Geographical variation in health-related physical fitness and body composition among Chilean 8th graders: a nationally representative cross-sectional study

Cardiorespiratory fitness and socioeconomic influences in Chilean schoolchildren: a cross-sectional study

OBJECTIVE

To compare the cardiovascular risk and physical fitness, according to type of school in a national sample of Chilean school students.

METHODS

A total of 7,218 students participated, who completed all the national tests of the National System for Measuring the Quality of Education, which included physical fitness and anthropometric tests. The results were compared according to the type of educational establishment and anthropometric indicators were considered. Physical fitness was measured by lower extremity strength, abdominal strength, upper extremity strength, trunk flexibility, exertional heart rate, and cardiorespiratory fitness. Body mass index, heart rate, and waist-to-height ratio were analyzed as predictors of cardiovascular risk.

RESULTS

There were differences according to the type of establishment in the predictors of cardiovascular risk (p < 0.05). Differences were also found in the physical fitness tests evaluated (p < 0.01). Students in private schools (PSC) and subsidized schools (SC) had lower levels of cardiovascular risk and higher levels of physical fitness than public schools (PS) and schools with delegated administration (DA).

CONCLUSIONS

In conclusion, students in educational establishments with a higher socioeconomic level have lower levels of cardiovascular risk and better physical fitness than students in public establishments. The authors suggest considering specific school interventions to mitigate cardiovascular risk and improve physical fitness among this vulnerable population. To this end, future studies should analyze the characteristics of physical activity and nutritional habits in schools to determine the factors that affect the results.

Healthy fitness zone prevalence and age-specific fitness profile of young people in seven European countries in 2022: The EUFITMOS project

BACKGROUND

Physical fitness is a health marker in youth and is associated with current and future health.

OBJECTIVE

Present the healthy fitness zone (HFZ) prevalence and age-specific fitness profile of young people from seven European countries.

METHODS

This study used data from the European Fitness Monitoring System project. The sample comprised 4965 (51.4% boys) youths aged 9 to 18 years. Fitness data were collected by physical education teachers using field-based tests. Raw data from the fitness tests were used to calculate the prevalence and 95% confidence intervals (CI) of participants in the HFZ.

RESULTS

The overall prevalence of boys and girls in the HFZ for all tests was 16.6% (95% CI = 14.7, 18.1) and 14.9% (95% CI = 13.2, 16.6), respectively. Boys have a mainly positive HFZ profiles, except for the 9-year-olds in the sit and reach (z-score difference = -1.20) and the 20 m run for boys 13-18-year-olds (z-score difference range: -0.09 to -0.01). Girls have worse HFZ profiles than boys, being out of the HFZ in several tests. Furthermore, a decreasing trend in z-score difference from the HFZ with age was observed in VO2 peak for boys and girls and sit and reach for girls. Notwithstanding, several country-related, sex and age differences were observed.

CONCLUSIONS

Boys presented mostly healthy age-specific fitness profiles in several fitness tests and ages. These differences should be considered when promoting youth's health through physical activity and fitness, as different fitness levels may require different approaches to implementing health-enhancing physical activity policies.

Top 10 International Priorities for Physical Fitness Research and Surveillance Among Children and Adolescents: A Twin-Panel Delphi Study

BACKGROUND

The measurement of physical fitness has a history that dates back nearly 200 years. Recently, there has been an increase in international research and surveillance on physical fitness creating a need for setting international priorities that could help guide future efforts.

OBJECTIVE

This study aimed to produce a list of the top 10 international priorities for research and surveillance on physical fitness among children and adolescents.

METHODS

Using a twin-panel Delphi method, two independent panels consisting of 46 international experts were identified (panel 1 = 28, panel 2 = 18). The panel participants were asked to list up to five priorities for research or surveillance (round 1), and then rated the items from their own panel on a 5-point Likert scale of importance (round 2). In round 3, experts were asked to rate the priorities identified by the other panel.

RESULTS

There was strong between-panel agreement (panel 1: r_s = 0.76, p < 0.01; panel 2: r_s = 0.77, p < 0.01) in the priorities identified. The list of the final top 10 priorities included (i) "conduct longitudinal studies to assess changes in fitness and associations with health". This was followed by (ii) "use fitness surveillance to inform decision making", and (iii) "implement regular and consistent international/national fitness surveys using common measures".

CONCLUSIONS

The priorities identified in this study provide guidance for future international collaborations and research efforts on the physical fitness of children and adolescents over the next decade and beyond.

