Health-related fitness, body mass index, and risk of depression among adolescents

The Mediating Role of Cardiorespiratory Fitness in the Association between a Negative Lifestyle and Poor Mental Health in Chilean Schoolchildren

BACKGROUND

A negative lifestyle has a reported relationship with psychological problems and deteriorated well-being. However, there is little information regarding the mediating role of cardiorespiratory fitness (CRF) in this relationship.

OBJECTIVES

The objectives of the present study are twofold: first, to investigate the association between negative lifestyle, physical self-concept (PSC), and depression, and second, to assess the potential mediating role of CRF in this complex relationship.

METHODS

This cross-sectional study included 612 schoolchildren aged between 9 and 14 years from the Araucanía region (southern Chile). CRF was measured using the Leger test, and lifestyle, depression, and PSC were measured using validated questionnaires.

RESULTS

A negative lifestyle reported an inverse association with PSC (p < 0.001) and a positive association with depression levels (p < 0.001). The mediation analysis showed that CRF was positively related to PSC (p < 0.001) and inversely related to depression (p = 0.001); besides, the indirect effect CRF acted as a partial mediator in the association between a negative lifestyle and PSC (indirect effect = -1.15; SE = 0.01; 95% CI, -1.87, -0.55) and depression levels (indirect effect = 0.22; SE = 0.08; 95% CI, 0.08, 0.38).

CONCLUSION

In conclusion, CRF in schoolchildren played a potential mediating role in the association between a negative lifestyle and depression and PSC.

Prevalence of depression and anxiety, and associated factors, among Chinese primary and high school students: A cross-sectional, epidemiological study

INTRODUCTION

This study aimed to investigate the prevalence of depression and anxiety, and associated factors, among Chinese children and adolescents aged 8-18 years who attend primary or high school.

METHODS

A total of 23 005 primary and high school students were recruited from February to December, 2019 for this cross-sectional study. The questionnaire included demographic information, questions assessing suicidality, resilience, depression (Center for Epidemiological Studies Depression Scale for Children), and anxiety (Screen for Child Anxiety Related Disorders). Binary logistic regression was used to analyze the independent correlates of depression and anxiety.

RESULTS

Overall, 13.06% of participants experienced depressive symptoms, 22.34% experienced anxiety symptoms, 26.34% experienced transient suicidal ideation, 2.23% had serious suicidal ideation, and 1.46% had a history of suicide attempts. Anxiety (odds ratio [OR], 4.935; 95% confidence interval [CI][4.442-5.485]), suicidality (OR, 2.671; 95% CI[2.203-3.237]), skipping breakfast (OR, 1.920; 95% CI[1.348-2.736]), sleep duration (OR, 0.470; 95% CI[0.398-0.556]) and self-expectations (OR, 1.924; 95% CI[1.550-2.389]) were associated with depression (all p < .05). Depression (OR, 4.424; 95% CI[3.983-4.914]), female sex (OR, 1.903; 95% CI[1.759-2.060]), school-based traumatic experience(s) (OR, 1.905; 95% CI[1.747-2.077]), relationships with teachers (OR, 1.575; 95% CI[1.103-2.249]), and suicidality (OR, 1.467; 95% CI[1.218-1.766]) were associated with anxiety symptoms (all p < .05).

DISCUSSION

Depression and anxiety are common among school-age children and adolescents in China. Childhood school- and family-based traumatic experience(s), female sex, and lifestyle factors (eating breakfast, sleep duration, exercising, and Internet use) are significantly associated with mental health among children and adolescents. Developing interventions targeting these factors to protect students from depression and anxiety are needed.

Healthier Minds in Fitter Bodies: A Systematic Review and Meta-Analysis of the Association between Physical Fitness and Mental Health in Youth

BACKGROUND

Physical fitness is an important marker of current and future health status, yet the association between physical fitness and indicators of mental health in youth has not been systematically reviewed and meta-analyzed.

OBJECTIVE

The aim of this work was to systematically review and meta-analyze the association between physical fitness components (i.e. cardiorespiratory fitness, muscular fitness, speed-agility, flexibility and fitness composite) and mental health indicators (i.e. psychological well-being and psychological ill-being) in preschoolers, children and adolescents.

