Associations between health-related physical fitness and obesity in Taiwanese youth

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

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

The Association between Body Mass Index and Muscular Fitness in Chinese College Freshmen

(1) Background: The present study aimed to investigate the association between body mass index (BMI) and muscular fitness in Chinese college freshmen. (2) Methods: A total of 6425 college freshmen in mainland China were recruited. BMI was classified as underweight (<18.5 kg/m²), normal weight (18.5~23.9 kg/m²), overweight (24~27.9 kg/m²), and obese (≥28 kg/m²), according to the Working Group on Obesity in China. Health-related physical fitness components including cardiorespiratory fitness, lower body explosive power, upper body muscular endurance, abdominal muscular endurance, flexibility, and vital capacity were assessed. Physical fitness index and muscular fitness index were calculated, respectively, as the sum score of the standardized values (z-score) of the corresponding components. Three regression models were used to evaluate the potential associations: a linear regression model, a polynomial regression model, and a restricted cubic spline regression model. Adjust R square was used to compare among models. (3) Results: Significant differences were observed among different BMI categories in nearly all physical fitness components as well as physical fitness z-score and muscular fitness z-score (p < 0.001), regardless of gender. Significant linear associations were found between BMI and physical fitness z-score as well as muscular fitness z-score among total, male, and female groups (p < 0.05). However, the restricted cubic spline regression model showed a better fitting effect (adjust R² was 7.9%, 11.2%, and 4.8% in total, male, and female for physical fitness and 7.7%, 15.7%, and 4.0%, for muscular fitness, respectively), compared with the linear and polynomial regression models, presented by a higher adjusted R². Restricted cubic splines analysis showed that BMI value and physical fitness z-score showed a non-linear relationship with an approximate inverted U curve in all groups, while an approximate reversed J-shaped association was observed between BMI and muscular fitness z-score in all groups. (4) Conclusions: The present study showed a nonlinear negative relationship between BMI and physical fitness with underweight and overweight/obese college freshmen having poorer physical fitness and muscular fitness than their normal BMI peers, which may provide useful evidence to the development of public health recommendations and encourage the health management of young adults. Future studies should further explore the relationship between BMI and muscular fitness with multi-centered large sample size studies.

The Impact of Physical Activity at School on Body Fat Content in School-Aged Children

(1) Background: Excessive amounts of adipose tissue is a health risk. The aim of this study was to assess the impact of increased physical activity (PA) at school on body fat content in children aged 10 to 12 years over a 2-year follow-up. (2) Methods: Children born in 2007 (n = 245) in two groups, (1) standard PA and (2) increased PA at school, 4 and 10 h of physical education lessons per week, respectively. BIA measurements of body fat content were taken twice a year. Results were interpreted based on children's fat content reference curves. (3) Results: During 2 years of observation, the percentage of children with excessive fat mass (overweight and obese) increased by one-third (from 28.11% to 39.67%) in the group of standard PA, while decreased by one-third in the increased PA one (from 28.92% to 21.00%); with normal fat content increased by one-quarter in the increased PA group (from 59.86% to 76.26%) and decreased by one-tenth in the standard PA one (from 61.61% to 56.29%). (4) Conclusions: An increase in PA at school has a positive impact on children's body fat content. It is recommended to increase the number of physical education lessons at school, which has a positive effect on children's health, reducing the risk of obesity.

The Relationship between Body Composition and Physical Fitness and the Effect of Exercise According to the Level of Childhood Obesity Using the MGPA Model

