The broader impact of walking to school among adolescents: seven day accelerometry based studyBMJ 2005; 331 doi: https://doi.org/10.1136/bmj.38567.382731.AE (Published 03 November 2005) Cite this as: BMJ 2005;331:1061
All rapid responses
The article by Alexander et al. (1) regarding the impact of walking
to school by adolescents in UK represents a valuable addition to the
prevention of childhood obesity literature in globe.
Globally, the epidemic of obesity and related comorbidities is
increasingly attracting the attention of scientists, health professionals,
and policy makers. Obesity is now pandemic, affecting millions of people
worldwide. (2) In rich countries, between 10% and 20% of people are obese,
and the problem is not unknown even in poor countries. The World Health
Organization recommends the continued surveillance of the population
prevalence of obesity using body mass index (BMI, calculated as kg/m2) as
Increases in childhood overweight and obesity have become a major
public health problem in industrialized nations. The numerous
psychosocial, physical and economic consequences of overweight and obesity
are well-known. Childhood overweight affects self-esteem and has negative
consequences on cognitive and social development. (3, 4)
As a whole, the obesity epidemic constitutes a substantial decrease
in quality of life and life expectancy and accounts for billions of
dollars in health care spending. (5, 6)
Insufficient physical activity and poor nutrition are widely acknowledged
as the primary mechanisms underlying the rise in excess body weight. (7)
School age is an important moment in life to learn protective
lifestyles. It is well known that healthful behavior learnt at school can
be maintained over time. School-related factors could predict future
health behavior, especially in relation to low physical activity.
Perhaps we need to persuade more kids to walk to school, even those who
live a bit further away - when it might make a significant difference to
overall activity levels. Since danger from traffic is perceived to be one
of the main barriers to walking or cycling, the decision of some parents
to drive their children to school may be helping to discourage other,
older, less active children from taking up this opportunity for physical
There are certainly many other reason why walking to school is a good
idea – not least removing some of the danger to others from the excessive
volume and speed of cars around schools. Schools across the globe should
help to clear the air, create safer neighborhood routes for children,
increase physical activity levels and foster community spirit.
We need widespread multisectoral preventive efforts to ensure that
they do not increase their risk of future problems during their school
years. This will require health promotion policies in schools concerning
healthy diet and exercise. Support from public and private sectors to
facilitate healthy lifestyles by improving leisure and more affordable
recreational facilities. We need to lift all taxes related to sport and
recreation. Membership of sport clubs and buying sports equipments and
outfits should be free from taxation.
We need more local, provincial and national initiatives and
legislation to improve the safety of neighborhoods and increase access to
playgrounds and recreational facilities in every neighborhood. Leadership
and advocacy from both health professionals and social scientists is
required to bring about these changes. Governments should create urban
public spaces where safe walking, cycling and exercising can be
incorporated into daily life-an infrastructure that has been neglected for
With school budgets tightening across less developed countries, North
America and in Western countries, physical education and after-school
sport programs have recently been on the chopping block. This is
particularly troubling since high-quality, school-based physical education
can help promote healthier living and encourage a lifetime of active
living. Given the convincing scientific evidence that physical inactivity
leads to a host of chronic degenerative conditions and premature death,
the promotion of a physically active lifestyle is an urgent and important
public health priority.
(1). Alexander, L.M., Inchley, J., Todd, J., Currie, D., Cooper, A.
R., Currie, C., The broader impact of walking to school among adolescents:
seven day accelerometry based study. BMJ 2005:5; 331(7524):1061-2.
(2). World Health Organization. Obesity: preventing and managing the
global epidemic. Geneva: The Organization; 2000. Technical report series
(3). Tremblay MS, Inman JW, Willms JD. Relationships between physical
activity, self esteem, and academic achievements in ten- and eleven-year-
old children. Pediatrtic Exer Sci 2000; 11:312-23.
(4). Hesketh K, Wake M, Waters E. Body mass index and parent-reported
self-esteem in elementary school children: evidence for a causal
relationship. Int J Obes Relat Metab Disord 2004; 28:1233-7.
(5). Fontaine KR, Redden DT, Wang C, Westfall AO, Allison DB. Years
of life lost due to obesity. JAMA 2003; 289:187-93.
(6). Katzmarzyk PT, Janssen I. The economic costs associated with
physical inactivity and obesity in Canada: An update. Can J Appl Physiol
(7). Nicklas T, Johnson R. Position of the American Dietetic
Association: dietary guidance for healthy children ages 2 to 11 years. J
Am Diet Assoc 2004; 104:660-77
Competing interests: No competing interests