Artificial neural network-based equation for estimating VO2max from the 20m shuttle run test in adolescents

Cardiorespiratory fitness and socioeconomic influences in Chilean schoolchildren: a cross-sectional study

OBJECTIVE

To compare the cardiovascular risk and physical fitness, according to type of school in a national sample of Chilean school students.

METHODS

A total of 7,218 students participated, who completed all the national tests of the National System for Measuring the Quality of Education, which included physical fitness and anthropometric tests. The results were compared according to the type of educational establishment and anthropometric indicators were considered. Physical fitness was measured by lower extremity strength, abdominal strength, upper extremity strength, trunk flexibility, exertional heart rate, and cardiorespiratory fitness. Body mass index, heart rate, and waist-to-height ratio were analyzed as predictors of cardiovascular risk.

RESULTS

There were differences according to the type of establishment in the predictors of cardiovascular risk (p < 0.05). Differences were also found in the physical fitness tests evaluated (p < 0.01). Students in private schools (PSC) and subsidized schools (SC) had lower levels of cardiovascular risk and higher levels of physical fitness than public schools (PS) and schools with delegated administration (DA).

CONCLUSIONS

In conclusion, students in educational establishments with a higher socioeconomic level have lower levels of cardiovascular risk and better physical fitness than students in public establishments. The authors suggest considering specific school interventions to mitigate cardiovascular risk and improve physical fitness among this vulnerable population. To this end, future studies should analyze the characteristics of physical activity and nutritional habits in schools to determine the factors that affect the results.

Proposed Protocol for Field Testing of Endurance Fitness of Young Labrador Retrievers

The number of dogs and, with it, dog sports are growing in popularity, and the training of dogs begins at an early age. Although fitness testing is an imperative part of purposeful training and sports, to our knowledge, no objective field tests are available for measuring young dogs' endurance fitness. The aim of this study is to describe a simple, easy-to-repeat, and inexpensive way to test training intervention effects on endurance fitness in young Labrador Retrievers. Healthy client-owned 16-week-old Labrador Retrievers will be recruited and divided into test and control groups. The test group will have an eight-week training program followed by a four-week detraining period, while the control group will live a normal puppy life. All dogs will be tested for endurance fitness four times at four-week intervals: at baseline, one month later, two months later at the end of the training period, and one month after ending the training program. Each of the four testing sessions will be identical and will consist of four measurements of heart rate (HR) and blood lactate (BL): at baseline, after trotting 1000 m, after sprinting 200 m, and at recovery 5-8 min after the sprint. The training-induced changes in endurance fitness are evaluated by changes in HR and heart rate recovery times (HRR), BL, and running times.

Prediction of Marathon Performance using Artificial Intelligence

Although studies used machine learning algorithms to predict performances in sports activities, none, to the best of our knowledge, have used and validated two artificial intelligence techniques: artificial neural network (ANN) and k-nearest neighbor (KNN) in the running discipline of marathon and compared the accuracy or precision of the predicted performances. Official French rankings for the 10-km road and marathon events in 2019 were scrutinized over a dataset of 820 athletes (aged 21, having run 10 km and a marathon in the same year that was run slower, etc.). For the KNN and ANN the same inputs (10-km race time, body mass index, age and sex) were used to solve a linear regression problem to estimate the marathon race time. No difference was found between the actual and predicted marathon performances for either method (p>0,05). All predicted performances were significantly correlated with the actual ones, with very high correlation coefficients (r>0,90; p<0,001). KNN outperformed ANN with a mean absolute error of 2,4 vs 5,6%. The study confirms the validity of both algorithms, with better accuracy for KNN in predicting marathon performance. Consequently, the predictions from these artificial intelligence methods may be used in training programs and competitions.

The Multistage 20-m Shuttle Run Test for Predicting VO2Peak in 6–9-Year-Old Children: A Comparison with VO2Peak Predictive Equations

Simple Summary

Cardiorespiratory fitness is one of the main components of physical fitness. For children, a simple test that can be used to assess cardiorespiratory fitness is the multistage 20-m shuttle run test (20mSRT). Research has often used a portable gas analyzer to measure cardiorespiratory fitness in clinical and scientific settings; however, this may not be practical due to the high cost of the device. Moreover, the use of such a device with children is almost impracticable in school environments. Thus, to avoid using such a device, one possibility is to use equations for predicting peak oxygen consumption, which is recognized as one of the best indicators of aerobic fitness. In the present study, 22 equations were used to determine which predictive equations had greater agreement with VO₂peak values measured by direct oximetry through performance of the 20mSRT. Furthermore, we verified if wearing and carrying a portable gas analyzer constrained the children’s performances. To accomplish these aims, 67 boys and 63 girls were included in the analysis. Our results showed that only six predictive equations correctly predicted the peak oxygen consumption. In addition, for girls, higher values of maximal speed, total laps, and total time were found when a portable gas analyzer was used. This information is helpful to strength and conditioning professionals and to schoolteachers if portable gas analyzers are unavailable or if the environment is not suitable for such assessments.

Abstract

This study aimed (i) to verify if using and carrying a portable gas analyzer (PGA) constrained the performance of school children on the multistage 20-m shuttle run test (20mSRT), (ii) to verify which peak oxygen consumption (VO₂peak) predictive equations have greater agreement with VO₂peak values measured by direct oximetry using the 20mSRT. The study participants were 130 children ((67 boys (age 7.76 ± 0.97 years) and 63 girls (age 7.59 ± 0.91 years)), who performed two randomized trials of the 20mSRT with and without a PGA. Twenty-two predictive equations predicted the VO₂peak values through the performance of the test with and without a PGA. Without a PGA, lower values of maximal speed (MS), total laps (TL), and total time (TT) were found for girls than for boys with a PGA. Only six equations were considered to correctly predict VO₂peak. In general, higher MS, TL, and TT values were found with the use of a PGA. The predicted VO₂peak values from the 20mSRT varied significantly among the published predictive equations. Therefore, we suggest that the six equations that presented satisfactory accuracy could be practically used to examine cardiorespiratory fitness in schools and in research with large populations when direct measurement of VO₂peak is not feasible.

Individual responsiveness to a school-based karate intervention: An ancillary analysis of a randomized controlled trial

INTRODUCTION

School-based sport interventions have shown beneficial effects on psychosocial functioning and academic performance in children. However, the inter-individual variability in response to these types of interventions remains unclear. We aimed to determine which children benefit most from a school-based sport intervention.

METHODS

This is an ancillary analysis of a randomized controlled trial assessing the effects of a 1-year school-based karate intervention (versus "traditional" physical education lessons) in children (7-8 years) from twenty schools across five European countries. Outcomes included psychosocial functioning (Strengths and Difficulties Questionnaire [SDQ] for parents) and academic performance (grade point average). Only participants of the intervention group were included in the present ancillary analysis, and were categorized as responders or non-responders for the analyzed outcomes attending to whether improvements surpassed a minimal clinically important difference.

RESULTS

About 388 children (187 girls) from the intervention group completed the study, of which 17% and 46% were considered responders for SDQ and academic performance, respectively. Responders for the SDQ presented higher SDQ scores (i.e., higher psychosocial difficulties) at baseline than non-responders (p < 0.001). Responders for academic performance were mostly males (p = 0.017), with an older age (p = 0.030), and with worse academic performance (p < 0.001) at baseline compared with non-responders, and tended to present higher SDQ scores (p = 0.055). Responders for one outcome obtained greater benefits from the intervention on the other outcome (e.g., responders for SDQ improved academic performance [p < 0.001] compared with non-responders).