Florentine Normative Values for Physical Fitness in Adolescents Aged 14-15 Years

Physical fitness during youth is linked to the health of today's young people and future adults. Therefore, fitness evaluation can direct any physical exercise interventions and verify improvements. The study aims to provide normative values of the physical fitness of the Florentine adolescent population. This cross-sectional study enrolled 1915 subjects aged 14 and 15 from the first and second high school classes. Tests were performed to assess cardiovascular endurance, upper and lower limb strength, running speed and agility, and lower limb muscle flexibility. Sex and age-related percentiles were elaborated. The study included 1028 subjects in the first class (aged 14.3 ± 0.8 years; 54.5% females) and 887 in the second class (aged 15.3 ± 0.7 years; 53.4% females). Males showed higher values than females except for flexibility. Furthermore, both genders show increased results in transitioning from the first to the second class, except for muscle flexibility and running speed. The percentiles of the present study provide normative values of the physical fitness of the 14-15-year-old Florentine adolescent population. These results, characterized by a sociocultural specificity linked to the territory from which they were collected, can contribute to the assessment and improvement of the physical status of young people, promoting current and future health.

Elevated Risk of Overweight/Obesity-Related Markers and Low Muscular Fitness in Children Attending Public Schools in Chile

In Chile, children of low socioeconomic status usually attend public schools and have few opportunities to engage in healthy behaviors. This may increase their risk of overweight/obesity and low muscular fitness. Therefore, we aimed to determine the association between the school type attended with overweight/obesity-related markers and the muscular fitness of children in Chile. We included 1410 children (6-13 years old) attending public, subsidized, or private schools. Overweight/obesity-related markers included BMI Z-scores, waist circumference, and body fat percentage. Muscular fitness assessment included handgrip strength and standing long jump. The odds ratios [95% CI] of overweight/obesity, elevated waist circumference, elevated body fat, low handgrip strength, and low standing long jump were compared between school types. Compared with boys attending public schools, those attending subsidized or private schools had lower odds ratios of low handgrip strength (0.63 [0.42-0.94] and 0.44 [0.25-0.78], respectively). Girls attending subsidized schools, compared with those in public schools, had lower odds of overweight/obesity (0.63 [0.44-0.90]) and of having low handgrip strength (0.51 [0.34-0.78]). Compared with girls in public schools, those attending private schools had lower odds (vs. public schools) of overweight/obesity (0.45 [0.28-0.74]), of having elevated body fat (0.53 [0.29-0.96]), and of having low standing long jump (0.41 [0.21-0.77]). The elevated risk of overweight/obesity-related markers and lower muscular fitness in children, particularly girls, attending public schools increase their current and future disease risk. This suggests that childhood socioeconomic status plays a central role in determining disease risk. Health-promoting interventions specifically focused on children from disadvantaged contexts are required.

Lifestyle Habits and Health Indicators in Migrants and Native Schoolchildren in Chile

In Chile, the migrant population has increased in the last years. Migrants adopt behaviors of this new culture, which can have an effect on their health. Contradictory results regarding differences between migrant and native children have been reported. The aim of this study was to explore the associations between nationality with health indicator and lifestyle habits among schoolchildren in Chile. A cross-sectional and observational study with a non-probabilistic sample was conducted in 1033 children (86.4% Chilean and 13.6% migrant) from second to fourth grade of seven public schools from low-income municipalities from the Metropolitan Region, Chile. Anthropometric measurements (weight, height, waist circumference, triceps and subscapular folds), handgrip strength, and standing long jump measurements, physical activity, self-esteem and food guidelines accomplishments were determined. Migrant children presented lower body mass index (BMI), Z-BMI, body fat% and waist circumference values; and higher handgrip strength, standing long jump, and more satisfactory compliance with food guidelines than natives (p < 0.05). No significant difference for physical activity and self-esteem was observed. In the adjusted models, migrants presented lower odds for overweight/obesity, risk of abdominal obesity, low handgrip strength and unsatisfactory food guidelines accomplishment in all models (p < 0.05). The nutritional and muscular fitness of migrant children was better than that of the Chilean ones.

Relationship between cardiorespiratory fitness and latitude in children and adolescents: Results from a cross-sectional survey in China

Background

This study assessed the correlation between latitude and the cardiorespiratory fitness (CRF) of children and adolescents.

Methods

In 16 provinces and autonomous regions in China, 25,941 children and adolescents aged 10–18 were included. CRF was measured using the 20 m shuttle run test (20 m SRT) and estimated peak oxygen uptake (VO_2peak). One-way ANOVA and multiple regression analysis were used to explore the correlation between CRF and latitude in children and adolescents.

Results

The VO_2peak values of the low (south), middle, and high (north) latitude groups for boys were 43.1, 43.1, and 40.7 mL/kg/min, respectively, and 40.0, 40.0, and 38.5 mL/kg/min for girls, respectively. After adjusting for confounding factors, the regression coefficients (β) between VO_2peak-Z and both latitude-Z and (latitude-Z)² for boys were −0.151 and −0.043, respectively. For girls, they were −0.142 and −0.020, respectively. The Partial correlation coefficient (r) for latitude-Z and (latitude-Z)² were −0.14 and −0.04 for boys, and −0.13 and −0.02 for girls, respectively.

