Active Transportation and Adolescents’ Health

The Canadian Health Measures Survey


      Active transportation (AT; e.g., walking and cycling) is increasingly promoted to increase youth physical activity (PA). Most previous research focused solely on school trips, and associations among AT and cardiovascular risk factors have seldom been examined in adolescents.


      To address these important research gaps using data from the nationally representative 2007–2009 Canadian Health Measures Survey.


      A total of 1,016 adolescents aged 12–19 years reported their weekly time spent utilitarian walking and cycling, and wore an Actical accelerometer for 7 days. They underwent a series of physical tests (measures of fitness, body composition, blood pressure, and blood sampling) following standardized protocols. In 2013, differences in PA and health-related outcomes across levels of walking and cycling were assessed with ANCOVA analyses adjusted for age, gender, parental education, and usual daily PA.


      Greater walking and cycling time was associated with higher moderate-to-vigorous PA (MVPA). Compared to adolescents reporting walking 1–5 hours/week, those reporting <1 hour/week had lower waist circumference and total cholesterol/high-density lipoprotein (HDL) ratio and higher glycohemoglobin; those reporting >5 hours/week had better grip strength, lower total cholesterol, and total cholesterol/HDL ratio. Compared to adolescents reporting no cycling, those reporting ≥1 hour/week accumulated more light PA, had greater aerobic fitness, and lower BMI, waist circumference, and total cholesterol/HDL ratio; those who reported cycling <1 hour/week had lower total cholesterol.


      Utilitarian walking and cycling were associated with higher daily MVPA in youth. Cycling was associated with a more consistent pattern of health benefits than walking.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to American Journal of Preventive Medicine
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Tremblay M.S.
        • Warburton D.E.R.
        • Janssen I.
        • et al.
        New Canadian physical activity guidelines.
        Appl Physiol Nutr Metabol. 2011; 36: 36-46
        • USDHHS
        Physical activity guidelines advisory committee report, 2008.
        USDHHS, Washington DC2008
        • Basterfield L.
        • Adamson A.J.
        • Pearce M.S.
        • Reilly J.J.
        Stability of habitual physical activity and sedentary behavior monitoring by accelerometry in 6- to 8-year-olds.
        J Phys Act Health. 2011; 8: 543-547
        • Colley R.C.
        • Garriguet D.
        • Janssen I.
        • Craig C.L.
        • Clarke J.
        • Tremblay M.S.
        Physical activity of Canadian children and youth: accelerometer results from the 2007 to 2009 Canadian Health Measures Survey.
        Health Reps. 2011; 22: 15-23
        • Troiano R.
        • Berrigan D.
        • Dodd K.W.
        • Mâsse L.C.
        • Tilert T.
        • McDowell M.
        Physical activity in the United States measured by accelerometer.
        Med Sci Sports Exerc. 2008; 40: 181-188
        • Hallal P.
        • Andersen L.B.
        • Bull F.C.
        • et al.
        Physical activity levels of the world population: surveillance progress, pitfalls, and prospects.
        Lancet. 2012; 380: 247-257
        • Janssen I.
        • LeBlanc A.G.
        Systematic review of the health benefits of physical activity and fitness in school-aged children and youth.
        Int J Behav Nutr Phys Act. 2010; 7: 40
        • Ekelund U.
        • Luan J.
        • Sherar L.B.
        • Esliger D.W.
        • Griew P.
        • Cooper A.R.
        Moderate to vigorous physical activity and sedentary time and cardiometabolic risk factors in children and adolescents.
        JAMA. 2012; 307: 704-712
        • Biddle S.J.H.
        • Avare M.
        Physical activity and mental health in children and adolescents: a review of reviews.
        Br J Sports Med. 2011; 45: 886-895
        • Jago R.
        • Wedderkopp N.
        • Kristensen P.L.
        • et al.
        Six-year change in youth physical activity and effect on fasting insulin and HOMA-IR.
        Am J Prev Med. 2008; 35: 554-560
        • Andersen L.B.
        • Harro M.
        • Sardinha L.B.
        • et al.
        Physical activity and clustered cardiovascular risk in children: a cross-sectional study (The European Youth Heart Study).
        Lancet. 2006; 368: 299-304
        • Bao W.H.
        • Srinivasan S.R.
        • Wattigney W.A.
        • Berenson G.S.
        Persistence of multiple cardiovascular risk clustering related to syndrome X from childhood to young adulthood: the Bogalusa Heart Study.
        Arch Intern Med. 1994; 154: 1842-1847
      1. American Public Health Association. Promoting active transportation: an opportunity for public health. Washington DC: American Public Health Association, 2012.

