Prevalence and correlates of meeting the muscle-strengthening exercise recommendations among Chinese children and adolescents: Results from 2019 Physical Activity and Fitness in China-The Youth Study

Comparison of physical activity and physical fitness in children and adolescents of Chinese Han and Tibet ethnicity

Background

Physical activity (PA) and physical fitness (PF) are important markers of health status in children and adolescents in different ethnicities. In this study, we aimed to compare the PA and PF indicators between Tibetan and Han children and adolescents.

Methods

Children and adolescents of 4-9 grades were recruited in Shigatse (n = 963) and Shanghai (n = 2,525) respectively. The information related to demographic, PA, and PF was collected via a self-reported questionnaire. PA was assessed through the participation of moderate to vigorous PA (MVPA), muscle-strengthening exercise (MSE) and organized sport participation (OSP). PF was estimated using the International Fitness Scale containing components of overall fitness, cardiorespiratory fitness, speed and agility, muscular strength and flexibility.

Results

Han (mean age = 13.45 ± 3.3 years; 49.7% girls) and Tibet (mean age = 13.8 ± 2.5 years; 48.3% girls) children and adolescents from Shanghai and Shigatse completed the questionnaire survey. It was revealed that Tibetan students had higher MVPA, MSE and OSP than children and adolescents of Han ethnicity (p < 0.01, small to medium effect size). A relatively higher percentage of student in Shanghai did not participate in any form of PA. On the other hand, less Tibetan students thought their PF indicators including overall fitness, cardiorespiratory fitness, speed and agility, muscular strength and flexibility were poor or very poor than their counterparts of Han ethnicity (p < 0.01, small to medium effect size).

Conclusion

Tibetan children and adolescents have higher levels of PA and PF in comparison to their Han counterparts. More children and adolescents of Han ethnicity engage in no PA and think their PF indicators were poor.

Trajectories of osteogenic physical activity in children and adolescents: A 3-year cohort study

OBJECTIVES

We explored the latent profiles based on locomotor skills and cardiorespiratory fitness in Finnish schoolchildren and examined their associations with latent growth curves of osteogenic physical activity (PA) over three years.

DESIGN

Prospective cohort study.

METHODS

Altogether 1147 Finnish adolescents aged 11-13 years participated in the study. Osteogenic PA in terms of osteogenic index (OI) was calculated based on acceleration peak histograms using all of the peaks with acceleration >1.3 g. Locomotor skills were assessed using the five-leap and side-to-side jumping tests and cardiorespiratory fitness (CRF) using 20-metre shuttle run test. The latent growth curve models for the locomotor skills and cardiorespiratory fitness profiles were tested to examine the longitudinal development of OI scores over time three years (from T0 to T3).

RESULTS

OI scores were lower amongst children in the "Low locomotor profile" compared with "Moderate" and "High locomotor" profiles. The OI scores linearly decreased from T0 to T3 in each locomotor profile and the decrease was similar in all the profiles. Moreover, OI scores were lower in the "Low CRF profile" compared with "Moderate" and "High CRF" profiles. The OI scores decreased in each profile over time, but the decrease was steepest in the "Low CRF profile", whereas "Moderate" and "High CRF profiles" had similar developmental trajectories.

CONCLUSIONS

Children with the highest locomotor skills and higher CRF accumulate more osteogenic PA than their least skilful and fit peers, which can have important implications on bone health in this critical period for bone growth.

Meeting muscle-strengthening recommendation is associated with lower adiposity, higher physical fitness and healthier lifestyle in adolescents: The EHDLA study

AIM

To determine the prevalence of adolescents who meet muscle-strengthening activities (MSA) recommendation and their associations with anthropometric variables, physical fitness, and lifestyle behaviours in a sample of Spanish adolescents aged 12-17 years.

METHODS

This was a cross-sectional study using data from The Eating Healthy and Daily Life Activities (EHDLA) Study. Participants reported the days on which they engaged in MSA (≥3 days per week were considered to meet World Health Organization recommendation). Physical fitness was assessed with the ALPHA fitness battery. Additionally, body mass index, waist circumference, skinfolds and body fat percentage were assessed. Lifestyle variables were recreational screen time, sleep time and adherence to the Mediterranean diet. The associations between MSA and outcome variables were tested with linear and logistic regressions.

