Relationships between active school transport and adiposity indicators in school-age children from low-, middle- and high-income countries

O L Sarmiento; P Lemoine; S A Gonzalez; S T Broyles; K D Denstel; R Larouche; V Onywera; T V Barreira; J-P Chaput; M Fogelholm; G Hu; R Kuriyan; A Kurpad; E V Lambert; C Maher; J Maia; V Matsudo; T Olds; M Standage; M S Tremblay; C Tudor-Locke; P Zhao; T S Church; P T Katzmarzyk

doi:10.1038/ijosup.2015.27

Relationships between active school transport and adiposity indicators in school-age children from low-, middle- and high-income countries

Int J Obes Suppl. 2015 Dec;5(Suppl 2):S107-14. doi: 10.1038/ijosup.2015.27. Epub 2015 Dec 8.

Authors

O L Sarmiento¹, P Lemoine², S A Gonzalez¹, S T Broyles³, K D Denstel³, R Larouche⁴, V Onywera⁵, T V Barreira⁶, J-P Chaput⁴, M Fogelholm⁷, G Hu³, R Kuriyan⁸, A Kurpad⁸, E V Lambert⁹, C Maher¹⁰, J Maia¹¹, V Matsudo¹², T Olds¹⁰, M Standage¹³, M S Tremblay⁴, C Tudor-Locke¹⁴, P Zhao¹⁵, T S Church³, P T Katzmarzyk³

Affiliations

¹ Department of Public Health, School of Medicine, Universidad de los Andes , Bogotá, Colombia.
² Department of Public Health, School of Medicine, Universidad de los Andes, Bogotá, Colombia; Department of Industrial Engineering, Faculty of Engineering, CeiBA Complex Systems Research Center, Universidad de los Andes, Bogotá, Colombia.
³ Pennington Biomedical Research Center , Baton Rouge, LA, USA.
⁴ Children's Hospital of Eastern Ontario Research Institute , Ottawa, Ontario, Canada.
⁵ Department of Recreation Management and Exercise Science, Kenyatta University , Nairobi, Kenya.
⁶ Pennington Biomedical Research Center, Baton Rouge, LA, USA; Department of Exercise Science, University of Syracuse, Syracuse, NY, USA.
⁷ Department of Food and Environmental Sciences, University of Helsinki , Helsinki, Finland.
⁸ St John's Research Institute , Bangalore, India.
⁹ Department of Human Biology, Faculty of Health Sciences, Division of Exercise Science and Sports Medicine, University of Cape Town , Cape Town, South Africa.
¹⁰ Alliance for Research In Exercise Nutrition and Activity (ARENA), School of Health Sciences, University of South Australia , Adelaide, South Australia, Australia.
¹¹ CIFI2D, Faculdade de Desporto, University of Porto , Porto, Portugal.
¹² Centro de Estudos do Laboratório de Aptidão Física de São Caetano do Sul , Sao Paulo, Brazil.
¹³ Department of Health, University of Bath , Bath, UK.
¹⁴ Pennington Biomedical Research Center, Baton Rouge, LA, USA; Department of Kinesiology, University of Massachusetts Amherst, Amherst, MA, USA.
¹⁵ Tianjin Women's and Children's Health Center , Tianjin, China.

Abstract

Objectives: Within the global context of the nutrition and physical activity transition it is important to determine the relationship between adiposity and active school transport (AST) across different environmental and socio-cultural settings. The present study assessed the association between adiposity (that is, body mass index z-score (BMIz), obesity, percentage body fat (PBF), waist circumference) and AST in 12 country sites, in the International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE).

Methods: The analytical sample included 6797 children aged 9-11 years. Adiposity indicators included, BMIz calculated using reference data from the World Health Organization, obesity (BMIz ⩾+2 s.d.), PBF measured using bioelectrical impedance and waist circumference. School travel mode was assessed by questionnaire and categorized as active travel versus motorized travel. Multilevel linear and non-linear models were used to estimate the magnitude of the associations between adiposity indicators and AST by country site and sex.

Results: After adjusting for age, sex, parental education and motorized vehicle availability, children who reported AST were less likely to be obese (odds ratio=0.72, 95% confidence interval (0.60-0.87), P<0.001) and had a lower BMIz (-0.09, s.e.m.=0.04, P=0.013), PBF (least square means (LSM) 20.57 versus 21.23% difference -0.66, s.e.m.=0.22, P=0.002) and waist circumference (LSM 63.73 cm versus 64.63 cm difference -0.90, s.e.m.=0.26, P=0.001) compared with those who reported motorized travel. Overall, associations between obesity and AST did not differ by country (P=0.279) or by sex (P=0.571).

Conclusions: AST was associated with lower measures of adiposity in this multinational sample of children. Such findings could inform global efforts to prevent obesity among school-age children.