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Myers J, Cadenas-Sanchez C, Ross R, Kokkinos P. The critical role of cardiorespiratory fitness in disease prevention. J Sports Med Phys Fitness 2024; 64:1361-1371. [PMID: 39287581 DOI: 10.23736/s0022-4707.24.16159-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/19/2024]
Abstract
Cardiorespiratory fitness (CRF) has been increasingly recognized in recent years as an important predictor of risk for adverse outcomes in numerous chronic conditions. In fact, a growing body of epidemiological and clinical evidence demonstrates that CRF is a potentially stronger predictor of mortality than established risk factors such as smoking, hypertension, hyperlipidemia, and type 2 diabetes. Moreover, adding CRF to these traditional risk factors significantly improves the reclassification of risk for adverse outcomes. The utility of CRF now extends far beyond all-cause and cardiovascular mortality to include the prevention and treatment of numerous other chronic conditions; CRF has been demonstrated to have a mitigating influence in as many as 40 such conditions. Herein we discuss the impact of CRF in the prevention of chronic disease in both adults and children. This discussion includes recent data on interactions between CRF and aging, obesity, statin use, incidence of diabetes, and the impact of CRF and physical activity patterns in adolescents including mental health, scholastic achievement, and cardiometabolic health. Finally, we discuss how CRF, as an essential vital sign, can be implemented in clinical practice.
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Affiliation(s)
- Jonathan Myers
- Division of Cardiology, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA -
- Division of Cardiology, Stanford University, Stanford, CA, USA -
| | - Cristina Cadenas-Sanchez
- Division of Cardiology, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA
- Division of Cardiology, Stanford University, Stanford, CA, USA
- Department of Physical Education and Sports Sciences, University of Granada, Granada, Spain
| | - Robert Ross
- School of Kinesiology and Health Studies, Queen's University, Kingston, ON, Canada
| | - Peter Kokkinos
- Veterans Affairs Medical Center, Washington, DC, USA
- Department of Kinesiology and Health, Rutgers University, New Brunswick, NJ, USA
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Ortega FB, Zhang K, Cadenas-Sanchez C, Tremblay MS, Jurak G, Tomkinson GR, Ruiz JR, Keller K, Nyström CD, Sacheck JM, Pate R, Weston KL, Kidokoro T, Poon ET, Wachira LJM, Ssenyonga R, Gomes TNQF, Cristi-Montero C, Fraser BJ, Niessner C, Onywera VO, Liu Y, Liang LL, Prince SA, Lubans DR, Lang JJ. The Youth Fitness International Test (YFIT) battery for monitoring and surveillance among children and adolescents: A modified Delphi consensus project with 169 experts from 50 countries and territories. JOURNAL OF SPORT AND HEALTH SCIENCE 2024; 14:101012. [PMID: 39577493 DOI: 10.1016/j.jshs.2024.101012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2024] [Revised: 09/11/2024] [Accepted: 09/26/2024] [Indexed: 11/24/2024]
Abstract
BACKGROUND Physical fitness in childhood and adolescence is associated with a variety of health outcomes and is a powerful marker of current and future health. However, inconsistencies in tests and protocols limit international monitoring and surveillance. The objective of the study was to seek international consensus on a proposed, evidence-informed, Youth Fitness International Test (YFIT) battery and protocols for health monitoring and surveillance in children and adolescents aged 6-18 years. METHODS We conducted an international modified Delphi study to evaluate the level of agreement with a proposed, evidence-based, YFIT of core health-related fitness tests and protocols to be used worldwide in 6- to 18-year-olds. This proposal was based on previous European and North American projects that systematically reviewed the existing evidence to identify the most valid, reliable, health-related, safe, and feasible fitness tests to be used in children and adolescents aged 6-18 years. We designed a single-panel modified Delphi study and invited 216 experts from all around the world to answer this Delphi survey, of whom one-third are from low-to-middle income countries and one-third are women. Four experts were involved in the piloting of the survey and did not participate in the main Delphi study to avoid bias. We pre-defined an agreement of ≥80% among the expert participants to achieve consensus. RESULTS We obtained a high response rate (78%) with a total of 169 fitness experts from 50 countries and territories, including 63 women and 61 experts from low- or middle-income countries/territories. Consensus (>85% agreement) was achieved for all proposed tests and protocols, supporting the YFIT battery, which includes weight and height (to compute body mass index as a proxy of body size/composition), the 20-m shuttle run (cardiorespiratory fitness), handgrip strength, and standing long jump (muscular fitness). CONCLUSION This study contributes to standardizing fitness tests and protocols used for research, monitoring, and surveillance across the world, which will allow for future data pooling and the development of international and regional sex- and age-specific reference values, health-related cut-points, and a global picture of fitness among children and adolescents.
