Muscle strength field-based tests to identify European adolescents at risk of metabolic syndrome: The HELENA study

Clustered Cardiometabolic Risk and the "Fat but Fit Paradox" in Adolescents: Cross-Sectional Study

The "fat but fit paradox" states that people who are fit have a lower cluster cardiometabolic risk (CCMR), even if they are overweight or obese. Therefore, the objective was to investigate the CCMR between four categories based on the "fat but fit paradox" variable, in different fitness categories-cardiorespiratory fitness, muscular fitness, and physical fitness-in adolescents. Body composition, cardiorespiratory fitness, muscle fitness, blood samples, and blood pressure were assessed in 230 adolescents, and cardiometabolic risk and three different "fat but fit paradox" variables were calculated. Participants with a higher CRF exhibited a lower CCMR within their body mass index (BMI) category (p < 0.05). Participants with a high BMI and high muscular fitness showed a lower CCMR than participants with a low muscular fitness and a similar BMI, or low BMI and low muscular fitness (p < 0.05). When both variables, CRF and muscular fitness, were combined, their effectabove CCMR increased (p < 0.05). Across all fitness categories, the fat and unfit group, whether considered individually or combined, exhibited the highest risk of CCMR (p < 0.05). This study confirms the "fat but fit paradox" in different physical fitness categories, showing the importance of both CRF and muscular fitness as predictors of CCMR, with the combination of both variables showing a greater agreement.

Physical fitness trends in a nationally representative sample of Portuguese youth: What has changed from 2008 to 2018?

This investigation aimed to describe the current physical fitness (PF) status of Portuguese youth, compare secular trends from 2008 and 2018, and establish updated age- and sex-specific percentile values for distinct PF tests. In 2008 and 2018, 22 048 and 8960 children and adolescents (10-18 years) were included in two national cross-sectional investigations. PF was evaluated using the FITESCOLA® battery tests and the handgrip strength test. Independent sample t-tests and chi-squared tests were used to model the results. Weight smoothed percentile values were calculated using Cole's Lambda-Mu-Sigma (LMS) method. All analyses were weighted according to age, sex, and geographic region. In 2018, boys surpassed girls in the 20-m shuttle run, curl-ups, push-ups, standing long, and vertical jump tests, while girls performed better in the sit-and-reach (p < 0.05). The percentage of boys and girls meeting the healthy zone in the 20-min shuttle run test did not differ between 2008 and 2018 (p ≥ 0.05). In boys, a higher percentage fell in the healthy zone for the curl-up and push-up tests in 2018 compared to 2008 (85.8% vs. 83.4%, and 57.8% vs. 53.8%; p < 0.05). Girls improved their flexibility component (sit-and-reach test), with a higher percentage meeting the healthy zone in 2018 (32.6% vs. 36.9%; p < 0.05); an opposite trend was seen for boys (65.5% vs. 50.1%; p < 0.05). The present investigation provides new and updated PF percentile curves for Portuguese youth, which can be used as a general overview of the current PF state among the Portuguese young population.

Prevalence of Metabolic Syndrome According to Physical Activity, Dietary Habits, Mental Status, Social Status, Health Behavior, and Obesity Phenotypes in Korean Adolescents: 2016-2021

