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Background Route environments may influence people's active commuting positively and thereby contribute to public health. Assessments of route environments are, however, needed in order to better understand the possible relationship between active commuting and the route environment. The aim of this study was, therefore, to assess the potential associations between perceptions of whether the route environment on the whole hinders or stimulates bicycle commuting and perceptions of environmental factors. Methods The Active Commuting Route Environment Scale (ACRES) was used for the assessment of bicycle commuters' perceptions of their route environments in the inner urban parts of Greater Stockholm, Sweden. Bicycle commuters (n = 827) were recruited by advertisements in newspapers. Simultaneous multiple regression analyses were used to assess the relation between predictor variables (such as levels of exhaust fumes, noise, traffic speed, traffic congestion and greenery) and the outcome variable (hindering - stimulating route environments). Two models were run, (Model 1) without and (Model 2) with the item traffic: unsafe or safe included as a predictor. Results Overall, about 40% of the variance of hindering - stimulating route environments was explained by the environmental predictors in our models (Model 1, R 2 = 0.415, and Model 2, R 2 = 0.435). The regression equation for Model 1 was: y = 8.53 + 0.33 ugly or beautiful + 0.14 greenery + (-0.14) course of the route + (-0.13) exhaust fumes + (-0.09) congestion: all types of vehicles ( p ≤ 0.019). The regression equation for Model 2 was y = 6.55 + 0.31 ugly or beautiful + 0.16 traffic: unsafe or safe + (-0.13) exhaust fumes + 0.12 greenery + (-0.12) course of the route ( p ≤ 0.001). Conclusions The main results indicate that beautiful, green and safe route environments seem to be, independently of each other, stimulating factors for bicycle commuting in inner urban areas. On the other hand, exhaust fumes, traffic congestion and low 'directness' of the route seem to be hindering factors. Furthermore, the overall results illustrate the complexity of a research area at the beginning of exploration.

Active commuting to school increases children's daily physical activity. The built environment is associated with children's physical activity levels in cross-sectional studies. This study examined the role of the built environment on the outcomes of a \"walking school bus\" study. Geographical information systems was used to map out and compare the built environments around schools participating in a pilot walking school bus randomised controlled trial, as well as along school routes. Multi-level modelling was used to determine the built environment attributes associated with the outcomes of active commuting to school and accelerometer-determined moderate-to-vigorous physical activity (MPVA). There were no differences in the surrounding built environments of control (n = 4) and intervention (n = 4) schools participating in the walking school bus study. Among school walking routes, park space was inversely associated with active commuting to school (β = -0.008, SE = 0.004, P = 0.03), while mixed-land use was positively associated with daily MPVA (β = 60.0, SE = 24.3, P = 0.02). There was effect modification such that high traffic volume and high street connectivity were associated with greater moderate-to-vigorous physical activity. The results of this study suggest that the built environment may play a role in active school commuting outcomes and daily physical activity.

A cross-sectional study was designed to evaluate the relationship between the availability and proximity to parks and playgrounds and physical activity (PA). Moreover, the accessibility to parks and playgrounds and its association with active commuting to/from school (ACS) and body mass index (BMI) were analyzed. The sample was composed of children aged 6–12 years old from the BEACH (Built Environment and Active CHildren) study in Valencia, Spain. The availability and proximity to parks and playgrounds were calculated at different buffer sizes (250, 500, 1000 and 1250 m) using geographical information system data. PA out of school was assessed using accelerometers. Sociodemographics and ACS were measured with a parent questionnaire. Objectively measured weight and height were used to calculate BMI. Mixed linear regression analyses were conducted for each exposure variable, adjusting for sociodemographics, neighborhood walkability level, and participant clustering. The number of parks and playgrounds were positively associated with moderate to vigorous PA (MVPA) and total PA (TPA); including light PA and MVPA, during weekdays, in different buffer sizes. A negative relationship between distance to the nearest playground and TPA during weekdays was found. In addition, the number of playgrounds was positively related to ACS in different buffer sizes, whereas park land area was negatively related to the BMI percentile. This study highlights the importance of assessing the availability and proximity to parks and playgrounds in children’s neighborhoods when PA behavior and weight status are analyzed. Study findings may help policymakers when targeting interventions to promote health-enhancing behaviors in children.

