Fitness levels of Greek primary schoolchildren in relationship to overweight and obesity

Gender differences and climate zones in overweight and obesity prevalence in European elementary school children from 2000 to 2020: a systematic review and meta-analysis

Introduction

After 2000, there are more obese than underweight people in the world. We face a rapid increase in average global warming of 1.5°C, reported as a syndemic problem of three interconnected epidemics: obesity, global warming, and undernutrition. We aimed to analyze the impact and association between global warming and obesity in children and differences by gender across Europe after 2000.

Methods

We searched PubMed, MEDLINE, Google Scholar, ScienceDirect, and Embase databases. The considered population were children aged 6-14. Only cross-sectional studies that defined obesity by the IOTF cutoffs and the subjects' place of residence, used to determine precise climate zones, were included. We assessed the prevalence of obesity and overweight using a random-effects and the Mantel-Haenszel fixed-effect method when heterogeneity was greater/lower than 50%. We did a subgroup analysis for prevalence across gender, obesity, and overweight, two decades, regions, countries, and the Köppen-Geiger climate zones. Random effects of the meta-regression were used to study the global warming impact and differences in trends across European countries by gender for both conditions separately.

Results

We identified 114 studies that included 985,971 children from 39 European countries. A significant difference between genders was in favor of obese girls 4.78 (95% CI: 3.85-5.93) versus boys 5.76% (95% CI: 5.11-6.48, p = 0.03), respectively, but not for overweight children. Most of the obese girls were in South Europe 7.51% (95% CI: 6.61-8.51) versus East Europe 2.86% (95% CI: 23-3.12), versus boys in South Europe 8.66% (95% CI: 7.68-9.74) and North Europe 3.49% (95% CI: 2.90-4.19), respectively. The "cold" Köppen-Geiger climate zone, with lowest temperatures, has the largest trend rise between two decades of 2.8% and 1.53% for obese girls and boys, and 5.31% and 1.81% for overweight girls and boys, respectively, followed by the smallest number of obese girls 3.28% (95% CI: 2.17-4.92) and boys 3.58% (95% CI: 2.39-5.33), versus the zone with the highest temperatures "hot" for girls 7.02% (95% CI: 6.30-7.82) and for boys 8.23% (95% CI: 7.55-8.96), respectively. The meta-regression proved global warming has a significant impact on the distribution of obesity and overweight across climate zones, R2 = 0.52 and R2 = 0.22. No significant gender differences, or significant interaction, was noted.

Conclusion

Our meta-analysis provides a comprehensive overview of the association between and impact of global warming on obesity. This impact increases obesity among children in Europe throughout all climate zones, and emphasizes an urgent call for further preventive methods in schools, since obesity differences continue their trend of disappearing into the future.Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021282127, identifier: CRD42021282127.

Differences in the absolute muscle strength and power of children and adolescents with overweight or obesity: a systematic review

This study aimed to describe absolute muscle strength and power in children and adolescents with obesity, overweight and normal weight, and the assessment tests and tools used. We retrieved observational studies from MEDLINE (PubMed), TripDataBase, Epistemonikos, EBSCO essentials, NICE, SCOPUS, and LILACs up to February 2023. In addition, we recovered data from studies with at least three comparison groups (obesity, overweight, normal weight) and with a description of the absolute muscle strength and power and the assessment tests and instruments used. The methodologic quality of the studies was assessed with the Joanna Briggs checklist, and the review was carried out using the PRISMA 2020 methodology. Eleven studies with 13,451 participants from 6 to 18 years of age were once included, finding that the absolute muscle strength of their upper extremities was greater when they were overweight or obese; however, in the same groups, absolute muscle strength was lower when they carried their body weight. In addition, lower limb absolute muscle strength was significantly lower in obese participants than in normal weight, regardless of age and gender. The most used tools to measure the absolute muscle strength of the upper limbs were the grip dynamometers and push-up exercises. In contrast, different jump tests were used to measure the power of the lower limbs. There are great differences in muscle strength and power between overweight or obese children and adolescents and those with normal weight. Therefore, it is recommended to use validated tests, preferably that assess strength through the load of the patient's body weight, either of the upper or lower limbs, for greater evaluation objectivity that facilitates the management of these children and adolescents.

The Association of Body Mass Index and Fat Mass with Health-Related Physical Fitness among Chinese Schoolchildren: A Study Using a Predictive Model

Body fat mass (FM) has advantages over body mass index (BMI) in terms of accuracy of fitness assessment and health monitoring. However, the relationship between FM and fitness in Chinese children has not yet been well studied. This study aimed to investigate the relationship between health-related physical fitness, BMI, and FM, which was estimated using a predictive model among elementary schoolchildren in China. This cross-sectional study included 2677 participants (boys, 53.6%; girls, 46.4%) who underwent anthropometric measurements (height, weight, BMI, and FM) and five health-related fitness tests: 50-m sprint (speed), sit and reach (flexibility), timed rope-skipping (coordination), timed sit-ups (muscular endurance), and 50-m × 8 shuttle run (endurance). In boys, BMI showed a positive correlation with speed (p < 0.001) and endurance (p < 0.006) tests and a negative correlation with flexibility (p < 0.004) and coordination (p < 0.001) tests. In girls, a positive correlation between speed (p < 0.001) and endurance (p < 0.036) tests was observed. Both BMI and FM (estimated using the predictive model) were strongly associated with the health-related physical fitness of elementary schoolchildren. Our findings indicate that health-related physical fitness was similarly affected by FM and BMI. As FM can be quantified, it could therefore be used to develop strategies and intervention programs for the prevention and management of obesity in children.

Association between BMI and health-related physical fitness: A cross-sectional study in Chinese high school students

Background

Existing studies reporting on the levels of physical fitness among high school students use relatively few fitness tests for indicators of physical fitness, thus, incomprehensively evaluating the levels of physical fitness. Therefore, this study investigated the relationship between body mass index (BMI) and physical fitness index (PFI) by investigating five physical fitness indicators and calculating PHI.

Method

Anthropometric measurements and indicators from five measures of physical fitness (50-m sprint, sit and reach, standing long jump, 800/1,000-m run, pull-up/bent-leg sit-up) were assessed. BMI was calculated to classify individuals into underweight, normal weight, overweight, and obese categories. Z-scores based on sex-specific mean and standard deviation were calculated, and the sum of Z-scores from the six fitness tests indicated the PFI. The findings were fitted to a linear regression model to elucidate the potential relationship between BMI and PFI.

Results

In total, 176,655 high school students (male: 88,243, female: 88,412, age: 17.1 ± 1.05 years, height: 168.87 ± 11.1 cm, weight: 62.54 ± 15.15 kg) in Jinan, China, completed the physical fitness tests between 2020 and 2021. The one-way ANOVA models showed that PFI in the normal category was significantly higher as compared to all the other BMI categories within both male and female groups (p < 0.001), and PFI in the obese category was significantly lower as compared to all the other BMI categories for both male and female groups (p < 0.001). The association between PFI and BMI showed an inverted U-shape relationship.

Conclusions

This study demonstrated that BMI affects the PFI in both males and females. As compared to the obese and overweight categories based on BMI, significantly higher scores of PFI were observed for males and females.