Childhood obesity can lead to adulthood obesity with adverse effects. Since body composition and physical fitness differ depending on the obesity degree, a systemic analysis could help classify that degree. We used three study designs based on the obesity degree (body mass index [BMI] as a reference) for our objectives. First, we identified the relationship between body composition and physical fitness. Second, we determined the effects of exercise on body composition and physical fitness. Third, we performed a path analysis of the impact of exercise on body composition and physical fitness, and verified those effects among the groups. In study 1, 164 10-year-old subjects were divided into four groups: 33 in the normal weight (NO), 34 in overweight (OV), 54 in obesity (OB), and 43 in the severe obesity (SOB) group. In study 2, 101 participants from study 1 who wished to participate in the exercise program were divided into four groups (same criteria). The exercise program (three times a week for 60 min, for 16 weeks) consisted of sports and reinforcement exercises of increasing intensity. Body composition was measured by body weight, percentage of body fat (%BF), muscle mass, skeletal muscle mass (SMM), and body mass index (BMI). In contrast, physical fitness was measured by muscular strength, flexibility, muscular endurance, agility, and balance. As a result, all body composition variables were higher in the SOB group than in the other groups. Physical fitness, muscular strength and balance, and agility were highest in the SOB, NO, and OV groups, respectively. Pearson’s correlation revealed that muscular strength was associated with height and body weight across all groups. Agility showed a negative correlation with %BF in the NO, OB, and SOB groups. SMM was positively correlated in the OB and SOB groups. After the exercise intervention, BMI and the %BF of the SOB group were significantly reduced (p < 0.01, and p < 0.001, respectively), while SMM presented a significant increase (p < 0.001). Height also showed a significant increase in all groups (p < 0.001). Among physical fitness variables, muscular strength, flexibility, muscular endurance, and balance showed a significant increase in all groups, while a significant increase in power was observed in only the OB and SOB groups. As for the effects of the body composition on physical fitness after exercise intervention, the greatest impact was observed for balance, muscular strength and agility, and muscular endurance in NO, OV, and OB groups, respectively. In conclusion, the body composition, physical fitness relationship, and the effects of exercise intervention on them differed depending on the obesity degree. Furthermore, the results varied according to the obesity degree. Thus, our study highlights the importance of creating particular exercise programs for the effective prevention and treatment of childhood obesity considering the obesity degree.

Local Muscle Endurance and Strength Had Strong Relationship with CrossFit® Open 2020 in Amateur Athletes

This study analyzed the relationship between anthropometric measures, cardiorespiratory capacity, strength, power, and local muscle endurance with performance in the CrossFit^® Open 2020. For this, 17 volunteers (6 women) (29.0 ± 7.2 years) completed, on separate weeks, tests for body composition (dual-energy X-ray absorptiometry), maximal oxygen consumption (2 km row test), muscle strength (one repetition maximum (1 RM) back and front squat, isometric peak torque), muscle power (1 RM snatch and clean and jerk) and muscle endurance (Tibana test), which were compared with performance during the CrossFit^® Open 2020. Specific tests of localized muscular endurance and muscle strength had the strongest relationship with performance in the CrossFit^® Open 2020. On the other hand, the percentage of fat and cardiorespiratory capacity were not significantly correlated with CrossFit^® Open 2020 workout performance. Coaches and practitioners should therefore utilize these findings to assess physical fitness and organize the distribution of the training session based on less developed physical needs, in order to ensure an appropriate physiological adaptation for a given competition.

Poor health-related physical fitness performance increases the overweight and obesity risk in older adults from Taiwan

Background

The purpose of the present study was to investigate the associations between health-related physical fitness performance and overweight/obesity risk among Taiwanese healthy older adults.

Methods

A secondary dataset from the nationwide survey was applied in this study. Data from a total of 21,630 respondents aged 65–96 years were collected in this study. Demographic characteristics, life habits, perceived health status, anthropometric assessments, and health-related physical fitness measurements from this dataset were analyzed using the chi-square test, one-way analysis of variance, and logistic regression analysis.

Results

The results indicated that overweight and obesity significantly associated with health-related physical fitness performance in the Taiwanese older adult population. In particular, the upper extremity muscular endurance scores of older adults with poor activity and physical fitness scores revealed obesity as a critical indicator of health-related physical fitness performance.

Conclusions

Future studies can use muscle quality or body fat classification to predict obesity in older adults, which could more precisely portray the relationship between obesity and health-related physical fitness performance.

