Promoting active transport in a workplace setting: evaluation of a pilot study in Australia. Active transportation to school over 2 years in relation to weight status and physical activity. The association of cycling with all-cause, cardiovascular and cancer mortality: findings from the population-based EPIC-Norfolk cohort Exploring the Efficacy and Moderators of Two Computer-Tailored Physical Activity Interventions for Older Adults: A Randomized Controlled Trial Effects of active commuting and leisure-time exercise on fat loss in women and men with overweight and obesity: a randomized controlled trial Study protocol: the effectiveness and cost effectiveness of an employer-led intervention to increase walking during the daily commute: the Travel to Work randomised controlled trial All-cause mortality associated with physical activity during leisure time, work, sports, and cycling to work. “Walk in to Work Out”: a randomised controlled trial of a self help intervention to promote active commuting The 'Women's Lifestyle Study', 2-year randomized controlled trial of physical activity counselling in primary health care: rationale and study design Trial of prevention and reduction of obesity through active living in clinical settings: a randomized controlled trial. A randomized controlled trial to increase physical activity and reduce obesity in a predominantly African American group of women with mobility disabilities and severe obesity. Translating weight loss and physical activity programs into the community to preserve mobility in older, obese adults in poor cardiovascular health. The road to obesity or the path to prevention: motorized transportation and obesity in China. Go!: results from a quasi-experimental obesity prevention trial with hospital employees Increasing daily walking improves glucose tolerance in overweight women. Occupational, commuting, and leisure-time physical activity in relation to risk for Type 2 diabetes in middle-aged Finnish men and women Walking or bicycling to school and weight status among adolescents from Montería, Colombia.
Promoting active transport is an increasingly important focus of recent health promotion initiatives addressing the major public health concerns of car dependence , decreased levels of physical activity and environmental health . Using active transport that relies less on the use of private cars and more on alternatives such as walking , cycling and public transport has the potential to increase population levels of physical activity and to improve the environment . Over 12 months , a combined social and individualized marketing campaign was delivered to a cohort of r and omly selected health service employees ( n = 68 ) working at a health care facility in inner-city Sydney , Australia . Pre- and post-intervention surveys measured changes in mode of transport , awareness of active transport and attitudes towards mode of transport . Following the intervention , we found there was a reduction in the proportion of participants who drove to work 5 days per week and a decrease in trips travelled by car on weekends . In addition , there was high awareness of the intervention amongst participants and their underst and ing of the concept of active transport improved from 17.6 % at baseline to 94.1 % at the follow-up survey ( p < 0.01 ) . There was also a significant shift in attitudes , which suggested increased positive regard for active transport . Our findings suggest that a combined social and individualized marketing campaign in the workplace setting can increase the use of active transport for the journey to work and trips on weekends . However , before these findings are widely applied , the intervention needs to be tested in a controlled study with a larger sample size OBJECTIVE To prospect ively examine potential benefits of active commuting to school on measures of weight status and physical activity in a sample of youth . RESEARCH METHODS AND PROCEDURES A cohort of students from seven elementary schools was measured four times -- in the fall and spring of fourth grade ( N = 1083 ) and fifth grade ( N = 924 ) . Participants were classified as active ( walking , biking , or skateboarding to school almost every day for baseline analyses or at least 2 d/wk for analyses of consistent active commuting ) or non-active commuters to school . Accelerometers were used to measure physical activity . Height , weight , and skinfolds were objective ly assessed . RESULTS Boys who actively commuted to school had lower BMI ( p < 0.01 ) and skinfolds ( p < 0.05 ) than non-active commuters to school in the fourth grade . Active commuting to school over 2 years was not associated with BMI change or overweight status . DISCUSSION Walking and cycling to school may contribute to preventing excessive