DESIGN

Systematic review and meta-analysis.

DATA SOURCES

Systematic searches were conducted in PubMed, Web of Science and Scopus from database inception to May 2020.

ELIGIBILITY CRITERIA

Studies (cross-sectional, longitudinal and intervention designs) were included if they measured at least one physical fitness component and one mental health indicator in healthy youth (2-18 years).

RESULTS

A total of 58 unique studies (52 cross-sectional, 4 longitudinal and 4 intervention studies) met all eligibility criteria and were included. There was a significant positive overall association between physical fitness and mental health in children and adolescents (pooled r = 0.206, p < 0.001). We found suggestive evidence of moderation by age group, fitness components and socioeconomic status (all p < 0.08). No relevant studies focusing on preschoolers were identified. Evidence based on longitudinal and intervention studies was limited.

CONCLUSION

We observed a small to medium sized positive association between physical fitness and overall mental health in youth. However, as the majority of studies were cross-sectional, additional longitudinal and intervention studies are needed to provide evidence of causation.

TRIAL REGISTRATION

PROSPERO registration number CRD42017080005.

A cross-sectional association of physical fitness with positive and negative affect in children and adolescents: the up & down study

BACKGROUND

Affect and physical fitness play an important role in psychological and physical health; however, the association between those variables in youth remains unknown. The aim of the present study was to examine the influence of physical fitness on positive and negative affect in Spanish children and adolescents.

METHOD

Healthy young Spanish people (n = 1,490) were recruited for the present study: 542 children (n = 272 girls; mean age 9.6 years) and 948 adolescents (n = 454 girls; mean age 14.1 years) with complete baseline data on health-related fitness tests (20 m shuttle run test, 4 × 10 m test, muscular fitness index, and physical fitness index), and positive and negative affect (Positive and Negative Affect Schedule).

RESULTS

Higher performance on physical fitness components was associated with positive affect (β = -0.176-0.118, all P < 0.05). There was no association between all physical fitness components and negative affect (β = -0.100-0.15, all P > 0.05). There were differences on positive affect between the lowest and the highest quartile of the physical fitness index in boys (P = 0.037, Cohen's d 0.60) and girls (P = 0.004, Cohen's d = 0.69), and between the lowest and the highest quartile of muscular fitness index in girls (P < 0.001, Cohen's d = 0.76).

CONCLUSIONS

Promoting physical activity during the school years, including strength exercises to increase muscular fitness, could improve positive affect levels and thus psychological health.

Neurorehabilitation of Persistent Sport-Related Post-Concussion Syndrome

BACKGROUND

Persistent Sport-Related Post-Concussion Syndrome is often diagnosed with any type of prolonged PCS symptoms. However, there are not specific diagnostic criteria for PPCS such that misdiagnosis often occurs. Further, the signs and symptoms of PCS overlap with other common illnesses such as depression, anxiety, migraines, ADHD and others. Misdiagnosis may lead to less than efficacious treatment, resulting in prolonged symptoms.

OBJECTIVE

This article will review relevant evidence-based literature on PCS, pointing out the lack of a systemic diagnostic framework. It will also provide evidence that highlights the multiple conflicting findings in the literature. This article will posit the BioPsychoSocial framework as the best diagnostic framework for understanding the impact of concussions on the person and to generate individualized and personal interventions.

METHODS

A narrative review of sport concussion-related articles was conducted, after extensive searches of relevant and non-relevant literature by each author, as well as articles recommended by colleagues. Articles varied from American Academy of Neurology Class I to IV for evaluation and critique. Class IV articles were reviewed, as there is much public misconception regarding sport and other concussion treatment that needed identification and discussion.

RESULTS

Articles reviewed varied by quality of research design and methodology. Multiple symptoms, recovery patterns and rehabilitation treatment approaches are purported in the sport-related concussion literature. Current consensus data as well as the mixed and contradictory findings were explored.

CONCLUSIONS

Persistent Sport-Related Post-Concussion Syndrome is a topic of great interest to both professionals and the general public. There is much misunderstanding about the etiology, causation, diagnostic formulations, symptom presentation, prolonging factors and treatment involved in this syndrome. This article posits an individualized multi-system diagnostic formulation, examining all relevant factors, as generating the best interventions for neurorehabilitation of Persistent Sport-Related Post-Concussion Syndrome.

