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Wang Q, Guo H, Chen S, Ma J, Kim H. The Association of Body Mass Index and Fat Mass with Health-Related Physical Fitness among Chinese Schoolchildren: A Study Using a Predictive Model. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:ijerph20010355. [PMID: 36612677 PMCID: PMC9819089 DOI: 10.3390/ijerph20010355] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 12/16/2022] [Accepted: 12/20/2022] [Indexed: 06/07/2023]
Abstract
Body fat mass (FM) has advantages over body mass index (BMI) in terms of accuracy of fitness assessment and health monitoring. However, the relationship between FM and fitness in Chinese children has not yet been well studied. This study aimed to investigate the relationship between health-related physical fitness, BMI, and FM, which was estimated using a predictive model among elementary schoolchildren in China. This cross-sectional study included 2677 participants (boys, 53.6%; girls, 46.4%) who underwent anthropometric measurements (height, weight, BMI, and FM) and five health-related fitness tests: 50-m sprint (speed), sit and reach (flexibility), timed rope-skipping (coordination), timed sit-ups (muscular endurance), and 50-m × 8 shuttle run (endurance). In boys, BMI showed a positive correlation with speed (p < 0.001) and endurance (p < 0.006) tests and a negative correlation with flexibility (p < 0.004) and coordination (p < 0.001) tests. In girls, a positive correlation between speed (p < 0.001) and endurance (p < 0.036) tests was observed. Both BMI and FM (estimated using the predictive model) were strongly associated with the health-related physical fitness of elementary schoolchildren. Our findings indicate that health-related physical fitness was similarly affected by FM and BMI. As FM can be quantified, it could therefore be used to develop strategies and intervention programs for the prevention and management of obesity in children.
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Affiliation(s)
- Qiang Wang
- College of Sports Science, Shenyang Normal University, Shenyang 110034, China
| | - Hongzhi Guo
- Graduate School of Human Sciences, Waseda University, Tokorozawa 359-1192, Japan
| | - Sitong Chen
- Institute for Health and Sport, Victoria University, Melbourne, VIC 3011, Australia
| | - Jiameng Ma
- Faculty of Sports Science, Sendai University, Shibata 989-1693, Japan
| | - Hyunshik Kim
- Faculty of Sports Science, Sendai University, Shibata 989-1693, Japan
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Seral-Cortes M, De Miguel-Etayo P, Zapata P, Miguel-Berges ML, Moreno LA. Effectiveness and process evaluation in obesity and type 2 diabetes prevention programs in children: a systematic review and meta-analysis. BMC Public Health 2021; 21:348. [PMID: 33579237 PMCID: PMC7881469 DOI: 10.1186/s12889-021-10297-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 01/20/2021] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Obesity in children is one of the most severe public health challenges of the current century and Type 2 Diabetes Mellitus (T2DM) frequency is also escalating. More so, the importance of process evaluation (PE) in complex interventions is increasingly recognized. The present review, aims to identify the effectiveness in terms of body composition parameters in a generation of articles to prevent obesity and T2DM in children. We hypothesise that those studies reporting PE applying the latest implementation guidelines suggested by the researchers would potentially show positive changes in body composition compared to those not reporting it. Additionally, we will evaluate the implementation degree of PE in those articles considering it and describe the PE subcomponents. Lastly, we aim to assess the intervention target used and its results. METHODS A literature review was performed in parallel by 2 independent reviewers. A final number of 41 studies were selected for inclusion criteria. RESULTS Meta-analysis of BMI and zBMI found non-significant effects of the proposed interventions. Sub-group analysis revealed only a significant effect in studies which performed PE. Moreover, PE was reported in 42% effective studies and 57% non-effective studies. Fidelity and satisfaction were the most implemented PE subcomponents, although there was a generally low grade of PE use (7/41). The highest proportion of effectiveness (83%) was shown in interventions of physical activity alone while the intervention most used was 3-arm target (diet, PA and BS). CONCLUSIONS Overall, obesity and T2DM prevention studies included in this review are not effective in terms of BMI and zBMI. Those studies performing PE reported to be effective in terms of BMI, while studies not reporting PE did not have positive results in terms of BMI and zBMI. In addition, none of the intervention studies included all PE indicators and most studies, which included PE in their interventions, did not provide full report of the PE components, according to the guidelines used for the present review. PROSPERO registration number: CRD42018093667.
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Affiliation(s)
- M Seral-Cortes
- Growth, Exercise, NUtrition and Development (GENUD) Research Group, Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria, Aragón (IIS Aragón), Universidad de Zaragoza, 50009, Zaragoza, Spain
- Department of Psychiatry and Nursing, Faculty of Health Sciences, Universidad de Zaragoza, Zaragoza, Spain
| | - P De Miguel-Etayo
- Growth, Exercise, NUtrition and Development (GENUD) Research Group, Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria, Aragón (IIS Aragón), Universidad de Zaragoza, 50009, Zaragoza, Spain.
