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Normative reference values for the 20-meter shuttle-run test in a population-based sample of school-aged youth in Bogota, Colombia: The FUPRECOL Study
Abstract and Figures
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). We expressed CRF performance as the nearest stage (minute) completed and the estimated peak oxygen consumption (V˙O2peak) and smoothed percentile curves were calculated. In addition, we also present the prevalence of low CRF after applying a previously suggested correction factor, to account for the impact of Bogota’s altitude (2,625 meters 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 = 0.001). 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 = 0.001).
Conclusions: Our results provide sex- and age-specific normative reference standards for the 20-meter 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.
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Supplementary resources (5)
... Previous studies by Janz et al. [15] and Castillo-Garzón et al. [16] showed that a low cardiorespiratory fitness (CRF) level during childhood was associated with a higher risk of cardiovascular and metabolic disease during adulthood. Moreover, it has been described that a lower CRF level in children and adolescents from 9 to 17 years of age is a predictive factor of physical well-being in school-aged children [17,18]; hence, including this health indicator in epidemiological surveillance systems at the educational level is clearly justified [19]. ...
... And the CRF, estimated using a cycle-ergometer, was associated with better scores in the SRH in Colombia, which is a result that agrees with our study. We found that an unhealthy CRF in children and adolescents is a predictive factor of physical well-being [17,18]. It is important to delve into the components of SRH to detect risk factors associated with enduring future diseases with the aim of implementing different interventions with a perspective of primary health care. ...
... A previous study [47] has tested the degree of agreement between various equations used to estimate VO 2 peak and the actual VO 2 peak. The equation used to estimate VO 2 peak in this study may have underestimated CRF by up to 12% relative to other methods and therefore may have, in isolation, inflated the prevalence of unhealthy aerobic capacity [18,48,49]. Therefore, we considered our low CRF estimates to be conservative. ...
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 7,402 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 behaviours and prevent future diseases during adulthood.
... Previous studies by Janz et al. [15] and Castillo-Garzón et al. [16] showed that a low cardiorespiratory fitness (CRF) level during childhood was associated with a higher risk of cardiovascular and metabolic disease during adulthood. Moreover, it has been described that a lower CRF level in children and adolescents from 9 to 17 years of age is a predictive factor of physical well-being in school-aged children [17,18]; hence, including this health indicator in epidemiological surveillance systems at the educational level is clearly justified [19]. ...
... And the CRF, estimated using a cycle-ergometer, was associated with better scores in the SRH in Colombia, which is a result that agrees with our study. We found that an unhealthy CRF in children and adolescents is a predictive factor of physical well-being [17,18]. It is important to delve into the components of SRH to detect risk factors associated with enduring future diseases with the aim of implementing different interventions with a perspective of primary health care. ...
... A previous study [47] has tested the degree of agreement between various equations used to estimate VO 2 peak and the actual VO 2 peak. The equation used to estimate VO 2 peak in this study may have underestimated CRF by up to 12% relative to other methods and therefore may have, in isolation, inflated the prevalence of unhealthy aerobic capacity [18,48,49]. Therefore, we considered our low CRF estimates to be conservative. ...
Introducción: La morbilidad sentida (MS) hace referencia a la información suministrada por las personas acerca de su estado de salud como producto de sus conocimientos e interpretaciones. En la actualidad, se desconoce si la MS se relaciona con los niveles de condición física (CF) en escolares de Colombia.
Objetivo:
Determinar la relación entre la morbilidad sentida y el autoreporte de la condición física en escolares de Bogotá, Colombia, pertenecientes al estudio FUPRECOL.
Métodos: Se ha utilizado la encuesta de MS del estudio HBSC (Health Behaviour in School-aged Children) que indaga por autopercepción de síntomas como: dolor de cabeza, dolor de estómago, dolor de espalda, bajo estado de ánimo, nerviosismo e irritabilidad y mal genio. La CF se determinó con el cuestionario IFIS (The International Fitness Scale) en los componentes condición física general, aeróbica, fuerza muscular, velocidad/agilidad y flexibilidad, en una muestra de 3.332 niños y 3.413 adolescentes (56,6% mujeres) entre los 9 y 17.9 años de edad, procedentes de 24 escuelas públicas de Bogotá, Colombia.
