Strength and cardiometabolic risk in young adults: The mediator role of aerobic fitness and waist circumference

Effect of body composition on the athletic performance of soccer referees

Nutrition plays an important role in improving sports performance. The present study aimed at nutritional assessment and examined the relationship between athletic performance and body composition in soccer referees at different levels. The study participants were 120 male soccer referees. 5, 10 and 30 metres (m) sprint tests to measure speed and cooper test for physical fitness were applied in the referees. Participants were divided into two groups as city and class soccer referee. The anthropometric measurements, excluding fat mass (FM) (%), were higher in class referees. Fat mass (%) differences (14⋅1 ± 4⋅28 v. 12⋅3 ± 4⋅41) were statistically significant (P < 0⋅05). Daily energy and nutrient intakes were similar. The inadequacy percentages of energy, vitamin A and calcium were the highest (29⋅2, 30⋅0 and 34⋅2 %, respectively). It was found that a negative significant correlation between FM% and cooper test score (P < 0⋅01; r = -0⋅35), a positive significant correlation between FM% and 5, 10 and 30 m sprint test scores (P < 0⋅01, r = 0⋅38; P < 0⋅01, r = 0⋅38 and P < 0⋅01, r = 0⋅48, respectively). Similarly, there was a negative significant correlation between waist circumference (WC) and cooper test score (P < 0⋅01; r = -0⋅31), a positive significant correlation between WC and 5, 10 and 30 m sprint test scores (P < 0⋅01, r = 0⋅33; P < 0⋅01, r = 0⋅40; P < 0⋅01, r = 0⋅33, respectively). Nutritional recommendations for soccer referees should be made specific to the individual, considering body composition, training intensity and match frequency by a dietician.

The Association between Sedentary Behavior, Physical Activity, and Physical Fitness with Body Mass Index and Sleep Time in Chilean Girls and Boys: A Cross-Sectional Study

BACKGROUND

In recent decades, the school population has undergone behavioral changes that have affected their health and adult life. The current educational scenario presents high levels of sedentary behavior, physical inactivity, low physical fitness, high levels of obesity, and non-compliance with sleep recommendations. In Chile, the scientific evidence on associations between these behaviors is incipient.

OBJECTIVE

To analyze the association between sedentary behavior, physical activity, and physical fitness with BMI and minutes of sleep in Chilean children aged 10 to 11 years.

METHODS

A non-probabilistic convenience sample of 222 schoolchildren aged 10 to 11 years. The variables measured were body composition (BMI), cardiorespiratory fitness (20 m shuttle run test), lower and upper muscular strength (long jump test and handgrip dynamometry), speed (4 × 10 m running), and flexibility (sit and reach test). Physical activity and sleep were measured by accelerometers.

RESULTS

Of the participants, 60.4% and 90.6% did not comply with sleep and physical activity recommendations, respectively. Physical fitness was higher in boys in all components. The results of the linear regression show that in girls, moderate-vigorous-intensity physical activity, lower- and upper-body muscular strength, and cardiorespiratory endurance were associated with BMI and sleep. In boys, light-intensity physical activity and upper-body muscular strength were associated with both variables.

CONCLUSIONS

Physical activity intensity, strength, and cardiorespiratory fitness were associated with BMI and sleep; however, physical activity intensity and associated physical fitness components differed by gender.

Cross-Correlations between Scientific Physical Fitness, Body Mass Index Distribution, and Overweight/Obesity Risks among Adults in Taiwan

