The Netherlands is known globally for its widespread use of bicycles and some call it a “cycling nation”. Indeed, many Dutch inhabitants own a bike and cycle frequently. Numbers show that 84% of the Dutch inhabitants from age 4 years and older own a bike. Those owners have an average of 1.3 bikes per person. This results in 18 million bikes in the Netherlands and 13.5 million bike owners.6 The Dutch use their bike as a means of transportation, but also for sports and exercise. Bike-use fits well in an active lifestyle and it is highly plausible that cycling is responsible for a large part of the daily physical activity in Dutch youth. It is estimated that Dutch people have on average a 6 months longer life expectancy attributable to bicycle use.7 It seems that the nation itself is well shaped to cycle: no large mountains, only a few small hills, and an extensive layout of cycle paths and routes in every city and village. In many urban areas separate cycle paths are very common. Our results show that many Dutch children use the bike as their way of transportation. It was demonstrated that active transportation is responsible for a large part of schoolrelated physical activity in Dutch youth.8 80% of 12-17 year-old children cycled three or more days to or from school/work.9 This resulted in an ‘A’ for the indicator active transportation (walking is included in the grade as well). Active transport is associated with increased total physical activity among youth.10,11 Also evidence is reported for an association between active transport and a healthier body composition and healthier level of cardiorespiratory fitness among youth. Although Dutch children accumulate a lot of daily physical activity through cycling, it is not enough to meet the current national physical activity guidelines of 60 minutes of moderate-to-vigorous physical activity per day. Even though cycling is an important component to the amount of daily physical activity, Dutch youth are not cycling to health
The (pre)school environment is an important setting to improve children’s health. Especially, the (pre)school playground provides a major opportunity to intervene. This review presents an overview of the existing evidence on the value of both school and preschool playgrounds on children’s health in terms of physical activity, cognitive and social outcomes. In addition, we aimed to identify which playground characteristics are the strongest correlates of beneficial effects and for which subgroups of children effects are most distinct. In total, 13 experimental and 17 observational studies have been summarized of which 10 (77%) and 16 (94%) demonstrated moderate to high methodological quality, respectively. Nearly all experimental studies (n = 11) evaluated intervention effects on time spent in different levels of physical activity during recess. Research on the effects of (pre)school playgrounds on cognitive and social outcomes is scarce (n = 2). The experimental studies generated moderate evidence for an effect of the provision of play equipment, inconclusive evidence for an effect of the use of playground markings, allocating play space and for multi-component interventions, and no evidence for an effect of decreasing playground density, the promotion of physical activity by staff and increasing recess duration on children’s health. In line with this, observational studies showed positive associations between play equipment and children’s physical activity level. In contrast to experimental studies, significant associations were also found between children’s physical activity and a decreased playground density and increased recess duration. To confirm the findings of this review, researchers are advised to conduct more experimental studies with a randomized controlled design and to incorporate the assessment of implementation strategies and process evaluations to reveal which intervention strategies and playground characteristics are most effective. https://doi.org/10.1186/1479-5868-11-59 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited.
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