Emilio Villa-González

Effectiveness of an active commuting school-based intervention at 6-month follow-up

BACKGROUND Active commuting to school may provide a significant source of physical activity in youth. Previous school-based intervention studies have shown a positive effect on increasing the frequency of active commuting to school in the short-term. However, how the observed effects are after the intervention remains to be investigated. The objective of the present study was to investigate the effects of a school-based intervention on active commuting to school at 6-month follow-up. METHODS A total of 494 children ages 8-11 years from 5 primary schools were invited to the study. The schools were non-randomly allocated into control or experimental group. The experimental group received a 6-month programme focused on increasing active commuting to school, while the control group received no intervention. Frequency and mode of commuting to school were measured using a questionnaire at pre-intervention, post-intervention and 6-month follow-up. Children with valid data on commuting to school and provided data for sex, age and distance from home were included in this study (n= 206). RESULTS There was a significant difference in the change of number of walk and bike travels per week between groups at 6-month follow-up (Control-Group = -0.4 ± 0.3; Experimental-Group = 0.6 ± 0.2;p = 0.019). Regarding the frequency of mode of commuting, only a change in walking to school was significantly different between the groups at 6-month follow-up (Difference Follow-up-Post-intervention) (Control-Group = -0.6 ± 0.3; Experimental-Group = 0.7 ± 0.2;p = 0.004). CONCLUSIONS A 6-month school-based intervention focused on increasing active commuting to school could be effective strategy for increasing the frequency of active commuting to school even beyond the period of intervention.

The Threshold Distance Associated with Walking from Home to School.

Active commuting to school has health implications among young people. We aimed to (a) examine the patterns of commuting to school in children and adolescents regarding gender and area of residence, (b) study the association between distance from home to school and mode of commuting, and (c) identify the threshold distance below which young people are more likely to walk to school. A total of 6,004 students aged 7 to 18 years from Spain participated in this study. Mode of commuting was self-reported and distance was objectively measured using Google Maps software. Associations were examined using binary logistic regression and receiver operating characteristic curves analysis. Around 67% of children and 60% of adolescents commuted to school actively (mainly walking). The threshold distance for walking to school was 875 m, 0.54 miles, in children, and it was higher among urban (1,250 m, 0.78 miles) than in rural participants (675 m, 0.42 miles). The threshold distance for walking to school was 1,350 m, 0.84 miles, in adolescents, and it was lower among urban (1,350 m, 0.84 miles) than in rural participants (1,550 m, 0.96 miles). Future interventions on active commuting to school should consider this threshold distance, and chances of promoting an active commuting to school could have as a goal the increase of this threshold distance.

Parental perceptions of barriers to active commuting to school in Spanish children and adolescents.

Background : Understanding parental barriers is crucial to promote active commuting to school since the parental perceptions influence how young people commute. This study examined parental barriers to active commuting to school among Spanish children and adolescents, and their association with their gender and the usual mode of commuting. Parents of children ( n = 628) and parents of adolescents ( n = 151) from Granada (Spain) completed a paper-based questionnaire about perceived parental barriers to active commuting to school and mode of commuting. Data were analyzed using the Chi-square test. Among Spanish parents, the most common barriers reported by parents of children were traffic volume and dangerous intersections, whereas the most frequent barriers reported by parents of adolescents were distance to school and dangerous intersections. Compared to parents of children, a greater proportion of parents of adolescents reported distance to school and crime and smaller proportion reported traffic volume as barriers to active commuting to school. Among parents of children, crime was a more commonly reported as a barrier by parents of girls. Although some barriers reported by parents of passive commuters were similar for children and adolescents (such as distance to school and absence of a policeman at crosswalks), other barriers were specific to parents of children. The main parental barriers to active commuting in children were traffic volume and dangerous intersections whereas for adolescents were distance and dangerous intersections. Among Spanish parents, parental barriers to active commuting are influenced by childrens age, gender and mode of commuting to school.

Associations between Active Commuting to School and Health-Related Physical Fitness in Spanish School-Aged Children: A Cross-Sectional Study

Active commuting (walking or cycling) to school has been positively associated with improved fitness among adolescents. However, current evidence lacks information on whether this association persists in children. The aim of this study was to examine the association of active commuting to school with different fitness parameters in Spanish school-aged children. A total of 494 children (229 girls) from five primary schools in Granada and Jaén (Spain), aged between eight and 11 years, participated in this cross-sectional study. Participants completed the Assessing Levels of Physical Activity (ALPHA) fitness test battery and answered a self-reported questionnaire regarding the weekly travel mode to school. Active commuting to school was significantly associated with higher levels of speed-agility in boys (p = 0.048) and muscle strength of the lower body muscular fitness in girls (p = 0.016). However, there were no significant associations between active commuting to school and cardiorespiratory fitness and upper body muscular fitness. Our findings suggest that active commuting to school was associated with higher levels of both speed-agility and lower body muscular fitness in boys and girls, respectively. Future studies should confirm whether increasing active commuting to school increases speed-agility and muscle strength of the lower body.