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Affiliation(s)
- Francisco B Ortega
- Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada; CIBEROBN Physiopathology of Obesity and Nutrition, Granada, ES18071, Spain; Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, FI40014, Finland.
| | - Kai Zhang
- Healthy Activity Living and Obesity (HALO) research group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON K1H 8L1, Canada; School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, ON K1N 6N5, Canada
| | - Cristina Cadenas-Sanchez
- Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada; CIBEROBN Physiopathology of Obesity and Nutrition, Granada, ES18071, Spain; Department of Cardiology, Stanford University, Stanford, CA 94305, USA; Veterans Affair Palo Alto Health Care System, Palo Alto, CA 94304, USA
| | - Mark S Tremblay
- Healthy Activity Living and Obesity (HALO) research group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON K1H 8L1, Canada; Department of Pediatrics, University of Ottawa, Ottawa, ON K1H 8L1, Canada
| | - Gregor Jurak
- Faculty of Sport, University of Ljubljana, 1000 Ljubljana, Slovenia
| | - Grant R Tomkinson
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), Allied Health and Human Performance, University of South Australia, Adelaide, SA 5001, Australia
| | - Jonatan R Ruiz
- Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada; CIBEROBN Physiopathology of Obesity and Nutrition, Granada, ES18071, Spain; Instituto de Investigación Biosanitaria, ibs.Granada, Granada, ES18012, Spain
| | - Katja Keller
- Institute for Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe 71631, Germany
| | | | - Jennifer M Sacheck
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, Washington, DC 20052, USA
| | - Russell Pate
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
| | - Kathryn L Weston
- Department of Psychological Sciences and Health, University of Strathclyde, Glasgow G1 1QE, UK
| | - Tetsuhiro Kidokoro
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), Allied Health and Human Performance, University of South Australia, Adelaide, SA 5001, Australia; Faculty of Sport Science, Nippon Sport Science University, Tokyo 158-8508, Japan
| | - Eric T Poon
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Hong Kong, China
| | - Lucy-Joy M Wachira
- Department of Physical Education, Exercise and Sports Science, School of Health Sciences, Kenyatta University, P.O Box 43844-00100, Nairobi, Kenya
| | - Ronald Ssenyonga
- Department of Epidemiology and Biostatistics, College of Health Sciences, Makerere University, P. O Box 7072, Kampala, Uganda
| | - Thayse Natacha Q F Gomes
- Department of Physical Education, Federal University of Sergipe, São Cristóvão 49107-230, Brazil; Department of Physical Education and Sport Sciences, Health Research Institute, Physical Activity for Health Research cluster, University of Limerick, Limerick V94 T9PX, Ireland
| | - Carlos Cristi-Montero
- IRyS Group, Physical Education School, Pontificia Universidad Católica de Valparaiso, Valparaiso 2374631, Chile
| | - Brooklyn J Fraser
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), Allied Health and Human Performance, University of South Australia, Adelaide, SA 5001, Australia; Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania 7000, Australia
| | - Claudia Niessner
- Institute for Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe 71631, Germany
| | - Vincent O Onywera
- Division of Research, Innovation and Outreach, KCA University, P. O. Box 56808 - 00200, Nairobi, Kenya
| | - Yang Liu
- School of Physical Education, Shanghai University of Sport, Shanghai 200438, China
| | - Li-Lin Liang
- Institute of Public Health, College of Medicine, National Yang Ming Chiao Tung University
| | - Stephanie A Prince
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, ON K1A 0K9, Canada; School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON K1H 8M5, Canada
| | - David R Lubans
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, FI40014, Finland; Centre for Active Living and Learning, University of Newcastle, Newcastle, NSW 2308, Australia
| | - Justin J Lang
- Healthy Activity Living and Obesity (HALO) research group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON K1H 8L1, Canada; Alliance for Research in Exercise, Nutrition and Activity (ARENA), Allied Health and Human Performance, University of South Australia, Adelaide, SA 5001, Australia; Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, ON K1A 0K9, Canada; School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON K1H 8M5, Canada.