Environmental factors play a role in increasing or decreasing the risk of metabolic syndrome (MetS) in adolescents. We analyzed the impact of physical activity (PA), dietary habits, and mental and socioeconomic status on MetS prevalence in 2143 (boys: 1113, girls: 1030, age: 13-18 years) Korean middle- and high-school students. Metabolically healthy obesity and metabolically unhealthy normal weight were also evaluated. MetS occurred in 215 participants (10.0%), and boys had a higher MetS rate than girls. There was no significant difference in alcohol consumption and smoking experience between individuals with and those without MetS. The odds ratio (OR) for high-school students was 1.33 (95%CI, 1.001-1.789, p = 0.043) times that of middle-school students. Depression, low aerobic PA, and high sedentary time increased the ORs to 1.64 (95%CI, 1.059-2.539, p = 0.020), 1.52 (95%CI, 1.092-2.203, p = 0.003), and 1.86 (95%CI, 1.342-2.587, p < 0.001), respectively. Higher energy intake and low weekly breakfast consumption frequency yielded ORs of 1.46 (95%CI, 1.046-2.555, p = 0.025) and 1.70 (95%CI, 1.244-2.339, p = 0.011), respectively. Strength training, stress, suicidal ideation, dining out frequency, and household income did not impact MetS prevalence. Despite obesity, MetS decreased by 29.7% with high aerobic PA and 37.9% with high weekly breakfast consumption frequency. In conclusion, MetS risk was higher for men, individuals with depression, and high-school students. Low aerobic activity, high calorie intake, and low weekly breakfast consumption frequency increased MetS risk. Despite obesity, high aerobic activity, low sedentary time, and breakfast consumption was associated with lower MetS risk.

Fitness, body composition, and metabolic risk scores in children and adolescents: the UP&DOWN study

We aimed to analyse the longitudinal association between physical fitness (PF) and body composition (BC) with a metabolic risk score (Met4) in children and adolescents and to elucidate whether the association between PF and Met4 differs when using relativized or absolute fitness variables. A total of 188 children (86 females) and 195 adolescents (97 females) were included. Cardiorespiratory fitness (CRF) was determined by the 20-m shuttle run test, and muscular fitness (MF) was determined by hand grip and standing long jump tests. Height and weight were measured, and the body mass index (Kg/m²) was calculated. Triceps and subscapular skinfolds were assessed to compute body fat percentage. Met4 was computed from systolic blood pressure, triglycerides, high-density lipoprotein cholesterol, and glucose levels. Relative CRF was longitudinally and negatively associated with Met4 in female children (β =  -0.031, p = 0.025), while absolute CRF was positively associated with Met4 in male children and adolescents (β = 0.000, p < 0.05). Relative upper and lower-body MF were longitudinally and negatively associated with Met4 in female adolescents (β =  -1.347, β =  -0.005, p < 0.05), while absolute lower-body MF was positively associated with Met4 in male children (β = 0.000, p = 0.019). BC was longitudinally and positively associated with Met4 in male children (β-ranging from 0.011 to 0.055, all p < 0.05) and male adolescents (β-ranging from 0.011 to 0.046, all p < 0.05).  Conclusion: BC is more strongly associated with Met4 than PF in children and adolescents. An optimal body weight status should be considered the main objective of health-promoting programs at childhood and adolescence. Furthermore, the way of expressing the fitness variables determines the direction of the association with Met4. What is Known: • Physical fitness is an important health indicator in children and adolescents, with great amount of previous evidence supporting the preventive role of maintaining optimal levels of both cardiorespiratory and muscular fitness for future cardiometabolic issues. What is New: • The way of reporting physical fitness variables can affect the associations between physical fitness features and cardiometabolic outcomes. Since body composition variables have a great impact on both physical fitness and cardiometabolic health, relativizing physical fitness performance by body composition could lead to erroneous conclusions.

Cross-sectional association between physical fitness and cardiometabolic risk in Chilean schoolchildren: the fat but fit paradox

BACKGROUND

Previous studies have examined the "fat but fit" paradox, revealing that greater levels of physical fitness may diminish the harmful consequences of excess weight on cardiometabolic risk. Despite the above, specific information about the "fat but fit" paradox in prepuberal population is scarce. The aim of this study was to determine the relationship between cardiometabolic risk across (individual and combined) physical fitness and excess weight status and whether the "fat but fit" paradox is met in the sample of schoolchildren analyzed.

METHODS

A cross-sectional study was conducted including 452 children (59.1% girls), aged 7-9 years from Santiago (Chile). Physical fitness was assessed as cardiorespiratory fitness and muscular fitness. Cardiorespiratory fitness was determined by the 6-minute-walk-test and muscle strength was assessed by the handgrip and standing long jump tests. Excess weight (overweight and obesity) was computed through body mass index (z-score). Cardiometabolic risk was established by summing the z-score of the serum glucose, triglycerides, high-density lipoprotein, insulin and waist-to-height ratio.