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain.
| | - P Zapata
- Growth, Exercise, NUtrition and Development (GENUD) Research Group, Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria, Aragón (IIS Aragón), Universidad de Zaragoza, 50009, Zaragoza, Spain
- Departamento de nutrición y dietética, Universidad de Antioquia, Medellín, Colombia
| | - M L Miguel-Berges
- Growth, Exercise, NUtrition and Development (GENUD) Research Group, Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria, Aragón (IIS Aragón), Universidad de Zaragoza, 50009, Zaragoza, Spain
- Department of Psychiatry and Nursing, Faculty of Health Sciences, Universidad de Zaragoza, Zaragoza, Spain
| | - L A Moreno
- Growth, Exercise, NUtrition and Development (GENUD) Research Group, Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria, Aragón (IIS Aragón), Universidad de Zaragoza, 50009, Zaragoza, Spain
- Department of Psychiatry and Nursing, Faculty of Health Sciences, Universidad de Zaragoza, Zaragoza, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
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Chihaoui-Mamlouk A, Bouani H, Ouergui N, Zarrouk F, Bouassida A, Dardouri W. Effet de l’entraînement intermittent sur le rapport aporprotéineB/apoprotéineA–I, chez les enfants obèses atteints de syndrome métabolique. Sci Sports 2020. [DOI: 10.1016/j.scispo.2019.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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West SL, Banks L, Schneiderman JE, Caterini JE, Stephens S, White G, Dogra S, Wells GD. Physical activity for children with chronic disease; a narrative review and practical applications. BMC Pediatr 2019; 19:12. [PMID: 30621667 PMCID: PMC6325687 DOI: 10.1186/s12887-018-1377-3] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Accepted: 12/18/2018] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Physical activity (PA) is associated with a diverse range of health benefits. International guidelines suggest that children should be participating in a minimum of 60 min of moderate to vigorous intensity PA per day to achieve these benefits. However, current guidelines are intended for healthy children, and thus may not be applicable to children with a chronic disease. Specifically, the dose of PA and disease specific exercise considerations are not included in these guidelines, leaving such children with few, if any, evidence-based informed suggestions pertaining to PA. Thus, the purpose of this narrative review was to consider current literature in the area of exercise as medicine and provide practical applications for exercise in five prevalent pediatric chronic diseases: respiratory, congenital heart, metabolic, systemic inflammatory/autoimmune, and cancer. METHODS For each disease, we present the pathophysiology of exercise intolerance, summarize the pediatric exercise intervention research, and provide PA suggestions. RESULTS Overall, exercise intolerance is prevalent in pediatric chronic disease. PA is important and safe for most children with a chronic disease, however exercise prescription should involve the entire health care team to create an individualized program. CONCLUSIONS Future research, including a systematic review to create evidence-based guidelines, is needed to better understand the safety and efficacy of exercise among children with chronic disease.
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Affiliation(s)
- Sarah L. West
- Department of Biology, Trent/Fleming School of Nursing, Trent University, Toronto, Canada
- Translational Medicine, The Hospital for Sick Children, Toronto, Canada
| | | | - Jane E. Schneiderman
- Translational Medicine, The Hospital for Sick Children, Toronto, Canada
- Faculty of Kinesiology and Physical Education, The University of Toronto, Toronto, Canada
| | - Jessica E. Caterini
- Translational Medicine, The Hospital for Sick Children, Toronto, Canada
- Faculty of Kinesiology and Physical Education, The University of Toronto, Toronto, Canada
| | - Samantha Stephens
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Canada
- Institute of Health Policy Management and Evaluation, The University of Toronto, Toronto, Canada
| | - Gillian White
- Translational Medicine, The Hospital for Sick Children, Toronto, Canada
- Faculty of Kinesiology and Physical Education, The University of Toronto, Toronto, Canada
| | - Shilpa Dogra
- Faculty of Health Sciences (Kinesiology), University of Ontario Institute of Technology, Oshawa, Canada
| | - Greg D. Wells
- Translational Medicine, The Hospital for Sick Children, Peter Gilgan Centre for Research and Learning, 10th floor, 686 Bay St., Toronto, ON M5G 0A4 Canada
