Archives 1 - Impact of Physical Activity
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- The recent decline in children's active commuting (walking or biking) to school has become an important public health issue. Recent programs have promoted the positive effects of active commuting on physical activity (PA) and overweight. However, the evidence supporting such interventions among schoolchildren has not been previously evaluated.
- This article presents the results of a systematic review of the association between active commuting to school and outcomes of PA, weight, and obesity in children.
- The authors found 32 studies that assessed the association between active commuting to school and PA or weight in children. Most studies assessing PA outcomes found a positive association between active commuting and overall PA levels. However, almost all studies were cross-sectional in design and did not indicate whether active commuting leads to increased PA or whether active children are simply more likely to walk. Only 3 of 18 studies examining weight found consistent results, suggesting that there might be no association between active commuting and reduced weight or body mass index.
- Although there are consistent findings from cross-sectional studies associating active commuting with increased total PA, interventional studies are needed to help determine causation.
Lee, M.C., Orenstein, M.R., Richardson, M.J. (2008). Systematic Review of Active Commuting to School and Children’s Physical Activity and Weight. Journal of Physical Activity & Health 5(6):930–949.
- Data from the 1969 and 2001 National Household Transportation Survey report that a smaller percentage of students lived within 1 mile of school in 2001 than in 1969.
- The percentage of students who walked or biked any distance decreased from 42.0% to 16.2%.
- Nearly half of students used more than 1 travel mode or went to an additional destination en route between home and school in 2001.
- Implications from this study indicate that a multidisciplinary effort is needed to increase the percentage of students who walk or bike to school, as well as decrease the distances that students travel.
Ham, Sandra A., Martin, Sarah, and Kohl III, Harold W. “Changes in the Percentage of Students Who Walk or Bike to School – United States, 1969 and 2001.” Journal of Physical Activity and Health. 5.2 (2008): 205-215
- This study examines the relationship between active transportation and obesity rates.
- 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.
- The results do not prove causality although they suggest that active transportation could be one factor that explains international differences in obesity rates.
Bassett, David R., Pucher, John, Buehler, Ralph, Thompson, Dixie L. and Crouter, Scott E. "Walking, Cycling, and Obesity Rates in Europe, North America, and Australia." Journal of Physical Activity and Health. 5.6 (2008):795-814.
- Incorporating a health promotion approach in the design and development of the built environment can ease climate change and promote healthier living.
Dannenberg, Andrew L., Morrow Almeida, Heather, Vindigni, Stephen M. and Younger,Margalit. "The Built Environment, Climate Change, and Health Opportunities for Co-Benefits." American Journal of Preventive Medicine. 35.5 (2008): 517-526.
- This article summarizes research on predictors and health consequences of active commuting to school and evaluates programs specific to children’s walking and bicycling to school, including Safe Routes to School.
- 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.
- A review of the literature identifies a wide range of predictors of children’s active commuting behaviors, including demographic factors, individual and family factors, school factors (including the immediate area surrounding schools), and social and physical environmental factors.
- Safe Routes to School and the Walking School Bus are two public health efforts that promote walking and bicycling to school.
- Evidence suggests that these activities are viewed positively by key stakeholders and have positive effects on children’s active commuting to school.
Davison, Kirsten K., Werder, Jessica L. and Lawson, Catherine T. “Children’s Active Commuting to School: Current Knowledge and Future Directions.” Preventing Chronic Disease. 5.3 (2008): A100.
- This study estimates of the amount of land area and population in the United States that could be affected by Safe Routes to School programs, and examines the types of locations where such improvements are likely to affect the greatest number of people and the improvements it could have on the larger community.
- Communities with limited funds may be able to improve their overall walkability for all citizens by using federal Safe Routes to School funding to improve walking and cycling routes to schools.
Watson, Margaret and Dannenberg, Andrew. “Investment in Safe Routes to School Projects: Public Health Benefits for the Larger Community.” Preventing Chronic Disease. 5.3 (2008).