Background and Objectives: Health-related physical fitness reduces the risk of chronic disease, promotes quality of life, and has enormous economic benefits considering the global health care costs resulting from obesity. However, relatively limited information is available regarding the dose-response relationship between scientific physical fitness and obesity risk. This study aimed to determine the associations of scientific physical fitness with body mass index (BMI) distribution and overweight/obesity risk among adults aged 23-64 years in Taiwan. Materials and Methods: We conducted a cross-sectional study and reviewed data derived from the Scientific Physical Fitness Testing Program, Sports Administration, Ministry of Education, Taiwan. Responses from 16,939 participants from the database (7761 men and 9178 women, aged 23-64 years) were collected in this study. Each participant completed a series of scientific physical fitness measurements, including cardiorespiratory fitness (3 min progressive knee-up and step [3MPKS] test), muscular fitness (hand grip strength), and flexibility (sit-and-reach test). Anthropometric measurements included body height, weight, and BMI. The quartiles of scientific physical fitness results were identified as the dependent variable in the multiple linear and multiple logistic regression analysis to determine the associations of the scientific physical fitness measurements with BMI distribution and overweight/obesity risk, as well as the dose-response relationship. Results: The 3MPKS test was significantly associated with BMI (quartile 1 (Q1): β = 1.900; quartile 2 (Q2): β = 1.594; quartile 3 (Q3): β = 1.079 for men, and Q1: β = 1.454; Q2: β = 0.882; Q3: β = 0.555 for women), overweight (Q1: odds ratio (OR) = 2.117; Q2: OR = 2.056; Q3: OR = 2.063 for men, and Q1: OR = 3.036; Q2: OR = 2.542; Q3: OR = 1.959 for women), and obesity (Q1: OR = 6.530; Q2: OR = 5.747; Q3: OR = 3.557 for men, and Q1: OR = 3.238; Q2: OR = 1.431 for women) risk compared with quartile 4 (Q4) as the reference group with a dose-response relationship. In addition, relative hand grip strength was significantly associated with BMI (Q2: β = -0.922; Q3: β = -1.865; Q4: β = -3.108 for men, and Q2: β = -1.309; Q3: β = -2.161; Q4: β = -2.759 for women), overweight (Q2: OR = 0.806; Q3: OR = 0.697; Q4: OR = 0.278 for men, and Q2: OR = 0.667; Q3: OR = 0.398; Q4: OR = 0.228 for women), and obesity (Q1: OR = 0.528; Q2: OR = 0.206; Q3: OR = 0.049 for men, and Q1: OR = 0.351; Q2: OR = 0.129; Q3: OR = 0.051 for women) risk compared with Q1 as the reference group with a dose-response relationship. Conclusions: Higher levels of performance of the 3MPKS and relative grip strength tests were associated with lower BMI and overweight/obesity risk in both sexes. However, the sit-and-reach test was only partially related to BMI and overweight/obesity risk in both sexes. Cardiorespiratory fitness and muscular fitness were effective predictors of BMI distribution and overweight/obesity risk in Taiwanese adults.

Associations of Health-Related Physical Fitness with Waist Circumference and Abdominal Obesity Risk in Taiwanese Adults

In this study, we aimed to determine the associations among health-related physical fitness measurements, waist circumference (WC), and abdominal obesity risk in Taiwanese adults. We conducted a cross-sectional study based on data from the 2017 Taiwan Scientific Physical Fitness Survey (the TSPFS). We collected the responses from 17,973 participants (7907 men and 10,066 women) aged 23–64 years for this study. The participants completed the study protocol with a standardized structural questionnaire and a series of health-related physical fitness measurements. The fitness measurements included cardiorespiratory fitness (measured by a 3-min progressive knee-up and step test), muscular fitness (measured by a hand grip strength test), and flexibility (measured by a sit-and-reach test). Our anthropometric measurements included height, weight, WC, hip circumference (HC), body mass index (BMI), and waist-to-hip ratio (WHR). We identified the quartiles of the health-related physical fitness results as the dependent variable in the multiple linear and multiple logistic regression analysis to determine the associations of the physical fitness measurements with WC distribution and abdominal obesity risk. We also considered the dose–response relationship. We found that cardiorespiratory fitness, relative grip strength, and flexibility were each significantly negatively associated with WC, but absolute grip strength was significantly positively associated with WC. We also found that higher levels of cardiorespiratory fitness, relative grip strength, and flexibility were each associated with a lower risk of abdominal obesity. Moreover, our secondary finding was of a dose–response relationship between physical fitness performance, WC, and abdominal obesity risk. In short, health-related physical fitness was an effective predictor of waist circumference for both sexes of Taiwanese adults, and higher levels of health-related physical fitness were associated with lower risks of abdominal obesity in Taiwanese adults.

Physical Activity and Physical Fitness among University Students-A Systematic Review

The aim of this systematic review was to examine the scientific evidence regarding physical activity and physical fitness among university students. The search and analysis of the studies were done in accordance with the PRISMA guidelines. An electronic databases search (Google Scholar, PubMed, Science Direct, and Scopus) yielded 11,839 studies. Subsequently, the identified studies had to be published in English between 2011 and 2021, the experimental study had to have included males and females attending a faculty, and the participants had to have been evaluated for physical activity and fitness. A total of 21 studies were included in the quantitative synthesis, with a total of 7306 participants, both male and female. After analyzing the obtained results, it could be concluded that university students show a satisfactory level of physical activity and physical fitness. However, the results vary due to different factors involved, mostly related to the cultural differences and educational systems in different countries. As this study observes mediocre results of physical activity and physical fitness among university students, it is crucial to get their attention and awareness, to at least maintain a satisfactory level of physical activity and physical fitness.

