title: Active commuting to school, weight status, and cardiometabolic risk in children from rural areas: the Cuenca study.
abstract: OBJECTIVE
  The aim of this study was to examine (a) whether distance from home to school is a determinant of active commuting to school (ACS), (b) the relationship between distance from home to heavily used facilities (school, green spaces, and sports facilities) and the weight status and cardiometabolic risk categories, and (c) whether ACS has a positive impact on schoolchildren's health.
  
  
  METHODS
  A cross-sectional study was conducted with 956 schoolchildren aged 10 to 12 years from the province of Cuenca, Spain. Height, weight, fat mass, waist circumference, blood pressure, fasting plasma lipid profile, insulin, fitness, physical activity, and ACS were measured. Distances from home to facilities were measured by a geographic information system, and a validated metabolic syndrome index was used.
  
  
  RESULTS
  Children living closer to school (less than 600 m) commuted actively to school more frequently than children living further away (more than 800 m). Normoweight boys lived further away from sports facilities than overweight/obese peers, and children presenting higher cardiometabolic risk levels lived closer to school than those who did not. No differences were found between children who daily walked/cycled to school and those commuting actively to school less frequently in body mass index, metabolic syndrome index, fitness, and physical activity.
  
  
  CONCLUSIONS
  ACS had no positive impact on schoolchildren's health. Distance to school is an indicator of active commuting. However, it seems that not enough physical activity is done to prevent obesity and cardiometabolic risk factors in rural areas.
authors.affiliation: University of Castilla-La Mancha, Cuenca, Spain.
authors.forename: Myriam
authors.initials: M
authors.lastname: Gutiérrez-Zornoza
authors.affiliation: University of Castilla-La Mancha, Cuenca, Spain Mairena.Sanchez@uclm.es.
authors.forename: Mairena
authors.initials: M
authors.lastname: Sánchez-López
authors.affiliation: Universidad Autónoma de Chile, Talca, Chile.
authors.forename: Antonio
authors.initials: A
authors.lastname: García-Hermoso
authors.affiliation: University of Alcalá, Madrid, Spain.
authors.forename: Alberto
authors.initials: A
authors.lastname: González-García
authors.affiliation: University of Granada, Granada, Spain.
authors.forename: Palma
authors.initials: P
authors.lastname: Chillón
authors.affiliation: University of Castilla-La Mancha, Cuenca, Spain.
authors.forename: Vicente
authors.initials: V
authors.lastname: Martínez-Vizcaíno
mesh_terms: D001794:Blood Pressure; D015992:Body Mass Index; D001837:Body Weights and Measures; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D002648:Child; D003430:Cross-Sectional Studies; D015444:Exercise; D005260:Female; D006801:Humans; D008055:Lipids / Q000097:blood; D008297:Male; D010809:Physical Fitness; D011633:Public Facilities / Q000706:statistics & numerical data; D012307:Risk Factors; D012574:Schools; D013030:Spain; D014186:Transportation / Q000379:methods* / Q000706:statistics & numerical data*; D016138:Walking
chemical_list: D008055:Lipids
keywords: cardiovascular disease; child health; health promotion; obesity; physical activity/exercise; social determinant of health