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Mark S. Tremblay, Silvia A. Gonzalez, Peter T. Katzmarzyk, Vincent O. Onywera, and John. J. Reilly

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Silvia A. González, Olga L. Sarmiento, Richard Larouche, Jean-Philippe Chaput, Peter T. Katzmarzyk, and Mark S. Tremblay

Background: In Colombia, active transportation has been assessed in multiple local and regional studies, but national data on active transportation are scarce. This study aims to describe the prevalence and factors associated with active transportation to/from school among Colombian children and adolescents. Methods: The authors analyzed nationally representative data from the National Survey of Nutrition 2015, with a sample of 11,466 children and adolescents aged between 3 and 17 years. Descriptive statistics were calculated, and prevalence ratios were estimated using Poisson regression multivariable models with robust variance. Results: Approximately 70% of Colombian children and adolescents reported engaging in active transportation to/from school over the last week. There were no differences by sex among preschoolers nor school-aged children. Fewer adolescent females than males used active transportation. Preschoolers and school-aged children living in Bogota were more likely to report active transport than children from other regions (prevalence ratios for other regions ranged from 0.59 to 0.86). School-aged children and adolescents with a lower wealth index were more likely to use active transportation than their counterparts (prevalence ratios = 1.32 and 1.22, respectively). Conclusions: The wealthiest children and adolescents, adolescents from rural areas, and female adolescents should be a focus for future interventions. Actions need to be implemented to improve the involvement in active transportation to/from school in Colombia.

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Silvia A. González, Olga L. Sarmiento, Peter T. Katzmarzyk, Jean-Philippe Chaput, Diana M. Camargo-Lemos, and Mark S. Tremblay

Background: Global estimates have shown that a small proportion of children and adolescents are physically active. However, the evidence on physical activity (PA) among Colombian children and adolescents is limited. The objective of this study was to describe the prevalence and correlates of meeting PA guidelines among Colombian children and adolescents. Methods: Data were collected as part of the National Survey of Nutrition 2015. A national sample of 16,612 children and adolescents (3–17 y) was included. Prevalence estimates of meeting PA and active play guidelines were calculated, and Poisson regression models were conducted to identify correlates of PA. Results: Low proportion of Colombian children and adolescents met the PA guidelines. Low engagement in active play was observed among preschoolers. Correlates varied by age group. Female sex was a consistent negative correlate of meeting PA guidelines across all age groups. Conclusions: Urgent actions are needed to promote active play and PA among Colombian children and adolescents. The correlates identified in our study can help inform the development of actions to overcome the disparities and provide opportunities for children to achieve their full potential for healthy growth and development.

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Mark S. Tremblay, Silvia A. Gonzalez, Peter T. Katzmarzyk, Vincent O. Onywera, John J. Reilly, and Grant Tomkinson

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Mark S. Tremblay, Joel D. Barnes, Silvia A. González, Peter T. Katzmarzyk, Vincent O. Onywera, John J. Reilly, Grant R. Tomkinson, and the Global Matrix 2.0 Research Team