        • British Medical Association
        Healthy transport=healthy lives.
        British Medical Association, London2012
        • Larouche R.
        • Saunders T.
        • Faulkner G.E.J.
        • Colley R.C.
        • Tremblay M.S.
        Associations between active school transport and physical activity, body composition and cardiovascular fitness: a systematic review of 68 studies.
        J Phys Act Health. 2014; (In press)
        • Lubans D.R.
        • Boreham C.A.
        • Kelly P.
        • Foster C.E.
        The relationship between active travel to school and health-related fitness in children and adolescents: a systematic review.
        Int J Behav Nutr Phys Act. 2011; 8: 5
        • Shephard R.J.
        Is active commuting the answer to population health?.
        Sports Med. 2008; 38: 751-758
        • Andersen L.B.
        • Wedderkopp N.
        • Kristensen P.
        • Moller N.C.
        • Froberg K.
        • Cooper A.R.
        Cycling to school and cardiovascular risk factors: a longitudinal study.
        J Phys Act Health. 2011; 8: 1025-1033
        • Chillón P.
        • Ortega F.B.
        • Ruiz J.R.
        • et al.
        Bicycling to school is associated with improvements in physical fitness over a 6-year follow-up period in Swedish children.
        Prev Med. 2012; 55: 108-112
        • Pizarro A.N.
        • Ribeiro J.C.
        • Marques E.A.
        • Mota J.
        • Santos M.P.
        Is walking to school associated with improved metabolic health?.
        Int J Behav Nutr Phys Act. 2013; 10: 12
        • Bryan S.
        • St-Denis M.
        • Wojtas D.
        Canadian Health Measures Survey: clinic operations and logistics.
        Health Rep. 2007; 18: 53-70
        • Day B.
        • Langlois R.
        • Tremblay M.
        • Knoppers M.
        Canadian Health Measures Survey: ethical, legal and social issues.
        Health Reps. 2007; 18: 35-52
        • Giroux S.
        Canadian Health Measures Survey: sampling strategy overview.
        Health Rep. 2007; 18: 31-36
        • Tremblay M.S.
        • Wolfson M.
        • Connor Gorber S.
        Canadian Health Measures Survey: rationale, background and overview.
        Health Rep. 2007; 18: 7-20
      2. Statistics Canada, Statistics Canada. Canadian Health Measures Survey (CHMS) Data User Guide: Cycle 1. Ottawa, Ontario2011
        • Evenson K.
        • Catellier D.J.
        • Gill K.
        • Ondrak K.S.
        • McMurray R.G.
        Calibration of two objective measures of physical activity for children.
        J Sport Sci. 2008; 26: 1557-1565
        • Puyau M.R.
        • Adolph A.L.
        • Vohra F.A.
        • Zakeri I.
        • Butte N.F.
        Prediction of activity energy expenditure using accelerometers in children.
        Med Sci Sports Exerc. 2004; 36: 1625-1631
        • Canadian Society for Exercise Physiology
        The Canadian physical activity, fitness & lifestyle approach.
        3rd ed. Canadian Society for Exercise Physiology, Ottawa, Ontario2003
        • Tremblay M.S.
        • Shields M.
        • Laviolette M.
        • Craig C.L.
        • Janssen I.
        • Connor Gorber S.
        Fitness of Canadian children and youth: results from the 2007–2009 Canadian Health Measures Survey.
        Health Rep. 2010; 21: 7-20
        • Bryan S.
        • Saint-Pierre Larose M.
        • Campbell N.
        • Clarke J.
        • Tremblay M.S.
        Resting blood pressure and heart rate measurement in the Canadian Health Measures Survey, cycle 1.
        Health Rep. 2010; 21: 71-78
        • Colley R.C.
        • Connor Gorber S.
        • Tremblay M.S.
        Quality control and data reduction procedures for accelerometry-derived measures of physical activity.
        Health Rep. 2010; 21: 63-69
        • Rao J.N.K.
        • Wu C.F.J.
        • Yue K.
        Some recent work on resampling methods for complex surveys.
        Methodology. 1992; 18: 209-217
        • Rust K.F.
        • Rao J.N.K.
        Variance estimation for complex surveys using replication techniques.