weight gain , or leaner children may walk or cycle to school Objectives To investigate associations between modest levels of total and domain-specific ( commuting , other utility , recreational ) cycling and  mortality from all causes , cardiovascular disease and cancer . Design Population -based cohort study ( European Prospect i ve Investigation into Cancer and Nutrition study -Norfolk ) . Setting Participants were recruited from general practice s in the east of Engl and and attended health examinations between 1993 and 1997 and again between 1998 and 2000 . At the first health assessment , participants reported their average weekly duration of cycling for all purpose s using a simple measure of physical activity . At the second health assessment , participants reported a more detailed breakdown of their weekly cycling behaviour using the EPAQ2 physical activity question naire . Participants Adults aged 40–79 years at the first health assessment . Primary outcome measure All participants were followed for mortality ( all-cause , cardiovascular and cancer ) until March 2011 . Results There were 22 450 participants with complete data at the first health assessment , of whom 4398 died during follow-up ; and 13 346 participants with complete data at the second health assessment , of whom 1670 died during follow-up . Preliminary analyses using exposure data from the first health assessment showed that cycling for at least 60 min/week in total was associated with a 9 % reduced risk of all-cause mortality ( adjusted HR 0.91 , 95 % CI 0.84 to 0.99 ) . Using the more precise measures of cycling available from the second health assessment , all types of cycling were associated with greater total moderate-to-vigorous physical activity ; however , there was little evidence of an association between overall or domain-specific cycling and mortality . Conclusions Cycling , in particular for utility purpose s , was associated with greater moderate-to-vigorous and total physical activity . While this study provides tentative evidence that modest levels of cycling may reduce the risk of mortality , further research is required to confirm how much cycling is sufficient to induce health benefits Background Important health benefits can be derived when low-cost ( e.g. , computer-tailored ) physical activity interventions for older adults demonstrate sustained effects . Purpose The purpose of the study was to conduct in-depth analysis on the long-term efficacy of two tailored physical activity interventions for older adults . Methods A r and omized controlled trial ( n = 1,971 ) with two computer-tailored interventions  and a no-intervention control group was conducted . The two tailored interventions consisted of three tailored letters , delivered during 4 months . The basic tailored intervention targeted psychosocial determinants alone , while the environmentally tailored intervention additionally targeted environmental determinants , by providing tailored environmental information .  Self-reported behaviors ( i.e. , total physical activity , transport walking and cycling , leisure walking and cycling , and sports ) were measured at baseline and 12 months . Additionally , potential personal , health-related , and psychosocial moderators of the intervention effects were examined . Results The environmentally tailored intervention was effective in changing total physical activity , leisure cycling , and sports compared with the basic intervention and control group . No intervention effects were found for the basic intervention . Moderation analysis revealed that participants with a higher age , lower body mass index , and higher intention were unresponsive to the interventions . Conclusions Providing environmental information is an effective intervention strategy for increasing physical activity behaviors among older adults , especially among certain “ at-risk ” subgroups such as lower educated , overweight , or insufficiently active participants . Moderation analysis was perceived as a promising method for identifying meaningful subgroups that are unaffected by an intervention , which should receive special attention in future interventions Background : Aerobic exercise is recommended for weight management but energy balance is often less negative than predicted from exercise energy expenditure ( ExEE ) . Objective : To examine effects of active commuting and leisure-time exercise on  fat loss in women and men with overweight and obesity . Methods : We r and omized 130 younger , physically inactive women and men with overweight and obesity ( body mass index : 25–35 kg m−2 ) to 6 months of habitual lifestyle ( control ; CON , n=18 ) , active commuting ( BIKE  , n=35 ) or leisure-time exercise of moderate ( MOD , 50 % VO2peak reserve , n=39 ) or vigorous intensity ( VIG , 70 % VO2peak reserve , n=38 ) . The primary outcome was change in fat mass measured by dual-energy X-ray absorptiometry , which was analyzed intention-to-treat . Accumulated energy balance was calculated based on changes in body composition , and ExEE was calculated based on heart rate monitoring during exercise . Results : Testing at 3 and 6 months was completed by 95 and 90 participants , respectively . Fat mass was reduced after 3 and 6 months in BIKE ( 3 months : −3.6 ( −5.5 ; −1.7 ) kg ( mean ( 95 % CI ) ) ; 6 months : −4.2 ( −6.6 ; −1.9 ) kg ; both : P<0.001 ) , MOD ( 3 months : −2.2 ( −3.9 ; −0.4 ) kg ; 6 months : −2.6 ( −4.8 ; −0.5 ) kg , both : P<0.02 ) and VIG ( 3 months : −3.4 ( −5.2 ; −1.7 ) kg ; 6 months : −4.5 ( −6.6 ; −2.3 ) kg ; both : P<0.001 ) compared with CON . Furthermore , fat loss was greater in VIG compared with MOD ( 6 months : −1.8 ( −3.6 ; −0.1 ) kg , P=0.043 ) . Based on the ExEE and the accumulated energy balance MOD compensated for the ExEE ( 77 ( 48 ; 106 ) % ) but not BIKE ( 38 ( −18 ; 95 ) % ) and VIG ( 21 ( −14 ; 55 ) % ) . Conclusions : A meaningful fat loss was obtained by 6 months of active commuting and leisure-time exercise , but fat loss was greater with vigorous compared with moderate intensity exercise . Active commuting is an alternative to leisure-time exercise in the management of overweight and obesity .  The trial was registered at clinical trials.gov as NCT01962259 ( main trial ) and NCT01973686 ( energy metabolism sub- study ) Background Physical inactivity increases the risk of many chronic diseases including coronary heart disease , type 2 diabetes and some cancers . It is recommended that adults should undertake at least 150 minutes of moderate intensity physical activity throughout the week but many adults do not achieve this . An opportunity for working adults to accumulate the recommended activity levels is through the daily commute . Methods Employees will be recruited from workplaces in south-west Engl and and south Wales . In the intervention arm ,  workplace Walk-to-Work promoters  will be recruited and trained . Participating employees will receive Walk-to-Work material  s and support will be provided through four contacts from the promoters over 10 weeks . Workplaces in the control arm will continue with their usual practice . The intervention will be evaluated by a cluster r and omized controlled trial including economic and process evaluations . The primary outcome is daily minutes of moderate to vigorous physical activity ( MVPA ) . Secondary outcomes are : overall physical activity ; sedentary time ; modal shift away from private car use during the commute ; and physical activity/MVPA during the commute .  Accelerometers , GPS receivers and travel diaries will be used at baseline and one year follow-up . Question naires will be used at baseline , immediately post intervention , and one year follow-up . The process evaluation will examine the context , delivery and response to the intervention from the perspectives of employers , Walk-to-Work promoters and employees using question naires , descriptive statistics , fieldnotes and interviews . A cost-consequence study will include employer , employee and health service costs and outcomes . Time and consumables used in implementing the intervention will be measured . Journey time , household commuting costs and expenses will be recorded using travel diaries to estimate costs to employees . Presenteeism , absenteeism , employee wellbeing and health service use will be recorded . Discussion Compared with other forms of physical activity , walking is a popular , familiar and convenient , and the main option for increasing physical activity in sedentary population s. To our knowledge , this is the first full-scale r and omised controlled trial to objective ly measure ( using accelerometers and GPS receivers ) the effectiveness of a workplace intervention to promote walking during the commute to and from work . Trial registration IS RCT N15009100 ( 10 December 2014 ) BACKGROUND Physical activity is associated with low mortality in men , but little is known about the association in women , different age groups , and everyday activity . OBJECTIVE To evaluate the relationship between levels of physical activity during work , leisure time , cycling to work , and sports participation and all-cause mortality . DESIGN Prospect i ve study to assess different types of physical activity associated with risk of mortality during follow-up after the subsequent examination . Mean follow-up from examination was 14.5 years . SETTING Copenhagen University Hospital , Copenhagen , Denmark . PARTICIPANTS Participants were 13,375 women and 17,265 men , 20 to 93 years of age , who were r and omly selected .  