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Mora-Gonzalez J, Esteban-Cornejo I, Solis-Urra P, Rodriguez-Ayllon M, Cadenas-Sanchez C, Hillman CH, Kramer AF, Catena A, Ortega FB. The effects of an exercise intervention on neuroelectric activity and executive function in children with overweight/obesity: The ActiveBrains randomized controlled trial. Scand J Med Sci Sports 2024; 34:e14486. [PMID: 37691352 DOI: 10.1111/sms.14486] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 07/11/2023] [Accepted: 08/21/2023] [Indexed: 09/12/2023]
Abstract
OBJECTIVE To investigate whether a 20-week aerobic and resistance exercise program induces changes in brain current density underlying working memory and inhibitory control in children with overweight/obesity. METHODS A total of 67 children (10.00 ± 1.10 years) were randomized into an exercise or control group. Electroencephalography (EEG)-based current density (μA/mm2 ) was estimated using standardized low-resolution brain electromagnetic tomography (sLORETA) during a working memory task (Delayed non-matched-to-sample task, DNMS) and inhibitory control task (Modified flanker task, MFT). In DNMS, participants had to memorize four stimuli (Pokemons) and then select between two of them, one of which had not been previously shown. In MFT, participants had to indicate whether the centered cow (i.e., target) of five faced the right or left. RESULTS The exercise group had significantly greater increases in brain activation in comparison with the control group during the encoding phase of DNMS, particularly during retention of second stimuli in temporal and frontal areas (peak t = from 3.4 to 3.8, cluster size [k] = from 11 to 39), during the retention of the third stimuli in frontal areas (peak t = from 3.7 to 3.9, k = from 15 to 26), and during the retention of the fourth stimuli in temporal and occipital areas (peak t = from 2.7 to 4.3, k = from 13 to 101). In MFT, the exercise group presented a lower current density change in the middle frontal gyrus (peak t = -4.1, k = 5). No significant change was observed between groups for behavioral performance (p ≥ 0.05). CONCLUSION A 20-week exercise program modulates brain activity which might provide a positive influence on working memory and inhibitory control in children with overweight/obesity.
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Affiliation(s)
- Jose Mora-Gonzalez
- Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain
| | - Irene Esteban-Cornejo
- Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
| | - Patricio Solis-Urra
- Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain
- Faculty of Education and Social Sciences, Universidad Andres Bello, Viña del Mar, Chile
| | - María Rodriguez-Ayllon
- Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Cristina Cadenas-Sanchez
- Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
| | - Charles H Hillman
- Department of Psychology, Northeastern University, Boston, Massachusetts, USA
- Department of Physical Therapy, Movement & Rehabilitation Sciences, Northeastern University, Boston, Massachusetts, USA
| | - Arthur F Kramer
- Department of Psychology, Northeastern University, Boston, Massachusetts, USA
- Beckman Institute, University of Illinois at Urbana-Champaign, Champaign, Illinois, USA
| | - Andrés Catena
- School of Psychology, University of Granada, Granada, Spain
| | - Francisco B Ortega
- Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
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