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Metabolic effects of resistance or high-intensity interval training among glycemic control-nonresponsive children with insulin resistance. Int J Obes (Lond) 2017; 42:79-87. [PMID: 28757639 DOI: 10.1038/ijo.2017.177] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Revised: 07/03/2017] [Accepted: 07/14/2017] [Indexed: 02/06/2023]
Abstract
BACKGROUND Little evidence exists on which variables of body composition or muscular strength mediates more glucose control improvements taking into account inter-individual metabolic variability to different modes of exercise training. OBJECTIVE We examined 'mediators' to the effects of 6-weeks of resistance training (RT) or high-intensity interval training (HIT) on glucose control parameters in physically inactive schoolchildren with insulin resistance (IR). Second, we also determined both training-induce changes and the prevalence of responders (R) and non-responders (NR) to decrease the IR level. METHODS Fifty-six physically inactive children diagnosed with IR followed a RT or supervised HIT program for 6 weeks. Participants were classified based on ΔHOMA-IR into glycemic control R (decrease in homeostasis model assessment-IR (HOMA-IR) <3.0 after intervention) and NRs (no changes or values HOMA-IR⩾3.0 after intervention). The primary outcome was HOMA-IR associated with their mediators; second, the training-induced changes to glucose control parameters; and third the report of R and NR to improve body composition, cardiovascular, metabolic and performance variables. RESULTS Mediation analysis revealed that improvements (decreases) in abdominal fat by the waist circumference can explain more the effects (decreases) of HOMA-IR in physically inactive schoolchildren under RT or HIT regimes. The same analysis showed that increased one-maximum repetition leg-extension was correlated with the change in HOMA-IR (β=-0.058; P=0.049). Furthermore, a change in the waist circumference fully mediated the dose-response relationship between changes in the leg-extension strength and HOMA-IR (β'=-0.004; P=0.178). RT or HIT were associated with significant improvements in body composition, muscular strength, blood pressure and cardiometabolic parameters irrespective of improvement in glycemic control response. Both glucose control RT-R and HIT-R (respectively), had significant improvements in mean HOMA-IR, mean muscular strength leg-extension and mean measures of adiposity. CONCLUSIONS The improvements in the lower body strength and the decreases in waist circumference can explain more the effects of the improvements in glucose control of IR schoolchildren in R group after 6 weeks of RT or HIT, showing both regimes similar effects on body composition or muscular strength independent of interindividual metabolic response variability.
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Delgado-Floody P, Caamaño-Navarrete F, Jérez-Mayorga D, Cofré-Lizama A, Osorio-Poblete A, Campos-Jara C, Guzmán-Guzmán I, Martínez-Salazar C, Carcamo-Oyarzun J. Obesidad, autoestima y condición física en escolares. REVISTA DE LA FACULTAD DE MEDICINA 2017. [DOI: 10.15446/revfacmed.v65n1.57063] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Introducción. La obesidad infantil es un problema grave de salud pública, ya que genera resultados adversos para la salud física y mental.Objetivo. Relacionar el estado nutricional con los niveles de autoestima y rendimiento físico en escolares de 8 a 10 años de edad.Materiales y métodos. Participaron 236 escolares: 117 hombres y 119 mujeres, de entre 8 y 10 años de edad, pertenecientes a dos colegios del municipio de Temuco con carácter estatal-municipal. Se evaluó peso, talla, índice de masa corporal, porcentaje de masa/grasa, contorno cintura, condición física, horas de ejercicio físico a la semana y autoestima.Resultados. El 43.6% de los escolares presentó malnutrición por exceso. Los categorizados como obesos (19%) presentaron niveles superiores en masa grasa y contorno cintura (p<0.001), además obtuvieron un rendimiento físico menor (p<0.05). Las horas realizadas de ejercicio físico a la semana y el nivel de autoestima fueron menores en lo escolares obesos, pero estos no alcanzaron significancia (p≥ 0.05).Conclusiones. La obesidad en edad escolar pone de manifiesto alteraciones asociadas con el rendimiento físico, la masa grasa y las tendencias negativas sobre la autoestima. A pesar de ser una etapa temprana, se pueden apreciar las consecuencias asociadas a esta condición.