Association between Health-Related Physical Fitness and Self-Rated Risk of Depression in Adolescents: Dados Study

Depression is the most common mental disorder, affecting around 5% of adolescents. Physical fitness is considered a powerful marker of physical and mental health. The scientific results on the relationship between physical fitness and depression in the adolescent population are mixed. Therefore, the aim of the current study was to analyse the association between objectively assessed physical fitness and self-rated risk of depression in a group of adolescents. A total of 225 participants (44% girls), aged 13.9 ± 0.3 years, from the Deporte, ADOlescencia y Salud (DADOS) study were included in the analyses. Field-based Assessing Levels of Physical fitness and Health in Adolescents (ALPHA) health-related fitness test battery was used to objectively assess physical fitness components. The Behavior Assessment System for Children (BASC) level 3 was used to evaluate self-rated risk of depression. Our results showed that self-rated risk of depression was inversely associated with cardiorespiratory fitness (β = −0.172), as well as positively associated with body mass index (β = 0.146) and waist circumference (β = 0.137) (all p < 0.05). Adolescents with low levels of cardiorespiratory fitness had significantly higher odds of self-rated risk of depression (OR = 7.17; 95% CI, 1.51–33.95). These findings suggest that health-related physical fitness, particularly cardiorespiratory fitness and body composition, is associated with depression in adolescents.

The association between physical fitness and mental health in Norwegian adolescents

BACKGROUND

Studies indicate that health-related components of physical fitness are associated with mental health outcomes. However, research is scarce concerning this relationship in young adolescents in general and non-existent in Norwegian populations specifically. The aim of the study was to examine whether body composition, muscular strength and cardiorespiratory fitness were associated with self-reported mental health in Norwegian adolescents.

METHODS

Adolescents from four regions of Norway (n = 1486; mean age = 13.9; girls = 50.6%) participated. Self-reported mental health (psychological difficulties) was measured by completing the Strengths and Difficulties Questionnaire. Cardiorespiratory fitness was assessed with an intermittent running test; muscular strength was assessed by measuring handgrip strength, standing broad jump and sit-ups; and body composition was assessed by calculating body mass index from weight and height. Linear mixed effects models were conducted to assess the associations between the health-related components of physical fitness and psychological difficulties. School clusters were included as random effects and all models were controlled for sex, socioeconomic status and birthplace (domestic or foreign).

RESULTS

Body composition was not associated with psychological difficulties. Muscular strength was independently associated with psychological difficulties, but when all independent variables were entered in the fully adjusted model, only cardiorespiratory fitness was associated with psychological difficulties.

CONCLUSIONS

There was a small but significant inverse association between cardiorespiratory fitness and levels of psychological difficulties in Norwegian adolescents. The results suggest that muscular strength is not associated with psychological difficulties in adolescents, when controlling for cardiorespiratory fitness. Future research should focus on the prospective association between physical fitness components and mental health outcomes in adolescents.

TRIAL REGISTRATION

The study is registered in ClinicalTrials.gov ID nr: NCT03817047. Retrospectively registered January 25, 2019.

Recurrent depression in childhood and adolescence and low childhood socioeconomic status predict low cardiorespiratory fitness in early adulthood

BACKGROUND

Cardiorespiratory fitness (CRF) strongly influences health, but very little is known about the childhood determinants of adult CRF. Our longitudinal study investigated whether childhood psychopathology and socioeconomic status (SES) were related to adult CRF in 1647 Finnish male military conscripts.

METHODS

Childhood psychopathology was assessed at the age of eight using the Rutter and Children's Depression Inventory questionnaires. Parental education and family structure were used to assess childhood SES. In late adolescence, depressive symptoms were assessed with the Beck Depression Inventory and smoking with a questionnaire. CRF in early adulthood was examined with the Cooper's 12-minute run test.

