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

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

doi:10.1038/ijosup.2015.27

Cited by 89Obesity, Physical Activity, DietUrban Transport and AccessibilityPhysical Activity and Health

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

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for the ISCOLE Research Group, Sarmiento, O L, Lemoine, P, Gonzalez, S A, Broyles, S T, Denstel, K D, Larouche, R, Onywera, V +17 more·2015·International Journal of Obesity Supplements

DOI 10.1038/ijosup.2015.27PMC PMC4850628

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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.

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“also associated with the risk of being overweight [41-43] and selecting passive transportation modes for school-age children [44-46].”
Background
Barriers to children’s walking to school in Iranian and Chinese samples
Zavareh, M. F., Abolhasannejad, V., Mamdoohi, A. R., & Nordfjærn, T. (2020) · Transportation Research Part F Traffic Psychology and Behaviour · doi:10.1016/j.trf.2020.07.008 · Cited by 15 · see citing works
Influence of active commuting to school on daily physical activity among children and adolescents
de Jesus, G. M., Araújo, R. H. D. O., Dias, L. A., Barros, A. K. C., Araujo, L. D. M. D. S., & de Assis, M. A. A. (2021) · Journal of Transport & Health · doi:10.1016/j.jth.2021.101071 · Cited by 14 · see citing works
Prevalence and correlates of objectively measured weight status among urban and rural Mozambican primary schoolchildren: A cross-sectional study
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“MVPA [40] and active transport [49,50] are important lifestyle correlates of overweight/ obesity among children.”
Background
Physical Activity and Sedentary Behaviour Patterns among Kenyan and Japanese Children: A Comprehensive Cross-Country Comparison
Kidokoro, T., Fuku, N., Yanagiya, T., Takeshita, T., Takaragawa, M., Annear, M. J., Tian, X., Waiganjo, L. B., Bogonko, L. F., Isika, J. K., et al. (2020) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph17124254 · Cited by 12 · see citing works
“6% of Kenyan children aged 9–11 years living in Nairobi used active transport to school [19].”
BackgroundMethod
Walking to/from school is strongly associated with physical activity before and after school and whole-day in schoolchildren: A pilot study
Sasayama, K., Watanabe, M., & Ogawa, T. (2021) · Journal of Transport & Health · doi:10.1016/j.jth.2021.101077 · Cited by 13 · see citing works
Prevalence and Correlates of Active Transportation in Developing Countries
Oyeyemi, A. L., & Larouche, R. (2018) · Elsevier eBooks · doi:10.1016/b978-0-12-811931-0.00012-0 · Cited by 13 · see citing works
Association between the school physical activity environment, measured and self-reported student physical activity and active transport behaviours in Victoria, Australia
Crooks, N., Alston, L., Nichols, M., Bolton, K., Allender, S., Fraser, P., Le, H., Bliss, J., Rennie, C., Orellana, L., et al. (2021) · International Journal of Behavioral Nutrition and Physical Activity · doi:10.1186/s12966-021-01151-6 · Cited by 11 · see citing works
“87) and had a lower BMI z-scores than those who did not report active transport [36].”
Background
Active Transportation: The Role of Parent Attitude, The Physical Environment, and Social Capital
Ross, A., Kwon, J. Y., Kulinna, P. H., & Searle, M. S. (2018) · Journal of Physical Activity and Health · doi:10.1123/jpah.2017-0503 · Cited by 12 · see citing works
Epidemiological Transition in Physical Activity and Sedentary Time in Children
Barreira, T. V., Broyles, S. T., Tudor‐Locke, C., Chaput, J., Fogelholm, M., Hu, G., Kuriyan, R., Lambert, E. V., Maher, C. A., Maia, J. A. R., et al. (2019) · Journal of Physical Activity and Health · doi:10.1123/jpah.2018-0546 · Cited by 12 · see citing works
Is the physical activity environment surrounding primary schools associated with students’ weight status, physical activity or active transport, in regional areas of Victoria, Australia? A cross-sectional study
Jacobs, J., Crooks, N., Allender, S. E., Strugnell, C., Backholer, K., & Nichols, M. S. (2021) · BMJ Open · doi:10.1136/bmjopen-2020-045785 · Cited by 11 · see citing works
Patterns of children’s travel to school, their body weight, spatial factors, and perceptions: A survey on nine European cities
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Segmented physical activity and sedentary behavior patterns among children in Maasai village and Nairobi city
Kidokoro, T., Tian, X., Fuku, N., Waiganjo, L. B., Rintaugu, E. G., Kigaru, M. D., & Mwangi, F. M. (2021) · American Journal of Human Biology · doi:10.1002/ajhb.23649 · Cited by 8 · see citing works
Failure to Launch: Predictors of Unfavourable Physical Activity and Sedentary Behaviour Trajectories from Childhood to Adolescence: The Gateshead Millennium Study
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“However, this was less likely to result in bias because physical activity measures and BMI-z scores at baseline among participants that provided data were comparable to those who had missing accelerometer data.”
BackgroundInfluential
EFFECT OF SCHOOL FEEDING PROGRAMME ON NUTRITIONAL BALANCE IN PRIMARY SCHOOL PUPILS IN KANO METROPOLIS
