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

Research output: Contribution to journalArticlepeer-review


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.

Original languageEnglish (US)
Pages (from-to)S107-14
JournalInternational journal of obesity supplements
Issue numberSuppl 2
StatePublished - Dec 2015
Externally publishedYes


  • Journal Article


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