RESULTS

General linear models showed that low parental education (p=0.001), depressive symptoms in childhood (p=0.035) and late adolescence, smoking, underweight, and overweight/obesity (all p<0.001) independently predicted lower CRF. The interaction between depressive symptoms in childhood and adolescence was significant (p=0.003). In adolescents with depressive symptoms, childhood depressive symptoms (p=0.001) and overweight/obesity (p<0.001) predicted lower CRF. In adolescents without depressive symptoms, conduct problems in childhood predicted lower CRF in the initial models, but the effect disappeared after taking into account smoking and body mass index. Mediational analysis confirmed these results.

LIMITATIONS

We lacked data on physical activity and only studied males at three time-points.

CONCLUSIONS

Recurrent depression in childhood and adolescence and low SES in childhood predict lower adult CRF. Conduct problems in childhood predict lower CRF, but the effect is mediated by overweight/obesity and smoking. Psychiatric treatment for children and adolescents should promote physical activity, particularly for children with low SES.

Cardiorespiratory fitness, muscular fitness and mental health in older adolescents: A multi-level cross-sectional analysis

Physical activity interventions that promote cardiorespiratory (CRF) and muscular fitness (MF) may improve mental health in young adolescents. However, less is known about the links between fitness and mental health in older adolescents, as they are an understudied population. In addition, the association between MF and adolescents' mental health is less clear than it is for CRF. Our primary aim was to investigate whether MF is independently associated with mental health in a sample of older adolescents. Our secondary aim was to determine if the association between fitness and mental health was moderated by sex, socio-economic status (SES) or weight status. Participants were 670 students (16.0 [0.4] years, 44.6% female) from 20 secondary schools in New South Wales, Australia. Mental health (well-being and internalizing problems) was self-reported using the Short Warwick-Edinburgh Mental Wellbeing Scale and the Strengths and Difficulties Questionnaire. We assessed CRF using the Progressive Aerobic Cardiovascular Endurance Run and MF using the push-up and standing long jump tests. After controlling for CRF, MF was not associated with mental health. CRF was associated with well-being (β = 0.20, p < .001) and internalizing problems (β = -0.27, p < .001). The strength of association between CRF and mental health was stronger in girls, than boys. No interaction effects were observed for SES or weight status. Although cross-sectional, our findings provide further evidence of the potential benefits of CRF for adolescents' mental health (i.e., well-being and internalizing problems), particularly girls. However, MF may be less relevant for mental health among this population.

School-based physical activity intervention for older adolescents: rationale and study protocol for the Burn 2 Learn cluster randomised controlled trial

INTRODUCTION

This trial aims to investigate the impact of a school-based physical activity programme, involving high-intensity interval training (HIIT), on the physical, mental and cognitive health of senior school students.

METHODS AND ANALYSIS

The Burn 2 Learn (B2L) intervention will be evaluated using a two-arm parallel group cluster randomised controlled trial with allocation occurring at the school level (to treatment or wait-list control). Schools will be recruited in two cohorts from New South Wales, Australia. The trial will aim to recruit ~720 senior school students (aged 16-18 years) from 20 secondary schools (ie, 10 schools per cohort). A range of implementation strategies will be provided to teachers (eg, training, equipment and support) to facilitate the delivery of HIIT sessions during scheduled classes. In phase I and II (3 months each), teachers will facilitate the delivery of at least two HIIT sessions/week during lesson-time. In phase III (6 months), students will be encouraged to complete sessions outside of lesson-time (teachers may continue to facilitate the delivery of B2L sessions during lesson-time). Study outcomes will be assessed at baseline, 6 months (primary end point) and 12 months. Cardiorespiratory fitness (shuttle run test) is the primary outcome. Secondary outcomes include: vigorous physical activity, muscular fitness, cognition and mental health. A subsample of students will (i) provide hair samples to determine their accumulated exposure to stressful events and (ii) undergo multimodal MRI to examine brain structure and function. A process evaluation will be conducted (ie, recruitment, retention, attendance and programme satisfaction).

ETHICS AND DISSEMINATION

This study has received approval from the University of Newcastle (H-2016-0424) and the NSW Department of Education (SERAP: 2017116) human research ethics committees.

TRIAL REGISTRATION NUMBER

ACTRN12618000293268; Pre-results.

