Association of active school commuting with physical activity and sedentary behaviour among adolescents: A global perspective from 80 countries

Objectives: To examine associations of active school commuting (ASC) with time spent in physical activity (PA) and sedentary behaviour (SB) among adolescents. Design: Cross-sectional study. Methods: Global School-based Student Health Survey data from 277,833 adolescents aged 11-17 years (48.9% girls), collected during 2007-2016, were analysed. Adolescents were asked how many days per week they walked or bicycled to and from school, were physically active, and how much time they spent sitting on a typical day. ASC was defined as >3 days/week, meeting PA recommendations as >60 min/day, high SB as leisure-time sitting >3 h/day. Multilevel logistic regression analysis was used to estimate the odds ratios (OR) and 95% confidence intervals (CI) of the association estimates. Results: Adolescents who used ASC > 3 days/week had over double the odds of meeting PA recommendations (OR: 2.06, 95% CI: 2.01-2.12), after adjusting for a set of covariates. Adolescents who reported ASC > 3 days/week had 17% lower odds of reporting high SB (0.83, 0.81 & minus;0.85). The estimated OR of ASC and PA was 2.57 (2.31-2.86) in low-income and 1.84 (1.75-1.94) in high-income countries. Adolescents with ASC > 3 days/week had 22% lower odds of reporting high SB in African and Eastern Mediterranean regions (0.78, 0.73 & minus;0.84 and 0.75 & minus;0.82, respectively). Country-wise estimates of the associations are presented. Conclusions: ASC is strongly and positively associated with PA recommendations and moderately with lower SB in adolescents. These estimates vary across WHO regions and by country's income. Promoting ASC has the potential to promote active lifestyle among adolescents around the globe. (c) 2020 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.