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.

Effects of an 8-week aerobic exercise program on plasma markers for cholesterol absorption and synthesis in older overweight and obese men

BACKGROUND

Increased physical activity is inversely related to the risk to develop cardiovascular disease (CVD). In a recent systematic review, it was reported that CVD patients had an increased cholesterol absorption and a decreased synthesis as compared with control participants. As increased physical activity levels reduce CVD risk, we hypothesized that exercise training will reduce cholesterol absorption and increase endogenous cholesterol synthesis in older overweight and obese men.

METHODS

A randomized, controlled, crossover trial was performed. Seventeen apparently healthy older overweight and obese men were randomized to start with an aerobic exercise or no-exercise control period for 8 weeks, separated by 12 weeks washout. Fasting serum total cholesterol (TC) and non-cholesterol sterol concentrations were measured at baseline, and after 4 and 8 weeks.

RESULTS

The aerobic exercise program did not affect serum TC concentrations. In addition, exercise did not affect TC-standardized serum concentrations of sitosterol and cholestanol that are markers for cholesterol absorption. However, a trend for reduced TC-standardized campesterol concentrations, which is another validated marker for cholesterol absorption, was observed as compared with control. Lathosterol concentrations, reflecting cholesterol synthesis, did not differ between both periods.

CONCLUSIONS

Aerobic exercise training for 8 weeks did not lower serum TC concentrations in older overweight and obese men, but a trend towards a decrease in the cholesterol absorption marker campesterol was found. The cholesterol synthesis marker lathosterol did not change.

TRIAL REGISTRATION

posted on www.clinicaltrials.gov as NCT03272061 on 7 September 2017.

Eating Speed, Physical Activity, and Cardiorespiratory Fitness Are Independent Predictors of Metabolic Syndrome in Korean University Students

Background: Little is known regarding the role of eating quickly, physical inactivity, and poor cardiorespiratory fitness (CRF) in assessing the onset of metabolic syndrome (Mets) in Korean young adults. Objectives: This study examined the association between the three risk factors and Mets in 1891 Korean university students (30% female) aged 18–29 years. Methods: Eating speed (slow vs. fast) and physical activity (active vs. inactive) were assessed with a standardized questionnaire. Maximal oxygen uptake as an indicator of CRF was assessed with graded exercise testing. Components of Mets were waist circumference, systolic and diastolic blood pressures, fasting blood glucose (FBG), triglycerides (TG), and high-density lipoprotein cholesterol (HDLC). Results: All the three exposures were positively associated with abdominal obesity, elevated blood pressures, elevated FBG, elevated TG, and decreased HDLC. Logistic regression analysis showed that the odds ratio (OR) of Mets was incremental in the order of physical inactivity (odds ratio, OR = 1.666; 95% confidence interval, CI = 1.024–2.708; p = 0.040), fast eating (OR = 1.687; 95% CI = 1.094–2.601; p = 0.018), and poor CRF (OR = 5.378; 95% CI = 3.475–8.325; p < 0.001). Conclusions: The current findings suggest that a multifaceted intervention targeting at promotion of physical activity and CRF in concert with healthy eating behaviors should be implemented as a preventive strategy against Mets in Korean university students.

Mediation and Moderation of Adiposity Indicators for the Association Between Grip Strength and Cardiovascular Disease Risk Scores

Background: This cross-sectional study evaluated mediation or moderation of adiposity indicators on the association between handgrip strength (HGS) and the 10-year cardiovascular disease risk scores (CVDR). Methods: In data of 15,206 Korean adults (6961 men and 8245 women) aged ≥30 years using the Korea National Health and Nutrition Examination Survey, HGS, body mass index (BMI), height, waist circumference, the components of Framingham CVDR, and covariates (sociodemographic factors, health behaviors, perceived stress, health, functional status, and nutritional status) were used. BMI, waist circumference, and waist-to-height ratio were used as adiposity indicators. Gender-specific general linear model and PROCESS Macro were applied. Results: HGS had an inverse association with the CVDR after adjusting for the covariates and BMI (or waist circumference), while adiposity indicators had positive associations with the CVDR after adjusting for the covariates and HGS. Mediation analysis shows indirect effects of adiposity indicators (0.010-0.019, P < 0.05) and direct effect of HGS on the CVDR (-0.08 to -0.09, P < 0.05) after adjusting for the covariates. Moderation analysis reveals positive interactions between HGS and adiposity indicators in the relationship with the CVDR after adjusting for the covariates (P < 0.05). The inverse association between the HGS and the CVDR tended to be stronger with decrease in adiposity levels. Conclusions: Adiposity indicators mediated and moderated the association between HGS and the CVDR in Koreans. The moderating effects indicate that the lower the levels of the adiposity indicators, the stronger the CVDR improvement effect of HGS.

