Skip to main content

Table 3 Summary of included studies

From: The relationship between active travel to school and health-related fitness in children and adolescents: a systematic review

Study Sample Study design ATS classification HRF component(s) and method of assessment Analyses Results Prevalence of ATS
Evenson et al [19] 4448 adolescents
Grades 6-12
United States
Cross-sectional Walking or riding to/from school at least once/week BC- Self report BMI z-score (>85th percentile considered overweight) Logistic regression Middle school students above the 85th percentile were less likely to use ATS
BMI categories not associated with ATS in high school students.
6th grade- 12.3%
7th grade- 7.5%
8th grade- 8.2%
9th grade- 6.0%
10th grade- 5.7%
11th grade- 4.0%
12th grade- 3.0%
Tudor-Locke et al [8] 1518 adolescents
14-16 years
Philippines
Cross-sectional Usual travel to/from school (ATS, combination of ATS and PTS or PTS only) BC- BMI ANOVA BMI not associated with ATS in girls.
Boys using ATS only had significantly lower BMI values than boys using PTS only.
Boys- 47% (323/691)
Girls- 37% (303/827)
Metcalf et al [26] 275 children
5 years
England
Cross-sectional Usual travel to/from school (ATS or PTS) BC- BMI and sum of 5 skinfolds ANOVA No relationship between ATS and BMI or skinfolds. Boys- 63% (97/154)
Girls- 73% (88/121)
De Bourdeauhuij et al [30] 6078 children and adolescents
11-17 years Belgium
Cross-sectional Usual travel to/from school (ATS or PTS) BC- Self-report BMI z-score (>85th percentile considered overweight) Independent samples t-test Overweight youth less likely to use ATS. Not available
Fulton et al [21] 1395 children and adolescents
Grades 4 to 6, 7 to 9 and 10 to 12
United States
Cross-sectional Usual travel to/from school or work (ATS or PTS) BC- Proxy and self-report BMI Logistic regression No association between BMI and ATS. Boys- 17% (121/727)
Girls- 11% (74/668)
Gordon-Larsen et al [20] 10771 adolescents
Grades 7 to 12
United States
Cross-sectional Usual travel to/from school or work (ATS or PTS) BC- BMI Independent samples t-test Rates of ATS were higher among non-overweight adolescents.  
Heelan et al [43] 320 children
10.2 years
United States
Cross-sectional How they travelled to/from school in the past 24 hours (ATS or PTS) and amount of time taken BC- BMI, average of 3 skinfolds Multiple regression Significant association between BMI and ATS in overweight children. No association between skinfolds and ATS. Boys & girls- 33.3% (107/320)
Klein-Platat et al [31] 2714 adolescents
12 years
France
Cross-sectional Walking or riding to/from school- none, 0-20 min/day and > 20 min/day BC- BMI z-score (>90th percentile considered overweight) and WC ANCOVA ATS associated with weight status and WC. Boys- 40% (543/1357)
Girls- 37% (503/1357)
Sirard et al [22] 219 children
10.3 years
United States
Cross-sectional Walking or riding to/from school- regular active commuters (>5 times/week), irregular active commuters (1-4 times/week) or passive commuters (0 times/week) BC- BMI z-score (>85th percentile considered overweight) ANOVA No association between weight status and ATS. Boys- 3% (3/96)
Girls- 8% (8/123)
Cooper et al [32] 529 children and 390 adolescents
9.7 and 15.5 years Denmark
Cross-sectional Usual travel to/from school [passive (car, motorcycle, train, bus), bicycle or walk] and duration of journey CRF- Progressive cycle ergometer ANOVA Children and adolescents who cycled to school had higher CRF than those who used PTS.
No relationship between walking to school and CRF.
Boys (child)-66% (168/254)
Girls (child)- 62% (172/276)
Boys (adol)-87.5% (169/193)
Girls (adol)-85% (167/196)
Mota et al [35] 450 adolescents
14.6 years
Portugal
Cross-sectional Usual travel to/from school (ATS or PTS) and duration of journey BC- BMI z-score (>85th percentile considered overweight) Bivariate correlation No association between weight status and ATS. Boys & girls- 23.1% (105/450)
Rosenberg et al [23] 1083 children
Grades 4 and 5
United States
Longitudinal ATS- 2 or more days/week of ATS at each of the 4 assessment periods. BC- BMI z-score (>85th percentile considered overweight), average of 3 skinfolds ANOVA Boys who used ATS at baseline had significantly lower BMI and skinfolds than passive commuters.
No association between ATS and weight status in girls.
No association between changes in BMI and skinfolds and ATS over 2-year period.
Boys- 36% (116/320)
Girls- 29% (79/274)
Timperio et al [36] 912 children
5 to 6 and 10 to 12 years
Australia
Cross-sectional ATS at least once per week BC- BMI z-scores (IOTF classification) Logistic regression No association between ATS and weight status. Boys- 9% (29/316)
Girls- 4% (13/361)
Ford et al [27] 239 children
5 to 11 years
England
Cross-sectional PST or ATS (walk) for > 10 mins, more than 3 times/week for at least 15 weeks BC- Air displacement plethysmorgaphy (BodPed Self-Test) Mann-Whitney U test No significant difference in body fat between ATS a Boys- 47% (59/125)