The Impact of Obesity on the Fitness Performance of School-Aged Children Living in Rural Areas-The West Attica Project

This study aimed to investigate the relationship of body mass index (BMI) with muscle and cardiorespiratory fitness in children living within rural areas (regional unit of West Attica) in Greece. Participants included 399 students (187 boys, 212 girls), ages 8-12 years old, and were evaluated in physical performance tests. The point prevalence of overweight and obesity was 21.39% and 26.20% in boys, and 19.90% and 23.79% in girls. Significant differences were observed in all physical performance tests (handgrip, long jump, shuttle run, trunk flexors, and extensors endurance) between normal weight and obese participants. BMI was positively correlated with handgrip (r = 0.442-0.462, p < 0.001). There was a negative association with long jump (r = -0.206, p < 0.001), 20 m shuttle run (r = -0.394, p < 0.001), trunk flexors (r = -0.403, p < 0.001) and trunk extensors endurance (r = -0.280, p < 0.001). The regression analysis showed that 20-30% of the overall variation for physical performance assessments could be accounted for by BMI, age, and sex. With the exception of the long jump and the endurance of the trunk extensors, BMI alone may explain more than 10% of the outcome of most tests. This study highlights the determinant of BMI on muscle and cardiorespiratory fitness. The management of obesity should begin early in childhood to prevent adult chronic cardiovascular and metabolic diseases.

Correlations between Physical Fitness and Body Composition among Boys Aged 14–18—Conclusions of a Case Study to Reverse the Worsening Secular Trend in Fitness among Urban Youth Due to Sedentary Lifestyles

A secular trend can be observed throughout the world with an increase in childhood obesity and a decrease in fitness. The research aimed to examine the results of tests measuring the conditional abilities of young boys aged 14–18 in fitness tests and their correlations with body composition indicators. That was supported by research that has been prepared in Hungary so far. This research focuses on the results of fitness tests conducted on 14- to 18-year-old boys, presented along with body composition data. The authors sought to describe the development of the fitness profiles of males at a Budapest secondary school participating in the research, based on the results of the Hungarian National Student Fitness Test (NETFIT®), and also how their physical characteristics affect the results of NETFIT® tests in the sample measured. A total of 735 male high school students at a Budapest secondary school (14–18 years old) (mean ± SD, 16.05 ± 1.18 years) participated in the survey. The data were collected in the 2018/2019 academic year, and it was compared with the national data. The correlation between the performance indicators of the NETFIT® tests and the physical characteristic indicators was analyzed using the two-block Partial Least Squares method. In the resulting groups, Kruskal–Wallis variance analysis was performed to investigate the differences in performance. In contrast, pairs of group differences were tested with the Mann–Whitney test. Boys with a short physique were at some advantage in trunk-lifts and push-ups, compared to taller boys. It was also obvious that being overweight is a hindrance regarding the PACER test or the standing broad jump. The handgrip in the left and right hand was mostly of similar strength or weakness. Tall-heavy children performed better in this test. The grip strength of tall-thin students was also strong, but not as strong as in the tall-heavy group. Reducing the percentage of body fat (PBF) and creating the optimal BMI index is important for the younger age group, as our results have clearly demonstrated that overweight is a hindrance in the PACER, VO2 max, standing broad jump, back-saver sit-and-reach, and push-up tests.

Moderate Effects of School-Based Time Increasing Physical Education Intervention on Physical Fitness and Activity of 7-Year Pupils—A Report from a Follow-Up of a HCSC Study

We evaluated the effectiveness of a 15-week intervention that increased from three to five lessons of physical education (PE) a week on 7-year-old boys’ and girls’ physical fitness (PF), physical activity (PA) and sedentary behaviour on week and weekend days. A total of 212 first grade pupils (mean age 6.95 ± 0.43) from two urban schools in Poznań were randomly assigned to the experimental or control groups. The PF was measured with a battery of field tests, while health-related behaviours were assessed with the Healthy Children in Sound Communities questionnaire. There were some interaction effects noticed in the PF scores in the case of a 20-min run for boys (F_2,196 = 5.29, p = 0.0058) and for girls (F_2,220 = 3.31, p = 0.0382) and the sit-ups test for boys (F_2,196 = 1.93, p = 0.1478) and for girls (F_2,220 = 3.98, p = 0.0201) and for the sit and reach test in the case of girls (F_2,220 = 3.98, p = 0.0201). In terms of outdoor PA levels, there were no major differences between any of the examined groups. Differences were found between girls from the experimental and control groups in the post-test (p = 0.0107) and follow-up (p = 0.0390) during the weekdays, with no differences between the groups of boys. Despite the moderate effects of the extended PE time programme right after the intervention, there were some indications of progress in the follow-up experiments.

Muscular Fitness and Cardiometabolic Variables in Children and Adolescents: A Systematic Review

BACKGROUND

The importance of muscular fitness (MF) in the performance of activities of daily living is unequivocal. Additionally, emerging evidence has shown MF can reduce cardiometabolic risk in children and adolescents.

OBJECTIVES

The purpose of this study was to examine and summarize the evidence regarding the relationship between MF phenotypes (i.e., maximum muscular strength/power, muscular endurance, and maximum muscular strength/power/endurance) and cardiometabolic variables (obesity, blood pressure, lipids, glucose homeostasis, inflammatory markers, and clustered cardiometabolic variables) in children and adolescents.

DESIGN

This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and was registered with PROSPERO, number CRD42020179273.

DATA SOURCES

A systematic review was performed on five databases (PubMed, EMBASE, SciELO, Scopus, and Web of Knowledge) from database inception to May 2020, with complementary searches in reference lists.

ELIGIBILITY CRITERIA FOR SELECTING STUDIES

Eligibility criteria included (1) a study sample of youth aged ≤ 19 years, (2) an assessment of MF with individual or clustered cardiometabolic variables derived from adjusted models (regardless of test/measurement adopted or direction of reported association), and (3) a report of the association between both, using observational studies. Only original articles published in peer-reviewed journals in English, Portuguese, and Spanish languages were considered. The quality of the included studies was assessed by using the National Heart, Lung, and Blood Institute checklist. The percentage of results reporting a statistically significant inverse association between each MF phenotype and cardiometabolic variables was calculated.

RESULTS

Of the 23,686 articles initially identified, 96 were included (77 cross-sectional and 19 longitudinal), with data from children and adolescents from 35 countries. The score for the quality of evidence ranged from 0.33 to 0.92 (1.00 maximum). MF assessed by maximum muscular strength/power was inversely associated with lower obesity (64/113 total results (56.6%)) and reduction in clustered cardiometabolic risk (28/48 total results (58.3%)). When assessed by muscular endurance, an inverse association with obesity (30/44 total results (68.1%)) and cardiometabolic risk (5/8 total results (62.5%)) was identified. Most of the results for the relationship between MF phenotypes with blood pressure, lipids, glucose homeostasis, and inflammatory markers indicated a paucity of evidence for these interrelationships (percentage of results below 50.0%).

CONCLUSION

MF assessed by maximum muscular strength/power or muscular endurance is potentially associated with lower obesity and lower risk related to clustered cardiometabolic variables in children and adolescents. There is limited support for an inverse association between MF with blood pressure, lipids, glucose homeostasis biomarkers, and inflammatory markers in children and adolescents.