RESULTS

Of the 852 participants, 48% met MSA recommendation. Meeting MSA recommendation was associated with lower adiposity and higher performance in the shuttle run test, maximal oxygen consumption, standing long jump, speed-agility, flexibility, lower screen time (in weekdays) and higher adherence to the Mediterranean diet.

CONCLUSION

Engaging in MSA once or twice a week was linked with more desirable health outcomes than not engaging in such activities. However, meet with MSA recommendation (i.e., at least 3 days per week) reinforced these benefits.

Association Between Frequency of Muscle-Strengthening Exercise and Depression Symptoms Among Middle and High School Students: Cross-Sectional Survey Study

BACKGROUND

Existing literature on the association between the frequency of muscle-strengthening exercise (MSE) and depression among adolescents is limited and contradictory.

OBJECTIVE

This study aimed to elucidate the association of MSE frequency with depression symptoms among middle and high school students in China.

METHODS

A total of 27,070 students in grades 7-12 from 376 middle and high schools were surveyed using an anonymous self-administered questionnaire between April and June 2022. Information on engaging in MSE was self-reported, and depression symptoms were assessed using the Patient Health Questionnaire-9 (PHQ-9). Poisson regression was used to examine the association between MSE frequency and depression symptoms.

RESULTS

Among the 27,006 eligible students, 51.6% (n=13,933) were boys, and the mean age was 15.6 (SD 1.7) years. The overall prevalence of meeting MSE recommendations (ie, engaging in MSE ≥3 days/week) was 34.6% (95% CI 32.6%-36.6%; n=9145); the prevalence was higher in boys (43.8%, 95% CI 41.8%-45.8%; 6067/13,933) than in girls (24.3%, 95% CI 22%-26.6%; 3078/13,073; P<.001). A total of 5882 (21.8%) students reported having depression symptoms. After adjustment for sociodemographic status, lifestyle factors, academic performance, and experience of physical fighting, compared to students who did not engage in MSE, the prevalence ratios (PRs) for depression symptoms were 0.98 (95% CI 0.97-0.99) for those engaging in MSE once a week, 0.95 (95% CI 0.93-0.97) for 2 days/week, 0.93 (95% CI 0.90-0.96) for 3 days/week, 0.90 (95% CI 0.87-0.94) for 4 days/week, 0.88 (95% CI 0.84-0.93) for 5 days/week, 0.86 (95% CI 0.81-0.92) for 6 days/week, and 0.84 (95% CI 0.78-0.90) for 7 days/week, respectively.

CONCLUSIONS

The overall prevalence of meeting MSE recommendations among Chinese adolescents is low. The frequency of MSE was inversely associated with depression symptoms.

Unveiling the relationship of physical literacy with muscular fitness and muscle-strengthening activities in adolescents: the EHDLA study

Objective

This study evaluated the relationship between physical literacy (PL) and muscular fitness (MF) as well as muscle-strengthening activities (MSA) in adolescents.

Methods

A secondary cross-sectional study included 823 adolescents (45.1% boys) from the Eating Healthy and Daily Life Activities Study. The Spanish Perceived Physical Literacy Instrument for Adolescents (S-PPLI) assessed the participants' perceived PL. The evaluation of MF in the young population was conducted using the Assessing the Levels of Physical Activity and Fitness (ALPHA-FIT) test battery. MSA were assessed by the following question: 'In the past week, how many days did you exercise to strengthen or tone the muscle, such as through push-ups, sit-ups or lifting weights?' To examine the associations between S-PPLI scores and handgrip strength, standing long jump and MSA days in adolescents, we employed generalised additive models.

Results

Participants with high perceived physical literacty (PPL) had the highest handgrip strength (mean=25.1; PPL had the highest handgrip strength (mean=25.1; bias-corrected and accelerated (BCa) bootstrapped 95% CI 24.2 to 26.0) and standing long jump (mean=149.7; confidence interval (CI) 24.2 to 26.0) and standing long jump (mean=149.7; 24.2 to 26.0) and standing long jump (mean=149.7; BCa bootstrapped 95% CI 145.8 to 153.5). Conversely, those adolescents with low PPL had the lowest handgrip strength (mean=23.1; BCa bootstrapped 95% CI 22.3 to 23.8) and standing long jump (mean=137.3; BCa bootstrapped 95% CI 133.9 to 140.6). For MSA, adolescents with high PPL had the highest mean of MSA days (mean=3.0; BCa bootstrapped 95% CI 2.8 to 3.3), while the lowest mean was observed for those with low PPL (mean=2.0; BCa bootstrapped 95% CI 1.8 to 2.2).