        Stat Methods Med Res. 1986; 5: 281-310
        • McDonald N.C.
        Is there a gender gap in school travel? An examination of U.S. children and adolescents.
        J Transp Geogr. 2012; 20: 80-86
        • Pabayo R.
        • Gauvin L.
        • Barnett T.A.
        Longitudinal changes in active transportation to school in Canadian children aged 6 through 16 years.
        Pediatrics. 2011; 128: e404-e413
        • Panter J.R.
        • Jones A.P.
        • van Sluijs E.M.F.
        Environmental determinants of active travel in youth: a review and framework for future research.
        Int J Behav Nutr Phys Act. 2008; 5: 34
        • Sallis J.F.
        • Prochaska J.J.
        • Taylor W.C.
        A review of correlates of physical activity of children and adolescents.
        Med Sci Sports Exerc. 2000; 32: 963-975
        • Holm S.
        A simple sequentially rejective multiple test procedure.
        Scand J Stat. 1979; 6: 65-70
        • Faulkner G.E.J.
        • Buliung R.N.
        • Flora P.K.
        • Fusco C.
        Active school transport, physical activity levels and body weight of children and youth: a systematic review.
        Prev Med. 2009; 49: 3-8
        • Buliung R.N.
        • Mitra R.
        • Faulkner G.
        Active school transportation in the Greater Toronto area, Canada: an exploration of trends in space and time (1986–2006).
        Prev Med. 2009; 48: 507-512
        • Evenson K.R.
        • Huston S.L.
        • McMillen B.J.
        • Bors P.
        • Ward D.S.
        Statewide prevalence and correlates of walking and bicycling to school.
        Arch Pediatr Adolesc Med. 2003; 157: 887-892
        • Gropp K.
        • Pickett W.
        • Janssen I.
        Multi-level examination of correlates of active transportation to school among youth living within 1 mile of their school.
        Int J Behav Nutr Phys Act. 2012; 9: 124
        • Janssen I.
        • Boyce W.F.
        • Simpson K.
        • Pickett W.
        Influence of individual- and area-level measures of socioeconomic status on obesity, unhealthy eating, and physical inactivity in Canadian adolescents.
        Am J Clin Nutr. 2006; 83: 139-145
        • Stamatakis E.
        • Wardle J.
        • Cole T.J.
        Childhood obesity and overweight trends in England: evidence for growing socioeconomic disparities.
        Int J Obes. 2010; 34: 41-47
        • Lobstein T.
        • Baur L.
        • Uauy R.
        Obesity in children and young people: a crisis in public health.
        Obes Rev. 2004; 5: 4-85
        • Daniels S.R.
        • Pratt C.A.
        • Hayman L.L.
        Reduction of risk for cardiovascular disease in children and adolescents.
        Circulation. 2011; 124: 1673-1686
        • Murtagh S.
        • Rowe D.A.
        • Elliott M.A.
        • McMinn D.
        • Neslon N.M.
        Predicting active school travel: the role of planned behavior and habit strength.
        Int J Behav Nutr Phys Act. 2012; 9: 65
        • Lemieux M.
        • Godin G.
        How well do cognitive and environmental variables predict active commuting?.
        Int J Behav Nutr Phys Act. 2009; 6: 12
        • Gardner B.
        • Abraham C.
        Psychological correlates of car use: a meta-analysis.
        Transp Res Part F. 2008; 11: 300-311
        • Gordon-Larsen P.
        • Boone-Heinonen J.E.
        • Sidney S.
        • Sternfeld B.
        • Jacobs Jr, D.R.
        • Lewis C.E.
        Active commuting and cardiovascular disease risk: the CARDIA study.
        Arch Intern Med. 2009; 169: 1216-1223
        • Hamer M.
        • Chida Y.
        Active commuting and cardiovascular risk: a meta-analytic review.
        Prev Med. 2008; 46: 9-13
        • Hu G.
        • Sarti C.
        • Jousilahti P.
        • Silventoinen K.
        • Barengo N.C.
        • Tuomilehto J.
        Leisure time, occupational, and commuting physical activity and the risk of stroke.
        Stroke. 2005; 36: 1994-1999
        • Andersen L.B.
        • Schnohr P.
        • Schroll M.
        • Hein H.O.