Fatness mediates the influence of muscular fitness on metabolic syndrome in Colombian collegiate students

The purpose of this study was two-fold: to analyze the association between muscular fitness (MF) and clustering of metabolic syndrome (MetS) components, and to determine if fatness parameters mediate the association between MF and MetS clustering in Colombian collegiate students. This cross-sectional study included a total of 886 (51.9% women) healthy collegiate students (21.4 ± 3.3 years old). Standing broad jump and isometric handgrip dynamometry were used as indicators of lower and upper body MF, respectively. Also, a MF score was computed by summing the standardized values of both tests, and used to classify adults as fit or unfit. We also assessed fat mass, body mass index, waist-to-height ratio, and abdominal visceral fat, and categorized individuals as low and high fat using international cut-offs. A MetS cluster score was derived by calculating the sum of the sample-specific z-scores from the triglycerides, HDL cholesterol, fasting glucose, waist circumference, and arterial blood pressure. Linear regression models were used to examine whether the association between MF and MetS cluster was mediated by the fatness parameters. Data were collected from 2013 to 2016 and the analysis was done in 2016. Findings revealed that the best profiles (fit + low fat) were associated with lower levels of the MetS clustering (p <0.001 in the four fatness parameters), compared with unfit and fat (unfit + high fat) counterparts. Linear regression models indicated a partial mediating effect for fatness parameters in the association of MF with MetS clustering. Our findings indicate that efforts to improve MF in young adults may decrease MetS risk partially through an indirect effect on improvements to adiposity levels. Thus, weight reduction should be taken into account as a complementary goal to improvements in MF within exercise programs.

Body adiposity index performance in estimating body fat percentage in colombian college students: Findings from the FUPRECOL-adults study

Recently, a body adiposity index (BAI = (hip circumference)/((height)(1.5))−18) was developed and validated in adult populations. The aim of this study was to evaluate the performance of BAI in estimating percentage body fat (BF%) in a sample of Colombian collegiate young adults. The participants were comprised of 903 volunteers (52% females, mean age = 21.4 years ± 3.3). We used the Lin’s concordance correlation coefficient, linear regression, Bland–Altman’s agreement analysis, concordance correlation coefficient (ρc) and the coefficient of determination (R2) between BAI, and BF%; by bioelectrical impedance analysis (BIA)). The correlation between the two methods of estimating BF% was R2 = 0.384, p < 0.001. A paired-sample t-test showed a difference between the methods (BIA BF% = 16.2 ± 3.1, BAI BF% = 30.0 ± 5.4%; p < 0.001). For BIA, bias value was 6.0 ± 6.2 BF% (95% confidence interval (CI) = −6.0 to 18.2), indicating that the BAI method overestimated BF% relative to the reference method. Lin’s concordance correlation coefficient was poor (ρc = 0.014, 95% CI = −0.124 to 0.135; p = 0.414). In Colombian college students, there was poor agreement between BAI- and BIA-based estimates of BF%, and so BAI is not accurate in people with low or high body fat percentage levels.

Cycling to School and Body Composition, Physical Fitness, and Metabolic Syndrome in Children and Adolescents

Objective To evaluate the association between cycling to/from school and body composition, physical fitness, and metabolic syndrome among a sample of Colombian children and adolescents. Study design During the 2014–2015 school year, we examined a cross‐sectional component of the Association for muscular strength with early manifestation of cardiovascular disease risk factors among Colombian children and adolescents (FUPRECOL) study. Participants included 2877 youths (54.5% girls) from Bogota, Colombia. A self‐reported questionnaire was used to measure the frequency and mode of commuting to school. Four components of physical fitness were measured: (1) anthropometric (height, weight, body mass index, and waist circumference); (2) musculoskeletal (handgrip and standing long jump test); (3) motor (speed‐agility test; 4 × 10‐meter shuttle run); and (4) cardiorespiratory (20‐m shuttle run test [20mSRT]). The prevalence of metabolic syndrome was determined by the definitions provided by the International Diabetes Federation. Results Twenty‐three percent of the sample reported commuting by cycle. Active commuting boys had a likelihood of having an unhealthy 4 × 10 m value (OR, 0.72; 95% CI, 0.53–0.98; P = .038) compared with the reference group (passive commuters). Active commuting girls showed a lower likelihood of having unhealthy a 20mSRT value (OR, 0.81; 95% CI, 0.56–0.99; P = .047) and metabolic syndrome (OR, 0.61; 95% CI, 0.35–0.99; P = .048) compared with passive commuters. Conclusion Regular cycling to school may to be associated with better physical fitness and a lower incidence of metabolic syndrome than passive transport, especially in girls.