RESULTS

Schoolchildren with high physical fitness (individual or combined) showed the lowest cardiometabolic risk mean scores (P for trend <0.001 for all physical fitness groups). Conversely, schoolchildren with low physical fitness (individual or combined) showed the highest cardiometabolic risk mean scores (P for trend <0.001 for all categories). Additionally, schoolchildren without excess weight and with high individual or combined physical fitness status exhibits lower cardiometabolic risk mean scores compared to schoolchildren with excess weight and low physical fitness status (individual or combined) (P for trend <0.001 for all physical fitness groups). A lower odd of having high cardiometabolic risk was found in schoolchildren without excess weight and with both high physical fitness (both cardiorespiratory fitness and muscular fitness) [odds ratio (OR) =0.08; 95% confidence interval (CI): 0.04 to 0.16] in comparison to those with excess weight and low physical fitness.

CONCLUSIONS

Our results suggest that improvements in both fatness and aerobic fitness could be associated with lower cardiometabolic risk.

Comparison of Physical Fitness Profiles Obtained before and during COVID-19 Pandemic in Two Independent Large Samples of Children and Adolescents: DAFIS Project

COVID-19 pandemic restrictions might have negatively affected the health-related physical fitness of children and adolescents. The aim of this study was to contrast the body composition and physical fitness data of two independent samples of children and adolescents obtained from an online database (DAFIS project) before (n = 15,287) and during (n = 2101) the first academic year of the COVID-19 pandemic. The results revealed higher values for the body mass index (p = 0.002), waist circumference (p < 0.001), and waist to hip and waist to height ratios (p < 0.001) during than before the pandemic, particularly in the case of boys. On the other hand, lower muscular fitness was observed for girls during the pandemic. Quantitative and qualitative analysis did not detect relevant changes in cardiorespiratory fitness in children or adolescents (p > 0.05). Our data suggested that pandemic constraints might have affected body composition and muscular fitness of children and adolescents. These results might be of interest for designing specific interventions oriented toward counteracting the negative effects of pandemic restrictions on health-related physical fitness.

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.

Handgrip strength cut-off points for early detection of cardiometabolic risk in Chilean children

The aim of this study was to determine whether handgrip strength is associated with cardiometabolic risk in children. The secondary aim was to establish sex-specific handgrip strength cut-off points for early detection of cardiometabolic risk. A total sample of 452 Chilean children (267 girls and 185 boys) aged 7-9 years old was analyzed. Muscle fitness was measured by an adjustable dynamometer and normalized by body mass (i.e., handgrip strength/body mass). Sex-specific cardiometabolic risk scores were computed as the sum of the waist-to-height ratio (Equation 1) or waist circumference (Equation 2) and insulin, triglycerides, high-density lipoproteins, and glycemia levels. Receiver operating curve (ROC) analyses were performed to identify those with cardiometabolic risk scores > 1 standard deviation above the mean. ROC analyses showed a significant discriminating accuracy of normalized handgrip strength in identifying cardiometabolic risk in boys (≤ 0.33) and girls (≤ 0.40) using both equations. The highest sensitivity was offered by Equation 2 for boys [46%; 95% CI (32-59%)] and for girls [71%; 95% CI (60-80)]. The greatest specificity was also offered by Equation 2 for boys [82%; 95% CI (74-88)] and girls [63%; 95% CI (55-70)]. Since the values obtained by ROC analyses are low (especially in boys), caution is warranted regarding the strength of the existing evidence base.Conclusion: These specific cut-off points according to sex for possible cardiometabolic risk could be used by Chilean health professionals and school staff as an initial assessment in the field setting. What is known • There is strong evidence for the importance of muscular fitness during childhood and adolescence for cardiometabolic risk. • There has been no research to establish minimum handgrip strength capacity levels to predict cardiometabolic risk among Chilean children. What is new • Cut-off points for handgrip strength relative to body mass to identify cardiometabolic risk in Chilean children are 0.33 in boys and 0.40 in girls. • The early use of these cut-off points and its appropriate identification could have benefits of preventive and diagnostic therapeutic intervention and as a starting point to define adequate levels of handgrip strength.

