Parents' perceived barriers to active commuting to school. Comparative study between Spanish and Ecuadorian cities.

Parents´ perceptions can influence their children´s mode of commuting to school. In this sense, the purposes of this study were to compare parental barriers towards active commuting to school (ACS) between Ecuadorian and Spanish children, and to analyze the associations between those barriers and the children's mode of commuting. Descriptive and comparative analyses were performed using Chi-square and T-student test. Associations were analyzed by several logistic regression models. Results showed that road safety is the main barrier for ACS, and that all the barriers are perceived as higher by Ecuadorian parents (p<0.001). It was also found that Ecuadorian children were less likely to be active when parents perceive greater total barriers (OR=0.15, CI=0.06, 0.40). Public policies should focus on reducing the parental barriers in order to increase ACS, specifically those related to road safety.

Fitness and fatness in children and adolescents: investigating their role in the association between physical activity and cardiometabolic health.

To verify the role of the combination of fitness and fatness in the relationship between physical activity (PA) and cardiometabolic risk in children and adolescents. This is a cross-sectional study performed with 2786 children and adolescents (6 to 17 years). Fitness was determined by the cardiorespiratory fitness (CRF) six-minute walking and running test. Waist circumference (WC) was considered a fatness indicator. A selfreported questionnaire was used to determine PA practice, whereas the clustered cardiometabolic risk score (cMetS) was calculated by summing z-scores of triglycerides, total cholesterol/HDL-C ratio, systolic blood pressure, glucose, and WC. Considering the combination of CRF (fitness) and WC (fatness), the following phenotypes were created: Fit/Unfat, Fit/Fat, Unfit/Unfat and Unfit/Fat. Moderation analyses were tested using linear regression models. Significant interactions were found between PA and Unfit/Fat category (ß = -0.001; p = 0.001) only for adolescents. The interaction observed in the Unfit/Fat phenotype indicated that adolescents who practise PA for 330 minutes per week presented lower cMetS compared to those who do not practise or practise for 60 minutes respectively. The combination of fitness and fatness moderates the relationship between PA and cardiometabolic risk, suggesting that adolescents, particularly those who are less fit and present high adiposity, should be encouraged to engage in regular PA to improve their metabolic health.

Active commuting to school among 36,781 Spanish children and adolescents: A temporal trend study.

This study examines trends in the rates of active commuting to school (ACS) in Spanish children (n = 18 343; 8.93 ± 1.68) and adolescents (n = 18 438; 14.11 ± 1.58) aged 6-18 years from 2010 to 2017. Given the study period included the economic crisis in Spain (2008-2013), the second aim of this study was to compare ACS rates during and after the economic crisis. Data were obtained from 28 studies conducted across Spain. The overall trends in ACS were evaluated using multilevel logistic regression analysis. Among Spanish children and adolescents, the rates of ACS to school ranged around 60% between 2010 and 2017. The rates of ACS in Spanish youth did not change significantly during the 2010-2017 period, except a sporadic increase in the rate of ACS in adolescents in 2012-2013. No significant association between the ACS and the economic crisis time period in youth was found. As conclusion, the ACS remains stable in Spain during the last decade, which is a promising result regarding the evidenced decreasing trend in many countries. Further educational and policy strategies are important to continue promoting this behavior in children and adolescents in the long term.

School-based interventions modestly increase physical activity and cardiorespiratory fitness but are least effective for youth who need them most: an individual participant pooled analysis of 20 controlled trials.