Health-Related Motor Testing of Children in Primary School: A Systematic Review of Criterion-Referenced Standards

Being physically fit in younger years prevents several diseases in the presence as well as in the life course. Therefore, monitoring physical fitness and motor competence through motor testing is essential for determining developmental status and identifying health-related risks. The main objectives of this systematic review were (1) to identify currently available health-related criterion-referenced standards and cut-off points for physical fitness and motor competence test items, (2) to frame the methodological background on setting health-related criterion-referenced standards and (3) to give implications for a health-related evaluation system for physical fitness and motor competence tests. The electronic data base search (PubMed, Web of Science and SURF) yielded 2062 records in total and identified six empirical studies reporting cut-off points of motor test items for children (7-10 years), as well as 30 methodological papers discussing determination approaches to health-related criterion-referenced standards. Data collection, selection and analyses followed the PRISMA guidelines. Health-related motor test standards need to be gender- and age-specific but should refer to an absolute cut-off point rather than to relative performance in the reference group. Due to the lack of data on health-related criterion referenced standards, receiver-operating-characteristic (ROC) curves provide a tool for the determination of cut-off points and criterion referenced standards for physical fitness and motor competence tests. A standardized approach forms the fundamental base for a globally applicable evaluation of health-related fitness tests.

Students Living in the Islands are Heavier and have Lower Fitness Levels Compared to their Mainland Counterparts; Results from the National Action for Children's Health (EYZHN) Program

Few studies have examined variations in obesity by geographic location in youth and its relation with fitness levels. The present study investigated the association between geographic status (islands versus mainland), excess of body weight and fitness levels among 335.810 schoolchildren (male: 51.3%, 6-18 y, during the school year 2014-2015). Students' anthropometric parameters and fitness levels - accessed via the Euro-fit test - were measured by trained physical education teachers and evaluated according to published norms. Prevalence of overweight (23.0 Vs 21.8%) and obese (10.1 Vs 8.0%) was significantly higher for students living in the islands contrary to their mainland counterparts. A significant difference was also observed for centrally obese children (33.5 Vs 28.2%). Except for speed test .408), in all other four fitness tests, the students from the islands presented significantly lower performance (≤25^th percentile of published age- and sex-specific normative values) versus their mainland counterparts. Boys and girls living in the islands had 48% and 37% increased odds of low physical fitness (as a total), respectively, compared to their mainland counterparts. Likewise, children living in islands presented increased odds of being overweight or obese by 19% and 15% in boys and girls, respectively, as compared to those living in the mainland. Increased general and abdominal adiposity have a direct negative impact on students' performance in Physical Fitness tests. Our data highlight the problem of excessive body weight that children living in rural areas, face.

Physical fitness reference standards in Italian children

Physical fitness in childhood is considered a marker of current and future health. For this reason, there is a need for a simple but reliable test to assess the different components of physical fitness even at school during physical education lessons. However, standard values are required to correctly interpret the results of such tests. Hence, this study aimed to generate sex- and age-specific normative percentile values for health-related physical fitness in Italian children. To this aim, 30,472 children aged 6-11 years from the Friuli Venezia-Giulia region (Italy) were examined. The fitness test battery included the Léger test (cardiorespiratory), the shuttle test (agility), standing long jumps, frontal throws of a basketball (lower and upper limb strength), the sit-and-reach test (flexibility), and the standing balance test. Sex- and age-percentile curves were determined using the General Additive Model for Location Scale and Shape (GAMLSS).Conclusion: The reference standards are provided as 1st, 3rd, 10th, 25th, 50th, 75th, 90th, 97th, and 99th percentiles in the form of both tables and charts and are roughly comparable with those of other European children. What is Known: • Physical fitness in childhood is considered a marker of current and future health; • Several tests have been developed to assess physical fitness in children; • There are general European reference standards for a series of tests of the main fitness components for children. What is New: • The present study provides specific reference standards for a series of tests that are indicative of the main fitness components and easily applied in children, particularly those in the Italian population; • Standing balance test and basketball frontal throw test references in a wide sample of children; • The performance of children in the present study was roughly comparable to that of other European children.

Hamstring extensibility differences among elite adolescent and young dancers of different dance styles and non-dancers

Background

Hamstrings have been analyzed extensively due to their tendency to shorten and their effect in the lumbo-pelvic dynamics and the sagittal position of the spine in trunk flexion with extended knees positions. It has been demonstrated that practicing a certain sport results in long-term changes in hamstring extensibility. Despite this, adequate extensibility of the hamstring musculature is essential for the dancer’s performance. Several studies have found differences in the extensibility of the hamstrings depending on the dance style, but none have compared ballet, Spanish dance and modern dance. The purpose of the present research was to analyze the differences in hamstring extensibility among professional dance students based on dance style practiced and non-dancers.

Methods

The sample was comprised of 210 students from the Professional Dance Conservatory (70 for ballet, 70 for Spanish dance and 70 for modern dance) and 70 non-dancers. For the assessment of hamstring extensibility, the angle in the passive and active straight leg raise (PSLR and ASLR, respectively) test, and the scores of the pelvic tilt in sit-and-reach (SR) test and the toe-touch (TT) test were randomly conducted.

Results

The results showed significant differences for all the tests according to group (p < 0.001). In the PSLR and ASLR test, for both legs, and in the pelvic tilt in the SR test, the ballet dancers showed greater ranges of hamstring extensibility than the modern dancers and Spanish dancers (p ≤ 0.001). In the distance in the SR test and in the pelvic tilt in the TT test, the ballet dancers obtained higher values than the Spanish dancers (p = 0.004 and p = 0.003, respectively). The modern dancers showed higher ranges of hip flexion than the Spanish dancers in the ASLR test for both legs and in the pelvic tilt in the SR test (p from 0.007 to <0.001). Dancers showed significantly higher hamstring extensibility than non-dancers in all the tests (p < 0.001).

Conclusions

The systematic practice of dance, regardless of the style, seems to lead to high ranges of hamstring extensibility. Ballet dancers have the greatest hamstring extensibility.

Relationship between body mass index and physical fitness in Italian prepubertal schoolchildren

The objective of this study was to investigate the association between physical fitness and body mass index categories (obesity, OB; overweight, OW; normal-weight, NW; and underweight, UW) in prepubertal children. Anthropometric and physical fitness characteristics were collected from a convenience sample of 30472 Italian schoolchildren (6–11 years old). Six field-based tests were used: Léger, agility shuttle, long jump, frontal throw of the basketball, Sit & Reach and standing balance. Significant differences were found in the anthropometric characteristics, physical fitness and weight status prevalence between girls and boys (p<0.05) and, except for flexibility, by age class (p<0.05). Obese children performed worse than their NW counterparts in aerobic capacity (p<0.001), agility (p<0.001), muscular power of the lower limb (p<0.001) and balance (p<0.001). Conversely, children with obesity showed greater upper limb power than NW children (p<0.001). The discrepancy in physical fitness between OB and NW children increased in older girls (flexibility, p = 0.002; muscular power of the lower and upper limb, p = 0.002 and p = 0.005) and boys (aerobic capacity, p = 0.009; agility, p = 0.006; standing balance, p = 0.019; muscular power of the lower and upper limb, p<0.001 and p = 0.011) compared to their younger counterparts. On the other hand, UW children performed worse than NW children mainly in terms of muscular power of the arms (p<0.001). Additionally, there was an increasing disparity in the frontal throw test scores of UW and NW girls (p = 0.003) and boys (p = 0.011) in older children compared to younger children. In conclusion, the effect of body mass index on children’s physical fitness intensifies with age. OB and OW negatively affect aerobic capacity, agility, lower limb power and balance but positively affect upper limb power. UW negatively affects upper limb power. This study underscores the importance of preventing childhood OW, OB, and UW in early life to promote children’s health and proper fitness development.