The Active Healthy Kids Global Alliance organized the concurrent preparation of Report Cards on the physical activity of children and youth in 38 countries from 6 continents (representing 60% of the world’s population). Nine common indicators were used (Overall Physical Activity, Organized Sport Participation, Active Play, Active Transportation, Sedentary Behavior, Family and Peers, School, Community and the Built Environment, and Government Strategies and Investments), and all Report Cards were generated through a harmonized development process and a standardized grading framework (from A = excellent, to F = failing). The 38 Report Cards were presented at the International Congress on Physical Activity and Public Health in Bangkok, Thailand on November 16, 2016. The consolidated findings are summarized in the form of a Global Matrix demonstrating substantial variation in grades both within and across countries. Countries that lead in certain indicators often lag in others. Average grades for both Overall Physical Activity and Sedentary Behavior around the world are D (low/poor). In contrast, the average grade for indicators related to supports for physical activity was C. Lower-income countries generally had better grades on Overall Physical Activity, Active Transportation, and Sedentary Behaviors compared with higher-income countries, yet worse grades for supports from Family and Peers, Community and the Built Environment, and Government Strategies and Investments. Average grades for all indicators combined were highest (best) in Denmark, Slovenia, and the Netherlands. Many surveillance and research gaps were apparent, especially for the Active Play and Family and Peers indicators. International cooperation and cross-fertilization is encouraged to address existing challenges, understand underlying determinants, conceive innovative solutions, and mitigate the global childhood inactivity crisis. The paradox of higher physical activity and lower sedentary behavior in countries reporting poorer infrastructure, and lower physical activity and higher sedentary behavior in countries reporting better infrastructure, suggests that autonomy to play, travel, or chore requirements and/or fewer attractive sedentary pursuits, rather than infrastructure and structured activities, may facilitate higher levels of physical activity.

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Silvia A. González, Olga L. Sarmiento, Daniel D. Cohen, Diana M. Camargo, Jorge E. Correa, Diana C. Páez, and Robinson Ramírez-Vélez


Physical activity (PA) is central to the global agenda for the prevention on noncommunicable diseases (NCDs). Although 80% of NCDs occur in low-to-middle-income countries, the evidence on PA comes mainly from high-income countries. In this context, the report card for Colombia is an advocacy tool to help in the translation of evidence into concrete actions. The aims of this paper were two-fold: to present the methodology used to develop the first Report Card on Physical Activity in Colombian Children and Youth and to summarize the results.


Twelve indicators of PA were graded using numerical grades (5, highest, to 1, lowest) based on data from national surveys and policy documents.


National policy and obesity indicators were graded “4,” while departmental policy and overweight indicators were graded “3.” Overall PA levels, sports participation, sedentary behaviors and nongovernment initiatives were graded “2,” and school influence was graded “1.” Active transportation, active play, low cardiorespiratory fitness, and family and community influence received an incomplete.


PA levels are low and sedentary behaviors are high in Colombian children and youth. Although the prevalence of obesity in Colombia is lower compared with other Latin American countries, it is increasing. A rich legal framework and availability of institutional arrangements provide unique opportunities to bridge the gap between knowledge and practice that need to be evaluated.

Open access

Diego Augusto Santos Silva, Salomé Aubert, Kwok Ng, Shawnda A. Morrison, Jonathan Y. Cagas, Riki Tesler, Dawn Tladi, Taru Manyanga, Silvia A. González, Eun-Young Lee, and Mark S. Tremblay

Background: The aim of this study was to explore the associations between the 10 key indicators of the Global Matrix 4.0 project and human development index (HDI) at a national level according to sex, age, area of residence, and ability levels. Methods: Information from the 57 countries/localities included in the Global Matrix 4.0 project was compiled and presented according to the HDI of each country/locality for each of the 10 key indicators. Grades were assigned based on the benchmarks of the Global Matrix 4.0 project ranged between “A+” (best performance) and “F” (worst performance). Results: The population subgroups of females, children, rural residents, with/without disabilities from countries/localities with higher HDI performed better in the organized sport and physical activity indicator than their peers from countries/localities with lower HDI. Children and adolescents living in rural areas of countries/localities with higher HDI showed better performance for active play, and children and adolescents living in urban areas of countries/localities with lower HDI showed better performance for the active transportation. Countries/localities with higher HDI showed better grades for sources of influence than the countries/localities with lower HDI. Conclusions: Physical activity patterns in some population subgroups of children and adolescents differed according to the development level of countries/localities.