OBJECTIVES: To determine if subpopulations of students benefit equally from school-based physical activity interventions in terms of cardiorespiratory fitness and physical activity. To examine if physical activity intensity mediates improvements in cardiorespiratory fitness. DESIGN: Pooled analysis of individual participant data from controlled trials that assessed the impact of school-based physical activity interventions on cardiorespiratory fitness and device-measured physical activity. PARTICIPANTS: Data for 6621 children and adolescents aged 4-18 years from 20 trials were included. MAIN OUTCOME MEASURES: Peak oxygen consumption (VO2Peak mL/kg/min) and minutes of moderate and vigorous physical activity. RESULTS: Interventions modestly improved students' cardiorespiratory fitness by 0.47 mL/kg/min (95% CI 0.33 to 0.61), but the effects were not distributed equally across subpopulations. Girls and older students benefited less than boys and younger students, respectively. Students with lower levels of initial fitness, and those with higher levels of baseline physical activity benefitted more than those who were initially fitter and less active, respectively. Interventions had a modest positive effect on physical activity with approximately one additional minute per day of both moderate and vigorous physical activity. Changes in vigorous, but not moderate intensity, physical activity explained a small amount (~5%) of the intervention effect on cardiorespiratory fitness. CONCLUSIONS: Future interventions should include targeted strategies to address the needs of girls and older students. Interventions may also be improved by promoting more vigorous intensity physical activity. Interventions could mitigate declining youth cardiorespiratory fitness, increase physical activity and promote cardiovascular health if they can be delivered equitably and their effects sustained at the population level.

Feasibility and reliability of the Spanish version of the Youth Activity Profile questionnaire (YAP-Spain) in children and adolescents.

Considerable public health efforts across the globe have focused on promoting physical activity (PA) and minimizing sedentary behaviour (SB) in youths. However, it is important to have valid, reliable and feasible methods to assess these behaviours in youths. The purpose of this study was to analyse the feasibility and reliability of the Spanish version of the previously validated Youth Activity Profile questionnaire (YAP) in children and adolescents. The YAP-S is a 15-item self-report instrument designed to capture PA and SB in youths. A total of 604 children (5-12 years old) and 346 adolescents (12-17 years old) filled out the questionnaire twice (14 days apart). Feasibility was evaluated through required time and number of misunderstood questions by participants. The test-retest reliability was examined using the weighted kappa coefficient (κ) and intraclass correlation coefficient. The average time to complete the questionnaire was 28.85 ± 14.28 and 12.24 ± 9.84 minutes in children and adolescents, respectively. No misunderstanding of questions was reported. The questionnaire showed an adequate reliability for activity at school, out-of-school and sedentary behaviours (k = 0.61-0.77; ICC = 0.77-0.89) in children and adolescents. The YAP-S might be considered a feasible and reliable questionnaire for assessing PA and SB in Spanish children and adolescents.

Associations between active commuting to school, sleep duration, and breakfast consumption in Ecuadorian young people.

BACKGROUND: Daily behaviours such as active commuting to school (ACS) could be a source of physical activity, contributing to the improvement of youth cardiovascular health, however, the relationship between ACS and other aspects of a youth's health, such as sleep duration and breakfast consumption, require further clarification. The aims of this study were therefore: 1) to analyse the prevalence of modes of commuting to school, sleep duration, and breakfast consumption by age groups and gender, and 2) to analyse the association between ACS, sleep duration recommendations, and breakfast consumption by age groups and gender. METHOD: This cross-sectional study included 732 school-aged students of low-middle socioeconomic status, categorised into children (10-12 yr), young adolescents (13-15 yr), and older adolescents (16-18 yr). Modes of commuting to/from school, sleep duration, and breakfast consumption were self-reported. Logistic regression models were fitted to examine the association between ACS, sleep duration and breakfast consumption, analysed according to age groups and gender. RESULTS: The percentage of students meeting sleep duration and daily breakfast recommendations was lowest in older adolescents, and highest in children (6.3% versus 50.8% p < 0.001, and 62.1%, versus 76.8%, p = 0.001, respectively). Young adolescents and girls who met the sleep duration recommendations were more likely to be active commuters than their counterparts (OR = 4.25; 95% CI = 1.81 to 9.92, p = 0.001 and OR = 2.89; 95%CI = 1.01 to 8.27, p = 0.04, respectively). CONCLUSION: Young adolescents (13-15 yr) and girls who met the sleep duration recommendations during school days displayed a positive association with ACS. There was no association between ACS and breakfast consumption for any of the age groups or gender. Children (10-12 yr) were those that best meet with the adequate sleep duration and breakfast consumption recommendations.