Feasibility and Effectiveness of a Motion Tracking-Based Online Fitness Program for Office Workers

The development of technology-based home fitness has emerged from the booming digital healthcare market and recent demands for at-home fitness and health equipment due to the COVID-19 pandemic. Digital healthcare company Alyce Healthcare recently developed Weelo, which is a web-based online fitness program. Weelo recommends an exercise protocol through machine-learning-enabled recognition of the user’s motion and provides visual and auditory feedback. We evaluated whether Weelo improves physical and mental well-being to assess its capabilities and effectiveness. Thirty-two participants performed a total of 20 exercise sessions following the Weelo guide on a laptop. The participants were evaluated using a before and after exercise program, body composition, handgrip strength, six-minute walk test, modified star excursion balance test, short form 36, fatigue severity scale, Beck depression index, and a satisfaction survey. Overall, there was a significant improvement in muscle strength, endurance, and balance ability, as well as an improved quality of life and significant reduction in fatigue and depression. Participants showed high motivation to continue following the Weelo exercise program. In conclusion, utilizing Weelo improved physical and mental well-being and is considered to be an individual-use indoor exercise program that serves as an alternative to traditional face-to-face exercise.

Relevance of Physical Fitness and Cardiovascular Disease Risk

BACKGROUND

This study explored the relationship between fitness performance, in terms of muscular endurance and cardiorespiratory fitness (CRF), and cardiovascular disease (CVD) risk.

METHODS AND RESULTS

The study was performed on 51,500 eligible participants from the Republic of China Armed Forces. Participants were divided into 4 groups (obese or non-obese males and females). Correlations between the Framingham risk score of coronary artery disease (FRS-CAD) and physical fitness (evaluated using 2-min push-ups, 2-min sit-ups, and 3,000-m non-weight-bearing running tests) were calculated using univariate and multivariate linear regression, as well as an extended model that adjusted for covariates. In males, regardless of obesity status, there were significant negative correlations between quartiles of fitness performance and the FRS-CAD (P<0.001) in the unadjusted and adjusted models, except for the sit-up test in the model adjusted for age, serum uric acid, hemoglobin, creatinine, current drinking, betel nut chewing, and running test speed. FRS-CAD was lower for higher quartiles of physical fitness (P for trend <0.001) in male participants. However, no significant relationship between fitness performance and FRS-CAD was observed in females, regardless of obesity status.

CONCLUSIONS

The findings highlighted a substantial association between fitness performance and FRS-CAD, especially in adult males. Muscular endurance and CRF may be a convenient risk evaluation tool for future CVD risk in the general, healthy, young to middle-aged male population in Taiwan.

The independent and joint associations among muscle strength, abdominal obesity and cardiometabolic variables among adults

The aim of the present study was to investigate the independent and joint associations among muscle strength (MS) and obesity with blood pressure, atherosclerosis, and laboratory markers. This was a cross-sectional study comprising a representative sample of 642 adults (men: 44.9%, 39.9 ± 11.2 years; women: 55.1%, 39.3 ± 11.1 years) from Florianópolis, Brazil. MS was assessed by handgrip strength. Obesity was defined as a Body Mass Index (BMI) ≥30.0 kg/m² and a waist circumference ≥80.0 cm in women and ≥90.0 cm in men. Clinical variables included systolic (SBP) and diastolic blood pressure (DBP), C-reactive protein (CRP), lipids, glucose metabolism markers and carotid intima-media thickness (IMT). Linear regression models stratified by sex and adjusted for confounders were used. Higher MS levels were related to lower CRP (up to 0.59 times lower), triglycerides (up to 0.33 times lower), HOMA-IR (up to 0.35 times lower), and higher HDL cholesterol (up to 5.2 mg/dL) levels among men. Among women, higher MS levels were related to lower SBP and DBP (up to -10.2 mmHg), CRP (up to 0.56 times lower), HOMA-IR (up to 0.27 times lower) and IMT (up to -4.8 × 10^-2 mm). In addition, MS was inversely related to triglycerides and HOMA-IR among obese men, inversely related to CRP among obese men and women, and inversely associated to DBP only among obese women. This population-based study corroborates findings from clinical studies suggesting that even among individuals with obesity, higher MS might help adults to reduce cardiometabolic risk. HighlightsMuscle strength levels were directly associated with better prognosis in relation to cardiometabolic variables in individuals with or without abdominal obesity.Among men with abdominal obesity, to have higher values of muscle strength were associated with lower values of diastolic blood pressure, C-reactive protein, triglycerides, cholesterol and HOMA-IR.Higher muscle strength levels were inversely associated with C-reactive protein among women with abdominal obesity; Higher muscle strength might help adults to reduce cardiometabolic risk.