Rabiu, K. M., Idoko, A. S., & Ganiyu, A. I. (2023) · FUDMA Journal of Sciences · doi:10.33003/fjs-2023-0702-1689 · Cited by 6 · see citing works
Evaluation of a walking school bus program: a cluster randomized controlled trial
Johnson, A. M., Zhou, C., Haviland, M. J., & Mendoza, J. A. (2024) · International Journal of Behavioral Nutrition and Physical Activity · doi:10.1186/s12966-024-01602-w · Cited by 5 · see citing works
“ACS has also been associated with lower measures of adiposity among school-age children [8].”
Background
Effectiveness of an Ecological Model-Based Active Transport Education Program on Physical and Mental Health in High School Students (MOV-ES Project): Study Protocol for a Randomized Controlled Trial
Merellano-Navarro, E., Godoy-Cumillaf, A. E. R., Collado‐Mateo, D., Aguilar-Valdes, M. G., Mejías, J. T., Almonacid-Fierro, A., Valdés-Badilla, P. A., Giakoni-Ramírez, F., Bruneau-Chávez, J., & Olivares, P. R. (2024) · Healthcare · doi:10.3390/healthcare12131259 · Cited by 5 · see citing works
“The effectiveness of active transportation interventions in the school setting has been widely studied [20,21,24,34].”
Background
Looking forward to promoting the “power of physiology”
Bailey, D. M. (2022) · Physiology News · doi:10.36866/pn.127.11 · Cited by 5 · see citing works
Association between different contexts of physical activity and abdominal obesity and excess weight in adolescents.
Martins, P. C., de Lima, T. R., & Silva, D. A. S. (2018) · Motriz Revista de Educação Física · doi:10.1590/s1980-6574201700si00104 · Cited by 5 · see citing works
Active Transportation—Is the School Hiding the Forest?
Larouche, R., Sarmiento, O. L., & Stewart, T. I. (2018) · Elsevier eBooks · doi:10.1016/b978-0-12-811931-0.00017-x · Cited by 4 · see citing works
Prevalence and Correlates of Active Transportation to School Among Colombian Children and Adolescents
González, S. A., Sarmiento, O. L., Larouche, R., Chaput, J., Katzmarzyk, P. T., & Tremblay, M. S. (2021) · Journal of Physical Activity and Health · doi:10.1123/jpah.2021-0115 · Cited by 6 · see citing works
Community Factors Related to Active Transportation
Larouche, R. (2018) · Elsevier eBooks · doi:10.1016/b978-0-12-811931-0.00009-0 · Cited by 4 · see citing works
TRANSPORTATION MODE CHOICE AND OBESITY: A CROSS-SECTIONAL STUDY AT SENIOR HIGH SCHOOL FEMALE STUDENT IN YOGYAKARTA, INDONESIA
Mizwar, M., Astiti, D., Aji, A. S., & Siswati, T. (2022) · Journal of Nutrition College · doi:10.14710/jnc.v11i2.33158 · Cited by 3 · see citing works
Child Freedom in Mobility to School: Measuring the Strong Factors of Choice of Mode among Parents
Khalid, N. S., Nasrudin, N., & Marzukhi, M. A. (2021) · Environment-Behaviour Proceedings Journal · doi:10.21834/ebpj.v6isi4.2895 · Cited by 3 · see citing works
“Families of lower-income face challenges related to housing prices, quality of housing, services and living in less than desirable neighbourhood (Sarmiento et al, 2015 and Rothman et al., 2015).”
Background
Lifestyle Behaviors Associated With Body Fat Percent in 9- to 11-Year-Old Children
Swindell, N. J., Berridge, D. M., McNarry, M. A., Mackintosh, K. A., Boddy, L. M., Fairclough, S. J., & Stratton, G. (2021) · Pediatric Exercise Science · doi:10.1123/pes.2020-0010 · Cited by 3 · see citing works
“This finding is consistent 197 with results from a study of children of the same age from 12 counties (45) which also found 198”
Result
Walking for Transportation and TransMilenio in Bogotá: Strengths and Shortcomings
Parra, D. C., & Lemoine, P. D. (2017) · Transport and sustainability · doi:10.1108/s2044-994120170000009019 · Cited by 2 · see citing works
Investigaciones realizadas en Colombia relacionadas con actividad física y obesidad 2010-2020
Roldán-Aguilar, E. E., Vergara-Ramos, G., & Jaramillo-Osorno, A. F. (2022) · Revista Politécnica · doi:10.33571/rpolitec.v18n36a5 · Cited by 2 · see citing works
“2) No tenían en cuenta la AF o ejercicio como tema principal o no eran investigaciones: [48], [49], [50], [51], [52], [53], [54] [55], [56], [57], [58], [59], [60], [61], [62], [63], [64], [65], [66], [67], [68], [69], [70], [71], [72], [73], [74] y [75].”
Using GIS analysis to examine home-school travel in a divided education system: the case of Northern Ireland
Roulston, S., & Cook, S. (2023) · Irish Educational Studies · doi:10.1080/03323315.2023.2188239 · Cited by 1 · see citing works
Policy Focus: How can our understanding of physiology help us mitigate and adapt to climate change?
Pande, S. (2022) · Physiology News · doi:10.36866/pn.127.9 · Cited by 1 · see citing works
Helping the most vulnerable survive heatwaves today and in the future: Using physiology to identify cooling interventions that work
Jay, O. (2022) · Physiology News · doi:10.36866/pn.127.29 · Cited by 1 · see citing works
Nivel de actividad física autoinformado en escolares que realizan educación física: una revisión sistemática
López‐Gil, J. F., Caetano, C. I., Sentone, R. G., Cavichiolli, F. R., & Lucas, J. L. Y. (2020) · Cadernos Brasileiros de Terapia Ocupacional · doi:10.4322/2526-8910.ctoar1962 · Cited by 3 · see citing works
President’s View: The heart of our new strategy: Building a strong community of physiologists to advance science
Paterson, D. J. (2022) · Physiology News · doi:10.36866/pn.127.6