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.

Raw bioelectrical impedance analysis variables (phase angle and impedance ratio) are significant predictors of hand grip strength in adolescents and young adults

OBJECTIVES

Musculoskeletal fitness and body composition are major components of health-related physical fitness that are expected to be linked to each other. The aim of this study was to explore the association of musculoskeletal fitness (expressed as hand grip strength [HGS]) and raw bioelectrical impedance analysis (BIA) variables and other predictors in the second and third decades of life.

METHODS

Four groups of healthy normal-weight and overweight participants were studied: 130 male adolescents (age 16.0 ± 1.1 y), 143 female adolescents (16.0 ± 0.9 y), 141 young men (25.5 ± 2.0 y), and 141 young women (25.2 ± 1.9 y). Raw BIA variables (impedance [Z] and phase angle [PhA]) for the whole body were measured at four frequencies (5, 50, 100, and 250 kHz), and HGS was measured in both upper limbs.

RESULTS

HGS was higher in males than females and higher in young men than male adolescents. A fairly strong correlation emerged in both genders between HGS and raw BIA variables-that is, bioimpedance index (height²/Z), PhA, and impedance ratios (Z at high frequency/Z at low frequency). In multiple regression analysis, bioimpedance index, PhA, and impedance ratio were more effective predictors of HGS than BIA-derived estimates of body composition or anthropometric variables such as height, weight, and body mass index. In both genders, HGS was significantly higher in young adults than in adolescents for the same PhA or impedance ratio.

CONCLUSIONS

This study provides some insight into the use of raw BIA variables and HGS in the first decades of life, suggesting a new approach for a reliable assessment of muscle quality in terms of both muscle structure and strength.

Metabolic syndrome and cardiorespiratory fitness in children and adolescents: the role of obesity as a mediator

OBJECTIVES

To analyse the prevalence and association between metabolic syndrome (MetS), clustered cardiometabolic risk (CCMR), obesity (body mass index [BMI], fat mass [FM] and waist circumference [WC]), and cardiorespiratory fitness (CRF); and to assess whether obesity (BMI, FM, and WC) acts as a mediator between CRF and MetS or CCMR.

METHODS

This cross-sectional study included a subsample of the AFINA-te Study (n = 209; 11.51 ± 0.72 years old). BMI, FM, and WC were assessed. The Course-Navette test was used to assess CRF. MetS was calculated following the International Diabetes Federation (IDF) definitions, and assessed using WC, triglycerides (TGs), high density lipoprotein (HD), fasting glucose (FG), and systolic and diastolic blood pressures (SBP/DBP). CCMR was calculated based on the sex and age-specific z score.

RESULTS

The prevalence of overweightness, obesity, MetS, and CCMR were 17.22, 1.44, 5.74, and 18.36%, respectively. After including BMI, FM, or WC into the model, the association between CRF and MetS was no longer significant, and the association between CRF and CCMR was only significant when it was mediated by BMI (β = -0.006; p = 0.026). The rest of the analysis of the mediation did not show a direct effect, although a significant indirect effect with a significant value for the Sobel test was observed (all p < 0.001).

CONCLUSIONS

BMI, FM, and WC act as full mediators in the association between CRF and MetS; FM and WC act as full mediators in the association between CRF and CCMR; and BMI acts as a partial mediator. The use of FM or WC as obesity variables is recommended.

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.

Physical fitness percentiles of Polish children aged 4-7 years

The purpose of this study was to report sex- and age-specific physical fitness level in Polish children aged 4 to 7. 11.709 children participated in the study, including 5.684 girls and 6.025 boys aged 4 to 7 who attended kindergarten institutions throughout Poland. Physical fitness was assessed using four tests developed by Sekita including shuttle run 4 × 5 m with moving the block, standing long jump, throwing 1 kg medicine ball with two hands above the head and 20 m run. Percentile charts were developed separately for males and females using the LMS method. Boys showed higher physical fitness values than girls. In addition, an increase in the level of physical fitness was observed along with the age of the subjects. The developed reference values by age and sex in the field of physical fitness can be used for diagnostic purposes and assessing the level of physical fitness of preschool children. In addition, they can be helpful for healthcare professionals, parents and teachers to develop children's motor activation programs and monitor their physical fitness.