Physical activity was assessed by self-report , and health status , including  blood pressure , total cholesterol level , triglyceride levels , body mass index , smoking , and educational level  , was evaluated . MAIN OUTCOME MEASURE All-cause mortality . RESULTS A total of 2,881 women and 5,668 men died . Compared with the sedentary , age- and sex-adjusted mortality rates in leisure time physical activity groups 2 to 4 were 0.68 ( 95 % confidence interval , 0.64 - 0.71 ) , 0.61 ( 95 % confidence interval , 0.57 - 0.66 ) , and 0.53 ( 95 % confidence interval , 0.41 - 0.68 ) , respectively , with no difference between sexes and age groups . Within the moderately and highly active persons , sports participants experienced only half the mortality of non participants . Bicycling to work decreased risk of mortality in approximately 40 % after multivariate adjustment , including leisure time physical activity . CONCLUSIONS Leisure time physical activity was inversely associated with  all-cause mortality in both men and women in all age groups . Benefit was found from moderate leisure time physical activity , with further benefit from sports activity and bicycling as transportation Study objective : To determine if a self help intervention , delivered via written interactive material s ( the “ Walk in to Work Out ” pack ) , could increase  active commuting behaviour ( walking and cycling ) . Design : R and omised controlled trial . The intervention group received the “ Walk in to Work Out ” pack , which contained written interactive material s based on the transtheoretical model of behaviour change , local information about distances and routes , and safety information . The control group received the pack six months later . Focus groups were also conducted after six months . Setting : Three workplaces in the city of Glasgow , Scotl and , UK . Participants : 295 employees who had been identified as thinking about , or doing some irregular , walking or cycling to work . Main results : The intervention group was almost twice as likely to increase walking to work as the control group at six months ( odds ratio of 1.93 , 95 % confidence intervals 1.06 to 3.52 ) . The intervention was not successful at increasing cycling . There were no distance travelled to work , gender , or age influences on the results . Twenty five per cent ( 95 % confidence intervals 17 % to 32 % ) of the intervention group , who received the pack at baseline , were regularly actively commuting at the 12 month follow up . Conclusion : The “ Walk in to Work Out ” pack was successful in increasing walking but not cycling . The environment for cycling must be improved before cycling will become a popular option Background Physical inactivity is an independent risk factor for diabetes and heart disease . There is evidence that increasing physical activity can reduce the risk of developing these chronic diseases , but less evidence about effective ways to increase adherence to physical activity . Interventions are therefore needed that produce sustained increases in adherence to physical activity , are cost-effective and improve clinical endpoints . Methods The Women 's Lifestyle Study is a two year r and omized controlled trial involving a nurse-led intervention to increase physical activity in 40–74 year old physically inactive women recruited from primary care . Baseline measures were assessed in a face-to-face interview with a primary care nurse . The intervention involved delivery of a ' Lifestyle script ' by a primary care nurse followed by telephone counselling for nine months and a face-to-face nurse visit at six months . Outcome measurements are assessed at 12 and 24 months . The primary outcome is physical activity measured using a vali date d physical activity question naire . Secondary outcomes include blood pressure , weight , waist circumference , physical fitness ( step test ) , serum HbA1c , fasting glucose , lipids , insulin , and quality of life ( SF36 ) . Costs were measured prospect ively to allow a subsequent cost-effectiveness evaluation if the trial is positive . Discussion Due to report in 2008 , the Women 's Lifestyle Study tests the effectiveness of an enhanced low-cost , evidence -based intervention in increasing physical activity , and improving cardiovascular and diabetes risk indicators over two years . If successful in demonstrating improvements in health outcomes , this r and omized controlled trial will be the first to demonstrate long-term cardiovascular and diabetes risk health benefit , in addition to improvements in physical activity , from a sustainable physical activity intervention based in primary care . Trial Registration Australian Clinical Trials Registry ( ACTR ) , ACTRN012605000490673 BACKGROUND The efficacy of physical activity with