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Toriola OO, Monyeki MA, Toriola AL. Two-year longitudinal health-related fitness, anthropometry and body composition status amongst adolescents in Tlokwe Municipality: The PAHL Study. Afr J Prim Health Care Fam Med 2015; 7:896. [PMID: 26842513 PMCID: PMC4656917 DOI: 10.4102/phcfm.v7i1.896] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Revised: 09/30/2015] [Accepted: 09/03/2015] [Indexed: 11/02/2022] Open
Abstract
AIM To evaluate a two-year longitudinal development of health-related fitness, anthropometry and body composition status amongst adolescents in Tlokwe Municipality, Potchefstroom, South Africa. SETTING A total of 283 high-school learners (111 boys and 172 girls) of ages 14 and 15 years who were part of the ongoing Physical Activity and Health Longitudinal Study (PAHLS) participated in the study. For the purpose of the present study, data collected for 2011 and 2012 for anthropometric, body composition and health-related physical fitness were used. RESULTS Body mass index (BMI) classification of boys and girls for 2011 and 2012 showed that 24.3% of them were underweight compared with 21% in 2012. In 2011, 50% of boys and girls had normal bodyweight compared with 52% in 2012, whilst 25.5% of the total group of participants were overweight compared with 27% in 2012. Both boys and girls showed significant increases of 5.9% in body fat (BF) and 3.2 kg in body weight over two years' measurements, respectively. Regarding health-related fitness (i.e BAH), boys showed an increase of 14.8 seconds whilst girls gained 9.6 seconds. Significant decreases were found for sit-ups in both boys and girls. A significant VO2max increase of 2.9 mL/kg/min. was found in boys over the time period. A non-significant decrease of -0.5 mL/kg/min. was observed in girls. Regression coefficients showed that changes in BMI were inversely associated with those in health-related physical fitness. The changes in percentage BF were negatively associated with standing broad jump (SBJ), bent arm hang (BAH) and VO2 max in both boys and girls. A low significant positive association was found between changes in waist-to-height ratio (WHtR) and SBJ in both genders, whilst inverse low associations were found between WHtR and BAH in girls and for VO2max in both genders. CONCLUSION Changes in BMI, %BF and WHtR were negatively associated with strength and running performances in the participating children. The relative increase in overweight, especially in girls, negatively affected their endurance running and static strength performances. The health implications of the observed findings are discussed and recommendations offered for physical activity intervention in school physical education (PE) programmes.
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Affiliation(s)
| | - Makama A Monyeki
- Physical Activity, Sport and Recreation Focus Area, North-West University, Potchefstroom Campus.
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Hao W, Yi H, Liu Z, Gao Y, Eshita Y, Guo W, Zhang H, Sun J. Gender comparisons of physical fitness indexes in Inner Mongolia medical students in China. Glob J Health Sci 2014; 7:220-7. [PMID: 25560355 PMCID: PMC4796522 DOI: 10.5539/gjhs.v7n1p220] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2014] [Accepted: 07/18/2014] [Indexed: 11/12/2022] Open
Abstract
Introduction: The aim of present study was to investigate gender differences in physical fitness indexes in regard to BMI (body mass index) levels among Inner Mongolia medical students in China. Methods: Data on participant characteristics came from basic information contained in the school database. Physical fitness indexes including BMI, vital capacity index, sidestep test, and standing long jump, were conducted. Results: Female students had a higher rate of normal weight than those of males. The obesity rate of males was 5 times higher compared to females. Compared with male students, female students had a higher pass rate in vital capacity index, sidestep and standing long jump. Females were higher 17% than males in the pass rate of the sidestep test. Males performed better than females in the standing long jump. In both the malnutrition and normal weight group, the pass rate of the 3 physical fitness indexes for both male and female students was higher than obese group. The not pass rate was higher than pass rate both male and female students in the vital capacity index in the obese group. Discussion: Males had a poor physical fitness level compared with females. Male students may be more likely to spend more time using computers and it will cut down the time of participating in physical activities. So, in our university, more attention should pay on physical education, especially for males.
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Affiliation(s)
| | | | | | | | | | | | | | - Juan Sun
- Inner Mongolia Medical University.
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Regaieg S, Charfi N, Kamoun M, Ghroubi S, Rebai H, Elleuch H, Feki MM, Abid M. The effects of an exercise training program on body composition and aerobic capacity parameters in Tunisian obese children. Indian J Endocrinol Metab 2013; 17:1040-1045. [PMID: 24381881 PMCID: PMC3872682 DOI: 10.4103/2230-8210.122619] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND The prevalence of children obesity is rising alarmingly in both developed and developing countries. Developing effective exercise programs is a strategy for decreasing this prevalence and limiting obesity-associated long-term comorbidities. OBJECTIVES To determine whether a 16-week training program; in addition to the school physical education and without dietary intervention; could have beneficial effects on body composition and aerobic capacity of obese children. MATERIALS AND METHODS Twenty-eight obese children (16 boys, 12 girls; aged 12-14 years) were enrolled and were divided into either the exercise group (EG, n = 14) or the control group (CG, n = 14). EG participated in a 16-week aerobic exercises (four 60-min sessions per week at 70-85% of HRmax (maximum heart rate)), in addition to the school physical education. Fat-Free Mass (FFM) and Fat Mass (FM) were assessed with bioelectrical impedance equipment. To assess aerobic capacity, maximal metabolic equivalent of task (METmax) and maximal workload (Wmax) were estimated with an electronically braked cycle ergometer (type Ergoline 500(®)). RESULTS At baseline, there were no differences between the two groups. After the training program, only the EG showed significant reduction in BMI (body mass index) and waist circumference compared with the baseline values (P < 0.001). Exercise training significantly decreased FM only in the EG. A significant increase in FFM was seen in both groups; more marked in the EG. There was a significant increase in METmax (P < 0.05) and Wmax (P = 0.02) in the EG, and no significant changes in these parameters were seen in the CG. HRmax significantly decreased only in the EG (P < 0.05). CONCLUSION This training program has beneficial effects on body composition and aerobic capacity parameters in obese children. Our intervention has the advantage of providing a sustainable and reproducible school and community approach for the management of children obesity.