- This study assesses the effects of interventions to promote walking in individuals and populations by conducting a systematic review of published and unpublished reports in any language identified by searching 25 electronic databases, by searching websites, reference lists, and existing systematic reviews, and by contacting experts.
- The authors perform a systematic search for and appraisal of controlled before and after studies of the effects of any type of intervention on how much people walk, the distribution of effects on walking between social groups, and any associated effects on overall physical activity, fitness, risk factors for disease, health, and wellbeing.
- The study included 19 randomized controlled trials and 29 non-randomized controlled studies. Interventions tailored to people's needs, targeted at the most sedentary or at those most motivated to change, and delivered either at the level of the individual (brief advice, supported use of pedometers, telecommunications) or household (individualized marketing) or through groups, can encourage people to walk more, although the sustainability, generalizability, and clinical benefits of many of these approaches are uncertain. Evidence for the effectiveness of interventions applied to workplaces, schools, communities, or areas typically depends on isolated studies or subgroup analysis.
- The most successful interventions could increase walking among targeted participants by up to 30-60 minutes a week on average, at least in the short term. From a perspective of improving population health, much of the research currently provides evidence of efficacy rather than effectiveness. Nevertheless, interventions to promote walking could contribute substantially towards increasing the activity levels of the most sedentary.
Ogilvie, D., Foster, C.E., Rothnie, H., et al. (2007). Interventions to Promote Walking: Systematic Review. British Medical Journal 334(7605):1204.
“Estimating the Number of Children Who Can Walk to School” (2007)
- National estimates suggest that 14%-19% of children walk to school while state and local estimates suggest that 4% to 20% of children walk to school.
- The most commonly reported reason by parents why children do not walk to school is distance (62%).
- This study estimates the percentage of children in Georgia who live within a safe and reasonable walking distance from school.
- Results report that the estimated percentage of potential walkers is well below 50% for all but the 1-mile radius for early and late elementary school students.
- This study suggests that increasing the percentage of students who walk will require educational efforts and changes to the built environment.
Falb, Matthew D., Kanny, Dafna, Powell, Kenneth E., and Giarrusso, Anthony J. “Estimating the Number of Children Who Can Walk to School.” American Journal of Preventive Medicine. 33.4 (2007): 269-275.
- Two small lifestyle changes, as promoted by the America on the Move initiative, 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, James O., Ogden, Lorraine G., Rodearmel, Susan J., Stroebele, Nanette and Wyatt, Holly R. “Small Changes in Dietary Sugar and Physical Activity as an Approach to Preventing Excessive Weight Gain: The America on the Move Family Study.” Pediatrics. 120 (2007): e869-e879.
“Many Pathways from Land Use to Health” (2006)
- This article examines single-use, low-density land use patterns and reports that a 5% increase in neighborhood walkability is associated with:
- 32.1% more minutes devoted to physically active travel
- About one-quarter point lower BMI (0.228)
- 6.5% fewer vehicle miles traveled (VMT) per capita
- 5.6% fewer grams of Nitrogen Dioxide per capita
- 5.5% fewer grams of volatile organic compound (VOC) emitted per capita
Frank, Lawrence D., Sallis, James F., Conway, Terry L., Chapman, James E., Saelens, Brian E. and Bachman, William. “Many Pathways from Land Use to Health. Associations between Neighborhood Walkability and Active Transportation, Body Mass Index, and Air Quality.” Journal of the American Planning Association. 72.1 (2006): 75-87.
- In 2003-2004, 17.1% of US children and adolescents were overweight.
- Research indicates an increase in the prevalence of overweight in female children and adolescents from 13.8% in 1999-2000 to 16.0% in 2003-2004 and an increase in the prevalence of overweight in male children and adolescents from 14.0% to 18.2%.
- From 1999-2004 the prevalence of overweight among children and adolescents increased. This suggests that increases in body weight are continuing in children and adolescents.