Background Individual health behavior is related to environmental and social structures. To promote physical activity (PA) effectively, it is necessary to consider structural influences. Previous research has shown the relevance of the built environment. However, sex/gender differences have yet not been considered. The aim of this systematic review was to identify built environmental determinants of PA by taking sex/gender into account. Methods A systematic literature search was carried out using six electronic databases (PubMed, CINAHL, SportDiscus, PsycInfo, Scopus, Web of Knowledge) to identify studies analyzing the effect of changes in the built environment on PA, taking sex/gender into account. To be included, studies had to be based on quantitative data and a longitudinal study design. Changes in the built environment had to be objectively assessed. The methodological quality of the studies was examined using the QualSyst tool for examining risk of bias. Results In total, 36 studies published since 2000 were included in this review. The data synthesis revealed that the majority of reviewed studies found the built environment to be a determinant of PA behavior for both, males and females, in a similar way. Creating a new infrastructure for walking, cycling, and public transportation showed a positive effect on PA behavior. Findings were most consistent for the availability of public transport, which was positively associated with overall PA and walking. The improvement of walking and cycling infrastructure had no effect on the overall level of PA, but it attracted more users and had a positive effect on active transportation. In women, the availability of public transport, safe cycling lanes, housing density, and the distance to daily destinations proved to be more relevant with regard to their PA behavior. In men, street network characteristics and road environment, such as intersection connectivity, local road density, and the presence of dead-end roads, were more important determinants of PA. Conclusion This review sheds light on the relevance of the built environment on PA. By focusing on sex/gender differences, a new aspect was addressed that should be further analyzed in future research and considered by urban planners and other practitioners.

Physical activity and sedentary behaviors have been linked to a variety of general health benefits and problems. However, few studies have examined how physical activity during childhood is related to brain development, with the majority of work to date focusing on cardio-metabolic health. This study examines the association between physical activity and screen time with white matter microstructure in the general pediatric population. In a sample of 2532 children (10.12 ± 0.58 years; 50.04% boys) from the Generation R Study, a population-based cohort in Rotterdam, the Netherlands, we assessed physical activity and screen time using parent-reported questionnaires. Magnetic resonance imaging of white matter microstructure was conducted using diffusion tensor imaging. Total physical activity was positively associated with global fractional anisotropy (β = 0.057, 95% CI = 0.016, 0.098, p = 0.007) and negatively associated with global mean diffusivity (β = −0.079, 95% CI = −0.120, −0.038, p < 0.001), two commonly derived scalar measures of white matter microstructure. Two components of total physical activity, outdoor play and sport participation, were positively associated with global fractional anisotropy (β = 0.041, 95% CI=(0.000, 0.083), p = 0.047; β = 0.053, 95% CI=(0.010, 0.096), p = 0.015, respectively) and inversely associated with global mean diffusivity (β = −0.074, 95% CI= (−0.114, −0.033), p < 0.001; β = −0.043, 95% CI=(-0.086, 0.000), p = 0.049, respectively). No associations were observed between screen time and white matter microstructure (p > 0.05). This study provides new evidence that physical activity is modestly associated with white matter microstructure in children. In contrast, complementing other recent evidence on cognition, screen time was not associated with white matter microstructure. Causal inferences from these modest associations must be interpreted cautiously in the absence of longitudinal data. However, these data still offer a promising avenue for future work to explore to what extent physical activity may promote healthy white matter development. •Higher levels of physical activity were associated with greater white matter microstructure in children.•Outdoor play and sport participation were specifically related to white matter microstructure.•No association was observed between screen time and white matter microstructure.