Girls- 43% (49/114)
Li et al [38] 6826 children and adolescents
7 to 17 years
China
Cross-sectional Usual travel to/from school- walking or riding classified as ATS BC- BMI z-score (>85th percentile considered overweight) Cox regression analysis controlling for parental overweight and SES Overweight youth less likely to use ATS. Boys & girls- 93.6% (6386/6826)
Mota et al [34] 705 adolescent girls
14.7 years
Portugal
Cross-sectional Usual travel to/from school- walking or riding classified as ATS BC- BMI Chi-square and bivariate correlation No association between BMI and ATS. Boys & girls- 52.6% (371/705)
Ortega et al [39] 2859 adolescents
13 to 18.5 years
Spain
Cross-sectional ATS classified as riding/walking to/from school > 15 min/day BC- BMI z-scores, WC adjusted for height ANCOVA Weights status not associated with ATS in boys or girls. Significant association between ATS and WC in girls. Boys- 9.6% (130/1357)
Girls- 13% (189/1502)
Saksvig et al [24] 1721 adolescent girls
12.0 years
United States
Cross-sectional Travel by walking on 1 or more weekdays before/after school. BC- BMI Linear mixed models No difference in BMI among those who walked to school and those who did not. Before school - 13.6% (232/1701)
After school 17.7% (301/1701)
Cooper et al [33] 384 children
9.7 years
Denmark
Longitudinal Usual travel to/from school (cycle, walk or PTS). CRF- Progressive cycle ergometer ANOVA CRF was significantly higher among children and adolescents who cycled to school at one or both time periods compared to those who used other forms of transport. Boys- 66% (110/170)
Girls- 65% (137/214)
Landsberg et al [40] 626 adolescents
14 years
Germany
Cross-sectional Usual travel to/from school (ATS or PTS) and duration of journey. BC- BMI z-score (>85th percentile considered overweight), Sum of 4 skinfolds (triceps, biceps, suprailiacal and subscapular), bioelectrical impedance (fat mass) and WC. General linear models ATS associated with lower fat mass and skinfolds. ATS associated with BMI or WC. Boys- 63% (206/328)
Girls- 50% (163/298)
Robertson-Wilson et al [41] 21345 adolescents
Grades 9 to 12
Canada
Cross-sectional Usual travel to/from school (ATS or PTS). BC- BMI z-score (>85th percentile considered overweight) Binary logistic regression No association between ATS and weight status. Boys- 44% (4699/10747)
Girls- 41% (4378/10598)
Silva and Lopez [42] 1570 children
7 to 12 years
Brazil
Cross-sectional Usual travel to/from school (ATS or PTS) and duration of journey. BC- BMI z-scores (IOTF classification) and skinfolds (tri-cipital) Regression ATS was associated with a lower prevalence of excess weight and body fat. Boys- 15% (117/785)
Girls- 18% (131/742)
Yeung et al [37] 107 children
4 to 12 years Australia
Cross-sectional ATS at least once/week. BC- Parental proxy BMI Mann-Whitney U test No association between BMI and mode of transportation to school. Boys- 40% (59/149)
Girls- 27% (46/169)
Andersen et al [15] 1249 adolescents
15 to 19 years
Denmark
Cross-sectional Usual travel to/from school (cycle, walk or PTS). BC- BMI CRF- Progressive cycle ergometer
MF- sit-ups, static back strength, arm flexion dynamic test
FL- sit and reach
ANOVA Cyclists had higher CRF, MF and FL than both walkers and those who use PTS.
No relationship between BMI and transportation mode.
Boys- 72% (391/545)
Girls- 79% (559/704)
Baig et al [28] 673 adolescents
12.6 years
England
Cross-sectional Usual travel to/from school (cycle, walk, public transport or bus) and duration of journey calculated. BC- BMI z-scores (IOTF classification) Binary logistic regression No association between ATS and weight status. Girls 3.6 times more likely to walk to school than boys
Madsen et al [25] 5357 adolescents
Grades 7 and 9
United States
Cross-sectional Travel to (day of survey) and from (day before survey) school. BC- BMI z-scores (CDC >85th percentile considered overweight)
CRF- 1 mile run test
Linear regression ATS was inversely associated with weight status
A non-significant (p = 0.07) trend between ATS and CRF was found.
To school - 29% (1554/5357)
From school - 46% (2464/5357)
Voss et al [29] 6085 children and adolescents
10 to 15.9 years England
Cross-sectional Usual travel to/from school (cycle, walk, public transport or bus) and duration of journey calculated. BC- BMI z-scores (IOTF classification)
CRF- 20 m shuttle run test
ANOVA No association between travel mode and BMI. ATS associated with improved CRF. Boys- 59% (1845/3135)
Girls- 57% (1587/2792)
  1. ATS = Active travel to school; BC = Body composition; BMI = Body mass index; CDC = Centers for Disease Control & Prevention; CRF = Cardiorespiratory fitness; FL = Flexibility HRF = Health-related fitness; IOTF = International Obesity Task Force; MF = Muscular fitness; NR = Not reported; PTS = Passive travel to school; WC = Waist circumference.