Co-benefits of physical activity: Assisting cardiometabolic disease prevention and climate change mitigation by active travel to school
Zakrzewski-Fruer, J. K. (2022) · Physiology News · doi:10.36866/pn.127.23
Physiology to the rescue
Tipton, M., & Milligan, G. S. (2022) · Physiology News · doi:10.36866/pn.127.40
Meeting Report: Processing and Modulation of Sensory Signals: From the Periphery to the Cortex
Oates, C. (2022) · Physiology News · doi:10.36866/pn.127.36
Book Review: Life Before Birth: Challenges of Fetal Development by Peter Nathanielsz
Torrens, C. (2022) · Physiology News · doi:10.36866/pn.127.14
How does air pollution affect our health? Exploring the health impacts associated with short- and long-term exposure to air pollutants
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Nathanielsz, P. W. (2022) · Physiology News · doi:10.36866/pn.127.38
Meeting Report: Climate Change: Research Gaps and Policy Priorities
Pande, S. (2022) · Physiology News · doi:10.36866/pn.127.37
New appointments, awards and honours
Staff members The Physiological Society (2022) · Physiology News · doi:10.36866/pn.127.41
Colossal changes in climate threaten our liveable future: Catastrophe is on the horizon; we must act fast and hard to secure our survival
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Heat stress and its severity during pregnancy: The worsening realities of heat stress for pregnant women in West Africa
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How sustainable can your laboratory be?
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Looking forward to our 2023 conferences: Sharing science, connecting communities, and furthering physiology
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Chief Executive’s View: Climate change and how it has made me reflect on my running
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(2022) · Physiology News · doi:10.36866/pn.127.5
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Obituary: Professor Colin Blakemore (1944-2022)
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Zero – One – Two
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Additional file 1 of Replacing school and out-of-school sedentary behaviors with physical activity and its associations with adiposity in children and adolescents: a compositional isotemporal substitution analysis
Gába, A., Dygrýn, J., Štefelová, N., Rubín, L., Hron, K., & Jakubec, L. (2021) · Figshare · doi:10.6084/m9.figshare.13655354
Additional file 1 of Evaluation of a walking school bus program: a cluster randomized controlled trial
Johnson, A. M., Zhou, C., Haviland, M. J., & Mendoza, J. A. (2024) · Figshare · doi:10.6084/m9.figshare.26718804
Additional file 2 of Evaluation of a walking school bus program: a cluster randomized controlled trial
Johnson, A. M., Zhou, C., Haviland, M. J., & Mendoza, J. A. (2024) · Figshare · doi:10.6084/m9.figshare.26718810
Additional file 2 of Replacing school and out-of-school sedentary behaviors with physical activity and its associations with adiposity in children and adolescents: a compositional isotemporal substitution analysis
Gába, A., Dygrýn, J., Štefelová, N., Rubín, L., Hron, K., & Jakubec, L. (2021) · Figshare · doi:10.6084/m9.figshare.13655357
Additional file 3 of Association between the school physical activity environment, measured and self-reported student physical activity and active transport behaviours in Victoria, Australia
Crooks, N., Alston, L., Nichols, M., Bolton, D. K., Allender, S., Fraser, P., Le, H., Bliss, J., Rennie, C., Orellana, L., et al. (2021) · Figshare · doi:10.6084/m9.figshare.14826220
Additional file 3 of Replacing school and out-of-school sedentary behaviors with physical activity and its associations with adiposity in children and adolescents: a compositional isotemporal substitution analysis
Gába, A., Dygrýn, J., Štefelová, N., Rubín, L., Hron, K., & Jakubec, L. (2021) · Figshare · doi:10.6084/m9.figshare.13655360
Additional file 2 of Association between the school physical activity environment, measured and self-reported student physical activity and active transport behaviours in Victoria, Australia
Crooks, N., Alston, L., Nichols, M., Bolton, D. K., Allender, S., Fraser, P., Le, H., Bliss, J., Rennie, C., Orellana, L., et al. (2021) · Figshare · doi:10.6084/m9.figshare.14826217
Additional file 1 of Association between the school physical activity environment, measured and self-reported student physical activity and active transport behaviours in Victoria, Australia
Crooks, N., Alston, L., Nichols, M., Bolton, D. K., Allender, S., Fraser, P., Le, H., Bliss, J., Rennie, C., Orellana, L., et al. (2021) · Figshare · doi:10.6084/m9.figshare.14826214
Association of walking to school with physical activity and physical fitness among children in Okayama Prefecture, Japan
Sasayama, K. (2026) · Sport Sciences for Health · doi:10.1007/s11332-026-01698-6
“In 12 countries, Sarmiento et al. [11] found 42.1% of children used active transport, but 79.3% walked less than 15 min.”
Influential
Effects of School Consolidation on Physical Activity in Primary School Children: A 1‐Year Prospective Study
Sasayama, K. (2026) · Health Science Reports · doi:10.1002/hsr2.72134
Access to school, choice of school and respective mobility choices in Delhi
Jain, D., & Khan, S. (2026) · International Journal of Educational Development · doi:10.1016/j.ijedudev.2026.103597