Conclusion

A high level of PL was associated with higher levels of MF and MSA among Spanish adolescents.

Influencing Factors on Cardiovascular Health in China

The Annual Report on Cardiovascular Health and Diseases in China (2022) intricate landscape of cardiovascular health in China. This is the first section of the report, which dissects influential factors across diverse domains. The investigation identifies tobacco use as a paramount concern, portraying China as the global epicenter of tobacco consumption. Cigarette smoking, exacerbated by second-hand smoke exposure, emerges as a critical and preventable risk factor, contributing to a surge in attributable deaths over the past three decades. In the realm of dietary nutrition, the study discerns an overall improvement, yet discerns worrisome deviations, notably an escalating fat intake surpassing recommended guidelines. The shifting dietary structure reveals diminished consumption of cereals and vegetables juxtaposed with an uptick in animal foods, while excessive intake of cooking oil and salt persists, straying substantially from endorsed levels. The exploration of physical activity patterns unfolds a nuanced narrative. Varied trends are observed among students, with concerns arising from sedentary behaviors and inadequate adherence to recommended guidelines. The analysis spans a trajectory of declining physical activity in Chinese adults, coupled with an alarming surge in sedentary leisure time, ultimately linking these factors to heightened risks of cardiovascular diseases and increased adiposity. An examination of overweight and obesity trends uncovers a relentless upward trajectory, projecting substantial prevalence by 2030. Noteworthy prevalence rates underscore the imperative for targeted interventions to curtail this burgeoning health crisis, with the anticipated prevalence extending to nearly two-thirds of the adult population. Psychological factors, notably depression, constitute an integral facet of cardiovascular health. Prevalence rates among patients with coronary artery disease and acute myocardial infarction underscore the intricate interplay between mental health and cardiovascular outcomes. Additionally, persistent depressive symptoms are shown to significantly elevate the risk of cardiovascular diseases and mortality. This first section underscores the multifaceted challenges facing cardiovascular health in China, emphasizing the imperative for tailored interventions across tobacco control, dietary habits, physical activity, obesity management, and psychological well-being to mitigate the escalating burden of cardiovascular diseases in the population.

Associations between Dietary Patterns and Physical Activity with Physical Fitness among Adolescents in Shandong Province, China: A Cross-Sectional Study

Background: The trend of physical fitness (PF) and physical activity (PA) among Chinese adolescents is not optimistic, and unhealthy dietary behaviors are common. PA and dietary patterns (DPs) have been linked to PF in adolescents, but the associations between DPs and PF with PF in Chinese adolescents are rarely discussed. Methods: A total of 8796 adolescents aged 11–18 were enrolled from Shandong Province, China. The CNSPFS battery was applied to assess PF. PA levels and diet quality were determined using the Physical Activity Questionnaire for Adolescents and the modified Chinese Diet Quality Questionnaire, respectively. This study used factor analysis to identify DPs and linear regression models to investigate the association between PF and related factors. Results: The average PF score of the participants was 75.67. Adolescents who were girls, lived in rural areas and were active in PA performed better on the PF test (p < 0.05). Boys whose fathers were university educated or above had a higher probability of achieving higher PF scores (OR 4.36, 95% CI 1.32–14.36); however, if their mothers were university educated or above, they had a lower probability of achieving higher PF scores (OR 0.22, 95% CI 0.063–0.76). Unhealthy dietary pattern was negatively correlated with cardiorespiratory fitness in boys (OR 0.56, 95% CI 0.31–0.98). The association between unhealthy dietary pattern and girls’ BMI became significant after adjustment for PA (p < 0.05). Conclusions: Girls performed better in PF than boys. Highly educated fathers could contribute to improve the PF performance in boys. There were four DPs among adolescents in Shandong Province, and different DPs may have different effects on PF in boys and girls.

The association between muscle strength and executive function in children and adolescents: Based on survey evidence in rural areas of China

Background

In recent years, muscle strength in children and adolescents has continued to decline, especially in rural areas. Executive function as a higher function of the brain, is closely related to the future achievement of children and adolescents. For this reason, this study analyzed the correlation between muscle strength and executive function in children and adolescents in rural areas of China to better promote the development of muscle strength and executive function.

Methods

Demographic factors, muscle strength, and executive function were tested in 1,335 children and adolescents in rural China using a three-stage stratified whole-group sampling method. One-way ANOVA and chi-square test were used to compare the differences in executive function among children and adolescents with different muscle strengths. Multiple linear regression analysis and logistic regression analysis were used to analyze the association that exists between muscle strength and executive function.

