Associations Between Active Commuting to School, Body Fat, and Mental Well-being: Population-Based, Cross-Sectional Study in China

doi:10.1016/j.jadohealth.2015.09.002

Journal of Adolescent Health

Volume 57, Issue 6, December 2015, Pages 679-685

https://doi.org/10.1016/j.jadohealth.2015.09.002 Get rights and content

Highlights

•
The first report on active commuting to school among national representative Chinese children.
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Active commuting to school is correlated with better physical and mental well-being.

Abstract

Purpose

Little is known about patterns of active commuting to school (ACS) among school-aged children in China. This study examines mode of transport to school in China and associations with physical and mental well-being among national representative children.

Methods

Data came from National Puberty Research Collaboration. Commuting mode to school was self-reported and categorized as three categories: walking, cycling, and passive commuting to school. Body mass index, percentage body fat (PBF, measured by skinfold thickness), waist circumference (WC) was measured, and depressive symptoms was assessed by Children's Depression Inventory.

Results

A total of 12,151 girls and 9,445 boys from grade 4 to grade 12 participated in this study. Totally 39.9% of Chinese children walked and 15.9% cycled to school, 44.2% traveled by passive commuting mode. ACS was predictive of lower body mass index, PBF, and WC. Children who commuted via active modes had body mass index, PBF, and WC scores of .167 (95% confidence interval [CI] .274–.060), .566 (95% CI .270–.862), and .724 (95% CI .423–1.025) points lower, respectively, than those who used passive transport. ACS was associated with .855 lower odds of being obese (p < .001) and .907 lower (p < .001) odds of having depressive symptoms compared with children using passive transport.

Conclusions

ACS is correlated with better physical and mental well-being. Sustainable transport planning aimed at increasing active travel to school among Chinese children and adolescents is in great need.

Section snippets

Participants

This research is framed within a multicentered National Puberty Research Collaboration in September 2010, cooperated with 8 research centers across China. Those 8 research sites are representative of China, Eastern (Shenyang and Shanghai), Central (Hefei, Wuhan, and Zhengzhou), Western (Chongqing and Kunming), and Southern (Guangzhou) of China. Detailed information on the study and its sampling methodology is reported elsewhere [15].

Students of Han ethnicity from grade 1 to grade 12 in selected

Results

Totally, 44.1% of boys and 44.3% of girls travel to school by passive transport modes, 37.5% of boys and 41.7% of girls reported walking as their main school travel mode, and 18.4% of boys and 14.0% of girls cycled to school. Significant differences were found in mean BMI, PBF, WHtR, and WC, with boys higher than girls except PBF. More girls reported no VPA and MPA per week than that of boys, while boys reported higher rate of weekday ST >2 hours.

Characteristics of children with different

Discussion

To our knowledge, this study was the first to find that ACS was independently associated not only with physical health but also with mental well-being among children and adolescents, using a large, nationally representative data set.

It found that, about half of Chinese children and adolescent commute to school through walking or cycling was the most common form. This is consistent with results from Canada [25], United States [26]. But lower than results from Child Heart and Health Study in

Acknowledgments

The authors express their sincere gratitude to the adolescents who participated in this study and thank the entire team members of China Puberty Research Collaboration for their dedication to the project.

References (39)

R. Larouche et al.
Active transportation and adolescents' health: The Canadian health measures survey
Am J Prev Med
(2014)
K.L. Monda et al.
China's transition: The effect of rapid urbanization on adult occupational physical activity
Soc Sci Med
(2007)
S.W. Ng et al.
Why have physical activity levels declined among Chinese adults? Findings from the 1991-2006 China Health and Nutrition Surveys
Soc Sci Med
(2009)
L. Qin et al.
Motorized transportation, social status, and adiposity: The China Health and Nutrition survey
Am J Prev Med
(2012)
Y. Sun et al.
National estimates of the pubertal milestones among urban and rural Chinese girls
J Adolesc Health
(2012)
N.D. Brener et al.
Reliability of the 1999 youth risk behavior survey questionnaire
J Adolesc Health
(2002)
R. Pabayo et al.
Sustained active transportation is associated with a favorable body mass index trajectory across the early school years: Findings from the Quebec Longitudinal Study of Child Development birth cohort
Prev Med
(2010)
R.A. Pabayo et al.
Understanding the determinants of active transportation to school among children: Evidence of environmental injustice from the Quebec Longitudinal Study of Child Development
Health Place
(2012)
A. Martin et al.
Does active commuting improve psychological wellbeing? Longitudinal evidence from eighteen waves of the British Household Panel Survey
Prev Med
(2014)
C. Fusco et al.
Toward an understanding of children’s perceptions of their transport geographies: (non)active school travel and visual representations of the built environment
J Transp Geogr
(2012)

2008 physical activity guidelines for Americans

(2008)

J. Pucher et al.

Walking and cycling to health: A comparative analysis of city, state, and international data

Am J Public Health

(2010)

N. Mori et al.

Walking to school in Japan and childhood obesity prevention: New lessons from an old policy

Am J Public Health

(2012)

P.A. Muennig et al.

The cost-effectiveness of New York City's Safe Routes to School Program

Am J Public Health

(2014)

X.N. Zong et al.

Physical growth of children and adolescents in China over the past 35 years

Bull World Health Organ

(2014)

Y. Song et al.

Secular trends of obesity prevalence in Chinese children from 1985 to 2010: Urban-rural disparity

Obesity (Silver Spring)

(2015)

H. Sun et al.

Prevalence and trends in obesity among China's children and adolescents, 1985-2010

PLoS One

(2014)

A.N. Pizarro et al.

Is walking to school associated with improved metabolic health?

Int J Behav Nutr Phys Act

(2013)

M. Gutiérrez-Zornoza et al.

Active commuting to school, weight status, and cardiometabolic risk in children from rural areas: The Cuenca study

Health Educ Behav

(2015)

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: Conflict of Interest: The authors have indicated they have no potential conflicts of interest to disclose.

View full text

Original articleAssociations Between Active Commuting to School, Body Fat, and Mental Well-being: Population-Based, Cross-Sectional Study in China

Highlights

Abstract

Purpose

Methods

Results

Conclusions

Section snippets

Participants

Results

Discussion

Acknowledgments

Am J Prev Med

Soc Sci Med

Soc Sci Med

Am J Prev Med

J Adolesc Health

J Adolesc Health

Prev Med

Health Place

Prev Med

J Transp Geogr

2008 physical activity guidelines for Americans

Walking and cycling to health: A comparative analysis of city, state, and international data

Am J Public Health

Walking to school in Japan and childhood obesity prevention: New lessons from an old policy

Am J Public Health

The cost-effectiveness of New York City's Safe Routes to School Program

Am J Public Health

Physical growth of children and adolescents in China over the past 35 years

Bull World Health Organ

Secular trends of obesity prevalence in Chinese children from 1985 to 2010: Urban-rural disparity

Obesity (Silver Spring)

Prevalence and trends in obesity among China's children and adolescents, 1985-2010

PLoS One

Is walking to school associated with improved metabolic health?

Int J Behav Nutr Phys Act

Active commuting to school, weight status, and cardiometabolic risk in children from rural areas: The Cuenca study

Health Educ Behav

Original article
Associations Between Active Commuting to School, Body Fat, and Mental Well-being: Population-Based, Cross-Sectional Study in China