Conclusion

The CRF among children and adolescents in high latitude regions is significantly lower than that in middle and low latitude region, and it generally shows a “parabolic” trend between Latitude-Z and VO_2peak-Z.

Food Habits and Screen Time Play a Major Role in the Low Health Related to Quality of Life of Ethnic Ascendant Schoolchildren

The objective of the present study was to determine the association between lifestyle parameters (i.e., physical activity (PA) level, screen time (ST), fitness and food habits) and health-related quality of life (HRQoL) in ethnic ascendant schoolchildren (i.e., Mapuche ascendant). This cross-sectional study included 619 schoolchildren with ethnic (EA; n = 234, 11.6 ± 1.0 years) and non-ethnicity ascendant (NEA; n = 383, 11.7 ± 1.1 years) from Araucanía, Chile. HRQoL and lifestyle were measured using a standard questionnaire and cardiometabolic markers (body mass index (BMI), waist circumference (WC), waist-to-height ratio (WtHR), systolic (SBP) and diastolic blood pressure (DBP)) and cardiorespiratory fitness (CRF) were additionally included. In the EA schoolchildren, the HRQoL reported association with CRF adjusted by age and sex (β; 0.12, p = 0.018) and non-adjusted with foods habits (β; 0.11, p = 0.034). By contrast, ST adjusted by age and sex presented an inverse association with HRQoL (β; −2.70, p < 0.001). EA schoolchildren showed low HRQoL (p = 0.002), low nutritional level (p = 0.002) and low CRF (p < 0.001) than NEA peers. Moreover, children’s ethnic presence showed an association with low nutritional levels (odd ratio (OR): 3.28, p = 0.002) and ST 5 h/day (OR: 5.34, p = 0.003). In conclusion, in the present study, EA schoolchildren reported lower HRQoL than NEA schoolchildren, which could be explained by the lifestyle patterns such as a low nutritional level and more ST exposure.

Promoting health-related cardiorespiratory fitness in physical education: A systematic review

Background

This article aimed to systematically review the contribution of physical education (PE) classes to improve cardiorespiratory fitness (CRF) in children and adolescents; and to define potentially relevant factors for promoting CRF in PE classes.

Methods

Studies were identified from searches in ERIC, PubMed, SPORTDiscus, and Web of Science databases. Primary source articles, relating PE classes and CRF, published up to July 2019 in peer-reviewed journals were eligible for inclusion. Specific inclusion criteria were: (a) having cross-sectional or longitudinal and observational or interventional study designs; (b) targeting school-aged children or adolescents; (c) measuring CRF, heart rate or CRF test results as an outcome; (d) having statistical analyses of the CRF, heart rate or CRF test results outcomes reported; (e) focusing on PE classes or PE interventions that did not extended time or frequency of the classes; and (f) published in English, French, Portuguese, or Spanish.

Results

A total of 24 studies met the inclusion criteria. Overall, 10 studies have found a neutral effect of PE classes in students’ CRF, eight studies found that PE indeed contributed to the improvement of CRF and six studies revealed mixed findings, when PE classes where controlled for others variables (e.g. body mass index, intensity). Higher intensity PE classes consistently demonstrated contributions to improving students’ CRF.

Conclusion

Review findings suggest that PE classes can contribute to the improvement of students’ CRF. Intensity, age and weight status were identified as potentially relevant factors for promoting CRF in PE classes. To improve CRF, higher intensity classes should be provided.

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

BACKGROUND

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

Socio-demographic differences in Colombian children's muscular fitness: Does scaling for differences in body size present a challenge to conventional thinking?

OBJECTIVES

In low- to middle-income countries, children from less-deprived areas (from families of higher socio-economic status [SES]) have superior muscular fitness than those from low-SES groups. They are also taller and heavier, factors associated with muscular fitness. The purpose of this study was to identify any socio-demographic differences in Colombian children's muscular fitness and examine how these conclusions can be modified by scaling for differences in body size.

METHODS

A total of 38,098 youths (46% girls), ninth grade students (aged 14-15 years), participated in a study of cross-sectional design. We recorded SES and family incomes, stature, and mass. Standing broad jump and handgrip strength were used to assess muscular fitness. A multiplicative allometric model was adopted to adjust for body-size differences.

RESULTS

Children from the mid- to high-SES groups jumped significantly higher than children from the lowest SES group, although no SES group difference in grip strength was observed. After adjusting for body size, children from higher SES and with higher family incomes had significantly lower handgrip strength, and their superior jump height performances remained but were greatly reduced. Only children from the highest SES now jumped significantly higher that the lowest SES group.

