Sarmiento O L, Lemoine P, Gonzalez S A, Broyles S T, Denstel K D, Larouche R, Onywera V, Barreira T V, Chaput J-P, Fogelholm M, Hu G, Kuriyan R, Kurpad A, Lambert E V, Maher C, Maia J, Matsudo V, Olds T, Standage M, Tremblay M S, Tudor-Locke C, Zhao P, Church T S, Katzmarzyk P T
Department of Public Health, School of Medicine, Universidad de los Andes , Bogotá, Colombia.
Department of Public Health, School of Medicine, Universidad de los Andes, Bogotá, Colombia; Department of Industrial Engineering, Faculty of Engineering, CeiBA Complex Systems Research Center, Universidad de los Andes, Bogotá, Colombia.
Int J Obes Suppl. 2015 Dec;5(Suppl 2):S107-14. doi: 10.1038/ijosup.2015.27. Epub 2015 Dec 8.
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).
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.
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).
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.
在营养与身体活动转变的全球背景下，确定不同环境和社会文化背景下肥胖与积极的学校交通方式（AST）之间的关系非常重要。本研究在国际儿童肥胖、生活方式与环境研究（ISCOLE）的12个国家站点中，评估了肥胖（即体重指数z评分（BMIz）、肥胖症、体脂百分比（PBF）、腰围）与AST之间的关联。
分析样本包括6797名9至11岁的儿童。肥胖指标包括使用世界卫生组织参考数据计算的BMIz、肥胖症（BMIz⩾+2标准差）、使用生物电阻抗测量的PBF和腰围。通过问卷调查评估学校出行方式，并将其分类为主动出行与机动化出行。使用多级线性和非线性模型，按国家站点和性别估计肥胖指标与AST之间关联的大小。
在调整年龄、性别、父母教育程度和机动车辆可用性后，报告采用AST的儿童肥胖的可能性较小（优势比=0.72，95%置信区间（0.60 - 0.87），P<0.001），且BMIz较低（-0.09，标准误=0.04，P=0.013），PBF较低（最小二乘均值（LSM）20.57%对21.23%，差异-0.66，标准误=0.22，P=0.002），腰围较低（LSM 63.73厘米对64.63厘米，差异-0.90，标准误=0.26，P=0.001），与报告采用机动化出行的儿童相比。总体而言，肥胖与AST之间的关联在不同国家（P=0.279）或不同性别（P=0.571）之间没有差异。
在这个多国儿童样本中，AST与较低的肥胖指标相关。这些发现可为全球预防学龄儿童肥胖的努力提供参考。