Low Muscular Strength, Weight Status, and Metabolic Syndrome in Adolescents: National Health and Nutrition Examination Survey 2011-2014

PURPOSE

To investigate the association between muscular strength and metabolic syndrome (MetS), with a specific focus on the role of weight status, using a nationally representative sample of US youth.

METHODS

The analysis included 409 boys and 415 girls from the 2011 to 2014 National Health and Nutrition Examination Survey between 12 and 18 years of age. The prevalence of MetS was defined using age- and sex-specific criteria for abdominal obesity, elevated triglycerides, blood pressure, fasting glucose, and low high-density lipoprotein (HDL) cholesterol. Strength was assessed via handgrip dynamometer and expressed as age- and sex-specific z scores of relative strength. Low strength was defined as a relative strength below the 25th percentile. Analyses controlled for age, sex, race/ethnicity, physical activity, and weight status.

RESULTS

The sample prevalence of MetS was approximately 5.3%. However, MetS prevalence was 18.5% in overweight/obese youth with low strength. The adjusted odds of MetS were 3.1 (95% confidence interval, 1.5-6.3, P < .001) times higher for overweight/obese youth with low strength versus sufficient strength.

CONCLUSION

Muscular strength is predictive of adolescent MetS, specifically in those with unhealthy weight status. Approximately one in 5 overweight/obese youth with low strength had MetS. These findings highlight the relevance of muscular strength in youth cardiometabolic morbidities.

Percentiles and Principal Component Analysis of Physical Fitness From a Big Sample of Children and Adolescents Aged 6-18 Years: The DAFIS Project

Assessing physical fitness has emerged as a proxy of the health status of children and adolescents and therefore as relevant from a public health point of view. DAFIS is a project included in Plan Galicia Saudable (Healthy Galicia Plan) of the regional government of Galicia (Spain). DAFIS consists of an on-line software devoted to record the results of a standard physical fitness protocol carried out as a part of the physical education curriculum. The aims of this study were: to obtain normative values of physical fitness of the Galician school population evaluated in the DAFIS project, and to identify a reduced number of components and tests able to capture a significant amount of the variability in the physical fitness of children and adolescents. From an initial sample of 27784 records, 15287 cases (7543 males, 7744 females) were considered after filtering. Generalized Additive Models for Location, Scale and Shape were used for obtaining percentile curves and tables for each sex. Furthermore, a principal components analysis was performed, selecting the number of components by applying the Kaiser's rule and selecting a subset of variables considering the correlation between each variable and the components. Percentile curves and normative values are reported for each test and sex. Physical fitness was better in boys than in girls throughout age groups, except for flexibility that was consistently higher in girls. Two main components were detected throughout age groups: the first one representing body composition and partially cardiorespiratory fitness and the second one muscular fitness. For boys and girls, waist to height ratio had the highest correlations with the first component in four out of six age groups. The highest correlation with the second component, was most frequently observed for the handgrip test both in boys and girls (four out of six age groups). This study provides evidence about the utility of school community actions like DAFIS aimed to track the health-related fitness of children and adolescents. The results suggest that fat mass distribution (i.e., waist to height ratio and waist circumference) and muscular performance (mainly handgrip) concentrate a high proportion physical fitness variance.