The Associations Between Physical Performance and Anthropometric Characteristics in Obese and Non-obese Schoolchild Handball Players

This study investigated the relationship of body fat and fitness measures in schoolchild handball players. Twenty-eight young male handball players from handball first youth league volunteered for the present investigation (age: 10.9 ± 0.72 years; body mass: 54.8 ± 22.9 kg; height: 1.48 ± 0.10 m; body fat: 27.6 ± 9.23%). Measures included the Yo-Yo Intermittent Recovery Test level 1 (Yo-Yo IR1), jumping ability [squat and counter-movement jumps (SJ, CMJ)], and sprint tests (10 m, 15 m). Anthropometry was assessed by body mass, body mass index (BMI), and fat percentage (%BF). The power of the upper limb was measured as the total distance thrown overhead using a 2 kg medicine ball. Intrarater reliability for all parameters showed a coefficient of variation (CV) below 10% and an intraclass correlation coefficient (ICC) above 0.75. All ICC were excellent (ICC ≥ 0.96). Reliability as shown by the CV differed between 1.0 (sprint 15 m) and 5.6 (sprint 10 m). With the exception of medicine ball throw, we found significant differences between non-obese and obese in all performance parameters. The differences ranged from η _p ² = 0.47 (sprint 10 m) to η _p ² = 0.09 (medicine ball throw). The two-step-linear regression analysis using the predictors body height and body weight (step 1) and body fat (step 2) showed a marked increase of explained variance by adding body fat. The largest r² changes were calculated for sprint 10 m (0.54), CMJ (0.49), and sprint 15 m (0.42). The lowest influence of the predictors was observed for medicine ball throw (step 1: r ² = 0.03, step 2: r ² = 0.07). With the exception of sprint parameters (β-coefficient sprint 10 m: -0.74; β-coefficient sprint 20: -0.66), a decrease of %BF leads to a higher performance in all parameters. %BF in youth handball players should be an important concern for practitioners working in this team sport in contrast to the frequently used BMI. It seems sensible and appropriate to engage very young children in physical activities such as team handball in order to improve their physical fitness. Decrease in% body fat could be considered both as a training and nutritional target to enhance and optimize sport performance-related outcomes.

Association between Obesity and Overweight and Cardiorespiratory and Muscle Performance in Adolescents

The high prevalence of obesity in childhood and adolescence has major public health consequences, since it is associated with various chronic diseases in the short- and long-term. The goal of our study was to examine the possible association between obesity and overweight and cardiorespiratory and muscle performance during a 4-year follow up period in adolescents. The body mass index (BMI) and physical performance of adolescents (360 girls and 348 boys) between 14-18 years of age was measured twice a year, and the possible correlation between overweight and obesity and cardiorespiratory and muscle performances were investigated. Our results revealed that cardiorespiratory performance increased significantly in boys during the 4 years (p < 0.001), but the aerobic performance of girls only showed seasonal fluctuation. Muscle performance significantly increased both in boys and girls (p < 0.001). Inverse association between obesity and cardiorespiratory and muscle performance was proved. Overweight was also inversely correlated with cardiorespiratory performance, but it demonstrated no correlation with muscle strength. Avoiding increased BMI and decreased physical fitness is essential for adolescents' health to prevent short- and long-term adverse effects.

The Relationship between Body Mass Index and Physical Fitness among Chinese University Students: Results of a Longitudinal Study

Over the past few decades, a gradual increase in sedentary lifestyles along with the increased consumption of a modern, hypercaloric diet has resulted in a substantial increase in the number of those classified as overweight or obese in China. The prevalence of overweight and obesity has become a key public health issue. However, it is important to be cautious when interpreting the literature as the majority of studies apply cross-sectional data to assess and subjectively compare the relationship between physical fitness and being overweight and obese. In the present study, longitudinal data were collected from 3066 students (enrolled in 2014) at a university in China at the beginning of each academic year throughout their four-year university program. The aim of this study was to analyze the various associations between BMI, explosive power, flexibility, and cardiorespiratory endurance, and a random-intercept panel model (RIPM) was separately employed on male and female participants to identify between- and within-person variations. In this way, the associations for between-person physical fitness and normal/overweight/obese weight ranges, and for within-person physical fitness and normal/overweight/obese weight ranges could be observed. The results of this study revealed that every physical fitness test chosen for evaluation (such as the standing long jump for explosive power or the distance run for cardiorespiratory endurance) was negatively related to the BMI results, irrespective of sex, with the notable exception of the flexibility results. In addition, this study showed that both males and females exhibited positively correlated results in both between-person BMI and flexibility as well as within-person BMI and flexibility. Furthermore, the relationships between and within persons of cardiorespiratory endurance, explosive power, and flexibility all showed positive correlations across both sexes. The dynamics between physical fitness and BMI identified in this study could prove useful to practitioners and researchers investigating such relationships in the future.