CONCLUSIONS

A school-based sport intervention (karate) seems particularly effective for children with psychosocial difficulties and low academic performance.

Defining Optimal Cut-Points for Cardiorespiratory Fitness Associated With Overweight/Obesity in Children: A School-Based Study

The main purpose of the study was to define optimal criterion-referenced cut-points for cardiorespiratory fitness (CRF) associated with overweight/obesity. In this cross-sectional study, participants were 1,612 children aged 7–14 years (mean age ± SD = 9.7 ± 2.4 years; 52.5% girls). CRF was assessed by the Maximal multistage 20-m shuttle run test, from which maximal oxygen uptake (VO₂max) was estimated. Anthropometric indices included body-mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR). Receiver operating characteristic (ROC) curves were performed to determine cut-off points. In boys, the optimal cut-off points of CRF in defining overweight/obesity for BMI, WC, and WHtR were 44.6, 46.4, and 46.9 mlO₂/kg/min. The areas under the curves (AUC) were 0.83 (95% CI 0.78–0.88, p < 0.001), 0.77 (95% CI 0.71–0.83, p < 0.001), and 0.90 (95% CI 0.86–0.93, p < 0.001). In girls, the optimal cut-off points were 41.0, 40.8, and 40.7 mlO₂/kg/min for BMI, WC, and WHtR, with the AUCs of 0.86 (95% CI 0.82–0.90, p < 0.001), 0.83 (95% CI 0.79–0.88), and 0.88 (95% CI 0.84–0.93, p < 0.001). In conclusion, our newly developed cut-off points for CRF assessed by the Maximal multistage 20-m shuttle run test may adequately detect primary school-aged boys and girls with general and abdominal obesity.

A Sustainable Swedish School Intervention with Extra Aerobic Exercise—Its Organization and Effects on Physical Fitness and Academic Achievement

A large majority of Swedish children do not reach the recommended daily activity level. Some, but not all, studies show that extra physical activity may have positive effects on children’s school performance, physical fitness and health. The present purpose was to offer pupils from the 7th to the 8th grade extra aerobic exercise led by physical education teachers and to evaluate the effects on aerobic fitness, muscle strength, school grades and health. The hypothesis was that extra aerobic exercise would improve physical fitness, school grades and health. In the two-year project, 122 pupils aged 13–14 years from three schools constituted an aerobic group with 30 min extra exercise sessions (≥70% maximal heart rate) twice weekly. A control group of 26 pupils was included. All 148 pupils also had regular 60 min physical education lessons (2/week). A moderate to large significant effect size (via partial eta-squared) of the interaction effect for the aerobic group compared to the control group over time was generally seen for aerobic fitness, the muscle strength test with push-ups, school grades in Swedish, English and physical education, and in average school grade for four school subjects combined, thus also including mathematics. Within the aerobic group, significant improvements were also shown for aerobic fitness, endurance and strength of abdominal and leg muscles, and the total physical test index during the two-year project. The control group showed no corresponding improvement in these parameters. Improvements in school grades were generally seen among both sexes in the aerobic group, whereas improvements in physical capacity were distinctly more pronounced among boys and seldom among girls. A similar pattern with significant improvement in several school grades was noted in all three intervention schools, although one of the schools had a distinctly larger proportion of children who immigrated to Sweden. The aerobic group showed significantly higher ratings (with a small to moderate effect size) on several questions about physical self-perception than the control group at the end of the 8th grade. This teacher-led school intervention generated a sustainable project with improvements in physical fitness and school grades. The project might act as an inspiration for other schools to increase physical activity to improve physical fitness and possibly school grades.

Artificial neural network model effectively estimates muscle and fat mass using simple demographic and anthropometric measures

BACKGROUND & AIMS

Lean muscle and fat mass in the human body are important indicators of the risk of cardiovascular and metabolic diseases. Techniques such as dual-energy X-ray absorptiometry (DXA) accurately measure body composition, but they are costly and not easily accessible. Multiple linear regression (MLR) models have been developed to estimate body composition using simple demographic and anthropometric measures instead of expensive techniques, but MLR models do not explore nonlinear interactions between inputs. In this study, we developed simple demographic and anthropometric measure-driven artificial neural network (ANN) models that can estimate lean muscle and fat mass more effectively than MLR models.

METHODS

We extracted the demographic, anthropometric, and body composition measures of 20,137 participants from the National Health and Nutrition Examination Survey conducted between 1999 and 2006. We included 13 demographic and anthropometric measures as inputs for the ANN models and divided the dataset into training and validation sets (70:30 ratio) to build and cross-validate the models that estimate lean muscle and fat mass, which were originally measured using DXA. This process was repeated 100 times by randomly dividing the training and validation sets to eliminate any effect of data division on model performance. We built additional models separately for each sex and ethnicity, older individuals, and people with underlying diseases. The coefficient of determination (R²) and standard error of estimate (SEE) were used to quantify the goodness of fit.

RESULTS

The ANN models yielded high R² values between 0.923 and 0.981. These values were significantly higher than those of the MLR models (p < 0.001) in all cases. The percentage difference in R² between the ANN and MLR models ranged between 0.40% ± 0.02% and 2.65% ± 0.27%. The SEE values of the ANN models, which were below 2 kg for all cases, were significantly lower than those of MLR models (p < 0.001). The percentage difference in SEE values between the ANN and MLR models ranged between -5.67% ± 0.39% and -22.32% ± 1.98%.

CONCLUSIONS

We developed and validated an inexpensive but effective method for estimating body composition using easily obtainable demographic and anthropometric data.

Estimation of Health-Related Physical Fitness (HRPF) Levels of the General Public Using Artificial Neural Network with the National Fitness Award (NFA) Datasets

Estimation of health-related physical fitness (HRPF) levels of individuals is indispensable for providing personalized training programs in smart fitness services. In this study, we propose an artificial neural network (ANN)-based estimation model to predict HRPF levels of the general public using simple affordable physical information. The model is designed to use seven inputs of personal physical information, including age, gender, height, weight, percent body fat, waist circumference, and body mass index (BMI), to estimate levels of muscle strength, flexibility, maximum rate of oxygen consumption (VO_2max), and muscular endurance. HRPF data (197,719 sets) gathered from the National Fitness Award dataset are used for training (70%) and validation (30%) of the model. In-depth analysis of the model’s estimation accuracy is conducted to derive optimal estimation accuracy. This included input/output correlation, hidden layer structures, data standardization, and outlier removals. The performance of the model is evaluated by comparing the estimation accuracy with that of a multiple linear regression (MLR) model. The results demonstrate that the proposed model achieved up to 10.06% and 30.53% improvement in terms of R² and SEE, respectively, compared to the MLR model and provides reliable estimation of HRPF levels acceptable to smart fitness applications.