a healthful diet to reduce obesity is established ; however , little is known about the translation of effective lifestyle strategies for obesity reduction in primary care setting s. METHODS We assessed the effectiveness of a 2-year behaviorally based physical activity and diet program implemented entirely within clinical practice s to reduce obesity . A total of 490 sedentary , obese adults were r and omized to usual care ( n = 241 ) or to the behavioral intervention ( n = 249 ) . The usual care group received advice from their physicians about lifestyle as a strategy for obesity reduction . The behavioral intervention included individual counseling from health educators to promote physical activity with a healthful diet . The primary outcome was change in waist circumference ( WC ) . RESULTS A total of 396 participants completed the trial ( 80.8 % ) . A significant main effect was observed for WC change within the intervention compared with usual care ( P < .001 ) that was sustained at 24 months ( mean [ SE ] , -0.9 [ 0.4 ] vs 0.2 [ 0.4 ] cm ; P = .05 ) . Secondary analyses revealed significant main effects for change in WC in men ( P = .009 ) and women ( P = .02 ) . In men , the mean ( SE ) reduction in WC at 24 months was greater with behavioral intervention compared with usual care ( -1.6 [ 0.6 ] vs 0.1 [ 0.6 ] cm ; P = .049 ) . In women , the behavioral intervention was associated with differences in WC compared with usual care at 6 and 12 months ( P ≤ .01 ) but not at 24 months ( P = .10 ) . CONCLUSIONS Behavioral intervention in clinical setting s is associated with modest reductions in WC during a 2-year study in obese patients . However , the effectiveness of the intervention is restricted to men . TRIAL REGISTRATION clinical trials.gov Identifier : NCT00665158 OBJECTIVE This r and omized controlled trial tested a tailored , telephone-based physical activity coaching intervention for a predominantly African American group of women with severe obesity and mobility disability . METHODS We recruited 92 clinic patients from the University of Illinois at Chicago Medical Center referred by their physicians during 2004 - 2007 and r and omized participants to one of three groups -- awareness(informational brochure , no coaching ) , lower support ( phone coaching only ) and higher support ( phone coaching plus monthly exercise support group)--to determine the efficacy of a tailored coaching intervention on key health outcomes , which included body weight and body mass index , blood pressure , cholesterol , physical activity ( barriers and self-reported activity ) , movement and mobility , general health , and social support . RESULTS The higher support group had the greatest reduction in Body Mass Index ( BMI ) ( 7.4 % ) compared with a 0.2 % and 1.6 % increase in BMI for the lower support and awareness groups , respectively ( pb.01 ) . Both the higher and lower support groups had a greater increase in physical activity scores ( 39 % and 30 % , respectively)compared with a decline of 13 % in the awareness group ( pb.05 ) . CONCLUSION Providing phone-based coaching and monthly in-person exercise support group sessions appear to be an effective approach for reducing body weight and increasing physical activity among severely obese , disabled adults residing in difficult social environments BACKGROUND Limitations in mobility are common among older adults with cardiovascular and cardiometabolic disorders and have profound effects on health and well-being . With the growing population of older adults in the United States , effective and scalable public health approaches are needed to address this problem . Our goal was to determine the effects of a physical activity and weight loss intervention on 18-month change in mobility among overweight or obese older adults in poor cardiovascular health . METHODS The study design was a translational , r and omized controlled trial of physical activity ( PA ) and weight loss ( WL ) on mobility in overweight or obese older adults with cardiovascular disease ( CVD ) or at risk for CVD . The study was conducted within the community infrastructure of Cooperative Extension Centers . Participants were r and omized to 1 of 3 interventions : PA , WL + PA , or a successful aging ( SA ) education control arm . The primary outcome was time to complete a 400-m walk in seconds ( 400MWT ) . RESULTS A significant treatment effect ( P = .002 ) and follow-up testing revealed that the WL + PA group improved their 400MWT ( adjusted mean [ SE ] , 323.3 [ 3.7 ] seconds ) compared with both PA ( 336.3 [ 3.9 ] seconds ; P = .02 ) and SA ( 341.3 [ 3.9 ] seconds ; P < .001 ) . Participants with poorer mobility at baseline benefited the most ( P < .001 ) . CONCLUSION Existing community infrastructures can be effective