Body Fat Is a Predictor of Physical Fitness in Obese Adolescent Handball Athletes

We examined the relationships between body fat (BF) and field measures of physical fitness in adolescent handball players. Twenty nine players (age: 16.6 ± 1.72 years; body mass: 79.8 ± 17.0 kg; height: 1.70 ± 0.12 m; body fat: 27.7 ± 8.67%) from Qatar handball first league performed a series of anthropometric and fitness tests related to their performance in sprinting (i.e., 15 m and 30 m sprint), jumping (i.e., countermovement and squat jumps), throwing (i.e., 3 kg medicine ball seated front throw) and running (i.e., agility T-Half and Yo-Yo intermittent recovery level 1 tests). Significant differences between obese and non-obese groups, classified based on age-stratified %BF norms, were found, with the largest difference being attributed to aerobic performance on the Yo-Yo test. Results indicated no significant relationships between anthropometric variables and sprinting or jumping abilities. %BF predicted a significant 8–15% portion in running performances of agility and aerobic capacity, while the latter were mainly explained by body height and mass. %BF was the only and strongest predictor of throwing performance, being an important determinant of performance in handball. Optimizing %BF should be considered as a training and nutrition goal in order to improve sport performance.

The Association between Body Mass Index and Physical Fitness of Normal Weight/Overweight/Obese University Students

This study aimed to apply longitudinal data (in four waves) to examine relationships between body mass index (BMI), flexibility, muscular endurance, and explosive power, and employed a random-intercept panel model (RIPM) to divide the variations of different waves into between- and within-person variations. Furthermore, a multi-group model test was conducted to explore whether an interaction effect existed between sex and these relationships. The data were collected from a university in Taiwan between August 2009 and July 2010, and 3863 freshman and junior students were recruited. Results showed that the between- and within-person relationships between BMI and explosive power, and between BMI and muscular endurance, were negative (independent of sex). The negative between- and within-person associations between BMI and muscular endurance were both invariant with respect to sex. The negative between-person associations between BMI and explosive power were not equivalent for both sexes, yet the within-person associations between BMI and explosive power were equivalent for both sexes. The between-person associations between BMI and flexibility were positive for both sexes, but the within-person associations of these two variables were negative for both sexes. The invariance test confirmed that the positive associations of between-person BMI and between-person flexibility were invariant for both sexes, yet the negative associations of within-person BMI and within-person flexibility were not equivalent for both sexes. Between-and within-person correlations among explosive power, muscular endurance, and flexibility were significantly positive. Only the auto-regressions of BMI and muscular endurance were significant and equivalent for both sexes.

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.

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

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

Characteristics of Physical Fitness and Cardiometabolic Risk in Chinese University Students with Normal-Weight Obesity: A Cross-Sectional Study

PURPOSE

To (i) describe the characteristics of physical fitness and cardiometabolic risk in Chinese university students with normal-weight obesity (NWO); (ii) assess the association between NWO with physical fitness and cardiometabolic risk.

METHODS

A total of 249 participants from the 2018 Shanghai University of Sport Alumni Health Cohort Study in China formed the study cohort. NWO was defined as normal body mass index (17.9-23.9 kg/m² for males; 17.2-23.9 kg/m² for females) but with excess body-fat percentage (≥20% for males; ≥30% for females). Body composition was assessed by dual-energy X-ray absorptiometry. Physical-fitness scores were calculated from a battery of sex-specific tests. Cardiometabolic risk was calculated using a continuous clustered risk (MetS) score.

RESULTS

We found that 16.7% of male and 45.3% of female university students were classified as having NWO. Participants with NWO showed worse cardiorespiratory fitness than those with normal weight (NW) (male NWO (37±8) vs male NW (41±6) mL/kg/min, p<0.01; female NWO (31±4) vs female NW (33±6) mL/kg/min, p<0.01). NWO was associated negatively with the fitness score (OR = 0.853; 95% CI = 0.793-0.917) and was associated positively with the MetS score (1.280; 1.162-1.410).