Poor Physical Fitness Performance as a Predictor of General Adiposity in Taiwanese Adults

The purpose of the present study was to investigate the association between different levels of health-related physical fitness measurements and obesity status in Taiwanese adults. A cross-sectional study was conducted by reviewing the National Physical Fitness Survey in Taiwan (HPFSIT) database. Responses from 60,056 participants, aged 23-64 years from the database were collected in the present study. Data from a standardized structured questionnaire and health-related physical fitness tests were analyzed. The quartiles of each physical fitness measurement were used for unconditional logistic regression analyses. Our results indicated clear trends in the association between cardiorespiratory fitness and overweight/obesity. Overweight and obesity were associated with a 10% to 60% increased risk of low levels of cardiorespiratory fitness in men and a 10% to almost 30% increased risk in women. However, the association between muscle strength/endurance and obesity status as well as flexibility and obesity status needs further investigation.

The Federated Practice of Soccer Influences Hamstring Flexibility in Healthy Adolescents: Role of Age and Weight Status

The aim of this study was to compare the hamstring flexibility between federated soccer and non-federated adolescents, and also to evaluate the effect of age and weight status on hamstring flexibility. The participants were 234 students (11–18 years old) divided into: (i) G1: non-federated (n = 127), and (ii) G2: federated in soccer (n = 107). The deep flexion of the trunk (DF) test and the sit and reach test (SRT) were performed. G2 showed higher values for the DF and SRT compared to G1 (p < 0.05). Both flexibility tests correlated positively (r = 0.4, p < 0.001). Body mass index (BMI) was negatively correlated with the DF test (r = −0.3, p < 0.001), but not with the SRT. Divided by BMI, the underweight and normal weight groups had higher scores in the DF test compared with the overweight and obese groups (p < 0.001). BMI was negatively correlated with hamstring flexibility. Federated soccer students present higher scores of hamstring flexibility.

The association between BMI and health-related physical fitness among Chinese college students: a cross-sectional study

Background

Existing studies reporting on the levels of physical fitness among college students used relatively few fitness tests as a reflection of physical fitness, which could not comprehensively evaluate the levels of physical fitness. Thus, the current study aimed to investigate the cross-sectional relationship between body mass index (BMI) and a physical fitness index (PFI) based on six indicators of fitness in Chinese college students.

Method

Anthropometric measurements and six measures of physical fitness (Vital capacity, 50-m sprint, sit and reach, standing long jump, 800/1000-m run, pull-up/bent-leg sit-up) were measured. BMI was calculated to classify individuals into underweight, normal weight, overweight, and obesity groups. Z-scores based on sex-specific mean and standard deviation were calculated, and the sum of z-scores for the six fitness tests was used as a PFI. Three models (a linear regression model, polynomial regression model with a second-order BMI term and a restricted cubic spline regression model) were fitted to discuss the potential relation between BMI and PFI. We compared the models using Akaike Information Criterion (AIC) and R square.

Results

Totally, 8548 freshmen from the years 2014 to 2016 in a medical college completed the physical fitness tests. There was a decreasing trend of physical fitness index from the years 2014 to 2016 (P for trend < 0.01). More male than female students were overweight or obese (23.5% vs. 11.9%), but more female than male students were normal weight (74.7% vs. 64.8%). A restricted cubic spline regression model was superior to linear and polynomial regression model with lower AIC and higher R square.

Conclusions

The relationships between BMI and PFI in college students were non-linear. Underweight, overweight and obese students had poorer performance in physical fitness index than normal weight students. Future prospective, longitudinal cohort studies to identify the causal relations and potential mechanism in a good manner are required.

Association between Weight Status and Physical Fitness in Chinese Mainland Children and Adolescents: A Cross-Sectional Study

Background: The increasing prevalence of obesity among children and adolescents is a major public health challenge worldwide. This study examined the relationship between physical fitness and BMI spanning the range from underweight to obese among Chinese mainland children and adolescents. Methods: Participants were 22,681 children and adolescents (11,300 boys and 11,381 girls) aged 10–18 years from the Chinese mainland. Weight status was classified as underweight, normal weight, overweight, and obese using WHO 2007 standards. Physical fitness parameters such as cardiorespiratory fitness (VO_2max), lower body explosive strength (standing broad jump), upper body explosive strength (handgrip strength), abdominal muscular endurance (sit-ups in 30 s), flexibility (sit-and-reach), and agility (repeat bestride (20 s)) were assessed. Results: There was a significant association between weight status categories and physical fitness in all age groups and sex (p_linear < 0.001, p_quadratic < 0.001). Underweight adolescents performed better in lower limb strength, flexibility, agility, and cardiorespiratory fitness than their obese peers, but worse in upper limb strength. Underweight boys aged 10–11 and 12–13 years and girls aged 10–11 years showed significantly (p < 0.05) high odds of meeting a low physical fitness index. Obese adolescents have high odds of meeting a low physical fitness index with age. Conclusion: The present study showed a nonlinear relationship between weight status and physical fitness. Children and adolescents who were classified as underweight or obese had poorer physical fitness than their normal-weight peers.

Motor Competence Levels in Young Children: A Cross-Cultural Comparison Between Belgium and Greece

The targeted continent and/or country driven promotion of physical activity and health from an early age onwards requires more insight into cross-cultural differences in motor competence. Using the Bruininks-Oseretsky Test of Motor Proficiency, Second Edition Short Form (BOT-2 SF), this study assessed and compared both fine and gross motor skill performances of 5- and 6-year-old children from Belgium (n = 325) and Greece (n = 245). Linear mixed effect models and a χ2 test analyzed between-country differences in BOT-2 SF scores and the distribution across descriptive performance categories. Overall, Belgian and Greek participants displayed quite similar levels of motor competence, with fewer children performing (well-)below average than could be expected. On test item level, however, several significant differences emerged. Large effect sizes were found for knee push-ups (Hedges’ g = 1.46) and copying a square (Hedges’ g = 2.59), which demonstrated a better outcome for Belgian and Greek preschoolers, respectively. These findings might be attributed to different (physical) education practices in both European countries. The present study also highlights the importance of using an assessment tool covering the entire range of motor skills as well as a focusing primarily on raw performance scores, containing and explaining more variance, for international comparative research purposes.

Multicomponent training with different frequencies on body composition and physical fitness in obese children

INTRODUCTION

The aim of the study was to compare the effects of ten-week multicomponent training with different exercise frequencies on body composition (BC) and physical fitness (PF) in overweight and obese young children.