Open access

Salomé Aubert, Joel D. Barnes, Megan L. Forse, Evan Turner, Silvia A. González, Jakub Kalinowski, Peter T. Katzmarzyk, Eun-Young Lee, Reginald Ocansey, John J. Reilly, Natasha Schranz, Leigh M. Vanderloo, and Mark S. Tremblay

Background: In response to growing concerns over high levels of physical inactivity among young people, the Active Healthy Kids Global Alliance developed a series of national Report Cards on physical activity for children and youth to advocate for the promotion of physical activity. This article provides updated evidence of the impact of the Report Cards on powering the movement to get children and youth moving globally. Methods: This assessment was performed using quantitative and qualitative sources of information, including surveys, peer-reviewed publications, e-mails, gray literature, and other sources. Results: Although it is still too early to observe a positive change in physical activity levels among children and youth, an impact on raising awareness and capacity building in the national and international scientific community, disseminating information to the general population and stakeholders, and on powering the movement to get kids moving has been observed. Conclusions: It is hoped that the Report Card activities will initiate a measurable shift in the physical activity levels of children and contribute to achieving the 4 strategic objectives of the World Health Organization Global Action Plan as follows: creating an active society, creating active environments, creating active lives, and creating active systems.

Open access

Mark S. Tremblay, Joel D. Barnes, Iryna Demchenko, Silvia A. Gonzalez, Javier Brazo-Sayavera, Jakub Kalinowski, Peter T. Katzmarzyk, Taru Manyanga, John J. Reilly, Stephen Heung Sang Wong, and Salomé Aubert

Background: This brief report provides an overview of the Active Healthy Kids Global Alliance (AHKGA); an introduction to the Global Matrix 4.0; an explanation of the value and opportunities that the AHKGA efforts and assets provide to the physical activity research, policy, practice, and advocacy community; an outline of the series of papers related to the Global Matrix 4.0 in this issue of the Journal of Physical Activity and Health; and an invitation for future involvement. Methods: The AHKGA was formed to help power the global movement to get kids moving. In 2019–2021, we recruited countries to participate in the Global Matrix 4.0, a worldwide initiative to assess, compare, and contrast the physical activity of children and adolescents. Results: A total of 57 countries/jurisdictions (hereafter referred to as countries for simplicity) were recruited. The current activities of the AHKGA are summarized. The overall findings of the Global Matrix 4.0 are presented in a series of papers in this issue of the Journal of Physical Activity and Health. Conclusions: The Global Matrix 4.0 and other assets of the AHKGA are publicly available, and physical activity researchers, practitioners, policy makers, and advocates are encouraged to exploit these resources to further their efforts.

Open access

Eun-Young Lee, Patrick Abi Nader, Salomé Aubert, Silvia A. González, Peter T. Katzmarzyk, Asaduzzaman Khan, Wendy Y. Huang, Taru Manyanga, Shawnda Morrison, Diego Augusto Santos Silva, and Mark S. Tremblay

Background: Macrolevel factors such as economic and climate factors can be associated with physical activity indicators. This study explored patterns and relationships between economic freedom, climate culpability, and Report Card grades on physical activity-related indicators among 57 countries/jurisdictions participating in the Global Matrix 4.0. Methods: Participating countries/jurisdictions provided Report Card grades on 10 common indicators. Information on economic freedom and climatic factors were gathered from public data sources. Correlations between the key variables were provided by income groups (ie, low- and middle-income countries/jurisdictions and high-income countries/jurisdictions [HIC]). Results: HIC were more economically neoliberal and more responsible for climate change than low- and middle-income countries. Annual temperature and precipitation were negatively correlated with behavioral/individual indicators in low- and middle-income countries but not in HIC. In HIC, correlations between climate culpability and behavioral/individual and economic indicators were more apparent. Overall, poorer grades were observed in highly culpable countries/jurisdictions in the highly free group, while in less/moderately free groups, less culpable countries/jurisdictions showed poorer grades than their counterparts in their respective group by economic freedom. Conclusions: Global-level physical activity promotion strategies should closely evaluate different areas that need interventions tailored by income groups, with careful considerations for inequities in the global political economy and climate change.