Cardiometabolic Changes in Response to a Calorie-Restricted DASH Diet in Obese Older Adults

Objective: To examine the response of a calorie-restricted Dietary Approaches to Stop Hypertension diet on indicators of cardiometabolic health in a cohort of sedentary obese older adults. Design: This was a controlled-feeding trial with a parallel design. Each participant consumed either 3 oz (85 g; n = 15) or 6 oz (170.1 g; n = 13) of lean fresh beef within a standardized calorie-restricted DASH-like diet for 12-weeks. Fasted blood samples were collected and used to measure conventional biomarkers of cardiovascular, metabolic and inflammatory health. Participants: Caucasian older (70.8 years), obese (BMI: 32 ± 6.9 kg/m²; WC: 101 ± 16.4 cm) females (n = 17) and males (n = 11) from the rural community of Brookings, South Dakota. Results: 28 participants completed the 12-week feeding trial, with no differences (p > 0.05) among the biomarkers of cardiometabolic health between the 3 and 6 oz beef intake groups. However, when the beef intake groups were combined, all biomarkers changed concentration in response to the intervention diet. Total cholesterol (p < 0.001), LDL-C (p = 0.004), HDL-C (p < 0.0001), insulin (p = 0.014), glucose (p = 0.008), HOMA-IR (p < 0.05), IL-12 (p < 0.001), and CRP (p = 0.006) all decreased in response to the study diet. IGF-1 (p < 0.001) and IL-8 (p = 0.005) increased in response to the intervention. Correlations among cardiometabolic biomarkers and body composition measures were observed. By study end, the decrease in insulin (R ² = 0.22; P = 0.012) and HOMA-IR (R ² = 0.22; P = 0.01) was positively correlated with the decrease in waist circumference. The increase in IGF-1 was significantly correlated with the decrease in waist circumference (R ² = 0.21; p = 0.014). The increase in IGF-1 was significantly correlated with the increase in sit-to-stand (R ² = 0.21; p = 0.016). The increase in IL-8 was significantly correlated with decreases in total cholesterol (R ² = 0.24; P = 0.008), LDL-C (R ² = 0.17; P = 0.031) and glucose (R ² = 0.44; P = 0.0001). Conclusions: These findings suggest that a DASH-like diet with restricted calories may potentially improve biomarkers of cardiometabolic health in sedentary obese older adults. These results also point to interrelationships between body composition changes and changes in cardiometabolic biomarkers. Lastly, regardless of meat intake amount, positive impacts on cardiometabolic biomarkers were observed in this cohort of older adults with an obese phenotype.

Combined Aerobic and Resistance Training Lowers Body Fat Percentage in Rural Black South African Women

Background: Obesity is currently one of the most dominating diseases affecting younger adults in South Africa. This is commonly caused by a poor lifestyle, which may lead to an increased risk of non-communicable diseases. Objectives: The aim of the study was to examine if a six-week concurrent resistance and aerobic training program could elicit body composition and cardiorespiratory changes in rural black college women. Methods: Forty sedentary black females (aged 18 - 25 years) were randomly assigned to a combined resistance and aerobic training (COM) group (n = 20) or a control group (n = 20). The COM group participated in four times weekly aerobic and resistance training. Aerobic training consisted of 30 minutes a session (week 1 - 3: cycling for 3 minutes at 60% heart rate reserve (HRR), followed by 2 minutes at 50% HRR; week 4 - 6: 3 minutes at 70% HRR, followed by 2 minutes at 60% HRR). Resistance training consisted of participants training at 50% of their one-repetition maximum (1-RM) for week 1 - 3, doing 3 sets of 15 repetitions; for week 4 - 6 at 60% 1-RM, doing 3 sets of 15 repetitions. Results: Following the intervention, the COM group significantly (P ≤ 0.05) decreased their body fat percentage when compared to the control group (P = 0.006; d = 0.9), while no significant changes were observed in waist-to-hip ratio (P = 0.223) and cardiorespiratory endurance (P = 0.260) in either group. Conclusions: Although body composition (especially waist circumference and body fat percentage) and cardiorespiratory fitness are recommended as the main targets of physical activity programs aimed at preventing CVD in college students, this study demonstrated that a six-week concurrent program improved body fat percentage, and not WHR and cardiorespiratory fitness, in sedentary rural college-aged females. Further, these findings suggest that one method of program design does not fit all populations and that exercise prescription should be targeted and not generalized.