CONCLUSIONS

The superior jump performance and no difference in handgrip strength of Colombian children from higher SES may simply reflect their superior physiques. When body size is accounted for, these differences are reduced or even reversed, suggesting that children from higher SES groups should not be complacent regarding their apparent superior muscular fitness.

Self-Rated Health Status and Cardiorespiratory Fitness in a Sample of Schoolchildren from Bogotá, Colombia. The FUPRECOL Study

To evaluate the relationship between Self-Rated Health (SRH) and cardiorespiratory fitness (CRF) in a sample of children and adolescents enrolled in official schools in Bogotá, Colombia. A cross-sectional study was performed with 7402 children and adolescents between 9 and 17 years of age. Participants were asked to rate their health based on eight validated questions, addressing the participants propensity for headache, stomach-ache, backache, feeling-low, irritability/bad mood, nervousness, sleeping-difficulties, and dizziness. The choices were "rarely or never", "almost every month", "almost every week", and "more than once a week/about every day". Participants performed the international course-navette shuttle run test to estimate CRF, and cut-off points for age and gender were used to categorize the healthy/unhealthy fitness zone according to the FITNESSGRAM® criteria. Overall, 16.4% of those surveyed reported a perception of irritability/bad mood "more than once a week/about every day", followed by feeling-low and nervousness (both with 9.9%). Dizziness had the lowest prevalence with a percentage of 6.9%. Unhealthy CRF in boys increased the likelihood of headaches by 1.20 times, stomach aches by 1.31 times, feeling-low by 1.29 times, nervousness by 1.24 times, and dizziness by 1.29 times. In girls, unhealthy CRF increased the likelihood of headaches by 1.19 times, backache by 1.26 times, feeling-low by 1.28 times, irritability/bad mood by 1.17 times, sleeping-difficulties by 1.20 times, and dizziness by 1.27 times. SRH was associated with CRF in both genders. Early identification of children and adolescents with low CRF levels will permit interventions to promote healthy behaviors and prevent future diseases during adulthood.

Cardiorespiratory Fitness and Muscular Strength as Mediators of the Influence of Fatness on Academic Achievement

OBJECTIVE

To examine the combined association of fatness and physical fitness components (cardiorespiratory fitness [CRF] and muscular strength) with academic achievement, and to determine whether CRF and muscular strength are mediators of the association between fatness and academic achievement in a nationally representative sample of adolescents from Chile.

STUDY DESIGN

Data were obtained for a sample of 36 870 adolescents (mean age, 13.8 years; 55.2% boys) from the Chilean System for the Assessment of Educational Quality test for eighth grade in 2011, 2013, and 2014. Physical fitness tests included CRF (20-m shuttle run) and muscular strength (standing long jump). Weight, height, and waist circumference were assessed, and body mass index and waist circumference-to-height ratio were calculated. Academic achievement in language and mathematics was assessed using standardized tests. The PROCESS script developed by Hayes was used for mediation analysis.

RESULTS

Compared with unfit and high-fatness adolescents, fit and low-fatness adolescents had significantly higher odds for attaining high academic achievement in language and mathematics. However, in language, unfit and low-fatness adolescents did not have significantly higher odds for obtaining high academic achievement. Those with high fatness had higher academic achievement (both language and mathematics) if they were fit. Linear regression models suggest a partial or full mediation of physical fitness in the association of fatness variables with academic achievement.

CONCLUSIONS

CRF and muscular strength may attenuate or even counteract the adverse influence of fatness on academic achievement in adolescents.

The Relationship between Socioeconomic Status, Family Income, and Measures of Muscular and Cardiorespiratory Fitness in Colombian Schoolchildren

OBJECTIVE

To determine the associations between socioeconomic status (SES) and physical fitness in a sample of Colombian youth.

STUDY DESIGN

Prueba SER is cross-sectional survey of schoolchildren in Bogota, Colombia. Mass, stature, muscular fitness (standing long-jump, handgrip), and cardiorespiratory fitness (20-m shuttle run) were measured in 52?187 schoolchildren 14-16 years of age. Area-level SES was categorized from 1 (very low) to 4 (high) and parent-reported family income was categorized as low, middle, or high.

RESULTS

Converting measures into z scores showed stature, muscular, and cardiorespiratory fitness were significantly (z?=?0.3-0.7) below European values. Children in the mid- and high SES groups jumped significantly further than groups with very low SES. Differences were independent of sex but became nonsignificant when adjusted for anthropometric differences. Participants in the mid-SES and high-SES groups had better handgrip scores when adjusted for body dimension. There were, however, no significant between-group differences in cardiorespiratory fitness, which was strongly clustered by school and significantly greater in students from private schools.