Estimated pulse wave velocity (ePWV) as a potential gatekeeper for MRI-assessed PWV: a linear and deep neural network based approach in 2254 participants of the Netherlands Epidemiology of Obesity study

Pulse wave velocity (PWV) assessed by magnetic resonance imaging (MRI) is a prognostic marker for cardiovascular events. Prediction modelling could enable indirect PWV assessment based on clinical and anthropometric data. The aim was to calculate estimated-PWV (ePWV) based on clinical and anthropometric measures using linear ridge regression as well as a Deep Neural Network (DNN) and to determine the cut-off which provides optimal discriminative performance between lower and higher PWV values. In total 2254 participants from the Netherlands Epidemiology of Obesity study were included (age 45–65 years, 51% male). Both a basic and expanded prediction model were developed. PWV was estimated using linear ridge regression and DNN. External validation was performed in 114 participants (age 30–70 years, 54% female). Performance was compared between models and estimation accuracy was evaluated by ROC-curves. A cut-off for optimal discriminative performance was determined using Youden’s index. The basic ridge regression model provided an adjusted R² of 0.33 and bias of < 0.001, the expanded model did not add predictive performance. Basic and expanded DNN models showed similar model performance. Optimal discriminative performance was found for PWV < 6.7 m/s. In external validation expanded ridge regression provided the best performance of the four models (adjusted R²: 0.29). All models showed good discriminative performance for PWV < 6.7 m/s (AUC range 0.81–0.89). ePWV showed good discriminative performance with regard to differentiating individuals with lower PWV values (< 6.7 m/s) from those with higher values, and could function as gatekeeper in selecting patients who benefit from further MRI-based PWV assessment.

Concurrent Validity and Reliability of a Novel Visual Analogue Fitness Perception Scale for Adolescents (FP VAS A)

Introduction: Self-reported physical fitness (PF) provides an accurate measure of PF, specifically for young people. The Visual Analogue Scale (VAS) is one of the most used psychosocial measurement methods. The main arguments in favor of VAS are its ease of use and comprehension, particularly for less educated participants. There are some scales that assess self-perception of PF, but the VAS presented in this study covers a higher range of responses and a number of variables than other already validated measures. Aims: The aim was to determine the concurrent validity of the Visual Analogue Fitness Perception Scale for Adolescents (FP VAS A) (Sub-study 1) and check its reliability (Sub-study 2). Methods: Anthropometric and body composition measurements were performed, as well as PF tests (manual dynamometry, Course Navette, 4 × 10 m, and sit and reach). The International Fitness Scale (IFIS) and FP VAS A were used to assess self-reported PF. Results: Two sub-studies were carried out: in sub-study 1 a total of 67 students (26 males and 41 females aged 12–16 years) participated. The results showed a significant direct correlation between the level of PF and self-perception of PF (IFIS and FP VAS A), with the FP VAS A obtaining a higher correlation with PF (r = 0.444 to 0.666) than the IFIS and PF (r = 0.154 to 0.557). In sub-study 2 (test–retest of the FP VAS A), a total of 217 students (120 males and 97 females aged 12–17 years) participated. It showed a moderate reliability for all items; the intraclass correlation coefficient (ICC) was between 0.800 and 0.870, and kappa values ranged from 0.622 (endurance) to 0.458 (flexibility). In addition, Cronbach’s α for the total was 0.860. Conclusion: This study showed good validity and reliability for the FP VAS A in adolescents.

Optimal Values of Body Composition for the Lowest Risk of Failure in Tabata Training's Effects in Adolescents: A Pilot Study

Background

The optimal body mass index (BMI) and fat mass index (FMI) values for a positive change or the lowest risk of no positive change after high-intensity interval training (HIIT) using the Tabata protocol remain unclear. This study is aimed at establishing these optimal BMI and FMI values for the lowest risk of failure of aerobic performance in adolescents.

Methods

A 10-week HIIT programme was introduced into the physical education of 73 students. BMI was calculated using height and weight. Bioelectrical impedance analysis measured body fat, and the InBody apparatus generated the FMI. Based on BMI and FMI, the participants were divided into four groups. Pre- and post-HIIT intervention analyses were carried out using the Harvard step test, which was used to determine the physical efficiency index (PEI).

Results

The Youden index confirmed that the risk of no positive effects in PEI was the lowest for the second BMI interval (19.01-22.00 kg/m²) and FMI Q₂₋₃ (7.96-8.91 kg/m²). The optimal BMI value for the lowest risk of no change in PEI was 20.60 kg/m², and the optimal FMI value was 8.84 kg/m².

Conclusion

A comparison of the two indices shows that FMI had stronger effects on PEI than BMI. In addition, the model obtained for FMI had higher accuracy. Identifying at-risk individuals, those in need of improving health-related fitness (H-RF), and those with a low risk of poor H-RF allows for efficient planning of individual intervention services and training programmes.

The "Fat but Fit" paradox in the academic context: relationship between physical fitness and weight status with adolescents' academic achievement

The present study aimed to analyze the relationship between obesity and different physical fitness markers with academic achievement in adolescents, as well as to check if the "Fat but Fit paradox" is applicable in this context. A total of 188 participants (83 boys) ranging from 12 to 18 years (14.51 ± 1.29 years) underwent a series of fitness tests, and were categorized as "fit" or "unfit" attending to their estimated cardiorespiratory fitness (above or below 42 and 35 ml·kg^-1·min^-1 for boys and girls, respectively). Participants were also categorized according to their body mass index as having overweight/obesity or not. A variety of fitness markers (i.e., cardiorespiratory fitness, lower-body power, sprint time, and flexibility) were positively associated with academic achievement (all p < 0.05), but no associations were found for upper-body power, upper-limb coordination or agility. Both being fit (β = 0.652, 95% confidence interval: 0.001-1.302) and normoweight (β = 1.085, 0.171-1.999) were positively associated with academic achievement. A higher academic achievement (p = 0.021) was found for fit and normoweight individuals compared to unfit and overweight/obese ones, but no differences were found for the remaining subgroups. These findings suggest that an optimal physical fitness might attenuate the negative consequences induced by obesity on academic achievement.

Validation of equations to estimate the peak oxygen uptake in adolescents from 20 metres shuttle run test

This study aimed to develop new prediction models from directly determined peak of oxygen uptake (VO_2peak) in adolescents using 20-metre shuttle run test (20 m-SR) and to compare the new models with previously published equations. This study included 148 adolescents (43% girls), aged 13.37 ± 1.84 years old. Adolescents were randomly assigned to validation (n = 91) and cross-validation (n = 57) groups. VO_2peak was measured using a gas analyser in both maximal exercise tests in the laboratory as well as by 20 m-SR. The multiple linear regression method was applied to develop the models using BMI, BMI-z score and body fat percentage (%FM). The proposed models presented better predictive performance (R2 = 75.6% to 78.9%) and a lower absolute percentage error (%error = 10.51 to 11.78%) than the previously published equations (R2 = 38.8% to 69.1%; %error = 13.13% to 21.54%). The Model with BMI-z was the best fit equation in girls, and the model with BMI-z and %FM in boys. Therefore, it is recommended that the equations developed in the present study be used in future research and projects in the school environment to estimate VO_2peak in adolescents by the 20 m-SR test.