Background Evidence on active commuting and heart failure (HF) under levels of air pollution exposure is limited, and little is known on the potential mediation roles of inflammation. The objective of this study was to investigate the association between active commuting and HF, as well as to ascertain whether air pollution may influence this relationship. Methods This prospective study included 241,786 participants without HF at baseline in UK Biobank. The commuting mode was recorded using questionnaire. We examined long-term exposure to air pollution, including particulate matter with an aerodynamic diameter smaller than 2.5 μm (PM 2.5 ) or 10 μm (PM 10 ), PM 2.5–10 , nitrogen dioxide (NO 2 ), and nitrogen oxide (NO x ). The incident HF was identified through linkages with medical records. Cox proportional hazard models were used to estimate the association of active commuting on HF under different air pollution concentrations. Furthermore, mediation analysis was performed to test the mediated role of inflammation. Results A median follow-up period of 13.7 years yielded 4485 incident cases of HF. Compared with non-active commuting, both cycling (HR = 0.66, 95%CI: 0.57–0.76) and walking mode (HR = 0.86, 95%CI: 0.78–0.94) were found to be associated with the reduced risk of HF, following the full adjustment for covariates, including PM 2.5 . The beneficial effect of cycling (HR = 0.68, 95%CI: 0.56–0.81) and walking mode (HR = 0.82, 95%CI: 0.72–0.92) on HF was also observed in the context of high PM 2.5 exposure. The inflammatory response was responsible for mediating 21.97% and 13.83% of the effect of the association between cycling mode and walking mode and HF. Conclusions For those residing in regions with relatively elevated air pollution levels, active commuting may still be a viable strategy for the prevention of HF. Graphical abstract

There is limited evidence on how active commuting is associated with health benefits in developing countries. The aim of this study therefore was to investigate the associations between active commuting and markers of adiposity and cardiometabolic risk in the Chilean adult population. In total, 5157 participants from the Chilean National Health Survey 2009-10 were included in this cross-sectional study. Active commuting was measured using the Global Physical Activity Questionnaire (GPAQ v2). Body mass index (BMI) and waist circumference (WC) were measured and used to define obesity and central obesity. Type 2 diabetes (T2D) and metabolic syndrome were determined using WHO and updated ATPIII-NCEP criteria, respectively. The main finding of this study is that a 30 min increase in active commuting is associated with lower odds for BMI > 25.0 kg m-2 (0.93 [95% CI: 0.88-0.98, P = 0.010]). Similarly, the odds for central obesity was 0.87 [0.82-0.92, P < 0.0001]. Similar associations were found for T2D (0.81 [0.75-0.88], P < 0.0001) and metabolic syndrome (OR: 0.86 [0.80-0.92], P < 0.0001). Our findings show that active commuting is associated with lower adiposity and a healthier metabolic profile including lower risk for obesity, diabetes and metabolic syndrome.

Active commuting to school (ACS) seems to be one of the means to increase physical activity (PA) levels in youth, but it is unclear if ACS reduces the prevalence of obesity, protecting and improving their health. Most of the previous research has been conducted on children or youth (i.e., children with adolescents together), and there is a paucity of research in adolescents only. The purpose of this review was to assess the association between ACS with overweight/obesity parameters in adolescents aged 11 to 19 years. We used PubMed, WOS and SPORTDiscus as electronics databases. All steps of the process followed the recommendations of the PRISMA flow-diagram. Fifteen articles (68.18%) found a consistent association between ACS and body composition and seven studies (31.82%) showed no differences in body composition between active and passive commuters to school. Fourteen studies observed that active commuters to school had a more favorable body composition and one study reported that ACS was associated with unfavourable body composition. ACS could be the steppingstone to improve PA promotion in adolescence but whether ACS is associated with improved body composition and prevention of obesity requires further research.