CONCLUSIONS

Area-level SES is associated with measures of muscular fitness in Colombian schoolchildren. These associations were largely explained by the large differences in body dimensions observed between SES groups. When area-level SES is considered, there was no evidence that family income influenced fitness. The clustering of outcomes reaffirms the potential importance of schools and area-level factors in promoting fitness through opportunities for physical activity. Interventions implemented in schools, can improve academic attainment; a factor likely to be important in promoting the social mobility of children from poorer families.

Adiposity as a full mediator of the influence of cardiorespiratory fitness and inflammation in schoolchildren: The FUPRECOL Study

BACKGROUND AND AIMS

Studies in the paediatric population have shown inconsistent associations between cardiorespiratory fitness and inflammation independently of adiposity. The purpose of this study was (i) to analyse the combined association of cardiorespiratory fitness and adiposity with high-sensitivity C-reactive protein (hs-CRP), and (ii) to determine whether adiposity acts as a mediator on the association between cardiorespiratory fitness and hs-CRP in children and adolescents.

METHODS AND RESULTS

This cross-sectional study included 935 (54.7% girls) healthy children and adolescents from Bogotá, Colombia. The 20 m shuttle run test was used to estimate cardiorespiratory fitness. We assessed the following adiposity parameters: body mass index, waist circumference, and fat mass index and the sum of subscapular and triceps skinfold thickness. High sensitivity assays were used to obtain hs-CRP. Linear regression models were fitted for mediation analyses examined whether the association between cardiorespiratory fitness and hs-CRP was mediated by each of adiposity parameters according to Baron and Kenny procedures. Lower levels of hs-CRP were associated with the best schoolchildren profiles (high cardiorespiratory fitness + low adiposity) (p for trend <0.001 in the four adiposity parameters), compared with unfit and overweight (low cardiorespiratory fitness + high adiposity) counterparts. Linear regression models suggest a full mediation of adiposity on the association between cardiorespiratory fitness and hs-CRP levels.

CONCLUSIONS

Our findings seem to emphasize the importance of obesity prevention in childhood, suggesting that having high levels of cardiorespiratory fitness may not counteract the negative consequences ascribed to adiposity on hs-CRP.

Aerobic capacity and future cardiovascular risk in Indian community from a low-income area in Cauca, Colombia

Background

Several studies indicates that children’s aerobic capacity levels are predictors of the future risk of non-communicable diseases. Therefore, the aim of this study was to establish the proportion of subjects whose aerobic capacity is indicative of future cardiovascular risk in Indian-Nasa community from a low-income area in Cauca, Colombia.

Methods

We performed a cross-sectional analysis of morphological component (height, weight, body mass index (BMI), waist circumference, triceps skinfold, subscapular skinfold, and body fat percent [BF%]), and the cardiorespiratory component (course-navette 20 m, shuttle run test and estimation of maximal oxygen consumption by indirect VO₂max) from 576 participants (319 boys and 257 girls) aged 10 to 17.9 years, using the standardized FUPRECOL test battery.

Results

We showed that the boys performed better than the girls in cardiorespiratory fitness. The proportion of subjects with an aerobic capacity indicative of future cardiovascular risk was 7.3%. By sex, 3.8% of boys and 11.7% of girls (X²p = 0.001) displayed an unhealthy aerobic capacity in this study.

Conclusion

The findings of this study that provide the first data on aerobic capacity health for Colombian Nasa Indian children and adolescents aged 10–17.9 years. Although the known loss of aerobic capacity is a serious consequence of the future risk of non-communicable diseases, the deterioration of physical fitness deserves increased attention among indigenous population.

Review of criterion-referenced standards for cardiorespiratory fitness: what percentage of 1 142 026 international children and youth are apparently healthy?

PURPOSE

To identify criterion-referenced standards for cardiorespiratory fitness (CRF); to estimate the percentage of children and youth that met each standard; and to discuss strategies to help improve the utility of criterion-referenced standards for population health research.

METHODS

A search of four databases was undertaken to identify papers that reported criterion-referenced CRF standards for children and youth generated using the receiver operating characteristic curve technique. A pseudo-dataset representing the 20-m shuttle run test performance of 1 142 026 children and youth aged 9-17 years from 50 countries was generated using Monte Carlo simulation. Pseudo-data were used to estimate the international percentage of children and youth that met published criterion-referenced standards for CRF.

RESULTS

Ten studies reported criterion-referenced standards for healthy CRF in children and youth. The mean percentage (±95% CI) of children and youth that met the standards varied substantially across age groups from 36%±13% to 95%±4% among girls, and from 51%±7% to 96%±16% among boys. There was an age gradient across all criterion-referenced standards where younger children were more likely to meet the standards compared with older children, regardless of sex. Within age groups, mean percentages were more precise (smaller CI) for younger girls and older boys.