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Affiliation(s)
- Sofien Regaieg
- Department of Endocrinology, Hedi Chaker Hospital, Jarzouna Bizerte, Tunisia
- Department of Endocrinology, Faculty of Sciences of Bizerte, Jarzouna Bizerte, Tunisia
| | - Nadia Charfi
- Department of Endocrinology, Hedi Chaker Hospital, Jarzouna Bizerte, Tunisia
| | - Mahdi Kamoun
- Department of Endocrinology, Hedi Chaker Hospital, Jarzouna Bizerte, Tunisia
| | - Sameh Ghroubi
- Department of Physical and Rehabilitation Medicine, Habib Bourguiba Hospital, Sfax, Tunisia
| | - Haithem Rebai
- Higher Institute of Sport and Physical Education, Sfax, Tunisia
| | - Habib Elleuch
- Department of Physical and Rehabilitation Medicine, Habib Bourguiba Hospital, Sfax, Tunisia
| | - Mouna Mnif Feki
- Department of Endocrinology, Hedi Chaker Hospital, Jarzouna Bizerte, Tunisia
| | - Mohamed Abid
- Department of Endocrinology, Hedi Chaker Hospital, Jarzouna Bizerte, Tunisia
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Abstract
Considerable evidence has accrued that cardiovascular disease (CVD) has its beginnings during childhood, with some reports of endothelial damage occurring in early adolescence. Thus, early prevention and intervention on developing cardiometabolic risk factors is important. Presently, diet and exercise are strategic parts of any CVD prevention or treatment program. Although diet is important, the effects of exercise training or regular moderate-to-vigorous intensity physical activity go beyond simply modifying the traditional risk factors. For children, the majority of studies show that regular physical activity can lower elevated blood pressure, positively influence lipid profiles, reduce inflammation, and improve vascular functioning. These changes are most evident in children who exercise and lose weight. Despite these potential benefits of physical activity, not all studies on children have found positive effects of habitual physical activity on CVD risk factors. Reasons for these differences are discussed throughout this review. The literature also suggests that habitual physical activity, although meeting guidelines, may not be sufficient for all individuals to bring about changes; thus, to be an effective modality physical activity needs to increase beyond habitual levels or be of a moderate to vigorous intensity. This review provides recent evidence (since 2008) regarding the influence of physical activity on the cardiometabolic risk factors in children.
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Affiliation(s)
- Robert G. McMurray
- Departments of Exercise and Sport Science and Nutrition, University of North Carolina, Chapel Hill (RGM)
- Center for the Study of Sport and Exercise, Seattle University, Seattle, Washington (KSO)
| | - Kristin S. Ondrak
- Departments of Exercise and Sport Science and Nutrition, University of North Carolina, Chapel Hill (RGM)
- Center for the Study of Sport and Exercise, Seattle University, Seattle, Washington (KSO)
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Dobbins M, Husson H, DeCorby K, LaRocca RL. School-based physical activity programs for promoting physical activity and fitness in children and adolescents aged 6 to 18. Cochrane Database Syst Rev 2013; 2013:CD007651. [PMID: 23450577 PMCID: PMC7197501 DOI: 10.1002/14651858.cd007651.pub2] [Citation(s) in RCA: 424] [Impact Index Per Article: 38.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND The World Health Organization (WHO) estimates that 1.9 million deaths worldwide are attributable to physical inactivity and at least 2.6 million deaths are a result of being overweight or obese. In addition, WHO estimates that physical inactivity causes 10% to 16% of cases each of breast cancer, colon, and rectal cancers as well as type 2 diabetes, and 22% of coronary heart disease and the burden of these and other chronic diseases has rapidly increased in recent decades. OBJECTIVES The purpose of this systematic review was to summarize the evidence of the effectiveness of school-based interventions in promoting physical activity and fitness in children and adolescents. SEARCH METHODS The search strategy included searching several databases to October 2011. In addition, reference lists of included articles and background papers were reviewed for potentially relevant studies, as well as references from relevant Cochrane reviews. Primary authors of included studies were contacted as needed for additional information. SELECTION CRITERIA To be included, the intervention had to be relevant to public health practice (focused on health promotion activities), not conducted by physicians, implemented, facilitated, or promoted by staff in local public health units, implemented in a school setting and aimed at increasing physical activity, included all school-attending children, and be implemented for a minimum of 12 weeks. In addition, the review was limited to randomized controlled trials and those that reported on outcomes for children and adolescents (aged 6 to 18 years). Primary outcomes included: rates of moderate to vigorous physical activity during the school day, time engaged in moderate to vigorous physical activity during the school day, and time spent watching television. Secondary outcomes related to physical health status measures including: systolic and diastolic blood pressure, blood cholesterol, body mass index (BMI), maximal oxygen uptake (VO2max), and pulse rate. DATA COLLECTION AND ANALYSIS Standardized tools were used by two independent reviewers to assess each study for relevance and for data extraction. In addition, each study was assessed for risk of bias as specified in the Cochrane Handbook for Systematic Reviews of Interventions. Where discrepancies existed, discussion occurred until consensus was reached. The results were summarized narratively due to wide variations in the populations, interventions evaluated, and outcomes measured. MAIN RESULTS In the original review, 13,841 records were identified and screened, 302 studies were assessed for eligibility, and 26 studies