METHODS

40 children, aged 12-15 (14.77±1.49), were randomly selected and assigned to experimental groups to train three times/week (EG1) or two times/week (EG2) for 10 weeks and a CG group (no training program).

RESULTS

It was shown that experimental groups (EG1 and EG2) improved similarly aerobic capacity (3.8% and 3.5%, respectively), muscular strength (29.7% and 25.2%), flexibility (6.1% and 9.9%), body mass index (5.0% and 4.6%), and body fat (6.4% and 5.6%) from pre- to post-training. CG group showed no significant improvements on BC and PF variables.

CONCLUSION

Short-term multicomponent training seems to be effective on PF improvements, independently of the exercise frequency, in overweight and obese young children. However, it seems to be more effective to perform a multicomponent exercise training three times/week to improve muscular strength, body mass index, and decrease body fat percentage. This knowledge should be considered by professionals in physical education or youth sport in order to adapt practical tasks depending on the training purposes.

Prevalence and Trends of Overweight and Obesity in European Children From 1999 to 2016: A Systematic Review and Meta-analysis

IMPORTANCE

Studies of trends in excess weight among European children throughout the last few decades have rendered mixed results. Additionally, some studies were outdated, were based on self-reported weight and height, or included only a few European countries.

OBJECTIVE

To assess prevalence trends in measured overweight and obesity among children across Europe from 1999 to 2016 using a systematic methodology.

DATA SOURCES

MEDLINE, Embase, CINAHL, and Web of Science were searched from their inception until May 2018. Moreover, searches were conducted on health institutions' websites to identify studies not published in scientific journals.

STUDY SELECTION

The inclusion criteria were: (1) studies reporting the population-based prevalence of excess weight (overweight plus obesity) or obesity according to body mass index cutoffs proposed by the International Obesity Task Force; (2) cross-sectional or follow-up studies; and (3) studies including populations aged 2 to 13 years.

DATA EXTRACTION AND SYNTHESIS

Literature review and data extraction followed established guidelines. The Mantel-Haenszel method was used to compute the pooled prevalence estimates and their 95% CI whenever there was no evidence of heterogeneity (I2 < 50%); otherwise, the DerSimonian and Laird random-effects method was used. Subgroup analyses by study year, country, or European region (Atlantic, Iberian, Central, and Mediterranean) were conducted. Prevalence estimates were calculated as an aggregate mean, weighted by the sample size and the number of individuals in each study.

RESULTS

A total of 103 studies (477 620 children aged 2 to 13 years) with data from 28 countries were included. The combined prevalence of overweight and obesity in the Iberian region tended to decrease from 30.3% (95% CI, 28.3%-32.3%) to 25.6% (95% CI, 19.7%-31.4%) but tended to increase in the Mediterranean region from 22.9% (95% CI, 17.9%-27.9%) to 25.0% (95% CI, 14.5%-35.5%). No substantial changes were observed in Atlantic Europe or Central Europe, where the overweight and obesity prevalence changed from 18.3% (95% CI, 14.0%-23.9%) to 19.3% (95% CI, 17.7%-20.9%) and from 15.8% (95% CI, 13.4%-18.5%) to 15.3% (95% CI, 11.6%-20.3%), respectively.

CONCLUSIONS AND RELEVANCE

The prevalence of childhood overweight and obesity is very high, but trends have stabilized in most European countries. There are substantial between-country differences in the current levels and trends of overweight and obesity. The rising prevalence in some Mediterranean countries is worrisome.

TRIAL REGISTRATION

PROSPERO identifier: CRD42017056924.

A Comparison of the Impact of Two Methods of Nutrition-Behavioral Intervention on Selected Auxological and Biochemical Parameters in Obese Prepubertal Children-Crossover Preliminary Study

Obese children are exposed to short and long-term health consequences, such as dyslipidemia, hypertension and diabetes mellitus. For these reasons, the prevention and treatment of obesity in the pediatric population is a challenge for health care professionals. The aim of this study was to evaluate whether an intensive intervention based on diet and physical activity has a better impact on the auxological and biochemical parameters than standard care (intervention). The study included 20 children (six boys, 14 girls), of the mean age 8.9 (SD 1.4) before puberty. The participants were randomly assigned to two groups: Group I (starting treatment with intensive intervention), and II (starting treatment with standard intervention). After three months, the groups were switched. The comparison of the two interventions in the study group indicates a better effectiveness of intensive intervention in the improvement of anthropometric parameters and majority of biochemical ones (except for insulin concentration, HOMA IR index and LDL cholesterol). As the result of intensive intervention, the mean % of weight-to-height excess and hip circumference decreased significantly (p < 0.005). Our results confirm that complex intervention based on systematic control visits, including personalized dietitian counselling and physician care, during the weight reduction process is more effective than a one-off standard visit.

Anthropometric Indices and Some Aspects of Physical Fitness in Croatian Adolescents by Gender

Background. The main purpose of this study was to explore the body-mass index and waist circumference associated with physical fitness by gender. Methods. In this cross-sectional study, we included 1036 adolescents (55.4% girls) from eight randomly selected secondary schools within the city of Zagreb (Croatia). Body-mass index and waist circumference were objectively measured. Physical fitness included three tests: (1) 1 min sit-ups, (2) standing long jump and (3) a sit-and-reach test. Associations were calculated using linear regression models. Results. Boys had higher body-mass index and waist circumference values, compared to girls (p < 0.001). They also performed better in 1 min sit-ups and the standing long jump tests (p < 0.001), while girls obtained higher values in the sit-and-reach test (p < 0.001). In boys, body-mass index and waist circumference were associated with 1 min sit-ups and the standing long jump. In girls, waist circumference was also associated with 1 min sit-ups and the standing long jump, while body-mass index was only associated with this standing long jump. Conclusions. Our study shows that anthropometric indices have non-linear associations with physical fitness tests in a large sample of Croatian adolescents. Screening for thinness and obesity to predict the level of physical fitness should be of a great interest.

Physical fitness and physical activity of 6-7-year-old children according to weight status and sports participation

BACKGROUND

The aim of this study was to investigate physical fitness and physical activity (PA) of 6-7-year-old children just before entering school according to their sports club (SC) participation and weight status, and to examine possible associations of their body mass index, fat mass and fat-free mass with physical fitness and PA.

METHODS

A total of 256 preschoolers aged 6 to 7 years participated in the study. Physical fitness was assessed using PREFIT test battery and objective PA by 7 day accelerometry. Body composition was estimated using two skinfold thickness parameters. SC participation and parental data were assessed by questionnaires.

RESULTS

Children participating in SC had higher moderate-to-vigorous PA, vigorous PA and cardiorespiratory fitness than children not participating in SC. Overweight children had lower results in cardiorespiratory fitness and all weight-bearing fitness tests, and better results in handgrip strength test in comparison with normal weight children. Significant associations were found between body composition indices and physical fitness tests. PA level was associated with fat-free mass and physical fitness but not with fatness indices.

CONCLUSIONS

Weight-status and body composition together with PA level were associated with physical fitness level. The differences in physical fitness based more upon weight status than SC participation among 6-7-years old children.