Influence of Body Composition on Physical Fitness in Adolescents

Background and objectives: Childhood obesity is one of the main public health issues facing advanced societies. The Spanish population presents 28.6% overweight or obese adolescents, and Extremadura, 22.3%. Physical fitness is considered one of the most important health markers and a common predictor of morbidity and mortality caused by cardiovascular diseases. Thus, fitness tests are needed for health monitoring, especially in overweight and obese adolescents. Therefore, this study aimed to explore the relationship between body composition and physical fitness in adolescents and to analyse if there are differences in physical condition and body composition between the sexes, as well as to compare the different body mass index (BMI) categories to each other. This project also tried to find regression equations to predict the physical fitness test results. Materials and Methods: A total of 225 adolescents were recruited. Weight status was classified according to WHO 2007 standards. Body composition variables (i.e., BMI, fat mass (FM), FM percentage (FM%), and fat-free mass (FFM)) and physical fitness (standing long jump (SLJ), speed–agility (SA), cardiorespiratory fitness (CF), and handgrip strength (HS)) were assessed. Results: Significant differences were found between the sexes in body composition (FM%, FM, and FFM) and physical fitness (SLJ, SA, CF, and HS) (p < 0.001) in favour of males. Significant differences were also found in speed (p = 0.002), CF (p < 0.001), and SLJ (p = 0.004) in favour of normal-weight adolescents compared to overweight and obese adolescents. Contrarily, the outcomes revealed a significantly greater HS (p = 0.014) in favour of overweight and obese participants compared to normal-weight adolescents. Moreover, the results showed that CF and SLJ correlated inversely with BMI, FM%, and total FM. There was also a direct relationship between SA and FM percentage, as well as between HS and FFM. Finally, four fitness test predictive models are proposed based on body composition, age, sex, and BMI. Conclusions: Overweight and obese adolescents have lower levels of physical fitness than their normal-weight peers, regardless of their sex. Normal-ranged body composition values are related to a greater physical fitness in adolescents. Furthermore, this study presents several equations that can help to predict the performance of different fitness tests in adolescents.

Well-Being, Obesity and Motricity Observatory in Childhood and Youth (WOMO): A Study Protocol

Background: Childhood obesity is one of the greatest public health problems facing advanced societies, and Spain is one of the countries with the highest incidence. There are many studies that monitor at the national level, but given the lack of specificity, lack of updating and scarcity of epidemiological data on overweight, obesity, physical condition and well-being of children and adolescents in Extremadura, it seems necessary to create a Well-being, Obesity and Motricity Observatory in Childhood and Youth (WOMO) in Extremadura in order to follow up on the evolution of this problem and to propose strategies to combat it. Therefore, this project aims (1) to obtain information on the physical condition, body composition and well-being of children and youth in Extremadura every year and (2) to evaluate the relationship between obesity, overweight, physical condition, well-being, self-perceived physical fitness, physical activity adherence, physical literacy, health-related quality of life (HRQoL), happiness and satisfaction with life, connection with nature, barriers to sports practice, self-concept and bullying in children and youth. Methods: An annual monitoring cross-sectional and follow-up study will be performed. Primary outcome measures will be (1) personal data and anthropometric measurements, (2) family and school information, (3) physical condition, (4) obesity and overweight level, and (5) well-being. Secondary outcome measures will be (1) self-perceived physical fitness, (2) physical activity adherence, (3) physical literacy, (4) HRQoL, (5) happiness and satisfaction with life, (6) connection with nature, (7) barriers to sports practice, (8) self-concept and (9) bullying. Discussion: This project will provide valuable information to adopt appropriate strategies to reduce the level of overweight and obesity in children and youth. Furthermore, orientations will be given to transfer the results obtained to the business sector or to the public sector to evaluate or change the policies adopted.

New 20 m Progressive Shuttle Test Protocol and Equation for Predicting the Maximal Oxygen Uptake of Korean Adolescents Aged 13-18 Years

Background: Although several equations for predicting VO_2max in children and adolescents have been reported, the validity of application of these equations to the Korean population has not been verified. The purpose of study was to develop and validate regression models to estimate maximal oxygen uptake (VO_2max) using a newly developed 20 m progressive shuttle test (20 m PST) protocol in Korean male (n = 80, 15.3 ± 1.86 years) and female (n = 81, 15.5 ± 1.73 years) adolescents aged 13-18 years. Methods: The modified 20 m PST was performed and the VO_2max was assessed in a sample of 161 participants. The participants underwent a treadmill test (TT) in the laboratory and the modified 20 m PST in a gymnasium. For the validation study, the participants performed the TT with a stationary metabolic cart and the 20 m PST with a portable metabolic cart once. In addition, they performed the 20 m PST two more times to establish test-retest reliability. Results: The mean VO_2max (49.6 ± 8.7 mL·kg^-1·min^-1) measured with the potable metabolic cart was significantly higher than that measured in the graded exercise test with the stationary metabolic cart (46.6 ± 8.9 mL·kg^-1·min^-1, p < 0.001) using the new 20 m PST protocol. The standard error of the estimate (SEE) between these two measurements was 1.35 mL·kg^-1·min^-1. However, the VO_2max derived from the newly developed equation was 46.7 ± 7.3 mL·kg^-1·min^-1 (p > 0.05) and the SEE was 2.90 mL·kg^-1·min^-1. The test and retest trials of the 20 m PST yielded comparable results (laps, r = 0.96; last speed, r = 0.93). Conclusions: Our data suggest that the new 20 m PST protocol is valid and reliable and that the equation developed in this study provides a valid estimate of VO_2max in Korean male and female adolescents aged 13-18 years.

Reference equation for the incremental shuttle walk test in Portuguese children and adolescents

BACKGROUND

The incremental shuttle walk test (ISWT) is one of the most widely used field tests to assess cardiorespiratory fitness in clinical and research settings. Reference equations to predict ISWT distance in different populations and age cohorts have been established. However, an equation for the Portuguese pediatric population is not available. This study aimed to develop a reference equation for predicting ISWT in Portuguese children and adolescents.

METHOD

Healthy children and adolescents aged between 5 and 17 years old were recruited. Sociodemographic (sex, age), anthropometric (height, weight) and physical activity (Physical Activity Index) data were collected. Lung function was assessed through spirometry and quadriceps muscular strength through hand-held dynamometry. The ISWT was performed twice. A reference equation was established with a multiple linear regression.

RESULTS

130 (60 male; 13.66±2.61y) participants with normal lung function (forced expiratory volume in one second 102.73±15.09% predicted), body mass index (BMI) (20.27±3.59kg/m²) and quadriceps muscular strength (19.75±6.84kgf), completed the assessment. 50.8% (n=66) of the participants were moderately active. Participants walked on average 1165.08±327.19m in the ISWT. Sex, age and BMI were independent contributors to the ISWT, explaining 54% of its variability (p<0.001). The derived reference equation was: ISWT=342.06+(283.07×sex)+(83.61×age)-(22.22×BMI), with female=0 and male=1.

CONCLUSION

Sex, age and BMI were found to be contributors to the ISWT predictive equation for pediatric population, providing a simple reference to assess their cardiorespiratory fitness.