CONCLUSION

There are several CRF criterion-referenced standards for children and youth producing widely varying results. This study encourages using the interim international criterion-referenced standards of 35 and 42 mL/kg/min for girls and boys, respectively, to identify children and youth at risk of poor health-raising a clinical red flag.

Normative reference values for the 20 m shuttle-run test in a population-based sample of school-aged youth in Bogota, Colombia: the FUPRECOL study

OBJECTIVES

Our aim was to determine the normative reference values of cardiorespiratory fitness (CRF) and to establish the proportion of subjects with low CRF suggestive of future cardio-metabolic risk.

METHODS

A total of 7244 children and adolescents attending public schools in Bogota, Colombia (55.7% girls; age range of 9-17.9 years) participated in this study. We expressed CRF performance as the nearest stage (minute) completed and the estimated peak oxygen consumption (V˙O2peak ). Smoothed percentile curves were calculated. In addition, we present the prevalence of low CRF after applying a correction factor to account for the impact of Bogota's altitude (2625 m over sea level) on CRF assessment, and we calculated the number of participants who fell below health-related FITNESSGRAM cut-points for low CRF.

RESULTS

Shuttles and V˙O2peak were higher in boys than in girls in all age groups. In boys, there were higher levels of performance with increasing age, with most gains between the ages of 13 and 17. The proportion of subjects with a low CRF, suggestive of future cardio-metabolic risk (health risk FITNESSGRAM category) was 31.5% (28.2% for boys and 34.1% for girls; X2 P = .001). After applying a 1.11 altitude correction factor, the overall prevalence of low CRF was 11.5% (9.6% for boys and 13.1% for girls; X2 P = .001).

CONCLUSIONS

Our results provide sex- and age-specific normative reference standards for the 20 m shuttle-run test and estimated V˙O2peak values in a large, population-based sample of schoolchildren from a large Latin-American city at high altitude.

Handgrip Strength and Ideal Cardiovascular Health among Colombian Children and Adolescents

OBJECTIVE

To evaluate the association between handgrip strength and ideal cardiovascular health (CVH) in Colombian children and adolescents.

STUDY DESIGN

During the 2014-2015 school years, we examined a cross-sectional component of the FUPRECOL (Association for Muscular Strength with Early Manifestation of Cardiovascular Disease Risk Factors among Colombian Children and Adolescents) study. Participants included 1199 (n = 627 boys) youths from Bogota (Colombia). Handgrip strength was measured with a standard adjustable hand held dynamometer and expressed relative to body mass (handgrip/body mass) and as absolute values in kilograms. Ideal CVH, as defined by the American Heart Association, was determined as meeting ideal levels of the following components: 4 behaviors (smoking status, body mass index, cardiorespiratory fitness, and diet) and 3 factors (total cholesterol, blood pressure, and glucose).

RESULTS

Higher levels of handgrip strength (both absolute and relative values) were associated with a higher frequency of ideal CVH metrics in both sexes (P for trend ≤ .001). Also, higher levels of handgrip strength were associated with a greater number of ideal health behaviors (P for trend < .001 in both boys and girls), and with a higher number of ideal health factors in boys (P for trend < .001). Finally, levels of handgrip strength were similar between ideal versus nonideal glucose or total cholesterol groups in girls.

CONCLUSIONS

Handgrip strength was strongly associated with ideal CVH in Colombian children and adolescents, and thus supports the relevance of early targeted interventions to promote strength adaptation and preservation as part of primordial prevention.

Associations between different components of fitness and fatness with academic performance in Chilean youths

Objectives

To analyze the associations between different components of fitness and fatness with academic performance, adjusting the analysis by sex, age, socio-economic status, region and school type in a Chilean sample.

Methods

Data of fitness, fatness and academic performance was obtained from the Chilean System for the Assessment of Educational Quality test for eighth grade in 2011 and includes a sample of 18,746 subjects (49% females). Partial correlations adjusted by confounders were done to explore association between fitness and fatness components, and between the academic scores. Three unadjusted and adjusted linear regression models were done in order to analyze the associations of variables.

Results

Fatness has a negative association with academic performance when Body Mass Index (BMI) and Waist to Height Ratio (WHR) are assessed independently. When BMI and WHR are assessed jointly and adjusted by cofounders, WHR is more associated with academic performance than BMI, and only the association of WHR is positive. For fitness components, strength was the variable most associated with the academic performance. Cardiorespiratory capacity was not associated with academic performance if fatness and other fitness components are included in the model.

Conclusions

Fitness and fatness are associated with academic performance. WHR and strength are more related with academic performance than BMI and cardiorespiratory capacity.