Supervised exercise following bariatric surgery in morbid obese adults: CERT-based exercise study protocol of the EFIBAR randomised controlled trial.

BACKGROUND: There is increasing evidence of weight regain in patients after bariatric surgery (BS), generally occurring from 12 to 24 months postoperatively. Postoperative exercise has been suggested to ad long-term weight maintenance and to improve physical function in BS patients. However, there are a limited number of intervention studies investigating the possible benefits of exercise in this population. The aim of the current report is to provide a comprehensive CERT (Consensus on Exercise Reporting Template)-based description of the rationale and details of the exercise programme implemented in the EFIBAR Study (Ejercicio FÍsico tras cirugía BARiátrica), a randomised controlled trial investigating the effects of a 16-week supervised concurrent (aerobic and strength) exercise intervention program on weight loss (primary outcome), body composition, cardiometabolic risk, physical fitness, physical activity and quality of life (secondary outcomes) in patients with severe/morbid obesity following bariatric surgery. METHODS: A total of 80 BS patients [60-80% expected women, aged 18 to 60 years, body mass index (BMI) ≥ 40 kg/m2 or ≥ 35 kg/m2 with comorbid conditions)] will be enrolled in the EFIBAR Randomized Control Trial (RCT). Participants allocated in the exercise group (n = 40) will undertake a 16-week supervised concurrent (strength and aerobic) exercise programme (three sessions/week, 60 min/session), starting 7 to 14 days after surgery. The rationale of the exercise programme will be described following the CERT criteria detailing the 16 key items. The study has been reviewed and approved by the Ethics Committee of the Torrecárdenas University Hospital (Almería, Spain) (ref. N° 76/2016). DISCUSSION: The present study details the exercise programme of the EFIBAR RCT, which may serve: 1) exercise professionals who would like to implement an evidence-based exercise programme for BS patients, and 2) as an example of the application of the CERT criteria. TRIAL REGISTRATION: The trial was prospectively registered at Clinicaltrials.gov NCT03497546 on April 13, 2018.

Interventions Based on Mind-Body Therapies for the Improvement of Attention-Deficit/Hyperactivity Disorder Symptoms in Youth: A Systematic Review.

Background and objectives: Attention-deficit/hyperactivity disorder (ADHD) is one of the most common psychiatric disorders in children and adolescents. Mind-body therapies (MBTs) seem to be effective for improving health in different populations; however, whether a positive effect occurs in children and adolescents with ADHD is still controversial. The main aim of this systematic review was to analyse the interventions based on MBT aimed to improve the main ADHD symptoms in children and adolescents. Materials and Methods: A systematic review was conducted following the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines to identify MBT studies on children and adolescents (4-18 years) with a clinical diagnosis of ADHD. Study quality was evaluated by the NIH quality tool (U.S. National Institute of Health). Results: There were positive results in eleven out of twelve included studies regarding the effect of the MBT interventions on ADHD symptoms. With respect to ADHD symptoms, we observed differences across studies. In relation to the studies' quality, eleven studies were rated "poor" and one was rated as "fair". Conclusions: MBTs, such as yoga or mindfulness, could be positive strategies to mitigate ADHD symptoms in children and adolescents. However, further research with high-quality designs, with randomization, greater sample sizes, and more intensive supervised practice programs are needed.

Active Commuting to University and its Association with Sociodemographic Factors and Physical Activity Levels in Chilean Students.