PREDICTIVE EQUATIONS OF MAXIMUM OXYGEN CONSUMPTION BY SHUTTLE RUN TEST IN CHILDREN AND ADOLESCENTS: A SYSTEMATIC REVIEW

ABSTRACT Objective: To systematically review the literature as for the level of evidence of predictive equations of VO2peak through the 20-meter shuttle run test (20m-SRT) in children and adolescents. Data sources: Searches were conducted independently by two researchers, according to the procedures adopted by PRISMA, in the electronic databases MEDLINE via PubMed, ScienceDirect, Web of Science, LILACS and SciELO, for articles published until September 2017 in English and Portuguese. The inclusion criteria were: original studies, abstract available, using predictive equations of VO2peak through 20m-SRT, conducted with adolescents and/or children, non-athletes, and mentioning correlation analysis between predicted and measured VO2peak. The level of evidence of equations was based on the risk of bias of the studies using the following criteria: sample number, sample characteristics, and statistical analysis. Data synthesis: Eighteen studies were selected, in which fifteen equations were found and analyzed. The studies had been conducted with samples composed of subjects of both sexes, aged 8 to 19 years. Equations of Léger and Matsuzaka had their level of evidence classified as high, and estimation ranged between r=0.54-0.90 and r=0.65-0.90. Equations by Ruiz, Barnett and Matsuzaka had their level of evidence classified as moderate, and estimation ranged between r=0.75-0.96, r=0.66-0.84 and r=0.66-0.89, respectively. Conclusions: Matsuzaka’s equation presented satisfactory parameters for estimates of VO2peak in children and adolescents. Although not explored in equations, body adiposity and pubertal stage are significantly associated with cardiorespiratory fitness in children and adolescents.

Making a Case for Cardiorespiratory Fitness Surveillance Among Children and Youth

We review the evidence that supports cardiorespiratory fitness (CRF) as an important indicator of current and future health among school-aged children and youth, independent of physical activity levels. We discuss the merit of CRF measurement for population health surveillance and propose the development of CRF guidelines to help support regional, national, and international surveillance efforts.

Cardiorespiratory fitness in children: Evidence for criterion-referenced cut-points

INTRODUCTION

Criterion-referenced cut-points for field-based cardiorespiratory fitness for children (CRF) are lacking. This study determined: (a) the association between CRF and obesity, (b) the optimal cut-points for low CRF associated with obesity in children, and (c) the association between obesity and peak oxygen uptake ([Formula: see text]) estimated from the 20-m shuttle run test using two different prediction equations.

METHODS

A total of 8,740 children aged 10.1±1.2 were recruited from 11 sites across Canada. CRF was assessed using 20mSRT reported as running speed at the last completed stage, number of completed laps and predicted [Formula: see text], which was estimated at the age by sex level using the Léger et al. and FitnessGram equations. Body mass index and waist circumference z-scores were used to identify obesity. Receiver operating characteristic (ROC) curves and logistic regression determined the discriminatory ability of CRF for predicting obesity.

RESULTS

20mSRT had satisfactory predictive ability to detect obesity estimated by BMI, WC, and BMI and WC combined (area under the curve [AUC]>0.65). The FitnessGram equation (AUC>0.71) presented somewhat higher discriminatory power for obesity than the equation of Léger et al. (AUC>0.67) at most ages. Sensitivity was strong (>70%) for all age- and sex-specific cut-points, with optimal cut-points in 8- to 12-year-olds for obesity identified as 39 mL•kg-1•min-1 (laps: 15; speed: 9.0 km/h) and 41 mL•kg-1•min-1 (laps: 15-17; speed: 9.0 km/h) for girls and boys, respectively.

CONCLUSIONS

20mSRT performance is negatively associated with obesity and CRF cut-points from ROC analyses have good discriminatory power for obesity.

VALIDITY OF FIELD TESTS TO ESTIMATE CARDIORESPIRATORY FITNESS IN CHILDREN AND ADOLESCENTS: A SYSTEMATIC REVIEW

Objective:

To systematically review the literature to verify the validity of field-tests to evaluate cardiorespiratory fitness (CRF) in children and adolescents.

Data sources:

The electronic search was conducted in the databases: Medline (PubMed), SPORTDiscus, Scopus, Web of Science, in addition to the Latin American databases LILACS and SciELO. The search comprised the period from the inception of each database until February 2015, in English and Portuguese. All stages of the process were performed in accordance with the PRISMA flow diagram.

Data synthesis:

After confirming the inclusion criteria, eligibility, and quality of the studies, 43 studies were analyzed in full; 38 obtained through the searches in the electronic databases, and 5 through private libraries, and references from other articles. Of the total studies, only 13 were considered high quality according to the adopted criteria. The most commonly investigated test in the literature was the 20-meter shuttle run (SR-20 m), accounting for 23 studies, followed by tests of distances between 550 meters and 1 mile, in 9 studies, timed tests of 6, 9, and 12 minutes, also 9 studies, and finally bench protocols and new test proposals represented in 7 studies.

Conclusions:

The SR-20-m test seems to be the most appropriate to evaluate the CRF of young people with the equation of Barnett, recommended to estimate VO₂ peak. As an alternative for evaluating CRF, the 1-mile test is indicated with the equation proposed by Cureton for estimating VO₂ peak.

One-year changes in physical activity and sedentary behavior among adolescents: the Croatian Physical Activity in Adolescence Longitudinal Study (CRO-PALS)

Background Little is known about the concurrent change in physical activity (PA), sedentary behavior (SB) and sport participation (SP) during adolescence. The main purpose of this prospective and partly objective study was to simultaneously investigate PA, SBs and SP changes between the 1st and 2nd grades of high school in urban adolescents. Methods In this 1-year follow-up study, the participants were 81 secondary-school students (28 boys and 53 girls) aged 15.5 years at the baseline. PA was assessed with the SenseWear Armband multi-sensor activity monitor, while SBs were assessed by using School Health Action, Planning and Evaluation System (SHAPES) PA questionnaire. The SHAPES questionnaire was supplemented with two questions inquiring about SP in organized sports in school and outside of school. Results PA decreased markedly in both genders between the 1st and 2nd grades of high school. Total energy expenditure (TEE) was reduced by 13 kcal/kg/day on average in boys and by 10 kcal/kg/day in girls (p for both <0.001), while mean daily active energy expenditure (AEE) decreased by 7 kcal/kg/day (p < 0.001) and 3 kcal/kg/day (p = 0.04) in boys and girls, respectively. Similarly, the amount of moderate PA declined by 49 min/day in boys and 21 min/day in girls (p for both <0.001). At the same time vigorous PA was cut by 14 min/day (p < 0.001) and 3 min/day (p = 0.003) in boys and girls, respectively. Conversely, time spent in SBs did not show any change. Conclusion In conclusion, a decline in PA between the 1st and 2nd grades of high school was marked but was not accompanied with an increase in SBs. Policies aimed at increasing PA should be targeting the period of entering secondary school to offset the observed drop in PA.

Comparison of Different Maximal Oxygen Uptake Equations to Discriminate the Cardiometabolic Risk in Children and Adolescents

OBJECTIVE

To determine the ability of 8 different maximal oxygen uptake (VO_2max) equations to discriminate between low and high cardiometabolic risk, and to determine cardiorespiratory fitness (CRF) cutoffs associated with a more favorable cardiometabolic risk profile in Colombian children and adolescents.