High muscular fitness has a powerful protective cardiometabolic effect in adults: influence of weight status

BACKGROUND

Low levels of muscular fitness (MF) are recognized as an important marker of nutritional status and a predictor of metabolic complications, cardiovascular disease and death, however, the relationship between MF, body mass index (BMI) and the subsequent cardiometabolic protective effects has been less studied among Latin American populations. This study identified an association between MF and the cardiometabolic risk score index (CMRSI) and the lipid-metabolic cardiovascular risk index (LMCRI) in a wide sample of university students grouped according to their BMI.

METHODS

Six thousand ninety five healthy males (29.6 ± 11.7 year-old) participated in the study. Absolute strength was measured using a T.K.K. analogue dynamometer (handgrip), and the participant's strength was then calculated relative to their body mass (MF/BM). The LMCRI was derived from the levels of triglycerides, low-density lipoprotein cholesterol (LDL-c), high-density lipoprotein cholesterol (HDL-c), and glucose levels in a blood sample. The CMRSI was calculated by summing the standardized residuals (z-score) for waist circumference, total cholesterol, LDL-c, triglycerides, HDL-c, and median blood pressure. Subjects were divided into six subgroups according to BMI (normal vs. overweight/obese) and MF/BM tertiles (unfit, average, fit).

RESULTS

The group of participants with low and moderate levels of MF/BM showed higher CMRSI values independent of BMI (P < 0.001). The group with normal BMI and high MF/BM had the highest levels of cardiometabolic protection. All overweight/obese BMI groups had significantly higher LMCRI values independent of the level of MF/BM (P < 0.001).

CONCLUSIONS

Participants with high MF/BM showed reduced cardiometabolic risk, which increased significantly when they were within normal parameters.

International variability in 20 m shuttle run performance in children and youth: who are the fittest from a 50-country comparison? A systematic literature review with pooling of aggregate results

OBJECTIVES

To describe and compare 20 m shuttle run test (20mSRT) performance among children and youth across 50 countries; to explore broad socioeconomic indicators that correlate with 20mSRT performance in children and youth across countries and to evaluate the utility of the 20mSRT as an international population health indicator for children and youth.

METHODS

A systematic review was undertaken to identify papers that explicitly reported descriptive 20mSRT (with 1-min stages) data on apparently healthy 9-17 year-olds. Descriptive data were standardised to running speed (km/h) at the last completed stage. Country-specific 20mSRT performance indices were calculated as population-weighted mean z-scores relative to all children of the same age and sex from all countries. Countries were categorised into developed and developing groups based on the Human Development Index, and a correlational analysis was performed to describe the association between country-specific performance indices and broad socioeconomic indicators using Spearman's rank correlation coefficient.

RESULTS

Performance indices were calculated for 50 countries using collated data on 1 142 026 children and youth aged 9-17 years. The best performing countries were from Africa and Central-Northern Europe. Countries from South America were consistently among the worst performing countries. Country-specific income inequality (Gini index) was a strong negative correlate of the performance index across all 50 countries.

CONCLUSIONS

The pattern of variability in the performance index broadly supports the theory of a physical activity transition and income inequality as the strongest structural determinant of health in children and youth. This simple and cost-effective assessment would be a powerful tool for international population health surveillance.

Cardiorespiratory Fitness, Adiposity, and Cardiometabolic Risk Factors in Schoolchildren: The FUPRECOL Study

The aim of this study was to investigate the association between cardiorespiratory fitness (CRF) and cardiovascular risk factors (CVRF) in schoolchildren. A secondary aim was to evaluate the degree of association between overall and abdominal adiposity and CRF in a total of 1,875 children and adolescents attending public schools. We expressed CRF performance as the nearest stage (minute) completed and the estimated peak oxygen consumption. A CVRF ( Z score) was calculated and participants were divided into tertiles according to low and high levels of overall (sum of the skinfold thicknesses) and abdominal adiposity. Schoolchildren with a high-level of overall adiposity demonstrated significant differences in seven of the 10 variables analyzed (i.e., systolic and diastolic blood pressure, triglycerides, triglycerides/high density lipoproteins [HDL-c] ratio, total cholesterol, glucose, C-reactive protein [usCRP], HDL-c, low density lipoproteins [LDL-c], and cardiovascular risk score). Schoolchildren with high levels of both overall and abdominal adiposity and low CRF had the least favorable CVRF score.

Sociodemographic factors related to handgrip strength in children and adolescents in a middle income country: The SALUS study

OBJECTIVE

To determine sociodemographic factors associated with handgrip (HG) strength in a representative sample of children and adolescents from a middle income country.