Results

When comparing the inconsistently, congruent, 1back, 2back, conversion, size parity, and cognitive flexibility response times of children and adolescents with different muscle strength indexes in rural China, the differences were statistically significant (F = 46.592, 45.610, 10.809, 32.068, 24.095, 19.260, 11.501, p < 0.001). Logistic regression analysis was performed using children and adolescents with muscle strength index >P80 as the control group. The results showed that the risk of 1back dysfunction was higher (OR = 1.764, 95% CI:1.094, 2.843) in children and adolescents with muscle strength index <P20 (p < 0.05). The risk of 2back dysfunction was higher in children and adolescents with a muscle strength index <P20 (OR = 2.129, 95% CI:1.329, 3.410) (p < 0.01). Compared with children and adolescents with muscle strength index >P80. The muscle strength index <P20 group had a higher risk of cognitive flexibility dysfunction (OR = 1.820, 95% CI:1.111, 2.982) (p < 0.05).

Conclusion

There is a association between muscle strength and executive function in children and adolescents in rural areas of China. Those with higher muscle strength have shorter executive function reaction times and are at lower risk of developing executive dysfunction. Future measures should be taken to improve muscle strength and executive function levels in children and adolescents in rural areas to promote healthy physical and mental development.

A Trend Analysis of Adherence to the Muscle Strengthening Exercise Guidelines in US Adolescents

Objectives: This study aimed to describe the trends of the muscle-strengthening exercise (MSE) guidelines adherence in adolescents and factors associated with the adherence. Methods: Using the Youth Risk Behavioural Survey data, this study assessed the trends of adhering to the MSE guidelines in adolescents. The survey-year-based trends of MSE guidelines adherence was assessed with logistic regression. Binary logistic regression was used to identify the correlates (i.e., sex, grade, race/ethnicity) of the guidelines' adherence. Results: 73,074 study participants (female = 36,497, male = 36,108; mean age = 16.04 years) were included for analysis. An overall declining trend of the MSE guidelines in adolescents was found (55.6% in 2011 → 49.5% in 2019, p < 0.001), and similar trends were observed in both sexes. The declining trends varied by sociodemographic factors (e.g., grade). Boys and younger adolescents were more likely to adhere to the MSE guidelines. Conclusion: The declining trend of adhering to MSE guidelines in US adolescents would be a health concern in this population. Girls and older adolescents should be targeted as intervention priorities.

Benefits of Physical Activity on Cardiometabolic Diseases in Obese Children and Adolescents

In the past few decades, obesity in the pediatric population has dramatically increased and is common in many countries. Childhood obesity often causes health problems and increases the risk of cardiometabolic diseases such as type 2 diabetes, nonalcohol fatty liver, and cardiovascular diseases. Obesity in young people has been closely associated with environmental, behavioral, and genetic defects, including the availability of high-energy and sugary food and beverages, sedentary behavior, and hereditary factors. Few drugs are currently available to treat obesity in children and adolescents because it is difficult to demonstrate the safety of these drugs on the growth and development of the youth. Lifestyle modifications, such as diet control and physical exercise, are the primary approaches for preventing and treating childhood obesity. Among them, physical activity is a crucial component. This review summarizes the epidemiology, cardiometabolic risk of obesity, therapeutic strategies, and the benefits of exercise on obesity-related chronic diseases in children and adolescents.

School-Based Comprehensive Strength Training Interventions to Improve Muscular Fitness and Perceived Physical Competence in Chinese Male Adolescents

Purpose. This research was to see how effective and feasible school-based comprehensive strength training programs are in improving muscular fitness and perceived physical competence in Chinese male adolescents. Methods. A total of 123 participants ( $13.46\pm 0.60$ years) were randomized to comprehensive strength training intervention group (CST) ( $n=62$ ) and the control group (CON) ( $n=61$ ). The training sessions were performed three times a week for ten weeks in CST. Muscular fitness (i.e., muscular strength, power, and muscular endurance) and perceived physical competence were assessed at initial testing and final testing. Results.The subjects in the CST significantly improved their mean performance in standing long jump ( $p<0.05$ ), vertical jump ( $p<0.05$ ), 1 min push-ups ( $p<0.05$ ), 1 min sit-ups ( $p<0.05$ ), handgrip strength ( $p<0.05$ ), and perceived physical competence ( $p<0.05$ ) after the intervention. Moreover, the CST were greater in standing long jump ( $p<0.05$ ), vertical jump ( $p<0.05$ ), 1 min sit-ups ( $p<0.05$ ), handgrip strength ( $p<0.05$ ), and perceived physical competence ( $p<0.05$ ) compared to the CON, but no in 1 min push-ups ( $p>0.05$ ). Conclusions. The comprehensive strength training interventions designed in this study can significantly increase male adolescents’ muscular fitness, especially in the lower extremity muscle power and abdominal core endurance, and can enhance their perceived physical competence.