Association Between Physical Fitness and Anxiety in Children: A Moderated Mediation Model of Agility and Resilience

Background: Anxiety is one of the most prevalent mental health problems in children. Although physical fitness as a predictor of mental health, the mechanisms underlying any association between physical fitness and anxiety in children have been understudied. Thus, the aim of the present study was to determine whether an association exists between physical fitness and anxiety and to explore the roles of agility and resilience in such an association.

Methods: This cross-sectional study investigated 269 children aged 7 to 12 years from three public primary schools in Shanghai (China). Physical fitness and agility were objectively measured, and resilience and anxiety were assessed using self-reported questionnaires. The moderated mediation model was examined using the SPSS PROCESS macro, in which the moderator variable was agility, and the mediator variable was resilience.

Results: Physical fitness was inversely associated with anxiety. Resilience partially and indirectly mediated this association, and agility moderated the association between physical fitness and resilience. Physical fitness had a greater impact on resilience in children with higher agility levels.

Conclusions: Agility moderated the mediation of resilience on the indirect, inverse association between physical fitness and anxiety; thus, incorporating methods to develop agility and resilience may lead to better outcomes for physical fitness programs designed to prevent or alleviate anxiety in children.

Reference Values for Fitness Level and Gross Motor Skills of 4-6-Year-Old Chilean Children

In childhood, fitness level is considered an important indicator of health, while gross motor skills are the basis of future motor competence. So far, no reference values have been found for the Chilean population. Therefore, this study aims to provide fitness level and gross motor skill reference values by gender and age of Chilean children aged 4–6 years. A cross-sectional analysis was conducted that included 728 children between 4 and 6 years old from the La Araucanía region of Chile. To assess the fitness level, the 20-m shuttle run test, standing long jump, handgrip dynamometry, 4x10m shuttle run, and Sit and Reach tests were used. Gross motor skills were assessed by five tests including aiming and catching and balance motor tasks. For fitness level, boys have better values in the long jump and dynamometry test, while girls have better values in flexibility. For estimated maximum volume of oxygen, at 5 years old there are significant differences in favour of boys, while at 6 years old in favour of girls. No statistically significant differences in speed/agility by gender were found. For gross motor skills, boys obtain higher values for catching and aiming tests, and girls for balance. The reference values for fitness level and gross motor skills shown in this study could aid physical education and health professionals in identifying children with low reference values, as well as in establishing objectives that will help to improve their health.

Clusters of cardiovascular risk factors and its association with muscle strength in adults

BACKGROUND

Cardiovascular diseases are the leading cause of death globally. The aim of the study was to investigate the relationship between muscle strength (MS) and clusters of metabolic syndrome (MetS) components in adults.

METHODS

Population-based cross-sectional study comprising 533 adults (45.3±11.1 years) from Florianópolis, Brazil. MS - calculated as the ratio between absolute strength (kgf) and body mass (kg) - was measured by handgrip dynamometry. Data on blood pressure, waist circumference, lipids and blood glucose were used to identify MetS components that were analyzed as individual variables and clusters. Multiple linear regression adjusted was used.

RESULTS

Individually, MS was inversely associated with all MetS components (1, 2, 3 and 4 factors, β of at least -0.08 kgf/kg). In addition, MS was negatively associated with number of positive MetS components (1, 2, 3 and 4 factors; β of at least -0.05 kgf/kg). Individually or combined in clusters of two, three and four risk factors (β of at least -0.20 kgf/kg), abdominal obesity was directly associated with lower MS values. All combinations of 3 and 4 MetS components (β of at least -0.13 kgf/kg) were inversely associated with MS.

CONCLUSIONS

Greater number of individual MetS components were related to lower MS values.