Background and Objectives: Active commuting to and from university (ACU) could be a strategy to increase physical activity levels (PA) and promote health in young university students. We aimed to a) examine the patterns of commuting to university in Chilean students; b) the association between the mode of commuting to and from university and socio-demographic factors and PA-levels. Materials and Methods: A total of 496 university students (21.6 ± 2.4 years old) from two universities from Valparaíso (central coast of Chile) participated in this study. Personal data, home address, socio-economic status, PA, and the usual mode of commuting to and from the university were self-reported by a questionnaire. The commute distances were objectively measured using Google-Maps-software. Associations were examined using binary logistic regressions. Results: The main mode of commuting was by bus (to university: 55.2% vs. from university: 59.3%; p < 0.001). The least used mode was cycling (1.4% to and from university). Students living >5-km from university were less active commuters than those living in closer distances: (2-5 km, odds ratio (OR): 4.424, 95% and 95% confidence intervals (CI): 2.443-8.011, p < 0.001; 2 km, OR: 143.052, 95% CI: 55.154-371.030, p < 0.001). Students with low PA-levels were less active commuters than those with medium (OR: 1.446; 95% CI: 0.864-2.421; p = 0.160) or higher levels (OR: 1.880; 95% CI: 1.880-1.094; p = 0.022). Students who lived between 2 and 5 km, presented a significant association to be active commuters when they showed medium PA-levels (OR: 5.244, 95% CI: 1.358-20.246; p = 0.016). Conclusions: Chilean university students from Valparaíso are mainly passive commuters using public transport as the main mode of commuting to and from university; longer distances from home to the university are associated with low PA levels. ACU in distances between 2-5 km (mainly walking) could contribute to having medium PA-levels in Chilean university students. Thus, promoting the ACU walking to and from the university in such distances could be an effective strategy to increase the overall PA levels in Chilean university students.

Systematic review of interventions for promoting active school transport.

Active commuting to school has been recognized as a potential avenue to increase physical activity in children and adolescents. However, active commuting to school has declined over time, and interventions are needed to reverse this trend. The main aim in the current study was to update a previous systematic review on interventions focused on active travel to school, following the same methodology and addressing the quality and effectiveness of new studies detected in the more recent scientific literature. A systematic review was conducted to identify intervention studies of active commuting to school published from February 2010 to December 2016. Five electronic databases and a manual search were conducted. Detailed information was extracted, including a quantitative assessment comparing the effect sizes, with Cohen's d, and a qualitative assessment using the Evaluation of Public Health Practice Projects tool. We identified 23 interventions that focused on active commuting to school. Among the 23 interventions, three were randomized control trials, 22 had a pre/post design, and 12 used control groups. Most interventions reported a small effect size on active commuting to school (14/23) (d: from -1.45 to 2.37). The quality assessment was rated as weak in most studies (21/23). Government funding continues investing in public policies to promote active commuting to school. However, even though seven years have passed since the last systematic review, research with high quality designs with randomization, greater sample size, and the use of valid and reliable instruments are needed.

Longitudinal associations between weather, season, and mode of commuting to school among Spanish youths.

AIM: To study the associations of weather conditions with the travel mode choice for commuting to and from school. METHODS: A total of 6979 Spanish youths aged 7 to 18 years old (80% adolescents aged 12-18 years old, 51% male) completed a 5-day survey of mode of commuting to school in autumn, winter, and spring. Weather data from the nearest weather station to each school were registered. We used Google Maps™ to calculate the distance from home to school. Multilevel logistic regression models were used to estimate odds of active travel based on weather and season. RESULTS: We analyzed a total of 163 846 discrete journeys. In winter, children (aged 7 to 11 years old) were less likely to choose an active mode of commuting to school (OR: 0.72, 95% CI: 0.59-0.89, P = 0.003). In spring, adolescents were more likely to choose an active mode of commuting to school (OR: 1.43, 95% CI: 1.19-1.73, P < 0.001). With higher mean temperatures, adolescents were more likely to choose an active mode of commuting from school (OR: 1.02, 95% CI: 1.00-1.04, P = 0.029). CONCLUSION: Certain weather conditions seem to influence the travel mode choice for commuting to and from school in youth, including season and temperature.

Active commuting to and from university, obesity and metabolic syndrome among Colombian university students.