CONCLUSION

University students with NWO were characterized by higher cardiometabolic risk and lower levels of physical fitness. Our findings implied that university students with NWO should be mindful of the potential hidden health risks of excess body fat and participate in exercise to enhance physical fitness.

Muscle fitness and its association with body mass index in children and adolescents aged 7-18 years in China: a cross-sectional study

BACKGROUND

The present study was the first one aimed to investigate the current muscle fitness and its associated factors among children and adolescents in mainland China.

METHODS

From Nov 2013 to Jul 2014, 2283 children and adolescents aged 7-18 were recruited in Hainan and Shaanxi Provinces in China by cross-sectional design. Information on anthropometry and muscle fitness, measured by hand grip strength (GS), vertical jump (VJ) and sit-and-reach (SR), were collected. Analysis of covariance was performed by using general linear regression models to identify the association between BMI and muscle fitness.

RESULTS

The means of GS, VJ and SR in boys were 22.30 ± 11.55 kg, 22.93 ± 6.80 cm and 3.58 ± 7.31 cm, respectively, and in girls were 16.61 ± 6.87 kg, 18.11 ± 4.08 cm and 7.18 ± 5.72 cm, respectively. GS (from 8.26 kg in the 7-8-year-old group to 27.91 kg in the 17-18 group) and SR (from 1.75 cm in the-8-year-old group to 10.12 cm in the 17-18 group) increased with age (both p for trend < 0.001). Boys had higher GS and VJ, but significantly lower SR than girls in each age group (p < 0.001). After adjusting for age, sex, residential areas and study regions, GS increased with elevated BMI (compared with normal weight group, the regression coefficient for thinness and overweight/obesity were - 2.997(95%CI: -3.693 to - 2.301) and 1.220 (95%CI: 0.285 to 2.155), respectively. With the p values less than 0.001 and 0.011, respectively). For VJ, there was no difference found between normal weight group and overweight/obesity group (p = 0.550), but the thinness group had the lowest performance (regression coefficient = - 2.681, 95%CI from - 3.965 to - 1.397, p < 0.001). For SR, compared with normal weight group, the regression coefficients for thinness and overweight/obesity were - 1.313(95%CI: -2.228 to - 0.399) and - 1.623(95%CI: -3.216 to - 0.030) respectively, both p < 0.05.

CONCLUSIONS

Increased body weight may have a positive association with isometric muscle strength measured by grip strength, but a negative one with strength of lifting the body. Sex difference was also found in the performance of flexibility.

The Relationship between Body Fat Percentage and Some Anthropometric and Physical Fitness Characteristics in Pre- and Peripubertal Boys

The main aim of this study was to compare anthropometric and physical fitness indicators of boys of the same chronical age but with different fat percentages. Subjects were Hungarian boys aged 9⁻13 years (N = 6919). Anthropometry was measured according the guidelines of the International Biological Program. Relative body fat was estimated by Drinkwater⁻Ross's method (1980); Conrad's growth type of physique was also estimated (1963). Physical fitness was tested with 30 m dash (s), standing long jump (cm), fistball throw (m), and 1200 m run (s). Subjects of each cohort were grouped into seven subgroups with fat percentage ranges of 4%. Differences between subgroups were tested by one-way ANOVA. In the case of a significant F-test, Tukey's post-hoc tests were used. The level of effective random error was set at 5% in all significance tests (p < 0.05). Except for the three groups with low fat percentages, values of body weight, stature, body mass index, and plastic and metric indexes were significantly higher; results of 30 m, 1200 m running, and standing long jump were worse in all groups with higher fat percentages. An interesting finding of the current study is that body fat percentage also influenced the physical fitness of non-overweight and obese children as well when using merely the 4% ranges in grouping by fatness. The lower the fat the better the physical fitness was in this sample of pre- and peripubertal boys.