were included in the review. There was some evidence that school-based physical activity interventions had a positive impact on four of the nine outcome measures. Specifically positive effects were observed for duration of physical activity, television viewing, VO2 max, and blood cholesterol. Generally, school-based interventions had little effect on physical activity rates, systolic and diastolic blood pressure, BMI, and pulse rate. At a minimum, a combination of printed educational materials and changes to the school curriculum that promote physical activity resulted in positive effects.In this update, given the addition of three new inclusion criteria (randomized design, all school-attending children invited to participate, minimum 12-week intervention) 12 of the original 26 studies were excluded. In addition, studies published between July 2007 and October 2011 evaluating the effectiveness of school-based physical interventions were identified and if relevant included. In total an additional 2378 titles were screened of which 285 unique studies were deemed potentially relevant. Of those 30 met all relevance criteria and have been included in this update. This update includes 44 studies and represents complete data for 36,593 study participants. Duration of interventions ranged from 12 weeks to six years.Generally, the majority of studies included in this update, despite being randomized controlled trials, are, at a minimum, at moderate risk of bias. The results therefore must be interpreted with caution. Few changes in outcomes were observed in this update with the exception of blood cholesterol and physical activity rates. For example blood cholesterol was no longer positively impacted upon by school-based physical activity interventions. However, there was some evidence to suggest that school-based physical activity interventions led to an improvement in the proportion of children who engaged in moderate to vigorous physical activity during school hours (odds ratio (OR) 2.74, 95% confidence interval (CI), 2.01 to 3.75). Improvements in physical activity rates were not observed in the original review. Children and adolescents exposed to the intervention also spent more time engaged in moderate to vigorous physical activity (with results across studies ranging from five to 45 min more), spent less time watching television (results range from five to 60 min less per day), and had improved VO2max (results across studies ranged from 1.6 to 3.7 mL/kg per min). However, the overall conclusions of this update do not differ significantly from those reported in the original review. AUTHORS' CONCLUSIONS The evidence suggests the ongoing implementation of school-based physical activity interventions at this time, given the positive effects on behavior and one physical health status measure. However, given these studies are at a minimum of moderate risk of bias, and the magnitude of effect is generally small, these results should be interpreted cautiously. Additional research on the long-term impact of these interventions is needed.
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Friedemann C, Heneghan C, Mahtani K, Thompson M, Perera R, Ward AM. Cardiovascular disease risk in healthy children and its association with body mass index: systematic review and meta-analysis. BMJ 2012; 345:e4759. [PMID: 23015032 PMCID: PMC3458230 DOI: 10.1136/bmj.e4759] [Citation(s) in RCA: 405] [Impact Index Per Article: 33.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/22/2012] [Indexed: 12/29/2022]
Abstract
OBJECTIVES To describe the association and its magnitude between body mass index category, sex, and cardiovascular disease risk parameters in school aged children in highly developed countries. DESIGN Systematic review and meta-analysis. Quality of included studies assessed by an adapted version of the Cochrane Collaboration's risk of bias assessment tool. Results of included studies in meta-analysis were pooled and analysed by Review Manager version 5.1. DATA SOURCES Embase, PubMed, EBSCOHost's cumulative index to nursing and allied health literature, and the Web of Science databases for papers published between January 2000 and December 2011. REVIEW METHODS Healthy children aged 5 to 15 in highly developed countries enrolled in studies done after 1990 and using prospective or retrospective cohort, cross sectional, case-control, or randomised clinical trial designs in school, outpatient, or community settings. Included studies had to report an objective measure of weight and at least one prespecified risk parameter for cardiovascular disease. RESULTS We included 63 studies of 49 220 children. Studies reported a worsening of risk parameters for cardiovascular disease in overweight and obese participants. Compared with normal weight children, systolic blood pressure was higher by 4.54 mm Hg (99% confidence interval 2.44 to 6.64; n=12 169, eight studies) in overweight children, and by 7.49 mm Hg (3.36 to 11.62; n=8074, 15 studies) in obese children. We found similar associations between groups in diastolic and 24 h ambulatory systolic blood pressure. Obesity adversely affected concentrations of all blood lipids; total cholesterol and triglycerides were 0.15 mmol/L (0.04 to 0.25, n=5072) and 0.26 mmol/L (0.13 to 0.39, n=5138) higher in obese children, respectively. Fasting insulin and insulin resistance were significantly higher in obese participants but not in overweight participants. Obese children had a significant increase in left ventricular mass of 19.12 g (12.66 to 25.59, n=223), compared with normal weight children. CONCLUSION Having a body mass index outside the normal range significantly worsens risk parameters for cardiovascular disease in school aged children. This effect, already substantial in overweight children, increases in obesity and could be larger than previously thought. There is a need to establish whether acceptable parameter cut-off levels not considering weight are a valid measure of risk in modern children and whether methods used in their study and reporting should be standardised.