Background: Since World War II, the number of motorized vehicles has increased dramatically. Yet, few studies have evaluated how perceptions of single and multiple motorized traffic variables, in different combinations, influence pedestrians’ appraisals of the route environment in relation to whether it facilitates or deters walking. We have previously illuminated this in an inner urban area of a metropolitan region. This study aims to scrutinize these matters in the suburban–rural parts of the same metropolitan area. For comparative reasons, we use the same methods as used for the inner urban area. Our hypothesis is that these kinds of perceptions, to some extent, may be context-specific. Methods: Relations between pedestrians’ perceptions of motorized traffic variables (flow and speeds of motor vehicles, noise, and exhaust fumes) and combinations of them, as well as if appraisals of route environments hinder–stimulate walking and are unsafe–safe for reasons of traffic, have been evaluated. This was studied in the suburban and rural areas of Greater Stockholm, Sweden. The pedestrians (n = 233) rated their route environment with the Active Commuting Route Environment Scale (ACRES). Correlation, multiple regression, and mediation analyses were used to study the relationships. Results: The regression analyses showed that noise was the primary negative predictor variable in relation to hindering–stimulating walking. With respect to the other outcome, unsafe–safe traffic, none of the variables had a significant relation. The mediation analyses showed that (1) vehicle speed had an indirect effect on unsafe–safe traffic via noise, (2) both vehicle speed and vehicle flow had, via noise, indirect effects on hinders–stimulates walking, and (3) vehicle speed had, via vehicle flow, an indirect effect on noise and exhaust fumes. Conclusions: In suburban–rural route environments, noise protrudes as a hindering variable for walking. The mediation analyses showed that vehicle speed intensified noise and had negative effects on both outcomes. Therefore, by reducing vehicle speed, noise levels will be lowered, and the walking experience is likely to be enhanced, which can influence the amount of walking. The results are further illuminated through the exploration of existing and potential future research strategies.

Although current research indicates that the active mode of displacement commuting influences the health of schoolchildren, what is known about the relationship between self-reported physical fitness and its relationship with activecommuting to school(ACS)is known less so. In addition, trends highlight the need to conduct country-specific analyses to understand each context better. The aims of this study were a) to analyze self-reported physical fitness and the ACS, and b) to determine the association between self-reported physical fitness andthe ACSthrough an extensive survey in southern Chile. A cross-sectional analytic design was conducted. The sample consisted of 733 schoolchildren (aged 10 to 16, 46.1% girls) from Chilean public schools. The International Fitness Scale (IFIS) was used to determine the self-reported physical fitness. The ACS was assessed using separate questions about commuting to and from school. The main results showed that the boys presented better self-reported physical fitness than the girls, except in the self-perception of flexibility (p= 0.041). In addition, an association was observed between the ACSand the self-reported flexibility (OR:1.53, p=0.022; OR:1.47, p= 0.036), an association that was maintained when adjusting for sex and age (OR:1.55, p=0.020; OR:1.50, p= 0.030), and self-reported speed and agility was associated only with active commuting from school (OR:1.60, p=0.005), also after adjusted model (OR:1.81, p=0.024). In conclusion,this study provides evidence regarding the relationship between self-reported physical fitness and active ways of ACS. Strategiesthat favor ACS should be soughtto promote health in schoolchildren. Aunque las investigaciones actuales indican que el modo activo de desplazamiento influye en la salud de los escolares, lo que se sabe sobre la relación entre la condición física autoinformada y su relación con la forma de desplazarse activamente hacia y desde la escuela (ACS, por sus siglas en inglés) se sabe menos. Los objetivos de este estudio fueron a) analizar la aptitud física autoinformada y la ACS, y b) determinar la asociación entre la aptitud física autoinformada con ACSa través de una encuesta realizada en el sur de Chile. Se realizó un diseño analítico transversal. La muestra estuvo compuesta por 733 escolares (de 10 a 16 años, 46,1% niñas) de colegios públicos chilenos. Se utilizó la International Fitness Scale (IFIS) para determinar la aptitud física autoinformada. Se evaluaron los modos de desplazamiento de los estudiantes a la escuela mediante preguntas separadas sobre ACS. Los principales resultados mostraron que los niños presentaron una mejor aptitud física autoinformada que las niñas, excepto en la autopercepción de flexibilidad (p= 0,041). Además, se observó asociación entre el tipo de ACS y la flexibilidad autoinformada (OR:1,53, p=0,022; OR:1,47, p= 0,036), asociación que se mantuvo al ajustar por sexo y la edad (OR:1,55, p=0,020; OR:1,50, p= 0,030), la velocidad y la agilidad autoinformada se asociaron sólo con el desplazamiento activo desde la escuela (OR:1,60, p=0,005), también después del modelo ajustado (OR:1,81, p=0,024). En conclusión, este estudio proporciona evidencia sobre la relación entre la aptitud física autoinformada y las formas de ACS. Para promover la salud en los escolares se deben buscar estrategias que favorezcan los ACS.