METHODS

We evaluated youth between the ages of 8 and 17 from a representative sample of individuals from the Department of Santander, Colombia. Anthropometric measures, HG strength, and self-reported physical activity were assessed, and parents/guardians completed sociodemographic questionnairres. Multinomial logistic regression models were used to estimate the association between sociodemographic and anthropometric characteristics and tertiles of relative HG strength. We also produced centile data for raw HG strength using quantile regression.

RESULTS

1,691 young people were evaluated. HG strength increased with age, and was higher in males than females in all age groups. Lower HG strength was associated with indicators of higher socioeconomic status, such as living in an urban area, residence in higher social strata neighborhoods, parent/guardian with secondary education or higher, higher household income, and membership in health insurance schemes. In addition, low HG strength was associated with lower physical activity levels and higher waist-to-hip ratio. In a fully adjusted regression model, all factors remained significant except for health insurance, household income, and physical activity level.

CONCLUSIONS

While age and gender specific HG strength values were substantially lower than contemporary data from high income countries, we found that within this middle income population indicators of higher socioeconomic status were associated with lower HG strength. This analysis also suggests that in countries undergoing rapid nutrition transition, improvements in socioeconomic conditions may be accompanied by reduction in muscle strength.

International normative 20 m shuttle run values from 1 142 026 children and youth representing 50 countries

OBJECTIVE

To develop sex-specific and age-specific international norms for the 20 m shuttle run test (20mSRT) in children and youth (aged 9-17 years), and to estimate the prevalence meeting the FITNESSGRAM criterion-referenced standards for healthy cardiorespiratory endurance (CRE).

METHODS

A systematic review was undertaken to identify papers explicitly reporting descriptive 20mSRT (with 1 min stages) data on children and youth since 1981. Data were included on apparently healthy (free from known disease/injury) 9-17 years old. Following standardisation to a common metric and for protocol differences, pseudo data were generated using Monte Carlo simulation, with population-weighted sex-specific and age-specific normative centiles generated using the Lambda Mu and Sigma (LMS) method. Sex-related and age-related differences were expressed as per cent and standardised differences in means. The prevalence with healthy CRE was estimated using the sex-specific and age-specific FITNESSGRAM criterion-referenced standards for [Formula: see text].

RESULTS

Norms were displayed as tabulated centiles and as smoothed centile curves for the 20mSRT using 4 common metrics (speed at the last completed stage, completed stages/minutes, laps and relative [Formula: see text]). The final data set included 1 142 026 children and youth from 50 countries, extracted from 177 studies. Boys consistently outperformed girls at each age group (mean difference±95% CI: 0.86±0.28 km/h or 0.79±0.20 standardised units), with the magnitude of age-related increase larger for boys than for girls. A higher proportion of boys (mean±95% CI: 67±14%) had healthy CRE than girls (mean±95% CI: 54±17%), with the prevalence of healthy CRE decreasing systematically with age.

CONCLUSIONS

This study provides the most comprehensive and up-to-date set of international sex-specific and age-specific 20mSRT norms for children and youth, which have utility for health and fitness screening, profiling, monitoring and surveillance.

A lower cardiorespiratory fitness is associated to an unhealthy status among children and adolescents from Bogotá, Colombia

OBJECTIVE

Several studies have shown that low cardiorespiratory fitness (CRF) is a significant independent risk factor for future cardiometabolic disease in adult life. The aim of this study was to examine the relationship between CRF and health status in children and adolescents in Bogotá, Colombia.

METHODS

A cross-sectional study was conducted in 921 children and adolescents aged 9-17 years living in the metropolitan area of the District of Bogotá, Colombia (2,480m asl). CRF was assessed with the 20m shuttle run test (Course-Navette) according to ALPHA-FITNESS and FITNESSGRAM standards. Blood pressure, waist circumference, hip circumference, body composition (body fat percentage, fat body mass, and fat-free mass by bioimpedance), skin fold calipers, body mass index, and sexual maturity (Tanner) were used as indicators of physical health.

RESULTS

After adjusting for sex, age, and sexual maturity, significant inverse relationships were seen between CRF and body mass index (r=-0.107), body fat percentage (r=-0.197), fat body mass (r=-0.159), skin fold (r=-0.246), and waist circumference (r=-0.169); P<.001. Schoolchildren with low CRF levels showed OR 6.06 (95% CI 3.98-9.24) increase in body fat by bioimpedance; OR 4.04 (95% CI 1.83-9.11) risk of overweight/obese by body mass index and OR 2.47 (95% CI 1.14-5.37) abdominal obesity due to increased waist circumference.

CONCLUSION

Approximately two thirds of participants had a CRF level suggesting future cardiovascular disease. Early identification of children and adolescents with low CRF levels will allow for implementing interventions to prevent cardiometabolic disease in adulthood.