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Affiliation(s)
- Claire Friedemann
- University of Oxford, Department of Primary Care Health Sciences, New Radcliffe House, Radcliffe Observatory Quarter, Oxford OX2 6GG, UK.
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Esmaeilzadeh S, Ebadollahzadeh K. Physical fitness, physical activity and sedentary activities of 7 to 11 year old boys with different body mass indexes. Asian J Sports Med 2012; 3:105-12. [PMID: 22942996 PMCID: PMC3426729 DOI: 10.5812/asjsm.34709] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2011] [Accepted: 01/12/2012] [Indexed: 12/11/2022] Open
Abstract
Purpose The purpose of this study was to examine the differences in physical fitness, physical activity, and sedentary activities among 7 to 11 year old boys with varying body mass index in Ardabil, Iran. Methods The sample consisted of 766 boys who participated in eight weight bearing (1 mile walk/run, sit ups, standing long jump, vertical jump, shuttle run 4 × 10 m, 30-meter sprint, pull ups, pushups) and four non-weight-bearing physical fitness tests (flamingo balance, handgrip; sit and reach and finger reaction time). Physical activity and sedentary activities were assessed by questionnaires. Body mass index (BMI) was computed to classify participants into normal weight, underweight, overweight and obese groups. Results The prevalence of underweight, overweight and obesity was 10.7%, 14.1% and 4.2% respectively. Cardiorespiratory fitness (VO2max) decreased progressively as the BMI increased and differences among the all body mass index categories were significant (P<0.01). Obese subjects performed worse in all weight bearing fitness tests than normal weight subjects (P<0.01). Moreover, overweight subjects performed worse in one mile, pushups and pull ups than normal weight subjects (P<0.01). Underweight subjects had significantly lower Pushups than normal weight subjects (P<0.01). Obese subjects had significantly higher sedentary activities and lower physical activity than other counterparts (P<0.01). Conclusions This study showed that weight bearing physical fitness, cardiorespiratory fitness and physical activity progressively decreased as the BMI increased and conversely, sedentary activities increased as the BMI increased.
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Affiliation(s)
- Samad Esmaeilzadeh
- Corresponding Author:Address: 15 Hashembiddar, Mofatteh St., Ardabil, Iran. E-mail:
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Monyeki MA, Neetens R, Moss SJ, Twisk J. The relationship between body composition and physical fitness in 14 year old adolescents residing within the Tlokwe local municipality, South Africa: the PAHL study. BMC Public Health 2012; 12:374. [PMID: 22626033 PMCID: PMC3461487 DOI: 10.1186/1471-2458-12-374] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2011] [Accepted: 05/24/2012] [Indexed: 11/10/2022] Open
Abstract
Background Little is known about the relationship between body composition and physical fitness in 14 year-old high school adolescents of South Africa. Baseline data from a longitudinal study on physical activity and health (PAHLS) may provide valuable information for future studies, hence to inform public health policy makers. The objectives of this study are to determine the prevalence of underweight, normal weight and overweight among adolescents aged 14 years in the Tlokwe Local Municipality of the North West Province of South Africa, and to assess the association between physical fitness and body composition separately for boys and girls, adjusted for race and locality. Methods Body weight, height and triceps, and subscapular skinfolds of 256 adolescents (100 boys and 156 girls) aged 14 years were measured, and percentage body fat and body mass index (BMI) were calculated. BMI was used to determine underweight, normal weight and overweight based on the standard criterion. Physical fitness was assessed by standing broad jump, bent arm hang and sit-ups according to the EUROFIT fitness standard procedures. Multinomial logistic regression analyses stratified for gender and adjusted for race (black or white), and the locality (urban or township) of the schools were used to analyze the data. Results In the total group 35.9% were underweight and 13.7% overweight. Boys were more underweight (44%) than girls (30.7%). The prevalence of overweight was 8% in boys and 17.3% in girls. BMI was strongly (p = 0.01) related with percentage body fat. Strong and significant positive associations between physical fitness and BMI for the underweight girls with high physical fitness scores (OR, 10.69 [95%CI: 2.81-40.73], and overweight girls with high physical fitness scores (OR, 0.11 [95%CI: 0.03-0.50]) were found. Non-significant weaker positive relationship between physical fitness and BMI for the underweight boys with high physical fitness scores (OR, 1.80 [95%CI: 0.63-5.09]), and the overweight boys with high physical fitness scores (OR, 0.18 [95%CI: 0.02-1.78]) were found. Conclusion Both underweight and overweight among boys and girls in Tlokwe Local Municipality exist, and their effects on physical fitness performances were also noticed. As such, strategic physical activity, interventions or follow-up studies recognizing this relationship particularly in the overweight adolescents are needed. In addition, authorities in health and education departments dealing with adolescents should make use of this evidence base information in policies development.
