did not usually cycle at baseline in 2003–2004 were included in the study. Logistic regression models were used to relate changes in built environmental determinants to the probability of taking up cycling after relocation (2005–2006). Analyses were carried out in 2010–2011.
  • At baseline, 90% (n=1289) of the participants did not cycle for transport and 86% (n=1232) did not cycle for recreation. After relocation, 5% of the noncyclists took up transport-related cycling, and 7% took up recreational cycling. After full adjustment, the uptake of transport-related cycling was determined by an increase in objective residential density (OR=1.54, 95% CI=1.04, 2.26) and self-reported better access to parks (OR=2.60, 95% CI=1.58, 4.27) and other recreation destinations (OR=1.57, 95% CI=1.12, 2.22). Commencing recreational cycling mostly was determined by an increase in objective street connectivity (OR=1.20, 95% CI=1.06, 1.35).
  • Changes in the built environment may support the uptake of cycling among formerly noncycling adults.

Beenackers, M. A., S. Foster, et al. (2012). "Taking Up Cycling After Residential Relocation: Built Environment Factors." American journal of preventive medicine 42(6): 610-615.

“Is Active Travel to Non-School Destinations Associated with Physical Activity in Primary Schoolchildren?” (2012)

  • This study examines associations between mode of travel to non-school destinations and physical activity in schoolchildren.
  • The authors analyzed data from SPEEDY, an observational study of 9–10 year old British children. In summer 2007, children reported their usual mode of travel to four destinations (to visit family, friends, the park or the shops) and wore accelerometers for at least three days. Time spent in moderate to vigorous physical activity (MVPA) was computed for the following time segments: daily, after school, weekend and out-of-school. Associations between mode of travel and physical activity were assessed using adjusted two-level multiple regression models stratified by sex.
  • N=1859 pupils provided valid data. Boys who used active modes of travel spent significantly more time in MVPA in all time segments than boys who used passive modes. The median daily time spent in MVPA was 87 minutes for active travellers and 76 minutes for passive travellers. In girls, median time spent in MVPA after school was significantly higher in the active (34 minutes) than the passive travellers (29 minutes).
  • Active travel to non-school destinations is associated with higher overall physical activity levels in 9–10 year old schoolchildren. Active travel was associated with higher overall activity levels in males and greater after-school activity levels in females.
  • Promoting non-school active travel may help to achieve higher activity levels.

Smith, L., S. Sahlqvist, et al. (2012). "Is active travel to non-school destinations associated with physical activity in primary school children?" Preventive Medicine. Available online January 18, 2012.

“The effect of a school-based active commuting intervention on children's commuting physical activity and daily physical activity” (2012)

  • This study investigates the effect of a school-based intervention called Travelling Green (TG) on children's walking to and from school and total daily physical activity.
  • A quasi-experiment with 166 Scottish children (8–9 years) was conducted in 2009. One group (n = 79) received TG and another group (n = 87) acted as a comparison. The intervention lasted 6 weeks and consisted of educational lessons and goal-setting tasks. Steps and MVPA (daily, a.m. commute, p.m. commute, and total commute) were measured for 5 days pre- and post-intervention using accelerometers.
  • Mean steps (daily, a.m., p.m., and total commute) decreased from pre- to post-intervention in both groups (TG by 901, 49, 222, and 271 steps/day and comparison by 2528, 205, 120, and 325 steps/day, respectively). No significant group by time interactions were found for a.m., p.m., and total commuting steps. A medium (partial eta squared = 0.09) and significant (p < 0.05) group by time interaction was found for total daily steps. MVPA results were similar to step results.
  • TG has a little effect on walking to and from school. However, for total daily steps and daily MVPA, TG results in a smaller seasonal decrease than for children who do not receive the intervention.
  • The effect of a walk to school intervention was investigated among 8–9 year olds.
  • Educational lessons and goal setting tasks did not increase walking to school.
  • Walk to school interventions should be targeted to the parents of younger children.
  • Older children may have greater autonomy to change their school travel behaviors.

McMinn, D., D. A. Rowe, et al. "The effect of a school-based active commuting intervention on children's commuting physical activity and daily physical activity." Preventive Medicine.

“Moderate to Vigorous Physical Activity and Sedentary Time and Cardiometabolic Risk Factors in Children and Adolescents” (2012)

  • Sparse data exist on the combined associations between physical activity and sedentary time with cardiometabolic risk factors in healthy children.
  • This study examined the independent and combined associations between objectively measured time in moderate- to vigorous-intensity physical activity (MVPA) and sedentary time with cardiometabolic risk factors.
  • The study pooled data from 14 studies between 1998 and 2009 comprising 20 871 children (aged 4-18 years) from the International Children's Accelerometry Database. Time spent in MVPA and sedentary time were measured using accelerometry after reanalyzing raw data. The independent associations between time in MVPA and sedentary time, with outcomes, were examined using meta-analysis. Participants were stratified by tertiles of MVPA and sedentary time.
  • The main outcome measures for this study were: waist circumference, systolic blood pressure, fasting triglycerides, high-density lipoprotein cholesterol, and insulin.
  • Times (mean [SD] min/d) accumulated by children in MVPA and being sedentary were 30 and 354, respectively. Time in MVPA was significantly associated with all cardiometabolic outcomes independent of sex, age, monitor wear time, time spent sedentary, and waist circumference (when not the outcome).
  • Sedentary time was not associated with any outcome independent of time in MVPA. In the combined analyses, higher levels of MVPA were associated with better cardiometabolic risk factors across tertiles of sedentary time. The differences in outcomes between higher and lower MVPA were greater with lower sedentary time. Mean differences in waist circumference between the bottom and top tertiles of MVPA were 5.6 cm (95% CI, 4.8-6.4 cm) for high sedentary time and 3.6 cm (95% CI, 2.8-4.3 cm) for low sedentary time. Mean differences in systolic blood pressure for high and low sedentary time were 0.7 mm Hg (95% CI, −0.07 to 1.6) and 2.5 mm Hg (95% CI, 1.7-3.3), and for high-density lipoprotein cholesterol, differences were −2.6 mg/dL (95% CI, −1.4 to −3.9) and −4.5 mg/dL (95% CI, −3.3 to −5.6), respectively. Geometric mean differences for insulin and triglycerides showed similar variation. Those in the top tertile of MVPA accumulated more than 35 minutes per day in this intensity level compared with fewer than 18 minutes per day for those in the bottom tertile. In prospective analyses (N = 6413 at 2.1 years’ follow-up), MVPA and sedentary time were not associated with waist circumference at follow-up, but a higher waist circumference at baseline was associated with higher amounts of sedentary time at follow-up.
  • Higher MVPA time by children and adolescents was associated with better cardiometabolic risk factors regardless of the amount of sedentary time.

Ekelund, U., J. Luan, et al. (2012). "Moderate to Vigorous Physical Activity and Sedentary Time and Cardiometabolic Risk Factors in Children and Adolescents." JAMA: The Journal of the American Medical Association 307(7): 704-712.

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