Associations of sport participation, muscle-strengthening exercise and active commuting with self-reported physical fitness in school-aged children

Background

Numerous studies suggest a positive association between physical activity and physical fitness in schoolchildren. However, little is known about some neglected forms of physical activity and their associations with physical fitness. This study was conducted via a self-reported questionnaire, owing to the COVID-19 pandemic in many regions in China.

Purpose

This study explores the associations between participating in sports, muscle-strengthening exercises, and active commuting with self-reported physical fitness assessed by the International Fitness Scale (IFIS).

Methods

A total of 3,807 study participants (ages 11–17) from 12 public schools in South-eastern China were recruited, with 2,407 providing valid data on variables for analysis. Study participants were asked to self-report their sociodemographic factors (i.e., sex, grade, age), participation in sports (never, 1–3 times per month, 1–2 times per week, and 3 or more times per week), muscle-strengthening exercise (0–7 days) and active commuting (0–5 days). Generalized linear models were used to explore the associations between sports participation, muscle-strengthening exercise, and active commuting with self-reported physical fitness (comprising general physical fitness, cardiorespiratory fitness, muscular strength, speed and agility, and flexibility). A total of 2,407 children and adolescents with a mean age of 13.82 (±2.1) years were included in the study's final analysis.

Results

The study found no significant association between active commuting and physical fitness. Regarding participating in sports and muscle-strengthening exercises, positive, significant associations were found, which showed that a higher frequency of participating in sports and more participation in muscle-strengthening exercises are associated with improved physical fitness.

Conclusion

This study offered evidence on the roles of some aspects of physical activity in physical fitness. To promote health in children and adolescents, they should be encouraged to participate in more sports and engage in muscle-strengthening exercises.

The Eating Healthy and Daily Life Activities (EHDLA) Study

BACKGROUND

Childhood obesity is one of the greatest public health concerns facing advanced societies, Spain being one of the countries with the highest incidence. In this sense, the Region of Murcia has been pointed out as the Spanish autonomous community with the highest prevalence of excess weight among young people. More specifically, the Valle de Ricote has shown an even greater proportion of excess weight among young people. Several sociodemographic, environmental, lifestyle, health-related, cognitive, and psychological factors are related to excess weight. Based on the lack of information, this research project will try to provide relevant information to design intervention programs, as well as to implement effective public policies to try and reverse this alarming situation. Therefore, this research project aims (1) to obtain cross-sectional and longitudinal data on the excess weight and their potential sociodemographic, environmental, lifestyle, health-related, cognitive, and psychological factors associated among adolescents from the Valle de Ricote (Region of Murcia, Spain) (aged 12-17 years), and (2) to examine the association between excess weight and their potential sociodemographic, environmental, lifestyle, health-related, cognitive, and psychological factors associated among this population.

METHODS

A cross-sectional study and follow-up study will be performed. This research project will involve adolescents using a simple random sampling technique. A total of three secondary schools from the Valle de Ricote (Region of Murcia, Spain) will be included in this project. The minimum sample size will be 1138, establishing a 95% confidence interval, a 40% prevalence of excess weight, a 3% margin of error, and a non-response rate of 10%. Primary outcome measures will be: (1) anthropometric measurements, (2) sociodemographic factors, (3) environmental factors, (4) lifestyle factors, (5) health-related factors, (6) cognitive factors, and (7) psychological factors.

CONCLUSION

This research project will aim to determine the prevalence of excess weight and interrelate their potential sociodemographic, environmental, lifestyle, health-related, cognitive, and psychological factors associated. The obtained results will help to manage and propose possible multidisciplinary interventions and strategies in order to prevent and reduce the excess weight in adolescents from the Valle de Ricote. Furthermore, orientations will be given to transfer the obtained results to the public sector to evaluate or change the adopted policies.