BACKGROUND: There is limited evidence concerning how active commuting (AC) is associated with health benefits in young. The aim of the study was to analyze the relationship between AC to and from campus (walking) and obesity and metabolic syndrome (MetS) in a sample of Colombian university students. METHODS: A total of 784 university students (78.6% women, mean age = 20.1 ± 2.6 years old) participated in the study. The exposure variable was categorized into AC (active walker to campus) and non-AC (non/infrequent active walker to campus: car, motorcycle, or bus) to and from the university on a typical day. MetS was defined in accordance with the updated harmonized criteria of the International Diabetes Federation criteria. RESULTS: The overall prevalence of MetS was 8.7%, and it was higher in non-AC than AC to campus. The percentage of AC was 65.3%. The commuting distances in this AC from/to university were 83.1%, 13.4% and 3.5% for < 2 km, 2-5 km and > 5 km, respectively. Multiple logistic regressions for predicting unhealthy profile showed that male walking commuters had a lower probability of having obesity [OR = 0.45 (CI 95% 0.25-0.93)], high blood pressure [OR = 0.26 (CI 95% 0.13-0.55)] and low HDL cholesterol [OR = 0.29 (CI 95% 0.14-0.59)] than did passive commuters. CONCLUSIONS: Our results suggest that in young adulthood, a key life-stage for the development of obesity and MetS, AC could be associated with and increasing of daily physical activity levels, thereby promoting better cardiometabolic health.

Cycling to School and Body Composition, Physical Fitness, and Metabolic Syndrome in Children and Adolescents.

OBJECTIVE: To evaluate the association between cycling to/from school and body composition, physical fitness, and metabolic syndrome among a sample of Colombian children and adolescents. STUDY DESIGN: During the 2014-2015 school year, we examined a cross-sectional component of the Association for muscular strength with early manifestation of cardiovascular disease risk factors among Colombian children and adolescents (FUPRECOL) study. Participants included 2877 youths (54.5% girls) from Bogota, Colombia. A self-reported questionnaire was used to measure the frequency and mode of commuting to school. Four components of physical fitness were measured: (1) anthropometric (height, weight, body mass index, and waist circumference); (2) musculoskeletal (handgrip and standing long jump test); (3) motor (speed-agility test; 4 × 10-meter shuttle run); and (4) cardiorespiratory (20-m shuttle run test [20mSRT]). The prevalence of metabolic syndrome was determined by the definitions provided by the International Diabetes Federation. RESULTS: Twenty-three percent of the sample reported commuting by cycle. Active commuting boys had a likelihood of having an unhealthy 4 × 10 m value (OR, 0.72; 95% CI, 0.53-0.98; P = .038) compared with the reference group (passive commuters). Active commuting girls showed a lower likelihood of having unhealthy a 20mSRT value (OR, 0.81; 95% CI, 0.56-0.99; P = .047) and metabolic syndrome (OR, 0.61; 95% CI, 0.35-0.99; P = .048) compared with passive commuters. CONCLUSION: Regular cycling to school may to be associated with better physical fitness and a lower incidence of metabolic syndrome than passive transport, especially in girls.

Effects of a school-based intervention on active commuting to school and health-related fitness.

BACKGROUND: Active commuting to school has declined over time, and interventions are needed to reverse this trend. The main objective was to investigate the effects of a school-based intervention on active commuting to school and health-related fitness in school-age children of Southern Spain. METHODS: A total of 494 children aged 8 to 11 years were invited to participate in the study. The schools were non-randomly allocated (i.e., school level allocation) into the experimental group (EG) or the control group (CG). The EG received an intervention program for 6 months (a monthly activity) focused on increasing the level of active commuting to school and mainly targeting children's perceptions and attitudes. Active commuting to school and health-related fitness (i.e., cardiorespiratory fitness, muscular fitness and speed-agility), were measured at baseline and at the end of the intervention. Children with valid data on commuting to school at baseline and follow-up, sex, age and distance from home to school were included in the final analysis (n = 251). Data was analyzed through a factorial ANOVA and the Bonferroni post-hoc test. RESULTS: At follow up, the EG had higher rates of cycling to school than CG for boys only (p = 0.04), but not for walking to school for boys or girls. The EG avoided increases in the rates of passive commuting at follow up, which increased in the CG among girls for car (MD = 1.77; SE = 0.714; p = 0.010) and bus (MD = 1.77; SE = 0.714; p = 0.010) modes. Moreover, we observed significant interactions and main effects between independent variables (study group, sex and assessment time point) on health-related fitness (p < 0.05) over the 6-month period between groups, with higher values in the control group (mainly in boys). CONCLUSION: A school-based intervention focused on increasing active commuting to school was associated with increases in rates of cycling to school among boys, but not for walking to school or health-related fitness. However, the school-based intervention avoided increases in rates of passive commuting in the experimental group, which were significantly increased in girls of the control group.