Sedentary behavior and physical activity predicting depressive symptoms in adolescents beyond attributes of health-related physical fitness

BACKGROUND

Sedentary behavior (SB), physical activity (PA), and attributes of physical fitness have been shown to be related to depressive symptoms in adolescents. The purpose of the present study was to investigate whether SB and fitness-producing activity predicted depression in active adolescents over and above gender and fitness attributes.

METHODS

Participants were 249 adolescents (age: 12.85 ± 0.89 years, mean ± SD) from 3 public middle schools who wore Actical accelerometers to assess their SB and PA. Participants also completed the FITNESSGRAM health-related fitness assessment and a brief depression questionnaire. A 3-step hierarchical regression analysis was conducted with gender and fitness attributes (i.e., body mass index (BMI), maximal volume oxygen uptake (VO_2max), curlups, and pushups), moderate- and vigorous-intensity activity, and SB entered in respective steps.

RESULTS

Regression analysis indicated activity variables (i.e., moderate- and vigorous-intensity activity) significantly predicted depression (ΔR ² = 0.12, p < 0.01) beyond gender and fitness attributes. Overall, gender, fitness attributes, activity variables, SB explained 31% of the variance in depression. Structure coefficients revealed VO_2max (r _s = -0.77), moderate-intensity activity (r _s = -0.67), vigorous-intensity activity (r _s = -0.81), and SB (r _s = 0.57) were substantially correlated with the criterion variable; thus, they were the strongest predictors of depression.

CONCLUSION

The findings of the current study indicated SB and PA were both significant predictors of depression; however, sufficient fitness-producing activity and adequate cardiorespiratory fitness may nullify the negative influence of SB on depressive symptoms in active adolescents.

Fitness, Sleep-Disordered Breathing, Symptoms of Depression, and Cognition in Inactive Overweight Children: Mediation Models

OBJECTIVES

We used mediation models to examine the mechanisms underlying the relationships among physical fitness, sleep-disordered breathing (SDB), symptoms of depression, and cognitive functioning.

METHODS

We conducted a cross-sectional secondary analysis of the cohorts involved in the 2003-2006 project PLAY (a trial of the effects of aerobic exercise on health and cognition) and the 2008-2011 SMART study (a trial of the effects of exercise on cognition). A total of 397 inactive overweight children aged 7-11 received a fitness test, standardized cognitive test (Cognitive Assessment System, yielding Planning, Attention, Simultaneous, Successive, and Full Scale scores), and depression questionnaire. Parents completed a Pediatric Sleep Questionnaire. We used bootstrapped mediation analyses to test whether SDB mediated the relationship between fitness and depression and whether SDB and depression mediated the relationship between fitness and cognition.

RESULTS

Fitness was negatively associated with depression ( B = -0.041; 95% CI, -0.06 to -0.02) and SDB ( B = -0.005; 95% CI, -0.01 to -0.001). SDB was positively associated with depression ( B = 0.99; 95% CI, 0.32 to 1.67) after controlling for fitness. The relationship between fitness and depression was mediated by SDB (indirect effect = -0.005; 95% CI, -0.01 to -0.0004). The relationship between fitness and the attention component of cognition was independently mediated by SDB (indirect effect = 0.058; 95% CI, 0.004 to 0.13) and depression (indirect effect = -0.071; 95% CI, -0.01 to -0.17).

CONCLUSIONS

SDB mediates the relationship between fitness and depression, and SDB and depression separately mediate the relationship between fitness and the attention component of cognition.

