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 TremblayC Tudor-Locke, P Zhao, T S Church, P T Katzmarzyk

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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 greater than or equal to+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.
Original languageEnglish
Pages (from-to)S107-S114
JournalInternational Journal of Obesity
Issue numberS5
Publication statusPublished - Dec 2015


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