Physical fitness for sedentary students: a common trend from six European countries

BACKGROUND

Several studies have assessed the fitness level of students to evaluate physical condition, compare groups with differences in social disadvantage and to define indexes for post training programs. Often, these large surveys compared groups without normative value that could define the real, practical gaps. Thus, the aim of this study was the definition of baseline values describing the fitness level of sedentary European students.

METHODS

Standing broad jump (SBJ), sit up (SUP) and sit and reach (SAR) physical fitness tests were assessed on 31,476 students (age=11-13) from 6 European countries were collected and analyzed.

RESULTS

The effect size for multiple groups ANOVA was obtained to verify the biological consistence of differences. Then, weighted-means were calculated and stratified for age and gender. Overall, boys obtained SAR scores close to zero, while girls obtained results between 2 and 7 cm. The SUP test revealed similar results between boys and girls (about 20). SBJ performances were similar among countries (over 160 cm for boys and 150 for girls).

CONCLUSIONS

Our results were aligned to other studies performed in other Continents or Countries and can contribute to the establishment of a large and objective reference to readily evaluate the physical fitness and health-related status of young students.

Association of Anthropometric and Lifestyle Parameters with Fitness Levels in Greek Schoolchildren: Results from the EYZHN Program

Objective

The aim of the study was to evaluate physical fitness (PF) and identify its anthropometric and lifestyle determinants in a sample of Greek schoolchildren.

Methods

The study sample consisted of 335,810 schoolchildren (♂: 51.3%, 6–18 years old). Students’ anthropometric parameters and PF levels—assessed via the Eurofit test battery—were measured by trained physical education teachers and evaluated according to the available norms, while their lifestyle habits were assessed through a questionnaire.

Results

In all applied PF tests, students’ performance was negatively associated with the presence of obesity and central obesity, defined through international criteria for body mass index and waist to height ratio, respectively. According to multiple logistic regression analysis, the presence of overweight/obesity [odds ratio (OR): 4.43, 95% confidence interval (CI): 3.98–4.93], low adherence to the MD (KIDMED ≤ 3) (OR: 1.27, 95% CI: 1.09–1.48), and increased time spent in sedentary activities (>2 h per day) (OR: 1.16, 95% CI: 1.03–1.29) were positively associated with poor PF, after adjusting for age and sex. In contrast, for every 1 day increase in the weekly frequency of engagement in athletic activity, the probability of poor PF decreased by 26% (OR: 0.74, 95% CI: 0.72–0.77). In a similar model, the presence of central obesity emerged as an even stronger possible predictor of poor PF (OR: 5.20, 95% CI: 4.66–5.78), compared to the presence of general obesity.

Conclusion

Higher general or abdominal adiposity, as well as the adoption of a low-quality diet and a sedentary lifestyle, is strongly associated with low PF levels during childhood.

Relationships between different nutritional anthropometric statuses and health-related fitness of South African primary school children

BACKGROUND

A double burden of both under- and over-nutrition exists among South African children.

AIM

To describe associations between nutritional statuses and health-related fitness test performances.

SUBJECTS AND METHODS

Height and weight of 10 285 children (6-13 years; n = 5604 boys and 4681 girls) were measured and used to calculate body mass index (BMI) and prevalence of overweight and obesity, stunting, wasting and underweight. Physical fitness scores for standing long jump, shuttle run, sit-and-reach, sit-up (EUROFIT) and cricket ball throw were assessed. Age- and gender-specific z-scores were calculated for these variables. Physical fitness for each nutritional status group was compared to children of normal weight.

RESULTS

Compared to normal weight children, overweight and obese children scored lower on all fitness tests (p < .001), except cricket ball throw (p = .235) and sit-and-reach (p = .015). Stunted and underweight children performed poorer than normal weight children on most fitness tests (p < .001), except sit-and-reach (stunted: p = .829; underweight: p = .538) and shuttle run (underweight: p = .017). Performance of wasted children was not as highly compromised as other under-nourished groups, but they performed poorer on the cricket ball throw (p < .001).

CONCLUSIONS

When compared to normal weight children, both under- and over-nourished children performed poorer on some, but not all, health-related fitness tests.

Physical fitness and academic performance in youth: A systematic review

Physical fitness (PF) is a construct of health- and skill-related attributes which have been associated with academic performance (AP) in youth. This study aimed to review the scientific evidence on the association among components of PF and AP in children and adolescents. A systematic review of articles using databases PubMed/Medline, ERIC, LILACS, SciELO, and Web of Science was undertaken. Cross-sectional and longitudinal studies examining the association between at least one component of PF and AP in children and adolescents, published between 1990 and June 2016, were included. Independent extraction of articles was carried out by the two authors using predefined data fields. From a total of 45 studies included, 25 report a positive association between components of PF with AP and 20 describe a single association between cardiorespiratory fitness (CRF) and AP. According to the Strengthening the Reporting of Observational Studies in Epidemiology guidelines: 12 were classified as low, 32 as medium risk, and 1 as high risk of bias. Thirty-one studies reported a positive association between AP and CRF, six studies with muscular strength, three studies with flexibility, and seven studies reported a positive association between clustered of PF components and AP. The magnitude of the associations is weak to moderate (β = 0.10-0.42 and odds = 1.01-4.14). There is strong evidence for a positive association between CRF and cluster of PF with AP in cross-sectional studies; and evidence from longitudinal studies for a positive association between cluster of PF and AP; the relationship between muscular strength and flexibility with AP remains uncertain.

International variability in 20 m shuttle run performance in children and youth: who are the fittest from a 50-country comparison? A systematic literature review with pooling of aggregate results

OBJECTIVES

To describe and compare 20 m shuttle run test (20mSRT) performance among children and youth across 50 countries; to explore broad socioeconomic indicators that correlate with 20mSRT performance in children and youth across countries and to evaluate the utility of the 20mSRT as an international population health indicator for children and youth.

METHODS

A systematic review was undertaken to identify papers that explicitly reported descriptive 20mSRT (with 1-min stages) data on apparently healthy 9-17 year-olds. Descriptive data were standardised to running speed (km/h) at the last completed stage. Country-specific 20mSRT performance indices were calculated as population-weighted mean z-scores relative to all children of the same age and sex from all countries. Countries were categorised into developed and developing groups based on the Human Development Index, and a correlational analysis was performed to describe the association between country-specific performance indices and broad socioeconomic indicators using Spearman's rank correlation coefficient.

RESULTS

Performance indices were calculated for 50 countries using collated data on 1 142 026 children and youth aged 9-17 years. The best performing countries were from Africa and Central-Northern Europe. Countries from South America were consistently among the worst performing countries. Country-specific income inequality (Gini index) was a strong negative correlate of the performance index across all 50 countries.

CONCLUSIONS

The pattern of variability in the performance index broadly supports the theory of a physical activity transition and income inequality as the strongest structural determinant of health in children and youth. This simple and cost-effective assessment would be a powerful tool for international population health surveillance.