STUDY DESIGN

In a cross-sectional study, CRF was estimated using the 20-m shuttle run test in 2870 schoolchildren (54.5% girls) from Bogota, Colombia. We computed a metabolic syndrome score (MetScore) as the sum of the age- and sex-standardized scores of waist circumference, triglycerides, high-density lipoprotein cholesterol, glucose, and systolic and diastolic blood pressure.

RESULTS

Linear regression analyses showed that the Barnett et al (b) and Mahar equations were negatively associated with MetScore, showing the highest discriminatory accuracy for identifying the low/high cardiometabolic risk in both sexes and both age groups (9-12 years and 13-17 years).

CONCLUSIONS

We propose that the Barnett et al (b) equation for boys and girls, VO_2max = 25.8 × (6.6 × G × 0.2 × (body mass + 3.2 × (final speed))), where G is gender (male = 0; female = 1), be used to classify youths at metabolic risk. The CRF cutoffs can serve as a quantitative marker of a healthier cardiovascular profile in Colombian children and adolescents.

Estimating VO2max in children aged 5-6 years through the preschool-adapted 20-m shuttle-run test (PREFIT)

PURPOSE

(1) To examine the comparability, i.e., discriminatory power, in a preschooler test (PREFIT 20-m shuttle-run test) and the 20mSRT-Original in 5-6-year-olds; (2) to provide an equation to estimate VO₂max from the 20mSRT-PREFIT.

METHODS

138 participants aged 5-6 years performed the 20mSRT-PREFIT and the 20mSRT-Original in a counterbalanced order. Total test duration, completed stages, maximum speed and maximum heart rate were registered.

RESULTS

Participants finished stages from 2-10 in the 20mSRT-PREFIT, whereas stages 1-5 were completed in the 20mSRT-Original and a null was registered, showing the original version a lower discriminatory power. We also observed that the higher the cardiorespiratory fitness level the more comparable were the tests, i.e., - 0.04 km h^-1 difference between tests in the fittest participants (i.e., maximum speed ≥ 9.5 km h^-1). Using the original equation proposed by Leger and colleagues in 1988 and based on the estimation regression of maximum speed in the 20mSRT-Original from the PREFIT version, we computed a new equation to estimate VO₂max from the 20mSRT-PREFIT: Y = 44.657 + 1.795X ₁   - 2.601X ₂  + 0.0852X ₁ X ₂ (r = 0.77; r ² = 0.59; SEE = 1.25 ml kg^-1 min^-1 or 2.59% of estimated mean VO₂max = 48.38 ml kg^-1 min^-1), where X ₁ is the 20mSRT-PREFIT maximum speed (km h^-1) and X ₂ is the age of participants. The 20mSRT-PREFIT resulted in a significantly higher maximum heart rate than the 20mSRT-Original.

CONCLUSIONS

The 20mSRT-PREFIT has higher discriminatory power than the 20mSRT-Original. Our study provides for the first time an opportunity to estimate VO₂max in preschoolers and children based on the 20mSRT-PREFIT maximum speed and the age of participants.

Proof of concept of a 45-second cardiorespiratory fitness self-test for coronary artery disease patients based on accelerometry

Cardiorespiratory fitness (CRF) provides important diagnostic and prognostic information. It is measured directly via laboratory maximal testing or indirectly via submaximal protocols making use of predictor parameters such as submaximal V˙O2, heart rate, workload, and perceived exertion. We have established an innovative methodology, which can provide CRF prediction based only on body motion during a periodic movement. Thirty healthy subjects (40% females, 31.3 ± 7.8 yrs, 25.1 ± 3.2 BMI) and eighteen male coronary artery disease (CAD) (56.6 ± 7.4 yrs, 28.7 ± 4.0 BMI) patients performed a V˙O2peak test on a cycle ergometer as well as a 45 second squatting protocol at a fixed tempo (80 bpm). A tri-axial accelerometer was used to monitor movements during the squat exercise test. Three regression models were developed to predict CRF based on subject characteristics and a new accelerometer-derived feature describing motion decay. For each model, the Pearson correlation coefficient and the root mean squared error percentage were calculated using the leave-one-subject-out cross-validation method (r_cv, RMSE_cv). The model built with all healthy individuals’ data showed an r_cv = 0.68 and an RMSE_cv = 16.7%. The CRF prediction improved when only healthy individuals with normal to lower fitness (CRF<40 ml/min/kg) were included, showing an r_cv = 0.91 and RMSE_cv = 8.7%. Finally, our accelerometry-based CRF prediction CAD patients, the majority of whom taking β-blockers, still showed high accuracy (r_cv = 0.91; RMSE_cv = 9.6%). In conclusion, motion decay and subject characteristics could be used to predict CRF in healthy people as well as in CAD patients taking β-blockers, accurately. This method could represent a valid alternative for patients taking β-blockers, but needs to be further validated in a larger population.

Systematic review of the relationship between 20m shuttle run performance and health indicators among children and youth

OBJECTIVE

This systematic review aimed to summarize research that assessed the associations between 20m shuttle run test (20mSRT) performance and indicators of physiological, psychosocial and cognitive health among school-aged children and youth.

DESIGN

Systematic review.

METHODS

Five online databases were used to identify peer-reviewed studies published from 1980 to 2016. Studies were included if they matched these criteria: population (children and youth with a mean age of 5-17 years and/or in Grades 1-12), intervention/exposure (performance on the 20mSRT), and outcomes (health indicators: adiposity, cardiometabolic biomarkers, cognition, mental health, psychosocial health, self-esteem and physical self-perception, quality of life and wellbeing, bone health, musculoskeletal fitness, motor skill development, and injuries and/or harm). Narrative syntheses were applied to describe the results. A lack of homogeneity precluded a meta-analysis approach.

RESULTS

Overall, 142 studies that determined an association between 20mSRT performance and a health indicator were identified, representing 319,311 children and youth from 32 countries. 20mSRT performance was favourably associated with indicators of adiposity, and some indicators of cardiometabolic, cognitive, and psychosocial health in boys and girls. Fewer studies examined the relationship between 20mSRT performance and measures of quality of life/wellbeing, mental health and motor skill development, and associations were generally inconsistent. The quality of the evidence ranged from very low to moderate across health indicators.

CONCLUSION AND IMPLICATIONS

These findings support the use of the 20mSRT as a holistic indicator of population health in children and youth.

Cardiorespiratory fitness, waist circumference and liver enzyme levels in European adolescents: The HELENA cross-sectional study

OBJECTIVES

(1) To examine whether cardiorespiratory fitness (CRF) is related to liver enzyme levels independent of waist circumference (WC), and (2) To test whether having a high CRF is associated with an improved liver enzyme profile with a high WC.

DESIGN

Cross-sectional.

METHODS

CRF (20m-shuttle-run test) and WC were assessed in 811 European adolescents (48.5% males) aged 12.5-17.5 years. Fatty liver biomarkers included fasting serum alanine-aminotransferase (ALT), gamma-glutamyl-transpeptidase (GGT) and the aspartate-aminotransferase to ALT (AST/ALT) ratio. Participants were categorized as fit or unfit (CRF below or above 43.8mL/kg/min and 34.6mL/kg/min, for boys and girls, respectively) and as high or non-high WC (sex and age-specific cut-offs).

