Associations Between Active Commuting to School, Body Fat, and Mental Well-being: Population-Based, Cross-Sectional Study in China

Purpose: Little is known about patterns of active commuting to school (ACS) among school-aged children in China. This study examines mode of transport to school in China and associations with physical and mental well-being among national representative children. Methods: Data came from National Puberty Research Collaboration. Commuting mode to school was self-reported and categorized as three categories: walking, cycling, and passive commuting to school. Body mass index, percentage body fat (PBF, measured by skinfold thickness), waist circumference (WC) was measured, and depressive symptoms was assessed by Children's Depression Inventory. Results: A total of 12,151 girls and 9,445 boys from grade 4 to grade 12 participated in this study. Totally 39.9% of Chinese children walked and 15.9% cycled to school, 44.2% traveled by passive commuting mode. ACS was predictive of lower body mass index, PBF, and WC. Children who commuted via active modes had body mass index, PBF, and WC scores of .167 (95% confidence interval [CI].274-.060), .566 (95% CI.270-.862), and .724 (95% CI.423-1.025) points lower, respectively, than those who used passive transport. ACS was associated with .855 lower odds of being obese (p < .001) and .907 lower (p < .001) odds of having depressive symptoms compared with children using passive transport. Conclusions: ACS is correlated with better physical and mental well-being. Sustainable transport planning aimed at increasing active travel to school among Chinese children and adolescents is in great need.