Learning to Cycle: A Cross-Cultural and Cross-Generational Comparison.

Background: Learning to cycle is an important milestone for children, but the popularity of cycling and the environmental factors that promote the development and practice of this foundational movement skill vary among cultures and across time. This present study aimed to investigate if country of residence and the generation in which a person was born influence the age at which people learn to cycle. Methods: Data were collected through an online survey between November 2019 and December 2020. For this study, a total of 9,589 responses were obtained for adults (self-report) and children (parental report) living in 10 countries (Portugal, Italy, Brazil, Finland, Spain, Belgium, United Kingdom, Mexico, Croatia, and the Netherlands). Participants were grouped according to their year of birth with 20-year periods approximately corresponding to 3 generations: 1960-79 (generation X; n = 2,214); 1980-99 (generation Y; n = 3,994); 2000-2019 (generation Z; n = 3,381). Results: A two-way ANOVA showed a significant effect of country, F(9,8628) = 90.17, p < 0.001, ηp2 = 0.086, and generation, F(2,8628) = 47.21, p < 0.001, ηp2 = 0.122, on the age at which individuals learn to cycle. Countries with the lowest learning age were the Netherlands, Finland and Belgium and countries with the highest learning age were Brazil and Mexico. Furthermore, the age at which one learns to cycle has decreased across generations. There was also a significant country x generation interaction effect on learning age, F(18,8628) = 2.90, p < 0.001; however, this effect was negligible ( ηp2 = 0.006). Conclusions: These findings support the socio-ecological perspective that learning to cycle is a process affected by both proximal and distal influences, including individual, environment and time.

Study protocol: health survey of Sao Paulo: ISA-Physical Activity and Environment.

BACKGROUND: Many studies have investigated the association between the built environment and physical activity behavior in urban settings. However, most of the studies conducted in low- and middle-income countries were cross-sectional, which are limited to identify behavioral determinants. We propose a prospective cohort study to verify the relationship between built environment features and leisure-time and transport-related physical activity in adults from Sao Paulo city, Brazil. METHODS: Prospective multilevel cohort, denominated "ISA-Physical Activity and Environment". It will build on the Health Survey of Sao Paulo in 2015 ("Inquérito de Saúde de São Paulo (ISA)" in Portuguese). The Health Survey of Sao Paulo, originally designed as a cross-sectional survey, had a multi-stage sample, covering 150 census tracts distributed in five health administrative areas. Data collection was performed by face-to-face interviews until December 2015 and the sample comprised 4043 individuals aged 12 years or more. The ISA-Physical Activity and Environment study will reassess people who are aged 18 years or more in 2020, including telephone and household interviews. The primary outcome will be leisure-time and transport-related physical activity, assessed through the International Physical Activity Questionnaire long version. Exposure variables will be built environment features in the areas participants live and work in the follow-up. Data analysis will include multivariate multilevel linear and logistic models. We will also conduct cost-effectiveness analysis and develop agent-based models to help inform decision-makers. The study will be conducted by an interdisciplinary research team specialized in physical activity epidemiology, nutritional epidemiology, georeferencing applied to health, statistics, agent-based modeling, public health policy, and health economics. DISCUSSION: There are few longitudinal studies on the relationship between the built environment and physical activity behavior in low- and middle-income countries. We believe that the ISA-Physical Activity and Environment study will contribute with important results for the progress of the knowledge in this field and for the implementation of policies that promote leisure-time physical activity and active travel in Sao Paulo and similar cities across the world.

Association between Different Modes of Travelling and Adiposity in Chilean Population: Findings from the Chilean National Health Survey 2016-2017.

BACKGROUND: Active travel has been suggested as a feasible way of increasing physical activity levels. Although international studies have demonstrated its effect over different health outcomes and adiposity, there is still limited evidence on this topic in developing countries, such as Chile. AIM: To investigate the associations between different types of travelling and markers of obesity in the Chilean adult population. METHODS: 5411 participants from the Chilean National Health Survey 2016-2017 (CNHS) were included in this study. Active travel was assessed using a questionnaire. Car commuters, public transport (PT), walking and cycling were the four forms of travelling assessed. Bodyweight, body mass index and waist circumference were used as markers of adiposity. RESULTS: Compared to car travellers, body weight, WC and BMI levels were lower for PT walking and cycling travellers. The odds for obesity (Odds ratio (OR): 0.41 (95% CI: 0.28; 0.61 p ≤ 0.001) were lower for walking and the odds (OR: 0.56 (95%CI: 0.35; 0.89 p = 0.014) for central obesity were significantly lower for cyclist in comparison to car travellers. Additionally, participation in any form of active travel (walking or cycling) was low, with only 20.9% of the population reporting being active travellers. CONCLUSION: Active travel, such as walking and cycling, was associated with lower adiposity levels in the Chilean adult population. Promoting active travel could be a feasible strategy to tackle the high prevalence of obesity and physical inactivity in the Chilean population.