Investigating the relationship between district-level socioeconomic status and individual obesity in Taiwanese adolescents: A large-scale cross-sectional analysis

The current study aimed to assess the prevalence of obesity and to explore the relationship between socioeconomic status and obesity among adolescents in Taiwan, a transitioning country. Data from the Taiwan School Physical Fitness Database on 1,875,627 Taiwanese adolescents aged 10-18 years were analyzed. The average family income per household in each district was collected from the national statistical institutional database. Descriptive statistics, Chi-square tests, Pearson correlation analysis, and mixed model analyses were used. The overall prevalence of combined overweight and obesity was 28.1%. The prevalence of overweight/obesity significantly differed according to gender and age. Furthermore, the average family income per household was negatively associated with the district-level prevalence of obesity. Additionally, when controlling for physical fitness, the average family income per household remained negatively associated with adolescent obesity. In addition, multilevel analysis was also applied to explore the relationship between district-level socioeconomic status and individual-level obesity to prevent the nested data structure from affecting the results. The results revealed that the average family income per household negatively correlated with individual obesity. These findings provide insight for public health officials into preventing and managing adolescent obesity.

Relationships among cardiorespiratory fitness, muscular fitness, and cardiometabolic risk factors in Japanese adolescents: Niigata screening for and preventing the development of non-communicable disease study-Agano (NICE EVIDENCE Study-Agano) 2

OBJECTIVE

To examine the independent and combined associations of cardiorespiratory fitness (CRF) and muscular fitness (MF) with cardiometabolic risk factors in Japanese adolescents.

METHODS

A cross-sectional study including 993 Japanese adolescents (aged 13-14 years) was undertaken. Height, body mass, blood pressure, lipid profile (non-fasting), and HbA1c were measured. The physical fitness (PF) test included measurements of CRF (20 m multistage shuttle run test), upper limb strength (hand grip strength), lower limb strength (standing long jump), and muscular endurance (sit-ups). The clustered cardiometabolic risk (CCMR) was estimated by summing standardized Z-scores of body mass index (BMI), mean arterial pressure (MAP), non-high-density lipoprotein cholesterol (non-HDL-C), and HbA1c.

RESULTS

Linear regression analysis showed that all PF factors except for muscular endurance were inversely correlated with CCMR (P < .001). Among metabolic risk components, HbA1c was unrelated to PF, while non-HDL-C was inversely associated with CRF (B = -2.40; P < .001), upper limb strength (B = -1.77; P < .05), and lower limb strength (B = -1.53; P < .05) after adjustment for lifestyle factors. Logistic regression showed that the probability of having high CCMR (≥1SD) was synergistically higher in those with the lowest tertiles of both CRF and upper limb strength (P for interaction = .001); however, a substantially lower likelihood of having high CCMR was observed among individuals with the lowest tertile of upper limb strength but moderate CRF.

CONCLUSIONS

Lower CRF and MF were significantly and synergistically associated with an unhealthier metabolic risk profile.

Traveling by Private Motorized Vehicle and Physical Fitness in Taiwanese Adults

BACKGROUND

Although the time spent sitting in motorized vehicles has been determined to be adversely associated with cardiometabolic health, its association with other health indicators remains unclear.

PURPOSE

This study examined associations between traveling by private motorized vehicle and 4 indicators of physical fitness in adults.

METHOD

Data from 52,114 Taiwanese adults aged 20 to 65 years who participated in the 2013 National Adults Fitness Survey were used. The examined variables were height, body mass, and performance in modified sit-and-reach (flexibility), bent-leg sit-up (abdominal muscular strength and endurance), and a 3-min step test (cardiorespiratory endurance). Participants were asked on how many days they had used a private car or motorcycle for traveling from place to place and categorized as non-, occasional, and daily private motorized vehicle travelers. Logistic and linear regression models were used to examine associations between the categories of using private motorized vehicles to travel and physical fitness performance.

RESULTS

After an adjustment for potential demographic and behavioral confounders, daily traveling by private motorized vehicle was associated with a higher probability of overweight (odds ratio = 1.18), lower performance of abdominal muscular strength and endurance (-0.37 times/min), and lower cardiorespiratory fitness (-0.60 physical fitness index) than was traveling that did not involve private motorized vehicles.