Association between health-related physical fitness and body mass index status in children

The purpose of this study was to investigate the association between body mass index (BMI) status and physical performance in Brazilian children. The analyzed sample was composed of 978 children of both sexes (518 boys and 460 girls), aged 7 to 11 years. BMI and skinfolds were measured, and three motor tests were applied (flexibility, cardiorespiratory fitness, and muscular strength/endurance). In both sexes, overweight/obese children presented poor performance in all motor tests, except flexibility. In general, overweight/obese children have an increased odds ratio (OR) to present poor physical performance (boys: OR = 3.64 for cardiorespiratory fitness, OR = 1.94 for muscular strength/endurance, OR = 1.52 for flexibility; girls: OR = 5.03 for cardiorespiratory fitness and OR = 2.62 for muscular strength/endurance). In conclusion, for both sexes, a poor physical performance in the tests measuring cardiorespiratory fitness and muscular strength/ endurance was associated with the presence of overweight/obesity.

International normative 20 m shuttle run values from 1 142 026 children and youth representing 50 countries

OBJECTIVE

To develop sex-specific and age-specific international norms for the 20 m shuttle run test (20mSRT) in children and youth (aged 9-17 years), and to estimate the prevalence meeting the FITNESSGRAM criterion-referenced standards for healthy cardiorespiratory endurance (CRE).

METHODS

A systematic review was undertaken to identify papers explicitly reporting descriptive 20mSRT (with 1 min stages) data on children and youth since 1981. Data were included on apparently healthy (free from known disease/injury) 9-17 years old. Following standardisation to a common metric and for protocol differences, pseudo data were generated using Monte Carlo simulation, with population-weighted sex-specific and age-specific normative centiles generated using the Lambda Mu and Sigma (LMS) method. Sex-related and age-related differences were expressed as per cent and standardised differences in means. The prevalence with healthy CRE was estimated using the sex-specific and age-specific FITNESSGRAM criterion-referenced standards for [Formula: see text].

RESULTS

Norms were displayed as tabulated centiles and as smoothed centile curves for the 20mSRT using 4 common metrics (speed at the last completed stage, completed stages/minutes, laps and relative [Formula: see text]). The final data set included 1 142 026 children and youth from 50 countries, extracted from 177 studies. Boys consistently outperformed girls at each age group (mean difference±95% CI: 0.86±0.28 km/h or 0.79±0.20 standardised units), with the magnitude of age-related increase larger for boys than for girls. A higher proportion of boys (mean±95% CI: 67±14%) had healthy CRE than girls (mean±95% CI: 54±17%), with the prevalence of healthy CRE decreasing systematically with age.

CONCLUSIONS

This study provides the most comprehensive and up-to-date set of international sex-specific and age-specific 20mSRT norms for children and youth, which have utility for health and fitness screening, profiling, monitoring and surveillance.

Muscle Strength and Fitness in Pediatric Obesity: a Systematic Review from the European Childhood Obesity Group

The increasing prevalence of paediatric obesity and related metabolic complications has been mainly associated with lower aerobic fitness while less is known regarding potential musculoskeletal impairments. The purpose of the present systematic review was to report the evidence regarding muscular fitness in children and adolescents with obesity. A systematic article search was conducted between November 2014 and June 2015 using MEDLINE, EMBASE, CINAHL psycINFO, SPORTDiscus and SocINDEX. Articles published in English and reporting results on muscle strength and muscular fitness in children and adolescents aged 6 to 18 years were eligible. Of 548 identified titles, 36 studies were included for analyses. While laboratory-based studies described higher absolute muscular fitness in youth with obesity compared with their lean peers, these differences are negated when corrected for body weight and lean mass, then supporting field-based investigations. All interventional studies reviewed led to improved muscular fitness in youth with obesity. Children and adolescents with obesity display impaired muscular fitness compared to healthy-weight peers, which seems mainly due to factors such as excessive body weight and increased inertia of the body. Our analysis also points out the lack of information regarding the role of age, maturation or sex in the current literature and reveals that routinely used field tests analysing overall daily muscular fitness in children with obesity provide satisfactory results when compared to laboratory-based data.

The health benefits of muscular fitness for children and adolescents: a systematic review and meta-analysis

BACKGROUND

Physical fitness during childhood and adolescence has been identified as an important determinant of current and future health status. While research has traditionally focused on the association between cardio-respiratory fitness and health outcomes, the association between muscular fitness (MF) and health status has recently received increased attention.

OBJECTIVE

The aim of this systematic review and meta-analysis was to evaluate the potential physiological and psychological benefits associated with MF among children and adolescents.

METHODS

A systematic search of six electronic databases (PubMed, SPORTDiscus, Scopus, EMBASE, PsycINFO and OVID MEDLINE) was performed on the 20th May, 2013. Cross-sectional, longitudinal and experimental studies that quantitatively examined the association between MF and potential health benefits among children and adolescents were included. The search yielded 110 eligible studies, encompassing six health outcomes (i.e., adiposity, bone health, cardiovascular disease [CVD] and metabolic risk factors, musculoskeletal pain, psychological health and cognitive ability). The percentage of studies reporting statistically significant associations between MF and the outcome of interest was used to determine the strength of the evidence for an association and additional coding was conducted to account for risk of bias. Meta-analyses were also performed to determine the pooled effect size if there were at least three studies providing standardised coefficients.

RESULTS

Strong evidence was found for an inverse association between MF and total and central adiposity, and CVD and metabolic risk factors. The pooled effect size for the relationship between MF and adiposity was r = -0.25 (95% CI -0.41 to -0.08). Strong evidence was also found for a positive association between MF and bone health and self-esteem. The pooled effect size for the relationship between MF and perceived sports competence was r = 0.39 (95% CI 0.34-0.45). The evidence for an association between MF and musculoskeletal pain and cognitive ability was inconsistent/uncertain. Where evidence of an association was found, the associations were generally low to moderate.

CONCLUSION

The findings of this review highlight the importance of developing MF in youth for a number of health-related benefits.

Excess of weight, but not underweight, is associated with poor physical fitness in children and adolescents from Castilla-La Mancha, Spain

We estimated the prevalence of underweight, overweight and obesity of children and adolescents from Castilla-La Mancha region (Spain), applying the new International Obesity Task Force (IOTF) 2012 criteria, and analysed differences in physical fitness components in relation to weight status. The sample was 2,330 schoolchildren aged 6-17 years. We measured height and weight, calculated body mass index (BMI) and assessed physical fitness using four tests included in the EUROFIT battery. Differences in physical fitness components across BMI categories, by sex, were calculated using ANOVA models. In children aged 6-11 years, 4.9 % were underweight, 26.7 % overweight and 11.0 % obese; in adolescents aged 12-17 years, 6.4 % were underweight, 16.7 % overweight and 5.8 % obese. Overall, overweight and obesity were associated with worse physical fitness but students in the underweight category did not score worse than their normal weight counterparts on fitness tests.

CONCLUSION

Childhood obesity in Spain remains a public health problem. Our results show low physical fitness levels in overweight/obese children and adolescents and low levels of handgrip strength in underweight adolescents compared with normal weight subjects. Exercise programmes must be tailored to the specific needs of the subjects according to the different weight status.

Physical fitness, physical activity and sedentary activities of 7 to 11 year old boys with different body mass indexes

Purpose

The purpose of this study was to examine the differences in physical fitness, physical activity, and sedentary activities among 7 to 11 year old boys with varying body mass index in Ardabil, Iran.