Healthy lifestyle moderates the relationship between cardiovascular disease with blood pressure, body composition, carotid intima-media thickness, and glycated hemoglobin among adults

We investigate whether the adherence to healthy lifestyle recommendations (regular physical activity, healthy diet, reduced alcohol consumption, nonsmoking) moderates the relationship between cardiovascular disease (CVD) and its risk factors (obesity, diabetes, dyslipidemia, and hypertension) with clinical variables among adults. This cross-sectional population-based study comprised 862 adults (39.3 ± 11.4 years, 46.4% men) from Florianópolis, Brazil. Clinical variables were systolic (SBP) and diastolic blood pressure, waist circumference, body mass index (BMI), percentage of body fat, muscular strength, carotid intima-media thickness (IMT), high sensitive C-reactive protein, and lipid and glucose metabolism markers. Multiple linear regression adjusted for confounding factors was used. Reduced IMT and HbA1c were observed in males with CVD or its risk factors who adopted healthy lifestyle recommendations (p < 0.001), and lower SBP levels were observed in females without CVD or its risk factors (p = 0.034). Females with CVD or its risk factors who followed healthy lifestyle recommendations showed higher BMI (p = 0.035). Adherence to number of healthy lifestyle recommendations moderated cardiovascular health in adults with CVD and without CVD. Novelty The adherence to healthy lifestyle recommendations moderated the relationship between IMT and HbA1c with CVD or its risk factors among males. The lower values of SBP among females without CVD or its risk factors were moderated by the adherence to healthy lifestyle recommendations.

Prevalence and predictors of dropout from high-intensity interval training in sedentary individuals: A meta-analysis

Recent evidence suggests that high-intensity interval training (HIIT) is an effective method to improve fitness and various health markers. However, the tolerability and acceptability of HIIT among sedentary individuals is currently controversially discussed. Therefore, our objective was to investigate the prevalence and predictors of dropout among sedentary individuals in HIIT-based exercise interventions. MEDLINE/PubMed, SPORTDiscus, and Web of Science were searched systematically for relevant articles until 06/2018. Studies included were required to (a) be written in English, (b) include sedentary healthy adults, (c) use some form of HIIT without any complementary intervention, (d) last ≥4 weeks, (e) report detailed description of the applied HIIT protocol, and (f) report data that allow calculation of a dropout rate. Fifty-five studies reporting results from 67 HIIT interventions with 1318 participants met the eligibility criteria. The trim and fill adjusted pooled dropout rate across all interventions was 17.6% (95% confidence interval 14.2-21.5%). Dropout rates were significantly lower in cycling-based interventions compared with studies using running/walking as exercise modality (P < 0.001). Longer session time (β = 0.02, P < 0.05), higher time effort/week (β = 0.005, P < 0.05), and overall time effort/intervention (β = 0.0003, P < 0.05) predicted greater dropout. Exercise intensity was not related to dropout. Our data suggest that HIIT-based interventions are tolerable and acceptable for previously sedentary individuals, exhibiting generally lower dropout rates than commonly reported for traditional exercise programs. Given the association between HIIT volume and dropouts, future studies should further focus on identifying the minimally effective dose of practical HIIT for improving health status. Such efforts would be important to increase implementation and public health impact of HIIT.

Muscle Fitness Cut Points for Early Assessment of Cardiovascular Risk in Children and Adolescents

OBJECTIVES

To study the cross-sectional and longitudinal (2-year follow-up) association between muscle fitness and cardiovascular disease (CVD) risk factors in youth; whether there are muscle fitness cut points associated with CVD risk (cross-sectional); and whether the health-related muscle fitness cut points identified at baseline are associated with CVD risk 2 years later.

STUDY DESIGN

In total, 237 children (110 girls) aged 6-10 years and 274 adolescents (131 girls) aged 12-16 years with complete data were included in the study (10.3% drop out). The handgrip strength and the standing long jump tests were used to assess muscle fitness. CVD risk score was computed with sum of 2 skinfolds, systolic blood pressure, insulin, glucose, triglycerides, and total cholesterol/high density lipoprotein cholesterol.

RESULTS

Muscle fitness at baseline was associated inversely with single CVD risk factors and CVD risk score at baseline and 2-year follow-up (all P < .05). Receiver operating characteristics curve analyses showed a significant discriminating accuracy of handgrip strength in identifying CVD risk in children and adolescents (boys: ≥ 0.367 and ≥0.473; girls: ≥ 0.306 and ≥0.423 kg/kg body mass, respectively, all P < .001). Similarly, the standing long jump cut points for children and adolescents were ≥104.5 and ≥140.5 in boys, and ≥81.5 and ≥120.5 cm in girls, respectively (all P < .05). These cut points were associated with CVD risk 2 years later (all P < .01).

CONCLUSIONS

Muscle fitness is associated with present and future cardiovascular health in youth, and is independent of cardiorespiratory fitness. It should be monitored to identify youth at risk who could benefit from intervention programs.