FATORES ASSOCIADOS À APTIDÃO CARDIORRESPIRATÓRIA DE ESCOLARES

RESUMO Introdução: Há alta prevalência de jovens que não atendem ao critério de saúde para aptidão cardior- respiratória, o que os expõe a riscos relacionados à saúde metabólica, cardiovascular e mental. Dessa forma, é relevante investigar quais aspectos estão associados à aptidão cardiorrespiratória de jovens. Objetivo: Analisar os fatores associados à aptidão cardiorrespiratória em escolares. Métodos: Estudo transversal que envolveu 736 escolares (50,1% do sexo feminino) com idade entre 10 a 18 anos. Foram analisadas a condição socioeconômica, escolaridade paterna, número de irmãos, percepção de atividade física, atividade física moderada a vigorosa, participação nas aulas de educação física, prática esportiva, local para prática, transporte ativo e comportamento sedentário. Foram coletadas medidas de estatura, massa corporal e realizado um teste de aptidão cardiorrespiratória. Para estimar a razão de prevalência (RP) e os intervalos de confiança de 95% foi utilizada a regressão de Poisson. Resultados: Para escolares com idade inferior a 14 anos, as variáveis que apresentaram associação com a aptidão cardiorrespiratória foram o sexo feminino (RP = 0,79, 0,68-0,91), sobrepeso (RP = 0,73, 0,61-0,89), percepção de atividade física igual às pessoas de mesma idade (RP = 1,26, 1,03-1,53), atividade física semanal de 3-6h (RP = 1,21, 1,05-1,38), participação nas aulas de educação física (RP = 1,35, 1,03-1,76) e comportamento sedentário ≥ 2h (RP = 0,82, 0,73-0,94). Com relação aos escolares com idade igual ou superior a 14 anos, o sexo feminino (RP = 0,35, 0,19-0,63), o sobrepeso (RP = 0,25, 0,09-0,66), praticar esportes algumas vezes (RP = 1,96, 1,00-3,81) e frequentemente (RP = 2,09, 1,01-4,31) apresentaram associação com a aptidão cardiorrespiratória. Conclusão: Programas de intervenção com o objetivo de aumentar o atendimento ao critério de saúde para aptidão cardiorrespiratória de escolares devem promover a prática de atividade física moderada a vigorosa, prática esportiva, participação nas aulas de educação física e redução do sobrepeso.

Biopsychosocial correlates of dietary intent in middle school girls

Adolescent girls commonly engage in weight management and dietary restriction with the hopes of changing their bodies to more closely approximate social body ideals. The purpose of this study was to examine biopsychosocial factors that predict dietary restraint. Participants (n=774, Mage=12.38) completed measures of dietary intent, pubertal status, sociocultural pressures, body comparison, internalization, body dissatisfaction, social support, and general self-esteem. Height, weight, and cardiorespiratory fitness were objectively measured. Pressures to lose weight and gain muscle mass, internalization of social body ideals, and friend support predicted higher levels of dietary intent; cardiorespiratory fitness predicted lower levels of dietary intent. Girls who experience pressure, adopt social body ideals as their own, and experience social support from friends may be at increased risk for disturbed eating attitudes and behaviors. Fitness may offer a protective effect against psychological and social risk factors. Additional research is needed to establish the causal nature of these relationships and determine effective methods for reducing disordered eating risk among adolescent girls.

Sedentary behavior and indicators of mental health in school-aged children and adolescents: A systematic review

OBJECTIVE

The presented systematic review aims at giving a comprehensive overview of studies assessing the relationship between sedentary behavior and indicators of mental health in school-aged children and adolescents.

METHODS

Six online databases (MEDLINE, EMBASE, PsycINFO, PsycARTICLES, CINAHL and SPORTDiscus) as well as personal libraries and reference lists of existing literature were searched for eligible studies.

RESULTS

Ninety-one studies met all inclusion criteria. There was strong evidence that high levels of screen time were associated with more hyperactivity/inattention problems and internalizing problems as well as with less psychological well-being and perceived quality of life. Concerning depressive symptoms, self-esteem, eating disorder symptoms, and anxiety symptoms, no clear conclusion could be drawn. But, taking quality assessment into account, self-esteem was negatively associated with sedentary behavior, i.e. high levels of time engaging in screen-based sedentary behavior were linked to lower scores in self-esteem.

CONCLUSIONS

Overall, the association between sedentary behavior and mental health indicators was rather indeterminate. Future studies of high quality and with an objective measure of sedentary behavior will be necessary to further examine this association as well as to investigate longitudinal relationships and the direction of causality. Furthermore, more studies are needed to identify moderating and mediating variables.

Cardiorespiratory Fitness May Help in Protecting Against Depression Among Middle School Adolescents

PURPOSE

Cross-sectional studies demonstrate a robust association between depression, physical activity, and cardiorespiratory fitness in adolescents, but longitudinal evidence that can better parse the direction of these effects is scarce and conflicting, and no such studies in adolescents have considered the importance of fitness (as opposed to physical activity per se) for preventing depression. Therefore, the present study sought to determine if cardiorespiratory fitness in the first year of middle school (sixth grade) would protect against developing depression a year later (seventh grade), even after controlling for other risk factors (i.e., preexisting depression levels and weight status).