RESULTS

CRF was associated with ALT (β=-0.106; p=0.049) and GGT levels (β=-0.225; p<0.001) and AST/ALT ratio (β=0.234; p<0.001), yet these relationships were attenuated after further controlling for WC (all p>0.1). High WC and fit adolescents had lower ALT levels (28±1U/L vs. 23±2U/L, unfit and fit respectively, p=0.018) and higher AST/ALT ratio (0.94±0.04 vs. 1.10±0.06, unfit and fit respectively, p=0.010) than those who were high WC but unfit.

CONCLUSIONS

The results showed that CRF is not independently associated with liver enzymes, and that WC is a stronger predictor in adolescents. These findings also suggest that high CRF may have specific protective effects on liver enzyme levels in adolescents with high WC. Exercise programs focused on increasing CRF and decreasing abdominal adiposity could be a good alternative in the treatment and prevention of obesity related fatty liver disease in adolescents.

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.

Cardiorespiratory fitness estimation in free-living using wearable sensors

OBJECTIVE

In this paper we propose artificial intelligence methods to estimate cardiorespiratory fitness (CRF) in free-living using wearable sensor data.

METHODS

Our methods rely on a computational framework able to contextualize heart rate (HR) in free-living, and use context-specific HR as predictor of CRF without need for laboratory tests. In particular, we propose three estimation steps. Initially, we recognize activity primitives using accelerometer and location data. Using topic models, we group activity primitives and derive activities composites. We subsequently rank activity composites, and analyze the relation between ranked activity composites and CRF across individuals. Finally, HR data in specific activity primitives and composites is used as predictor in a hierarchical Bayesian regression model to estimate CRF level from the participant's habitual behavior in free-living.

RESULTS

We show that by combining activity primitives and activity composites the proposed framework can adapt to the user and context, and outperforms other CRF estimation models, reducing estimation error between 10.3% and 22.6% on a study population of 46 participants.

CONCLUSIONS

Our investigation showed that HR can be contextualized in free-living using activity primitives and activity composites and robust CRF estimation in free-living is feasible.

Physical fitness in children with developmental coordination disorder: measurement matters

Children with Developmental Coordination Disorder (DCD) experience considerable difficulties coordinating and controlling their body movements during functional motor tasks. Thus, it is not surprising that children with DCD do not perform well on tests of physical fitness. The aim of this study was to determine whether deficits in motor coordination influence the ability of children with DCD to perform adequately on physical fitness tests. A case-control study design was used to compare the performance of children with DCD (n=70, 36 boys, mean age=8 y 1 mo) and Typically Developing (TD) children (n=70, 35 boys, mean age=7 y 9 mo) on measures of isometric strength (hand-held dynamometry), functional strength, i.e. explosive power and muscular endurance (Functional Strength Measurement), aerobic capacity (20 m Shuttle Run Test) and anaerobic muscle capacity, i.e. muscle power (Muscle Power Sprint Test). Results show that children with DCD were able to generate similar isometric forces compared to TD children in isometric break tests, but were significantly weaker in three-point grip strength. Performance on functional strength items requiring more isolated explosive movement of the upper extremities, showed no significant difference between groups while items requiring muscle endurance (repetitions in 30s) and items requiring whole body explosive movement were all significantly different. Aerobic capacity was lower for children with DCD whereas anaerobic performance during the sprint test was not. Our findings suggest that poor physical fitness performance in children with DCD may be partly due to poor timing and coordination of repetitive movements.

Evaluation of cardiorespiratory fitness using three field tests in obese adolescents: validity, sensitivity and prediction of peak VO2

OBJECTIVES

Evaluation of cardiorespiratory fitness in obese adolescents is necessary to develop personalised retraining programmes. We aimed to measure cardiorespiratory fitness using 3 field tests, and to evaluate their validity and sensitivity compared to values obtained by laboratory tests.

DESIGN

Longitudinal interventional study in obese adolescents admitted to a rehabilitation centre for a 9-month programme of obesity management.

METHODS

A 12-min walk/run test, an adapted 20 m shuttle walk-run test (starting speed 4 km h(-1), increments of 0.5 km h(-1)min(-1)) and a 4-level submaximal cycle ergometer test were performed to estimate respectively distance covered in 12 min, maximum speed and maximal aerobic power.

RESULTS

Thirty adolescents aged 14.2 ± 1.6 years were included. After 9 months intervention, we observed a significant reduction in body mass index, and an increase in peak VO2 and field test results. We observed significant correlations between pre- and post-intervention values of peak VO2 and distance covered in 12 min (r=0.70 pre; r=0.82 post), maximum speed (r=0.80 pre; r=0.83 post) and maximal aerobic power (r=0.71 pre; r=0.84 post). Multiple linear regression made it possible to estimate peak VO2 based on results from the 3 field tests using prediction equations specific to a population of obese adolescents.

CONCLUSIONS

These field tests, including the adapted 20 m shuttle walk-run test, adequately assess cardiorespiratory fitness in obese adolescents, and are sensitive to changes over time. Predictive equations including BMI are useful in clinical practice to predict peak VO2 in these patients.

Validity of equations for estimating V[combining dot above]O2peak from the 20-m shuttle run test in adolescents aged 11-13 years

The aim of this study was to analyze the validity of 4 regression equations to estimate the peak oxygen consumption (V[Combining Dot Above]O2peak) from the 20-m shuttle run test in adolescents aged 11-13 years. One hundred and fifteen adolescents, 61 boys (mean ± SD: age = 12.3 ± 0.9 years) and 54 girls (age = 12.1 ± 0.7 years) performed the 20-m shuttle run test and an incremental progressive maximal test for direct V[Combining Dot Above]O2peak analysis. Four linear regression equations were used to estimate the V[Combining Dot Above]O2peak: Barnett et al. (equation 1), Léger et al. (equation 2), Mahar et al. (equation 3), and Matsuzaka et al. (equation 4). For boys, only the V[Combining Dot Above]O2peak estimated by EQ3 did not differ from the value directly measured (p > 0.05). The EQ1, EQ2, and EQ4 underestimated the V[Combining Dot Above]O2peak, whereas the EQ3 overestimated, particularly in girls (p < 0.05). Large limits of agreement were found between the reference method and the 4 equations, with higher estimated values by EQ2 for boys (8.36 ± 15.24 mL·kg·min) and girls (2.45 ± 12.63 mL·kg·min). The highest correlation values were observed by EQ4 for boys (r = 0.80), EQ1 for girls (r = 0.72), and EQ3 for total sample (r = 0.80). The equations analyzed were not precise for individual V[Combining Dot Above]O2peak prediction; however, the EQ3 revealed better agreement, particularly for boys. Considering the data obtained in the boys and total sample, our results suggest that the EQ3 may provide the best predictive measure of V[Combining Dot Above]O2peak from the 20-m shuttle run test in adolescents aged 11-13 years.

Comparisons between inverted body mass index and body mass index as proxies for body fatness and risk factors for metabolic risk and cardiorespiratory fitness in Portuguese adolescents

OBJECTIVES

To compare inverted body mass index (iBMI, cm(2) /kg) and body mass index (BMI, kg/m(2) ) as predictors of body fatness, metabolic risk, and cardiovascular fitness in adolescents.