A school-based physical activity promotion intervention in children: rationale and study protocol for the PREVIENE Project.

BACKGROUND: The lack of physical activity and increasing time spent in sedentary behaviours during childhood place importance on developing low cost, easy-toimplement school-based interventions to increase physical activity among children. The PREVIENE Project will evaluate the effectiveness of five innovative, simple, and feasible interventions (active commuting to/from school, active Physical Education lessons, active school recess, sleep health promotion, and an integrated program incorporating all 4 interventions) to improve physical activity, fitness, anthropometry, sleep health, academic achievement, and health-related quality of life in primary school children. METHODS: A total of 300 children (grade 3; 8-9 years of age) from six schools in Granada (Spain) will be enrolled in one of the 8-week interventions (one intervention per school; 50 children per school) or a control group (no intervention school; 50 children). Outcomes will include physical activity (measured by accelerometry), physical fitness (assessed using the ALPHA fitness battery), and anthropometry (height, weight and waist circumference). Furthermore, they will include sleep health (measured by accelerometers, a sleep diary, and sleep health questionnaires), academic achievement (grades from the official school's records), and health-related quality of life (child and parental questionnaires). To assess the effectiveness of the different interventions on objectively measured PA and the other outcomes, the generalized linear model will be used. DISCUSSION: The PREVIENE Project will provide the information about the effectiveness and implementation of different school-based interventions for physical activity promotion in primary school children.

Parental perceptions of barriers to active commuting to school in Spanish children and adolescents.

Background: : Understanding parental barriers is crucial to promote active commuting to school since the parental perceptions influence how young people commute. This study examined parental barriers to active commuting to school among Spanish children and adolescents, and their association with their gender and the usual mode of commuting. Parents of children ( n = 628) and parents of adolescents ( n = 151) from Granada (Spain) completed a paper-based questionnaire about perceived parental barriers to active commuting to school and mode of commuting. Data were analyzed using the Chi-square test. Among Spanish parents, the most common barriers reported by parents of children were traffic volume and dangerous intersections, whereas the most frequent barriers reported by parents of adolescents were distance to school and dangerous intersections. Compared to parents of children, a greater proportion of parents of adolescents reported distance to school and crime and smaller proportion reported traffic volume as barriers to active commuting to school. Among parents of children, crime was a more commonly reported as a barrier by parents of girls. Although some barriers reported by parents of passive commuters were similar for children and adolescents (such as distance to school and absence of a policeman at crosswalks), other barriers were specific to parents of children. The main parental barriers to active commuting in children were traffic volume and dangerous intersections whereas for adolescents were distance and dangerous intersections. Among Spanish parents, parental barriers to active commuting are influenced by children's age, gender and mode of commuting to school.

Children who commute to school unaccompanied have greater autonomy and perceptions of safety.

AIM: We explored the rates of children who actively commuted to school, both accompanied and unaccompanied, and identified their safety perceptions. METHODS: This cross-sectional study focused on 745 children, aged 6-12 years, from public schools in the Spanish Granada region. They completed a questionnaire, providing personal data, their school grade, safety perceptions, whether they were accompanied to school and how they travelled to school. We analysed how active commuters were accompanied to school by age group and assessed the associations between safety perceptions and whether or not they were accompanied. RESULTS: Children aged 10-12 years were more likely to travel to school unaccompanied, more likely to travel actively and had better safety perceptions than younger children. We also found differences in how active commuters between 10 and 12 years and children aged 6-7 and 8-9 years (all p < 0.001) were accompanied to school. Children aged 10-12 years who actively commuted unaccompanied had a better understanding of safety issues than accompanied children (p < 0.010). CONCLUSION: Older children who actively commuted to school unaccompanied had better safety perceptions than other children in this sample of children aged 6-12.