Association between muscle strength and risk factors for metabolic syndrome in children and adolescents: a systematic review

The aim of this systematic review was to identify and summarize evidence for the association between muscle strength (MS) and metabolic syndrome (MetS), and MS and combinations of risk factors for MetS in children and adolescents. Five databases (Medline/PubMed, EBSCO, Scielo, Scopus, and Web of Knowledge) were searched up to November 2019 with complementary reference list searches. Inclusion criteria were studies that investigated the relationship between MS and MetS or MS and combinations of risk factors for MetS in children and adolescents (≤19 years of age). Risk of bias was assessed using standard procedures. From the total of 15,599 articles initially identified, 13 articles were included, representing 11,641 children and adolescents. Higher MS values were associated with lower risk for MetS or combinations of risk factors for MetS (n=11/13 studies). Of the total of included studies, about 23.1% (03/13) were longitudinal and all included studies were classified as having a moderate risk of bias. This review provides preliminary evidence for a beneficial relationship between MS and MetS among children and adolescents. Additionally, although the body of evidence points to the beneficial relationship between higher MS and lower risk for combination of factors for MetS in children and adolescents, this relationship is inconclusive.

Influence of Health Related Fitness on the Morphofunctional Condition of Second Mature Aged Women

To analyze the influence of health-related fitness on the condition of second mature aged women. Participants: 65 women divided into two groups. Group 1-40 women, (43.33 ± 0.93) years old and group 2-25 women (44.40 ± 0.93) years old. The participants trained for 8 months, three times a week for 1 h. Group 1 trained dance aerobics (Monday), strength fitness (Wednesday) and stretching (Friday). Group 2 trained only stretching. The body length and mass, handgrip strength test, vital capacity, blood pressure, heart rate, Stange and Genchi tests, and motion amplitude in joints were evaluated before and after the program. The significance of the differences between the groups was evaluated by Student's criterion (t) and Rosenbaum (Q). The different intensity of the health-related effect was confirmed at the end of the program. Physiometric indicators significantly increased in group 1. The complex physical activity led to a decrease in heart rate. The results of the Stange and Genchi tests significantly increased. Goniometric indicators of group 2 increased. The comparative analysis of the participants indicators confirms the generalized and higher health-related effect of the complex fitness program. The effect of such a program showed an increase of the adaptive potential, a significant increase in the functional capabilities of women, and the optimization of the studied indicators. With the same time expenditure for health-related fitness, the complex program has a more multifaceted effect in comparison with stretching.

Relationship Between the Practice of Physical Activity and Physical Fitness in Physical Education Students: The Integrated Regulation As a Mediating Variable

The practice of physical activity (PA) contributes to the prevention of chronic diseases such as obesity, metabolic syndrome or cardiovascular diseases, being also directly related to the individual’s physical fitness. Therefore, it is necessary to measure and monitoring the levels of PA in childhood and adolescence, since it may be useful to describe their current health status and the association with physical fitness, as well as to reveal putative consequences in the future. Within the educational field, it has been shown that physical education (PE) classes are a favorable context for the creation of healthy physical-sports habits and self-determined motivation could be a key for explaining the level of PA practice. For this reason, the purpose of this research was to study the mediating role of integrated regulation (IR) on the relationship between PA and physical fitness in children and adolescents. A total of 325 students between 11 and 14 years old participated in the study. The level of PA was estimated through the specific Physical Activity Questionnaire for Children (PAQ-C), while motivation and IR were measured by using the Perceived Locus of Causality scale (PLOC-2). In addition, physical fitness was measured through the Eurofit fitness battery of tests, composed of three body composition measures and seven tests of different physical capacities. The physical fitness score showed no differences when genders were compared. After regression analysis, the resulting models revealed a good adjustment and correlation between PA practice and physical fitness (β = 0.173; p < 0.001), being established through the macro Process that this relationship is partially conditioned by the IR (β = 0.122; p = 0.03). ROC curve analysis estimated the score of 5.88 as a cut-off point to discriminate between levels of IR for students, classified as physically active or not (AUC = 0.67; p < 0.001). The conclusions from these main and other complementary analyses reporting complete mediations, suggest that the IR could be decisive in predicting and explaining the relationship between the practice of PA and physical fitness at these ages, highlighting its importance for a greater adherence to the practice.