Health economic assessment of a shift to active transport.

Active transportation (walking or cycling) as a substitute for car trips still represents a small percentage of all daily travels in many European cities. This study aimed to estimate the health and economic co-benefits for the adult population of modal shift from driving to active travel in urban environments. Three scenarios were modelled for the case study, the city of Porto, Portugal, by comparing travel patterns of 2013 to hypothetical scenarios of modal shifts from driving to active transport, namely: i) SC1 - conservative scenario, with a change of 5% from driving to cycling and 10% from driving to walking; ii) SC2 - moderate scenario, with a shift of 10% and 15%, respectively; and iii) SC3 - optimistic scenario, with a shift of 15% and 20%, respectively. The mortality risk reduction for five health outcomes (colon and breast cancers, diabetes, ischemic heart disease, cerebrovascular disease) was assessed, including an estimation of traffic injury and air pollution exposure risks. Results were presented in Disability-Adjusted Life Years (DALYs) avoided. Economic valuation for each scenario was performed using a Willingness-to-Pay approach for morbimortality and a Cost of Illness approach for 2013 hospitalizations and work absenteeism. Significant health benefits were found in all modelled scenarios, ranging from 1657 (16%) to 2881 (28%) DALYs avoided. Total costs averted ranged from €3894 to €6769 million through the scenarios. Cardio and cerebrovascular diseases mortality presented the largest benefit, accounting for about 3/4 of all avoidable DALYs in all scenarios. Reductions in CO2 and PM10 emissions were calculated, showing a decrease from 31.6 to 73.7 kt of CO2 and 7 to 16 t for PM10, respectively. A modal shift towards active transportation could lead to significant health and economic benefits, indicating that the evaluation of health impacts should be included in the analysis of active transport interventions.

Associations between the duration of active commuting to school and academic achievement in rural Chilean adolescents.

BACKGROUND: Habitual active commuting to school may be positively associated with academic achievement. The aim of this study was to examine the relationship between duration of walking or otherwise actively commuting to school and academic achievement. METHODS: This cross-sectional study included 389 adolescents from seven rural schools (12-13 years). Mode and duration of active commuting to school (use of active means such as walking or biking to and from school) and screen time were self-reported. Academic achievement was determined by the outcome in basic grades (language and mathematics). RESULTS: Active commuting to school was not associated with higher scores in any grades after adjustment for potential confounders. No evidence was found of interactions between gender and academic achievement, but there was interaction with duration of walking (<30 min, 30-60 min, and >60 min). Adjusted binary logistic regression analysis suggested that adolescents who spent between 30 and 60 min actively commuting were more likely to obtain high academic achievement (language and mathematics). CONCLUSIONS: Thirty to 60 min of ACS may have a positive influence on academic achievement in adolescents, so, it is necessary to make recommendations for the children to walk from and/or to school. This could help society to recognize the relevance of physical activity to health as well as to academic performance.

Association between habitual school travel and muscular fitness in youth.

OBJECTIVE: To determine whether active school travel is associated with muscular fitness, which is an emerging marker of youth health. METHODS: Handgrip strength, vertical jump and vertical jump peak power were measured in n=6829 English schoolchildren (53% males, age 12.9 ± 1.2 years) between 2007 and 2011. Participants were grouped according to self-reported habitual school travel modality. RESULTS: Cyclists had greater handgrip strength than passive travelers. Vertical jump height was greater in walkers and cyclists compared with passive travelers. Jump peak power was also higher in walkers than in the passive travel group. Compared with passive travelers, cyclists had a higher (age, sex and BMI-adjusted) likelihood of good handgrip strength (OR 1.42, 95%CI;1.14-1.76) and walkers were more likely to have good measures for vertical jump peak power (OR 1.14, 95%CI;1.00-1.29). Cyclists' likelihood of having good handgrip strength remained significantly higher when adjusted for physical activity (OR 1.29, 95%CI;1.08-1.46). CONCLUSION: Muscular fitness differs according to school travel habits. Cycling is independently associated with better handgrip strength perhaps due to the physical demands of the activity. Better muscular fitness may provide another health-related reason to encourage active school travel.