METHODS

A cross-sectional school-based study was conducted on 445 Portuguese adolescents (252 girls and 193 boys) aged 10-17 years. Height and body mass were assessed to determine iBMI and BMI, percent body fatness was determined from skinfold measures (tricep, subscapular) using the Slaughter et al. (1988: Hum Biol 60: 709-723) regression equation and cardiorespiratory fitness (CRF) was assessed using the 20-m shuttle run test. Capillary blood sampling was used to determine: Total cholesterol, triglycerides, high, and low density lipoprotein. These were combined with measures of systolic blood pressure and waist circumference as z-scores. Metabolic risk (MRS) was constructed by summing the z-scores.

RESULTS

iBMI and BMI were both significantly related to percent body fatness, CRF and MRS (all P = 0.005 or better). BMI was not normally distributed (P = 0.0001), whereas iBMI was (P > 0.05). Regression analysis identified that iBMI and BMI, both alongside for age, were significant predictors of percent body fatness, CRF and MRS (all P = 0.005 or better). Compared with BMI, iBMI was a similar predictor of CRF, MRS and body fatness.

CONCLUSIONS

iBMI offers a biologically sound alternative to BMI to assess the effect of weight status on MRS and CRF in adolescents and allows appropriate use of parametrical statistical techniques without changing the conclusions drawn from such data.

Breakfast consumption and CVD risk factors in European adolescents: the HELENA (Healthy Lifestyle in Europe by Nutrition in Adolescence) Study

Objective

To examine the association between breakfast consumption and CVD risk factors in European adolescents.

Design

Cross-sectional. Breakfast consumption was assessed by the statement ‘I often skip breakfast’ and categorized into ‘consumer’, ‘occasional consumer’ and ‘skipper’. Blood pressure, weight, height, waist circumference, skinfold thickness, total cholesterol (TC), HDL cholesterol (HDL-C), LDL cholesterol (LDL-C), TAG, insulin and glucose were measured and BMI, TC:HDL-C, LDL-C:HDL-C and homeostasis model assessment–insulin resistance index (HOMA-IR) were calculated.

Setting

The European Union-funded HELENA (Healthy Lifestyle in Europe by Nutrition in Adolescence) Study.

Subjects

European adolescents, aged 12·50–17·49 years, from ten cities within the HELENA study (n2929,n925 with blood sample, 53 % females).

Results

In males, significant differences across breakfast consumption category (‘consumer’, ‘occasional consumer’ and ‘skipper’) were seen for age, BMI, skinfold thickness, waist circumference, cardiorespiratory fitness, systolic and diastolic blood pressures, TC:HDL-C, LDL-C:HDL-C, glucose, insulin, HOMA-IR and LDL-C; in females, for cardiorespiratory fitness, skinfold thickness, BMI, insulin and HOMA-IR. In overweight/obese males significant differences were also seen for TC and LDL-C, whereas no differences were observed in non-overweight males or in females regardless of weight status.

Conclusions

Our findings among European adolescents confirm previous data indicating that adolescents who regularly consume breakfast have lower body fat content. The results also show that regular breakfast consumption is associated with higher cardiorespiratory fitness in adolescents, and with a healthier cardiovascular profile, especially in males. Eating breakfast regularly may also negate somewhat the effect of excess adiposity on TC and LDL-C, especially in male adolescents.

Centile curves and normative values for the twenty metre shuttle-run test in English schoolchildren

The aim of this study was to provide normative data for performance on the 20 m shuttle-run test of cardiorespiratory fitness in English schoolchildren. A total of 7366 10-16 year olds completed the 20 m shuttle-run test. We expressed performance as the number of shuttles completed, test score (shuttles and levels) and estimated peak oxygen consumption (VO2peak). We calculated descriptive statistics for each age-sex group to construct percentile curves and tables. To assess the cardiorespiratory fitness of our sample, we calculated the number of participants who fell below proposed cut-offs for low cardiorespiratory fitness based on either completed shuttles or VdotO2peak. These cut-offs did not agree in terms of frequency of classification. The classification based on estimated VO2peak suggested low fitness was more prevalent in males and that the incidence of low fitness increased with age in both sexes. These are the first normative data for shuttle-run performance in English youth and can now be used to interpret data from this cardiorespiratory fitness test. The two cut-offs used for low fitness did not agree and future research should establish a cut-off for test performance which can predict present or future ill-health.

The International Fitness Scale (IFIS): usefulness of self-reported fitness in youth

BACKGROUND

We examined: (i) the usefulness of the International Fitness Scale (IFIS) to correctly rank adolescents into physical fitness levels; (ii) the capacity of the IFIS for predicting cardiovascular disease (CVD) risk; and (iii) the reliability of the IFIS in adolescents.

METHODS

The study comprised 3059 adolescents (aged 12.5-17.5 years) from nine European countries (HELENA study). Blood samples were collected in one-third of the participants (randomly selected, n = 981). Test-retest reliability of the IFIS was studied in a separate sample of 277 adolescents. Physical fitness-cardiorespiratory fitness (CRF), muscular fitness (MF), speed-agility (SP-AG), flexibility and overall fitness-was self-reported using 5-point Likert-scale questions (1 = very poor, 5 = very good) and measured using standard field-based tests. The CVD risk factors measured included total/central adiposity indices and mean arterial pressure, total and high density lipoprotein cholesterol, triglycerides, insulin resistance (HOMA) and C-reactive protein.

RESULTS

Analysis of covariance showed that adolescents reporting better fitness had higher measured fitness levels for all the variables studied (all P < 0.001), regardless of gender, age and weight status. Adolescents reporting very good overall fitness, CRF and SP-AG had a healthier cardiovascular profile in eight out of nine CVD risk factors studied. Perfect agreement (same test-retest answer) was observed in 65% of the adolescents and perfect-acceptable agreement (same answer or ±1) in 97% of the adolescents.

CONCLUSIONS

(i) The IFIS is able to correctly rank adolescents according to their measured physical fitness levels; (ii) adolescents reporting a good/very good overall fitness, CRF or SP-AG have a more favorable cardiovascular profile; and (iii) The IFIS is reliable in adolescents.

Physical activity, fitness, weight status, and cognitive performance in adolescents

OBJECTIVE

To examine the association of participation in physical sports activity during leisure time, sedentary behaviors, cardiorespiratory and muscular fitness, and weight status with cognitive performance in Spanish adolescents.

STUDY DESIGN

This cross-sectional study comprised a total of 1820 adolescents (958 female) aged 13.0 to 18.5 years. Cognitive performance (verbal, numeric and reasoning abilities, and an overall score) was measured with the "SRA-Test of Educational Ability." Participation in physical sports activity during leisure time (yes/no) and time devoted to study, television viewing, and playing video games were self-reported and categorized as ≤ 3 hours/day and >3 hours/day. We assessed cardiorespiratory and muscular fitness with field-based tests. Adolescents were classified as underweight, normal weight, overweight, and obese.

RESULTS

Participation in physical sports activities during leisure time was associated with better cognitive performance study variables (all P < .001), independent of potential confounders including cardiorespiratory fitness and body mass index. We did not observe an association of time devoted to study, television viewing, or playing video-games with cognitive performance. Likewise, cognitive performance was similar across cardiorespiratory and muscular fitness levels and body weight categories.

CONCLUSION

Participation in physical sports activity during leisure time may positively influence cognitive performance in adolescents.