Handgrip Strength and Current Smoking Are Associated with Cardiometabolic Risk in Korean Adolescents: A Population-Based Study

This study aimed to identify the independent association of handgrip strength and current smoking with cardiometabolic risk in adolescents. Data of 1806 adolescents (12–18 years) from the Korea National Health and Nutrition Examination Surveys were analyzed by complex samples logistic regression analyses. Handgrip strength was normalized by body weight into relative handgrip strength. A cardiometabolic risk index score was calculated from the z-scores of the following components: waist circumference, triglycerides, high-density lipoprotein cholesterol, glucose, and blood pressure. Relative handgrip strength showed an inverse association with high cardiometabolic risk, with an adjusted odds ratio of 8.5 (95% confidence interval [CI], 3.7–19.3) for boys and 5.7 (95% CI, 2.9–11.2) for girls on comparing the lowest and the highest age-and sex-specific quartiles of relative handgrip strength. The adjusted odds ratios for high cardiometabolic risk on comparing the second quartile and the highest quartile of relative handgrip strength were 3.9 (95% CI, 1.7–8.9) in boys and 2.6 (95% CI, 1.3–5.3) in girls. Current smoking was independently associated with high cardiometabolic risk in boys aged 15–18 years. These findings suggest the need to increase muscle strength in adolescents and reduce smoking in older boys to promote cardiometabolic health.

Health-related physical fitness indicators and clustered cardiometabolic risk factors in adolescents: A longitudinal study

Background/Objective

This study examined relationships between health-related physical fitness indicators and clustered cardiometabolic risk factors in adolescents between 2014 and 2017.

Methods

The sample consisted of 93 students (60% girls), with complete data sets in both 2014 and 2017. The physical fitness components evaluated were: flexibility (sit and reach), muscular fitness (curl-up and push-up), cardiorespiratory fitness (progressive aerobic cardiovascular endurance run), and body fat (BMI). The cardiometabolic risk factors were: waist circumference, blood pressure, high-density lipoprotein cholesterol (HDL-C), triglycerides and fasting blood glucose. Z-scores were calculated for each risk factor, with the sum of risk factor z-scores values used to represent clustered cardiometabolic risk.

Results

The results of cross-sectional analysis indicated that muscle fitness (curl-up: β = −0.37, p < 0.001; push-up: β = −0.38, p < 0.005) and cardiorespiratory fitness (β = −0.56, p < 0.001) were inversely associated with clustered cardiometabolic risk, with BMI positively associated (β = 0.58, p < 0.001). In the longitudinal analysis, cardiorespiratory fitness (β = −0.33; p < 0.005) and body fat (β = 0.46, p < 0.001) demonstrated a significant association with clustered cardiometabolic risk. However, no significant associations between the health-related physical fitness and clustered cardiometabolic risk were observed after adjustment for baseline values.

Conclusion

Our cross-sectional findings highlight the importance of health-related physical fitness indicators to adolescents. In regarding the longitudinal analysis, further studies are needed in order to clarify the influence of physical fitness in the adolescence and cardiometabolic risk later in life.

Association of handgrip strength with the prevalence of metabolic syndrome in US adults: the national health and nutrition examination survey

OBJECTIVE

Aimed to find the cut-off point of handgrip strength and it's association with MetS.

RESULTS

The relative handgrip strength was negatively associated with the prevalence of MetS. Of note, the odds ratios (ORs) with 95% confidence intervals (CIs) across tertiles of relative handgrip strength were 1 (reference), 0.45 (0.33, 0.62), and 0.13 (0.08, 0.20) in male participants after adjusting for demographic factors, calorie intake, and physical activity. Similar results were observed in female participants. The cutoff values of relative handgrip strength for male and female participants were 0.52 and 0.40, respectively.

CONCLUSIONS

Findings of this study suggest that a strong relationship exists between handgrip strength and prevalence of MetS in US adults, regardless of sex.

METHODS

A total of 5 056 participants in the National Health and Nutrition Examination Survey were analysed in this study. Handgrip strength was measured by using a handgrip dynamometer. MetS was defined in accordance with the criteria of the scientific statement of the American Heart Association in 2009. Multivariable binary logistic regression was used to explore the association between handgrip strength and MetS.