The Effect of a Multidisciplinary Lifestyle Intervention on Obesity Status, Body Composition, Physical Fitness, and Cardiometabolic Risk Markers in Children and Adolescents with Obesity

This study aimed to develop a multidisciplinary lifestyle intervention program targeted at children and adolescents with moderate to severe obesity, and assess the additional effects of exercise intervention when compared to usual care. Overall, the 103 enrolled participants were ≥85th percentile of age and sex-specific body mass index (BMI). Participants were divided into groups that received 16 weeks of either usual care or exercise intervention. The BMI z-score of the overall completers decreased by about 0.05 after the 16-week intervention (p = 0.02). After the intervention, only the exercise group had a significantly lower BMI z-score than the baseline score by about 0.1 (p = 0.03), but no significant group by time interaction effects were observed. At the 16-week follow-up, significant group by time interaction effects were observed in percentage body fat (%BF) (β = −1.52, 95%CI = −2.58–−0.45), lean body mass (LM) (β = 1.20, 95%CI = 0.12–2.29), diastolic blood pressure (β = −5.24, 95%CI = −9.66–−0.83), high-sensitivity C-reactive protein (β = −1.67, 95%CI = −2.77–−1.01), and wall sit test score (β = 50.74, 95%CI = 32.30–69.18). We developed a moderate-intensity intervention program that can be sustained in the real-world setting and is practically applicable to both moderate and severe obesity. After interventions, the exercise group had lower %BF and cardiometabolic risk markers, and higher LM and leg muscle strength compared to the usual care group.

Association of muscle strength with cardiovascular risk in Korean adults: Findings from the Korea National Health and Nutrition Examination Survey (KNHANES) VI to VII (2014-2016)

There are few existing studies that examine the association between muscle strength and cardiovascular disease (CVD) risk stratified by sex. Evaluation of the handgrip strength is a simple, quick, and inexpensive method to measure muscle strength. This study assessed the association of handgrip strength with the risk of CVD in the Korean general population.Data were derived from a subset of an ongoing nationally representative survey: the Korea National Health and Nutrition Examination Survey (KNHANES), 2014 to 2016, which included 8576 participants aged 40 to 79 years (men: 3807; women: 4769). Individual CVD risk was evaluated by calculating the atherosclerotic cardiovascular disease (ASCVD) risk score and the Framingham risk score (FRS) in subjects aged 40 to 79 years without prior CVD.Multivariate linear regression analysis revealed a significant inverse association (in both men and women) between relative handgrip strength and cardiovascular risk factors, including blood pressure, levels of fasting glucose and triglycerides, waist circumstance, FRS, high sensitivity C-reactive protein levels, and ASCVD risk. A significant positive association between relative handgrip and a low level of high density cholesterol levels in both men and women was identified. In both men and women, subjects in the lowest quartile of handgrip strength had an increased risk of CVD compared with those within the highest quartile (odds ratio range 2.05-3.03).The results of this study suggest that increased handgrip is associated with a lower degree of cardiovascular risk in both men and women. Longitudinal studies are needed to examine the association between muscle strength and cardiovascular risk.

Optimal Adherence to a Mediterranean Diet and High Muscular Fitness Are Associated with a Healthier Cardiometabolic Profile in Collegiate Students

The aim of the study was to investigate the combined association of adherence to a Mediterranean diet (MedDiet) and muscular fitness (MF) with cardiometabolic health in collegiate students. The present cross-sectional analysis consisted of 1248 (714 females) healthy collegiate students (20.1 ± 2.7 years old). Adherence to a MedDiet was assessed by a KIDMED (Mediterranean Diet Quality Index) questionnaire. Standing broad jump, standing vertical jump, and isometric handgrip dynamometry were used as indicators of MF. The cardiometabolic profile was assessed using the following components: triglycerides, blood pressure, triglycerides, high-density lipoprotein (HDL)-cholesterol, glucose, and waist circumference. Analysis of covariance shows a significant difference in the cardiometabolic profile of both genders between the high MF/low MedDiet and high MF/optimal MedDiet groups, and the low MF/low MedDiet and low MF/optimal MedDiet groups (p < 0.001). No difference was found on cardiometabolic profile between high MF/optimal MedDiet and high MF/low MedDiet, both in males and females. Additionally, logistic regression shows that both female (odds ratio (OR) = 2.01; 95% confidence interval (CI): (1.8–3.7); p = 0.02) and male (OR = 3.38; 95% CI: (1.9–5.8); p < 0.001) participants in the optimal MedDiet/high MF group had the highest odds of expressing a healthier cardiometabolic profile as compared to those in the low MF/low MedDiet group. In conclusion, a combination of high MF levels and optimal adherence to a MedDiet is associated with a healthier cardiometabolic profile; however, high MF levels seem to circumvent the deleterious effects of having a low adherence to a MedDiet.