        All-cause mortality associated with physical activity during leisure time, work, sports, and cycling to work.
        Arch Intern Med. 2000; 160: 1621-1628
        • Hu G.
        • Eriksson J.
        • Barengo N.C.
        • et al.
        Occupational, leisure time, and commuting physical activity in relation to total and cardiovascular mortality among Finnish subjects with type 2 diabetes.
        Circulation. 2004; 110: 666-673
        • Brook R.D.
        • Rajagopalan S.
        • Pope C.A.
        • et al.
        Particulate matter air pollution and cardiovascular disease: an update to the scientific statement from the American Heart Association.
        Circulation. 2010; 121: 2331-2378
        • Friedman M.S.
        • Powell K.E.
        • Hutwagner L.
        • Graham L.M.
        • Teague G.
        Impact of changes in transportation and commuting behaviors during the 1996 Summer Olympic Games in Atlanta on air quality and childhood asthma.
        JAMA. 2001; 285: 897-905
        • Cooper A.R.
        • Wedderkopp N.
        • Jago R.
        • et al.
        Longitudinal associations of cycling to school with adolescent fitness.
        Prev Med. 2008; 47: 324-328
        • Børrestad L.A.B.
        • Østergaard L.
        • Andersen L.B.
        • Bere E.
        Experiences from a randomized controlled trial on cycling to school: does cycling increase cardiorespiratory fitness?.
        Scand J Public Health. 2012; 40: 245-252
        • Pucher J.
        • Buehler R.
        Making cycling irresistible: lessons from the Netherlands, Denmark and Germany.
        Transp Rev. 2008; 28: 495-528
        • Andersen LB
        • Lawlor DA
        • Cooper AR
        • Froberg K
        • Andersen SA.
        Physical fitness in relation to transport to school in adolescents: the Danish youth and sports study.
        Scand J Med Sci Sports. 2009; 19: 406-411
        • Rose G.
        Sick individuals and sick populations.
        Int J Epidemiol. 1985; 14: 32-38
        • Laurencelle L.
        • Dupuis F.A.
        Statistical tables explained and applied.
        World Scientific, Washington DC2002
        • Southward E.F.
        • Page A.S.
        • Wheeler B.W.
        • Cooper A.R.
        Contribution of the school journey to daily physical activity in children aged 11–12 years.
        Am J Prev Med. 2012; 43: 201-204
        • Caspersen C.J.
        Physical activity epidemiology: concepts, methods, and applications to exercise science.
        Exerc Sports Sci Rev. 1989; 17: 423-473
        • Adamo K.
        • Prince S.A.
        • Tricco A.C.
        • Connor-Gorber S.
        • Tremblay M.S.
        A comparison of indirect versus direct measures for assessing physical activity in the pediatric population: a systematic review.
        Int J Pediatr Obes. 2009; 4: 2-27
        • Børrestad L.A.B.
        • Andersen L.B.
        • Bere E.
        Seasonal and socio-demographic determinants of school commuting.
        Prev Med. 2011; 52: 133-135
        • Mitra R.
        • Faulkner G.
        There’s no such thing as bad weather, just the wrong clothing: climate, weather and active school transportation in Toronto, Canada.
        Can J Public Health. 2012; 103: 35-41
        • Robertson-Wilson J.E.
        • Leatherdale S.T.
        • Wong S.L.
        Social-ecological correlates of active commuting to school among high school students.
        J Adolesc Health. 2008; 42: 486-495
        • Connor Gorber S.
        • Tremblay M.
        • Moher D.
        • Gorber B.
        A comparison of direct vs. self-report measures for assessing height, weight, and body mass index: a systematic review.
        Obes Rev. 2007; 8: 307-326
        • Martin S.L.
        • Lee S.M.
        • Lowry R.
        National prevalence and correlates of walking and bicycling to school.
        Am J Prev Med. 2007; 33: 98-105
        • Carson V.
        • Spence J.C.
        Seasonal variation in physical activity among children and adolescents: a review.
        Pediatr Exerc Sci. 2010; 22: 81-92