Influence Of Geographical Area And Living Setting On Weight Status, Gross Motor Coordination And Physical Activity Level Of Italian School Children: The Neighbourhood Walkability Approach

Background: The prevalence of overweight and obesity in childhood is increasing at an alarming rate worldwide, particularly in industrialized countries. Walkability measurements can be collected using the free open software Walk Score® that permit the measure of estimating neighbourhood walkability in many geographic locations. This study was aimed i) to investigate whether differences between rural and urban settings in the North, Centre and South of Italy could influence body-weight status, motor competence and physical activity (PA) level in school-age children; ii) to analyse the walkability of different school areas, and iii) to examine the relationship of motor competence, PA level, geographical areas, living setting, and neighbourhood walkability with children’s body-weight status. Methods: We assessed anthropometric parameters, gross motor coordination and PA level in 1549 children aged between 8 and 13 year. Three geographical areas (North, Centre, South of Italy), two settings (urban and rural) and neighbourhoods’ walkability (Walk Score®) were considered in the analysis. Results: The prevalence of overweight and obesity was 22.0% and 9.9%, respectively; 47.9% of the total sample showed motor impairments and 29.0% was inactive. Central children had higher BMI than Northern and Southern children. Northern children showed the highest MQ and PA level, followed by Southern and Central children. Children from the South of Italy attended schools located in neighbourhoods with the highest Walk Score®. Urban children attended schools located in neighbourhoods with a higher Walk Score® than rural children. Lower MQ, lower PA level, living in rural setting and in a car-dependent neighbourhood were associated with a higher relative risk for obesity. Being a girl was associated with a lower relative risk for obesity.Conclusions: The alarming high percentage of overweight and obesity in children as well as motor coordination impairments revealed the urgent need of targeted PA interventions in paediatric population.