Associations of active travel with adiposity among children and socioeconomic differentials: a longitudinal study
Laverty, A. A., Hone, T., Goodman, A., Kelly, Y. J., & Millett, C. J. (2021) · BMJ Open · doi:10.1136/bmjopen-2019-036041 · Cited by 24 · see citing works
Relationship Between Active School Transport and Body Mass Index in Grades-4-to-6 Children
Larouche, R., Lloyd, M., Knight, E., & Tremblay, M. S. (2011) · Pediatric Exercise Science · doi:10.1123/pes.23.3.322 · Cited by 26 · see citing works
Are the correlates of active school transport context-specific?
Larouche, R., Sarmiento, O. L., Broyles, S. T., Denstel, K. D., Church, T. S., Barreira, T. V., Chaput, J.-P., Fogelholm, M., Hu, G., Kuriyan, R., et al. (2015) · International Journal of Obesity Supplements · doi:10.1038/ijosup.2015.25 · Cited by 58 · see citing works
Biomechanics
(2018) · The Journal of Physical Fitness and Sports Medicine · doi:10.7600/jpfsm.7.448
Exploring the associations between active school transport, child obesity, and child poverty in California
Chaufan, C., Yeh, J. C., Ross, L., & Fox, P. (2012) · Journal of Behavioral Health · doi:10.5455/jbh.20121202085825 · Cited by 2 · see citing works