Ogden, Cynthia L., Carroll, Margaret D., Curtin, Lester R., McDowell, Margaret A.,Tabak, Carolyn J. and Flegal, Katherine M. “Prevalence of Obesity and Overweight in the United States: 1999-2004.” Journal of the American Medical Association. 295 (2006):1549-1555.
- By quantifying the magnitude of energy imbalance responsible for the increase in body weight among US children, this study looks to provide salient targets for population intervention.
- Consistent behavioral changes averaging 110 to 165 kcal/day may be sufficient to counterbalance the energy gap.
Wang, Claire Y., Gortmaker, Steven L., Sobol, Authur M. and Kuntz, Karen M. “Estimating the Energy Gap Among US Children: A Counterfactual Approach.” Pediatrics. 118 (2006): 1721-1733.
- This study uses an accelerometer and questions describing travel habits to evaluate physical activity levels among primary school children.
- Results reveal that children who walk to school are significantly more physically active than those who travel by car.
- Children who cycle to school record higher accelerometer counts than those who travel by car.
Cooper, Ashley R., Anderse, Lars Bo, Wedderkopp, Niels, Page, Angie S., and Frober, Karsten. “Physical Activity Levels of Children Who Walk, Cycle, or Drive to School.” American Journal of Preventive Medicine. 29.3 (2005): 170-184.
- This study reports that students who walk both to and from school accrue the most minutes of moderate to vigorous physical activity (MVPA).
- 90% of the students that walk one way to school accumulate an average of 60 or more minutes of MVPA on weekdays.
- 100% of the students that walk both to and from school accumulate an average of 60 or more minutes of MVPA on weekdays.
Alexander, Leslie M., Inchley, Jo, Todd, Joanna, Currie, Dorothy, Cooper, Ashley R. and Currie, Candace. “The Broader Impact of Walking to School Among Adolescents: Seven Day Accelerometry Based Study”. British Medical Journal. 331 (2005): 1061-1062.
- This article focuses on the relationship between the built environment, travel behavior, and public health outcomes.
Frank, Lawrence D. and Engelke, Peter. “Multiple Impacts of the Built Environment on Public Health: Walkable Places and the Exposure to Air Pollution.” International Regional Science Review. 28(2) (2005): 193-216.
- This review analyzes the effects of school physical education programs on physical activity levels and attitudes toward physical education and physical activity in children and adults.
- This study suggests that schools have the potential to influence habitual physical activity among children by encouraging increased participation in extracurricular sports activities, by favoring active commuting to school, and by providing exercise equipment and supervision for youth in their neighborhoods.
- Additionally, this study suggests that most young children have a very positive attitude towards physical education although as they grow older, their perception of physical education as a positive experience seems to become more ambiguous.
Trudeau, Francois and Shephard, Roy J. “Contribution of School Programmes to Physical Activity Levels and Attitudes in Children and Adults.” Sports Medicine. 35.2 (2005): 89-105.
- Using objective measurement to investigate the physical activity patterns of children by mode of travel to school, this study reports that children who walk to school are significantly more active than those who travel by car.
- A valuable implication of this study is that active transport may contribute to increased physical activity, supporting walk-to-school initiatives to increase children’s physical activity.
Cooper, Ashley R., Page, Angie S., Foster, Lucy J. and Qahwaji, Dina. “Commuting to School: Are Children Who Walk More Physically Active?” American Journal of Preventative Medicine. 25.4 (2003): 273-276.
- Walking and cycling are dangerous ways to get around American cities. Walking and cycling can be made safer, demonstrated by the lower fatality and injury rates in the Netherlands and Germany.
- Benefits of safer cities include reduced risk of death and injury from walking and cycling, providing valuable exercise options, mobility and independence.
- This study urges Americans to address the safety issue by public campaigns emphasizing the direct impacts on individuals, their families, and their friends.
Pucher, John and Dijkstra, Lewis. “Promoting Safe Walking and Cycling to Improve Public Health: Lessons From The Netherlands and Germany.” Public Health Matters. 93.9 (2003): 1509-1516.
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