A Cross Sectional Study of the Prevalence of Metabolic Syndrome and Associated Factors in Colombian Collegiate Students: The FUPRECOL-Adults Study.

Metabolic syndrome (MetS) is one of the major public health problems worldwide. The objective of the present study is to investigate the prevalence and the associated variables of MetS in Colombian collegiate students. This cross-sectional study included a total of 890 (52% women) healthy collegiate students (21.3 ± 3.2 years old). The prevalence of MetS was determined by the definition provided by the International Diabetes Federation (IDF). We further examined associations between the prevalence of MetS and related factors, such as age, gender, anthropometric and body composition, weight status, and nutrition profile. The overall prevalence of MetS was 6.0% (95% CI = 4.5% to 7.6%), and it was higher in men than women. The most prevalent components were low high-density lipoprotein cholesterol, high triglyceride levels, waist circumference, and blood pressure levels. The predisposing factors for having a MetS included: being male, over 23 years old, overweight or obese, and having an unhealthy waist-to-height ratio. In conclusion, the occurrence of MetS in young adults is substantial. These findings may be relevant to health promotion efforts for collegiate students in order to develop prospective studies and screening for young adults, which will aid in targeted intervention development to decrease cardiometabolic risk factors.

Systematic review of interventions for promoting active school transport

Active commuting to school has been recognized as a potential avenue to increase physical activity in children and adolescents. However, active commuting to school has declined over time, and interventions are needed to reverse this trend. The main aim in the current study was to update a previous systematic review on interventions focused on active travel to school, following the same methodology and addressing the quality and effectiveness of new studies detected in the more recent scientific literature. A systematic review was conducted to identify intervention studies of active commuting to school published from February 2010 to December 2016. Five electronic databases and a manual search were conducted. Detailed information was extracted, including a quantitative assessment comparing the effect sizes, with Cohens d, and a qualitative assessment using the Evaluation of Public Health Practice Projects tool. We identified 23 interventions that focused on active commuting to school. Among the 23 interventions, three were randomized control trials, 22 had a pre/post design, and 12 used control groups. Most interventions reported a small effect size on active commuting to school (14/23) (d: from -1.45 to 2.37). The quality assessment was rated as weak in most studies (21/23). Government funding continues investing in public policies to promote active commuting to school. However, even though seven years have passed since the last systematic review, research with high quality designs with randomization, greater sample size, and the use of valid and reliable instruments are needed.

Effects of preterm birth and fetal growth retardation on life-course cardiovascular risk factors among schoolchildren from Colombia: The FUPRECOL study

BACKGROUND Both fetal growth restriction and prematurity have been associated with cardiometabolic risk in youth and adults, however, data on their combined effects on cardiometabolic health in youth are scarce. AIMS This study aimed at assessing the effects of birth weight and gestational age combined on life-course cardiovascular risk factors and obesity among schoolchildren from Colombia. STUDY DESIGN A cross-sectional study. SUBJECTS Participants comprised 2510 Colombian schoolchildren (54.8% girls) aged 9-17.9years. OUTCOME MEASURES Four groups were created according to WHO criteria: those born at term with an appropriate birth weight (≥2500g to ≤4000g) for gestational age (term AGA); those born preterm (<37 to <42 completed weeks) with an appropriate birth weight for gestational age (preterm AGA); those born at term with low birth weight for gestational age (term SGA); and those born preterm with low birth weight for gestational age (preterm SGA). Anthropometric markers (body mass, height, waist circumference, and body mass index), blood pressure, lipids profile, fasting glucose, and pubertal stage were assessed. The prevalence of metabolic syndrome was determined by de Ferranti definition. RESULTS There were differences between the 4 groups for calendar age (p=0.011), body mass (p=0.001), height (p=0.001), and body mass index (p=0.027). Overall, preterm SGA group had a greater risk for having elevated fasting glucose and metabolic syndrome (total sample and in boys) compared with term AGA group (p<0.05). For other cardiovascular risk factors, no significant relationships were observed based on birth characteristics. CONCLUSIONS School-age children and adolescents with combined fetal growth restriction and prematurity exhibited an increased prevalence of glucose risk and metabolic syndrome.