The relationships of active commuting to school on adiposity, fitness, and cognition in children

Resumen

A growing body of literature supports the positive impact of regular physical activity (PA) on physical and mental health in children. Despite these benefits, the levels of physical inactivity and sedentary behaviours in children and adolescents are increasing alarmingly, thus leading to a higher prevalence of obesity and cardiovascular disease. Nowadays, this situation is considered as one of the most serious public health problem of the 21st century. One way to increase children’s levels of PA is to integrate active commuting to and from school (ACS) by walking, cycling, skateboarding, or other nonmotorized means into the daily routine of schoolchildren. Unfortunately, in the last few years, the prevalence of ACS has drastically declined in several countries, including Spain. Along these lines, several studies have identified different factors (such as socioeconomic status of families or population density) that could determine children and adolescents’ decision to commute actively. However, the influence of these factors in Spanish children below 6 years remains unknown. On the other hand, it is unclear whether ACS has the potential to improve various aspects of health in children. Although several studies have investigated the differences in physical fitness and adiposity between active and passive commuters, the results are inconsistent. Similarly, few studies have examined the relationship of ACS with cognition, and this field of research remains unclear. Thus, given the potential benefits of ACS to the health of schoolchildren, this doctoral thesis provides scientific evidence to clarify these important questions. With this aim, a systematic review and meta-analysis has been conducted, as well as some analysis of empirical data coming from the MOVI-KIDS study, a cluster randomised trial (NCT01971840) involving children of 21 schools from the provinces of Cuenca and Ciudad Real (Spain). This study was funded by the Ministry of Economy and Competitiveness-Carlos III Health Institute and FEDER funds (FIS PI12/02400 and FIS PI112/00761). Additional funding was obtained from the Research Network on Preventative Activities and Health Promotion (Ref. – RD12/0005/0009). As a result of these research works, this doctoral thesis allows us to conclude that: (1) less than half of the 4- to 6-year-old children from Castilla-La Mancha (Spain) actively commuted to school. Moreover, the likelihood of ACS was greater in boys and girls from families of low socioeconomic status (SES) and in girls who lived in urban areas; (2) walking to school has little impact to promote a better adiposity, physical fitness and cognitive performance in 4- to 6-year-old children from Castilla-La Mancha, Spain; and (3) there was insufficient evidence to draw a definitive conclusion regarding the relationship of ACS on cognitive performance and academic achievement in children and adolescents. This could be due to several factors and methodological weaknesses that future studies should take into account. Overall, we believe that these findings will bring more light to this field of research and positively contribute to upcoming research and to the implementation of effective interventions. The study was designed by Mairena Sánchez López and Abel Ruiz de la Hermosa Fernández Infante at the Health and Social Research Centre (Cuenca, Spain). Abel Ruiz de la Hermosa Fernández Infante has completed the present doctoral thesis as part of a scholarship-contract for the training of research staff of the Consejería de Educación, Cultura y Deportes (Ref. - 3A2400/NL38532).