Authors: for the ISCOLE Research Group, Sarmiento, O. L., Lemoine, P., Gonzalez, S. A., Broyles, S. T., Denstel, K. D., Larouche, R., Onywera, V, Barreira, T. V., Chaput, J.-P., Fogelholm, M., Hu, G., Kuriyan, R., Kurpad, A., Lambert, E. V., Maher, C., Maia, J., Matsudo, V, Olds, T., Standage, M., Tremblay, M. S., Tudor-Locke, C., Zhao, P., Church, T. S., & Katzmarzyk, P. T.
Affiliations: Universidad de Los Andes (CO)
Pennington Biomedical Research Center (US)
Children's Hospital of Eastern Ontario (CA)
Kenyatta University (KE)
University of Helsinki (FI)
St. John's Research Institute (IN)
University of Cape Town (ZA)
University of South Australia (AU)
Universidade do Porto (PT)
Centro de Estudos do Laboratório de Aptidão Física de São Caetano do Sul (BR)
University of Bath (GB)
Tianjin Women's and Children's Health Center (CN)
Corresponding author: Sarmiento, O L
ORCID: Lemoine, P
Broyles, S T
Denstel, K D
Larouche, R
Onywera, V
Barreira, T V
Fogelholm, M
Hu, G
Kuriyan, R
Kurpad, A
Lambert, E V
Maher, C
Maia, J
Matsudo, V
Olds, T
Standage, M
Tremblay, M S
Tudor-Locke, C
Zhao, P
Church, T S
Katzmarzyk, P T
Venue: International Journal of Obesity Supplements
Publisher: Springer Science and Business Media LLC
Published: 2015-12
Volume: 5
Issue: S2
Pages: S107-S114
ISSN: 2046-2166 (ISSN-L)
2046-2174
DOI: 10.1038/ijosup.2015.27
PMC: PMC4850628
OpenAlex: W1730743058
Cited by: 89
References: 38
Citations by year: 2026: 3 · 2024: 4 · 2023: 2 · 2022: 26 · 2021: 17 · 2020: 10 · 2019: 5 · 2018: 8 · 2017: 5 · 2016: 7 · 2015: 2
FWCI: 7.85
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Licence: www.springer.com/tdm (tdm)
www.springer.com/tdm (vor)
Locations: International Journal of Obesity Supplements (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
The University of Bath Online Publications Store (The University of Bath) (submittedVersion)
Kenyatta University Institutional Repository (Kenyatta University) (submittedVersion)
Pure (University of Bath) (submittedVersion, other-oa)
Funders: Coca-Cola Foundation
Departamento Administrativo de Ciencia, Tecnología e Innovación (COLCIENCIAS) (567. 2012)
Topics: Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
Social Sciences › Transportation › Urban Transport and Accessibility
Health Sciences › Medicine › Physiology › Physical Activity and Health
Keywords: active school transport, childhood obesity, adiposity, BMI z-score, body fat percentage, waist circumference, motorized travel, cross-national comparison, obesity prevention

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

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