Effectiveness of an active commuting school-based intervention at 6-month follow-up.

BACKGROUND: Active commuting to school may provide a significant source of physical activity in youth. Previous school-based intervention studies have shown a positive effect on increasing the frequency of active commuting to school in the short-term. However, how the observed effects are after the intervention remains to be investigated. The objective of the present study was to investigate the effects of a school-based intervention on active commuting to school at 6-month follow-up. METHODS: A total of 494 children ages 8-11 years from 5 primary schools were invited to the study. The schools were non-randomly allocated into control or experimental group. The experimental group received a 6-month programme focused on increasing active commuting to school, while the control group received no intervention. Frequency and mode of commuting to school were measured using a questionnaire at pre-intervention, post-intervention and 6-month follow-up. Children with valid data on commuting to school and provided data for sex, age and distance from home were included in this study (n= 206). RESULTS: There was a significant difference in the change of number of walk and bike travels per week between groups at 6-month follow-up (Control-Group = -0.4 ± 0.3; Experimental-Group = 0.6 ± 0.2;p = 0.019). Regarding the frequency of mode of commuting, only a change in walking to school was significantly different between the groups at 6-month follow-up (Difference Follow-up-Post-intervention) (Control-Group = -0.6 ± 0.3; Experimental-Group = 0.7 ± 0.2;p = 0.004). CONCLUSIONS: A 6-month school-based intervention focused on increasing active commuting to school could be effective strategy for increasing the frequency of active commuting to school even beyond the period of intervention.

Unveiling the relationship of physical literacy with muscular fitness and muscle-strengthening activities in adolescents: the EHDLA study.

Objective: This study evaluated the relationship between physical literacy (PL) and muscular fitness (MF) as well as muscle-strengthening activities (MSA) in adolescents. Methods: A secondary cross-sectional study included 823 adolescents (45.1% boys) from the Eating Healthy and Daily Life Activities Study. The Spanish Perceived Physical Literacy Instrument for Adolescents (S-PPLI) assessed the participants' perceived PL. The evaluation of MF in the young population was conducted using the Assessing the Levels of Physical Activity and Fitness (ALPHA-FIT) test battery. MSA were assessed by the following question: 'In the past week, how many days did you exercise to strengthen or tone the muscle, such as through push-ups, sit-ups or lifting weights?' To examine the associations between S-PPLI scores and handgrip strength, standing long jump and MSA days in adolescents, we employed generalised additive models. Results: Participants with high perceived physical literacty (PPL) had the highest handgrip strength (mean=25.1; PPL had the highest handgrip strength (mean=25.1; bias-corrected and accelerated (BCa) bootstrapped 95% CI 24.2 to 26.0) and standing long jump (mean=149.7; confidence interval (CI) 24.2 to 26.0) and standing long jump (mean=149.7; 24.2 to 26.0) and standing long jump (mean=149.7; BCa bootstrapped 95% CI 145.8 to 153.5). Conversely, those adolescents with low PPL had the lowest handgrip strength (mean=23.1; BCa bootstrapped 95% CI 22.3 to 23.8) and standing long jump (mean=137.3; BCa bootstrapped 95% CI 133.9 to 140.6). For MSA, adolescents with high PPL had the highest mean of MSA days (mean=3.0; BCa bootstrapped 95% CI 2.8 to 3.3), while the lowest mean was observed for those with low PPL (mean=2.0; BCa bootstrapped 95% CI 1.8 to 2.2). Conclusion: A high level of PL was associated with higher levels of MF and MSA among Spanish adolescents.