CONCLUSION

The results suggest that in addition to unfavorable cardiorespiratory fitness and a risk of overweight, daily traveling by private motorized vehicle is associated with poor performance in abdominal muscular strength and endurance.

Prevalence of overweight and obesity among students with intellectual disabilities in Taiwan: A secondary analysis

PURPOSE

The study aims to investigate the prevalence and likelihood of overweight and obesity in a large sample of students with intellectual disabilities (ID) from Taiwan.

METHOD

A secondary analysis of a cross sectional study was employed to examine the body weight status among 7 to 18 year-old students with ID enrolled in public special education schools in 2013. The students were divided into three age groups (7-12 yrs, 13-15 yrs, and 16-18 yrs), four ID levels (mild, moderate, severe, and profound) and six comorbidities of ID (ID only, ID caused by genetic disorders, ID with physical disability, ID with multiple disabilities without physical disabilities, ID with autism spectrum disorders, and others with rare diseases).

RESULTS

The sample represented 34.8% of students with ID attending public special education schools in Taiwan. Within this sample, 35.2% were identified as being overweight or obese. The 16 to 18 year-old age group were approximately two times (AOR=2.02, more likely to be obese than the 7-12 year-old group. Students with ID caused by genetic disorders such as Down syndrome (AOR=2.00) appeared to be more overweight or obese in comparison to those with ID only. Students with moderate (AOR=1.64) and severe ID (AOR=1.49) were more overweight/obese compared to those with profound ID.

CONCLUSION

The findings not only highlight the high prevalence of overweight/obesity but also stress the need for health promotion initiatives to address issues of overweight/obesity within this population.

Clinical outcome measures for monitoring physical function in pediatric obesity: An integrative review

OBJECTIVE

Measuring physical function in children with obesity is important to provide targets for clinical intervention to reduce impairments and increase participation in activities. The objective of this integrative review was to evaluate measurement properties of performance-based measures of physical function in children with overweight and obesity.

DESIGN AND METHODS

An integrative review of literature published in Cochrane Reviews, SPORTDiscus, CINAHL, PLoS, Medline, and Scopus was conducted.

RESULTS

Twenty-eight studies were eligible and represented 66 performance-based measures of physical function. Assessments of repeatability and feasibility were not conducted in the majority of performance measures reported; only 6-min-timed walk (6MTW) was examined for test-retest repeatability. Measures of flexibility, strength, aerobic performance, anaerobic performance, coordination, and balance demonstrated construct validity and responsiveness; however, findings were inconsistent across all performance-based measures. Multi-item tests of physical function demonstrated acceptable construct validity and responsiveness; however, internal consistency was not determined.

CONCLUSIONS

There is moderate evidence that 6MTW is suitable for the measurement of physical function in children with obesity. However, evidence is low for the use of aerobic and anaerobic performance, muscle strength, Movement Assessment Battery for Children, and Bruininks-Oseretsky Test of Motor Proficiency multi-item performance instruments and very low for flexibility, coordination, and balance tests. Based on this review, measurement of physical function using 6MTW is recommended.

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

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

The relationship between physical fitness and obesity among a sample of adolescents in Cyprus

Recent data revealed that adolescent obesity appeared to be a rising problem in Cyprus. However, there is a scarcity of published data regarding fitness-related parameters, which could contribute for the presence of obesity in Cyprus' adolescence population. The aim of the current study was to investigate the association between adolescent obesity, body composition, and fitness levels. A total of 270 high school students volunteered to participate in this cross-sectional study. Body mass and height were assessed in order to calculate body mass index, while body fat percentage was calculated by using bioelectrical impedance analysis. Physical fitness parameters were assessed through a battery of field tests. Body fat was inversely associated with cardiorespiratory fitness levels, sprint and jumping performance, as well as with the frequency of physical education class sessions per week (p<0.05). The adolescents with high body fat were found to exhibit significant reductions in all the fitness related parameters (p<0.05), except with the arm strength (p>0.05). This study is the first to uncover an inverse association between high body fat and fitness-related parameters among a sample of adolescents in Cyprus. These data can be used in order to develop effective interventions aiming to counterbalance obesity and improve the overall health and the quality of life of adolescents.