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Affiliation(s)
- Makama Andries Monyeki
- Physical Activity, Sport and Recreation Research Focus Area, Faculty of Health Sciences, North-West University, Meyer Street, Potchefstroom 2520, Republic of South Africa.
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Coledam DHC, Paludo AC, Oliveira ARD, Dos-Santos JW. Dynamic exercise versus tag game warm up: The acute effect on agility and vertical jump in children. JOURNAL OF HUMAN SPORT AND EXERCISE 2012. [DOI: 10.4100/jhse.2012.71.03] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Ben Ounis O, Elloumi M, Makni E, Zouhal H, Amri M, Tabka Z, Lac G. Exercise improves the ApoB/ApoA-I ratio, a marker of the metabolic syndrome in obese children. Acta Paediatr 2010; 99:1679-85. [PMID: 20594189 DOI: 10.1111/j.1651-2227.2010.01920.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
AIM This study was designed to examine the effect of training on components of the metabolic syndrome and ApoB/ApoA-I ratio in obese children. METHODS We studied thirty-two obese children (13.3 ± 0.4 years) with 16 subjects who participated to 8-week training and 16 subjects serving as a control group. Training was individualized at the point where fat oxidation was maximal (Fat max). In each subject, pre- and postintervention anthropometric measures and biochemical tests on fasting blood were performed. RESULTS After the programme, the training group showed an increase in VO(2peak) and fat oxidation during exercise. Body mass index (BMI), blood glucose and triglycerides were reduced, and high-density lipoprotein (HDL) was increased. ApoB/ApoA-I ratio decreased significantly (-0.43%, p < 0.01). Systolic and diastolic blood pressure also decreased (-8.4% and -10.9%, respectively). Among the training group, 10 subjects were classified as having the metabolic syndrome before the intervention and none after. No significant changes in any other variables were measured in the control group. CONCLUSIONS Training targeted at Fat max reduces the prevalence of metabolic syndrome and its associated factors in obese children. In particular, this intervention decreases the ApoB/ApoA-I ratio, which may be considered as a marker for following this syndrome.
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Affiliation(s)
- O Ben Ounis
- Laboratoire des adaptations cardio-circulatoires, respiratoires, métaboliques et hormonales à l'exercice, faculté de médecine, Sousse, Tunisie.
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The Association of Weight Status with Physical Fitness among Chinese Children. Int J Pediatr 2010; 2010:515414. [PMID: 20652083 PMCID: PMC2905728 DOI: 10.1155/2010/515414] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2010] [Revised: 04/02/2010] [Accepted: 06/03/2010] [Indexed: 01/15/2023] Open
Abstract
Objective. To investigate the association of weight status with physical fitness among Chinese children. Methods. A total of 6929 children aged 6–12 years were selected from 15 primary schools of 5 provincial capital cities in eastern China. The height and fasting body weight were measured. The age-, sex-specific BMI WHO criteria was used to define underweight, overweight and obesity. Physical fitness parameters including standing broad jump, 50 m sprint, and 50 m∗8 shuttle run were tested. Results. The prevalence of underweight, overweight, and obesity was 3.1%, 14.9%, and 7.8%, respectively. Boys performed better than girls, and the older children performed better than their younger counterparts for all physical fitness tests. No significant difference in all three physical fitness tests were found between children with underweight and with normal weight, and they both performed better than their counterparts with overweight and obese in all three physical fitness tests. The likelihood of achieving good performance was much lower among overweight and obese children in comparison with their counterparts with normal weight (OR = 0.13–0.54). Conclusions. An inverse association of obesity with cardiorespiratory fitness, muscle explosive strength, and speed was identified among Chinese children.
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