METHODS

Participants (N = 437 with 54.9% female) were recruited from six different middle schools during their sixth-grade year and reassessed during the seventh grade. At each assessment, participants completed self-report measures of depression and fitness. Participants were also weighed and were asked to complete a shuttle-run at both points.

RESULTS

A cross-lagged panel model indicated that cardiorespiratory fitness in the sixth grade was associated with significantly less depression by the seventh grade in girls, even after controlling for preexisting depression and weight. The effect was in the same direction for boys, but was nonsignificant. In both cases, effects were modest to small.

CONCLUSIONS

Cardiorespiratory fitness had a small, but significant protective effect against developing depression in middle school girls, and may have a similar but smaller effect in boys. Promotion of cardiorespiratory fitness can be an important strategy for preventing depression in middle school adolescents, but needs to be coupled with interventions that more directly address symptom treatment.

Cross-Validation of FITNESSGRAM® Health-Related Fitness Standards in Hungarian Youth

PURPOSE

The purpose of this study was to cross-validate FITNESSGRAM® aerobic and body composition standards in a representative sample of Hungarian youth.

METHOD

A nationally representative sample (N = 405) of Hungarian adolescents from the Hungarian National Youth Fitness Study (ages 12-18.9 years) participated in an aerobic capacity assessment via treadmill test to maximum to determine peak oxygen consumption (VO2peak) and a bioelectrical impedance assessment to estimate percent body fat (%BF). Additionally, metabolic syndrome status was assessed via finger-stick blood sample. Youth were categorized into Healthy Fitness Zone (HFZ) and Needs Improvement (NI) groups based on Fitnessgram standards. Prevalence of metabolic syndrome was calculated and logistic regression was used to estimate odds of metabolic syndrome.

RESULTS

Hungarian youth were generally fit with a low prevalence of metabolic syndrome. Approximately 69% to 77% of boys and 55% to 57% of girls were classified into the HFZ based on %BF and VO2peak. Youth in the NI health risk zones for VO2peak and %BF were 4 times to 5 and 2 times to 3 times more likely to have metabolic syndrome than children in the lower-risk groups, respectively.

CONCLUSIONS

Fitnessgram standards for aerobic capacity and body composition were associated with metabolic syndrome status, though odds ratios were larger for VO2peak than for %BF and varied by sex. Even though these standards were developed in U.S. youth, they can be applied in Hungary and still provide a criterion-referenced indication of fitness.

High aerobic intensity training and psychological States in patients with depression or schizophrenia

AIM

To explore changes in psychological states in response to a bout of high aerobic intensity training (HIT) in patients with depression or schizophrenia compared to healthy individuals.

METHODS

After familiarization training of HIT, 20 patients with schizophrenia, 13 patients with depression, and 20 healthy individuals performed a no-training day followed by a training day. HIT was 4 × 4 min intervals at 85-95% of peak heart rate, intermitted by 3 min active rest periods at 70% of peak heart rate. Self-evaluation questionnaires of positive affect, negative affect, state anxiety, well-being, distress, and fatigue were completed before training, 15 min after, and 3 h after training. The two latter measures were also completed the no-training day.

RESULTS

All three groups improved in positive affect and well-being 15 min after HIT (p < 0.01), but only patients with depression had maintained the effect after 3 h (p = 0.007, p = 0.012). The duration of the improved positive affect was longer in depression (p = 0.002) and schizophrenia (p = 0.025) than in healthy individuals (F 2.50 = 5.83, p < 0.01). Patients with depression or schizophrenia had reduced distress and state anxiety 15 min after HIT and 3 h after HIT (p < 0.05). The improvement in distress 15 min after HIT was larger in patients with depression (p = 0.028) compared to healthy individuals (F 2.50 = 5.05, p < 0.01). No changes were found during the no-training day (p > 0.05).

CONCLUSION

High aerobic intensity training used as an acute intervention improved positive affect and well-being and reduced distress and state anxiety in patients with depression and schizophrenia. ClinicalTrials.gov identifier: NCT01310998.