Methods

The sample consisted of 766 boys who participated in eight weight bearing (1 mile walk/run, sit ups, standing long jump, vertical jump, shuttle run 4 × 10 m, 30-meter sprint, pull ups, pushups) and four non-weight-bearing physical fitness tests (flamingo balance, handgrip; sit and reach and finger reaction time). Physical activity and sedentary activities were assessed by questionnaires. Body mass index (BMI) was computed to classify participants into normal weight, underweight, overweight and obese groups.

Results

The prevalence of underweight, overweight and obesity was 10.7%, 14.1% and 4.2% respectively. Cardiorespiratory fitness (VO_2max) decreased progressively as the BMI increased and differences among the all body mass index categories were significant (P<0.01). Obese subjects performed worse in all weight bearing fitness tests than normal weight subjects (P<0.01). Moreover, overweight subjects performed worse in one mile, pushups and pull ups than normal weight subjects (P<0.01). Underweight subjects had significantly lower Pushups than normal weight subjects (P<0.01). Obese subjects had significantly higher sedentary activities and lower physical activity than other counterparts (P<0.01).

Conclusions

This study showed that weight bearing physical fitness, cardiorespiratory fitness and physical activity progressively decreased as the BMI increased and conversely, sedentary activities increased as the BMI increased.

The Association of Physical Fitness With Body Mass Index and Waist Circumference in Filipino Preadolescents

Aim. The objective of this study is are to examine the association of preadolescent obesity using body mass index (BMI) and waist circumference (WC) with health-related physical fitness components. Methods. Grades 4 to 6 students in 2 private schools in Manila were included in this study. Height, weight, WC, and BMI were obtained. Physical fitness field tests were sit-and-reach test, 1-minute sit-ups, standing broad jump, 40-m sprint, and 20-m shuttle run. Results. Obese subjects had poorer scores in the field tests except in the sit-and-reach test. BMI and WC were significantly negatively associated with all the physical fitness parameters, except for the 40-m sprint where positive correlation was observed, and in the sit-and-reach test where no correlation was seen. Conclusion. In the management of preadolescent overweight and obesity, exercise programs should therefore be designed toward enhancing these fitness parameters, while not sacrificing enjoyment and creativity.

Predicting maintenance or achievement of healthy weight in children: the impact of changes in physical fitness

Physical fitness is often inversely associated with adiposity in children cross-sectionally, but the effect of becoming fit or maintaining fitness over time on changes in weight status has not been well studied in children. We investigated the impact of changes in fitness over 1-4 years of follow-up on the maintenance or achievement of healthy weight among 2,793 schoolchildren who were first measured as 1st to 7th graders. Students were classified as "fit" or "underfit" according to age- and gender-specific norms in five fitness domains: endurance, agility, flexibility, upper body strength, and abdominal strength. Weight status was dichotomized by BMI percentile: "healthy weight" (<85th percentile) or "overweight/obese" (≥85th percentile). At baseline, of the 38.3% overweight/obese children, 81.9% (N = 875) were underfit. Underfit overweight students were more likely to achieve healthy weight if they achieved fitness (boys: odds ratio (OR) = 2.68, 95% confidence interval (CI) = 1.24-5.77; girls: OR = 4.67, 95%CI = 2.09-10.45). Initially fit overweight children (N = 194) were more likely to achieve healthy weight if they maintained fitness (boys: OR = 11.99, 95%CI = 2.18-65.89; girls: OR = 2.46, 95%CI = 1.04-5.83). Similarly, initially fit healthy-weight children (N = 717) were more likely to maintain healthy weight if they maintained fitness (boys: OR 3.70, 95%CI = 1.40-9.78; girls: OR = 4.14, 95%CI = 1.95-8.78). Overweight schoolchildren who achieve or maintain physical fitness are more likely to achieve healthy weight, and healthy-weight children who maintain fitness are more likely to maintain healthy weight. School-based policies/practices that support physical fitness may contribute to obesity reduction and maintenance of healthy weight among schoolchildren.

Aptidão física relacionada à saúde de escolares: programa fitnessgram

O estudo identificou a proporção de crianças e adolescentes da população escolar de Montes Claros, Minas Gerais, Brasil, que atendem aos critérios referenciados para a saúde a partir de escores equivalentes aos componentes de aptidão física. A amostra foi constituída por 2.849 sujeitos (1.457 moças e 1.392 rapazes), com idades entre seis e 18 anos. Os componentes da aptidão física foram avaliados mediante bateria de testes composta por cinco itens: "sentar-e-alcançar" alternado, abdominal modificado, elevação do tronco, puxada em suspensão na barra modificado e caminhada/corrida de "vai-e-vem", adotando-se pontos de corte para gênero e idade sugeridos pelo Fitnessgram. Mediante análise dos resultados foi possível observar que a proporção de escolares que atenderam às exigências motoras mínimas estabelecidas que possam satisfazer aos critérios referenciados para a saúde não foi maior que 8%, e a quantidade de jovens que alcançaram os critérios foi menor a partir dos 10 anos de idade em ambos os sexos. Os dados mostram, ainda, que grande parte dos jovens estudados demonstrou componentes de aptidão física que podem comprometer melhor estado de saúde, apontando para urgente necessidade de implementar programas de intervenção direcionados ao incremento da prática de exercício físico na população escolar.

Physical fitness of primary school children in relation to overweight prevalence and physical activity habits

A cross-sectional study was carried out to analyse, through a limited number of fitness tests, the main conditioning and coordinative abilities in children aged 8-9 years, and their relationship with gender, anthropometric variables and physical activity habits. The height and weight of 256 boys and 241 girls were measured and information about physical activity habits was collected using a self-administered questionnaire. Physical performance was assessed by means of a few standardised tests: 'sit & reach', medicine-ball forward throw, standing long jump, 20 m running speed, and forward roll test. In both boys and girls, body weight and body mass index (BMI) were positively correlated with the medicine-ball throw performances and negatively correlated for the standing long jump and speed tests, while no association was found with tests measuring back flexibility and total body coordination. Daily physical activity and participation in sport were not significantly correlated with body weight and BMI, but were positively associated with children's motor performance. The standardised fitness tests selected in the current study have been found to be suitable to identify fitness levels of primary school children. Thanks to their limited number and ease of measurement, they can be used in any school context to classify children and for monitoring the effects of targeted interventions promoting physical activity.

Physical fitness and fatness in adolescents with intellectual disabilities

BACKGROUND

This study investigated health-related fitness in adolescents with intellectual disabilities and analysed the various performances in physical fitness tests according to degrees of obesity.

MATERIALS AND METHODS

Eighty-seven French intellectual disabilities adolescents (14.24 ± 1.48 years) performed the EUROFIT physical fitness test battery. Height, weight and waist circumference were assessed, and BMI and waist-to-height ratio were calculated. 'Bio-impedancemetry' evaluated body fat (BF) percentage.

RESULTS

Ninety-four per cent of the adolescents completed the aerobic running test, 52% of which had low VO(2max). Thirty-seven per cent were obese (%BF), and 32% had excess visceral adipose tissue. Adolescents with the lowest cardiorespiratory fitness had the highest BF percentages (P < 0.001).

CONCLUSIONS

Intellectual disabilities adolescents showed low physical fitness and high prevalence of obesity. Both could further worsen social participation and health status.