in delivering lifestyle interventions to enhance mobility in older adults in poor cardiovascular health with deficits in mobility ; attention should be given to intervening on both weight and sedentary behavior since weight loss is critical to long-term improvement in mobility . TRIAL REGISTRATION clinical trials.gov Identifier : NCT00119795 OBJECTIVE Dependence on motorized forms of transportation may contribute to the worldwide obesity epidemic . Shifts in transportation patterns occurring in China provide an ideal opportunity to study the association between vehicle ownership and obesity . Our objective was to determine whether motorized forms of transportation promote obesity . RESEARCH METHODS AND PROCEDURES A multistage r and om-cluster sampling process was used to select households from eight provinces in China . Data were included on household vehicle ownership and individual anthropometric and sociodemographic status .  Cross-sectional data ( 1997 ) from 4741 Chinese adults aged 20 to 55 years were used to explore the association between vehicle ownership and obesity . Cohort data ( 1989 to 1997 ) from 2485 adults aged 20 to 45 years in 1989 ( 59 % follow-up ) were used to measure the impact of vehicle acquisition on the odds of becoming obese . RESULTS Our main outcome measure was current obesity status and the odds of becoming obese over an 8-year period . In 1997 , 84 % of adults did not own motorized transportation . However , the odds of being obese were 80 % higher ( p < 0.05 ) for men and women in households who owned a motorized vehicle compared with those who did not own a vehicle . Fourteen percent of households acquired a motorized vehicle between 1989 and 1997 . Compared with those whose vehicle ownership did not change , men who acquired a vehicle experienced a 1.8-kg greater weight gain ( p < 0.05 ) and had 2 to 1 odds of becoming obese . DISCUSSION Encouraging active forms of transportation may be one way to protect against obesity Background Worksite obesity prevention interventions using an ecological approach may hold promise for reducing typical weight gain . The purpose of this study was to examine the effectiveness of Go ! , an innovative 12-month multi-component worksite obesity prevention intervention . Methods A quasi-experimental non-equivalent control group design was utilized ; 407 eligible hospital employees ( intervention arm ) and 93 eligible clinic employees ( comparison arm ) participated . The intervention involved pedometer distribution , labeling of all foods in the worksite cafeteria and vending machines ( with calories , step equivalent , and a traffic light based on energy density signaling recommended portion ) , persuasive messaging throughout the hospital , and the integration of influential employees to reinforce healthy social norms .  Changes in weight , BMI , waist circumference , physical activity , and dietary behavior after 6 months and 1 year were primary outcomes . Secondary outcomes included knowledge , perceptions of employer commitment to employee health , availability of information about diet , exercise , and weight loss , perceptions of coworker support and frequency of health discussion s with coworkers . A process evaluation was conducted as part of the study . Results Repeated measures ANCOVA indicated that neither group showed significant increases in weight , BMI , or waist circumference over 12 months . The intervention group showed a modest increase in physical activity in the form of walking , but decreases in fruit and vegetable servings and fiber intake . They also reported significant increases in knowledge , information , perceptions of employer commitment , and health discussion s with peers . Employees expressed positive attitudes towards all components of the Go ! intervention . Conclusions This low-intensity intervention was well-received by employees but had little effect on their weight over the course of 12 months . Such results are consistent with other worksite obesity prevention studies using ecological approaches . Implementing low-impact physical activity ( e.g. , walking , stair use ) may be more readily incorporated into the worksite setting than more challenging behaviors of altering dietary habits and increasing more vigorous forms of physical activity . Trial Registration This study was registered with clinical trials.gov ( NCT01585480 ) on April 24 , 2012 BACKGROUND Physical activity ( PA ) has been shown to benefit glucose tolerance . Walking is a convenient low-impact mode of PA and is reported to be the most commonly performed activity for those with diabetes . The purpose of this study was to determine whether a recommendation to accumulate 10,000 steps/day for 8 weeks was effective at improving glucose tolerance in overweight , inactive women . METHODS Eighteen women ( 53.3 + /- 7.0 years old , 35.0 + /- 5.1 kg/m(2 ) ) with a family history of type 2 diabetes completed a 4-week control period followed by an 8-week walking program with no changes in diet . The walking program provided a goal of accumulating at least 10,000 steps/day , monitored by a pedometer . RESULTS During the control period , participants walked 4972 steps/day . During the intervention period , the participants increased their accumulated steps/day by 85 % to 9213 , which result ed in beneficial changes in 2-h postload glucose levels ( P < 0.001 ) , AUC(glucose ) ( P = 0.025 ) , systolic blood pressure ( P < 0.001 ) , and diastolic blood pressure ( P = 0.002 ) . There were no changes in body mass , body fat percentage , and waist circumference during the walking intervention . CONCLUSIONS The 10,000 steps/day recommendation result ed in improved glucose tolerance and a reduction in systolic and diastolic blood pressure in overweight women at risk for type 2 diabetes . This demonstrates that activity can be accumulated throughout the day and does not have to result in weight loss to benefit this population Aim /hypothesisLeisure-time physical activity can reduce the risk of Type 2 diabetes , but the potential effect of different types of physical activity is still uncertain . This study is to examine the relationship of occupational , commuting and leisure-time physical activity with the incidence of Type 2 diabetes . Methods We prospect ively followed 6898 Finnish men and 7392 women of 35 to 64 years of age without a history of stroke , coronary heart disease , or diabetes at baseline . Hazards ratios of incidence of Type 2 diabetes were estimated by levels of occupational , commuting , and leisure-time physical activity . Results During a mean follow-up of 12 years , there were 373 incident cases of Type 2 diabetes . In both men and women combined , the hazards ratios of diabetes associated with light , moderate and active work were 1.00 , 0.70 and 0.74 ( p=0.020 for trend ) after adjustment for confounding factors ( age , study year , sex , systolic blood pressure , smoking , education , the two other types of physical activity and BMI ) . The multivariate-adjusted hazards ratios of diabetes with none , 1 to 29 , and more than 30 min of walking or cycling to and from work were 1.00 , 0.96 , and 0.64 ( p=0.048 for trend ) . The multivariate-adjusted hazards ratios of diabetes for low , moderate , high levels of leisure-time physical activity were 1.00 , 0.67 , and 0.61 ( p=0.001 for trend ) ; after additional adjustment for BMI , the hazards ratio was no longer significant . Conclusions /interpretationModerate and high occupational , commuting or leisure-time physical activity independently and significantly reduces risk of Type 2 diabetes among the middle-aged general population BACKGROUND Active school transport ( AST ) is a recommended strategy to promote physical activity ( PA ) and prevent overweight ( OW ) in school-aged children . In many developing countries , such as Colombia , this association has not been well characterized . OBJECTIVE To determine the association between AST and weight status in a representative sample of adolescents from Montería , Colombia . METHODS Participants were 546 adolescents ( 278 boys ) aged 11 to 18 years old from 14 r and omly selected schools in Montería , Colombia in 2008 . The PA module of the Global School Health Survey ( GSHS-2007 ) was used to determine the prevalence of AST . To identify OW , participants were classified according to CDC 2000 criteria ( BMI ≥ 85th percentile ) . Association between AST and OW was determined by binomial logistic regression . RESULTS Odds ratios adjusted for age , sex , location of school , compliance with PA , and screen time recommendations showed that adolescents who reported AST had a significantly lower likelihood to be OW compared with adolescents who reported nonactive transportation ( OR = 0.5 , 95 % CI 0.3 - 0.8 , P < .05 ) . CONCLUSIONS These results support the importance of AST as a useful PA domain with potential implication s for overweight prevention , in rapidly developing setting s. Further epidemiologic and intervention studies addressing AST are needed in the region
Active travel may have positive effects on health outcomes , but there is little robust evidence to date of the effectiveness of active transport interventions for reducing obesity .
BACKGROUND Increasing active travel ( primarily walking and cycling ) has been widely advocated for reducing obesity levels and achieving other population health benefits .
However , the strength of evidence underpinning this strategy is unclear .
This study aim ed to assess the evidence that active travel has significant health benefits .