Resultados: La irritabilidad y mal genio fue el síntoma más frecuentemente reportado en el 46,5% de los adolescentes y 36,6% de los niños, seguido del nerviosismo (25,7% adolescentes y 25,5% niños) y el dolor de cabeza (31% adolescentes y 27% niños). Cerca del 40% de los evaluados perciben como «muy mala y mala» los cinco componentes de la CF estudiados. En población general, los participantes que acusaron mejor condición aeróbica, mostraron menor frecuencia en los síntomas: dolor de cabeza (47,9% vs 65,5%; p=0,05), dolor de espalda (21,6% vs 75,8%; p=0,05), irritabilidad (12,3% vs 51,7%; p=0,01) y nerviosismo (15,7% vs 66,9%; p=0,05). Esta misma tendencia se observó con el autoreporte de la condición física general, fuerza muscular y flexibilidad (p<0,05).
Conclusión: El incremento en la frecuencia y en los síntomas asociados con la MS se relaciona con el deterioro en la autopercepción de la condición física en los escolares evaluados. Estos resultados indican la necesidad de mejorar el nivel de condición física de los escolares de Bogotá, Colombia.
... For the calculation of VO 2 max the following formula was used: VO 2 max=5.857 x Speed (Km/h) -19.458 5,8,15,17 . Participants were quoted in the morning hours (between 8-10 AM, GMT-5), times when exposure to sunlight was not so intense as to reduce each subject's physical performance, and thus, avoid biases in the results. ...
... However, no statistically significant difference was found (p> 0.05). 15 , who evaluated this same test in schoolchildren, finding closeness among the values reported by the SRT-20m compared to laboratory test data; however, these authors indicate the importance of applying a correction factor; in order to adjust aspects that at high altitudes become analysis variables such as: temperature, humidity, barometric pressure and physiological adaptations of subjects. ...
Introducción: Diversas investigaciones han empleado las pruebas de campo con la finalidad de establecer el fitness cardiorrespiratorio a partir del VO2máx obtenido; no obstante, en condiciones de gran altitud pueden existir variaciones que influencien el comportamiento de esta variable en sujetos sanos entrenados y no entrenados. Objetivo: El objetivo de este estudio fue comparar el VO2max obtenido mediante dos pruebas de campo: Cooper Run Test y Shuttle Run Test 20 metros (CRT y SRT-20m) y los valores obtenidos mediante ergoespirometría. Método: Estudio descriptivo de corte transversal; participaron 30 sujetos entrenados (8 mujeres 22 hombres), con una edad promedio de 19,0 ± 2,2 años para las mujeres y 20,1 ± 2,1 años para los hombres. Se aplicó un análisis de varianza de una vía; posteriormente se realizó un análisis post hoc con el procedimiento de Games-Howell, que es más poderoso en muestras pequeñas (p<0.01). Resultados: No se encontraron diferencias significativas en la media del VO2max para SRT-20m y el método directo, sin embargo, con respecto al CRT, se presentaron diferencias (p <0.01), reflejando la mayor precisión de la rueba SRT-20m para estimar el VO2max. en la muestra evaluada. Conclusiones: Nuestros resultados sugirieron que SRT-20m predijo los valores de VO2máx de manera cercana a los datos reportados en ergoespirometría tanto en hombres como en mujeres que habitan a gran altitud. Se justifica la investigación adicional con tamaños de muestra más grandes.
... For the calculation of VO 2 max the following formula was used: VO 2 max=5.857 x Speed (Km/h) -19.458 5,8,15,17 . Participants were quoted in the morning hours (between 8-10 AM, GMT-5), times when exposure to sunlight was not so intense as to reduce each subject's physical performance, and thus, avoid biases in the results. ...
... However, no statistically significant difference was found (p> 0.05). 15 , who evaluated this same test in schoolchildren, finding closeness among the values reported by the SRT-20m compared to laboratory test data; however, these authors indicate the importance of applying a correction factor; in order to adjust aspects that at high altitudes become analysis variables such as: temperature, humidity, barometric pressure and physiological adaptations of subjects. ...
Introduction: Various research has used field tests to establish cardiorespiratory fitness from VO 2 max obtained; however, under high altitude conditions there may be variations that influence the behavior of this variable untrained and untrained healthy subjects. Objective: The objective of this study was to compare the VO 2 max obtained by means of two field tests: Cooper Run Test and Shuttle Run Test 20 meters (CRT and SRT-20m) and the values obtained by ergospirometry in trained university students above 2600 masl. Method: Descriptive cross-sectional study;30 trained subjects (8 women 22 men) participated, with ± an average age of 19.0 to 2.2 years for women and 20.1 ± to 2.1 years for men. A one-way variance analysis was applied; a post hoc analysis was subsequently performed with the Games-Howell procedure which is most powerful in small samples (p<0.01). Results: No significant differences were founding the VO 2 max mean for SRT-20m and the direct method, however, with respect to the CRT, differences were presented (p <0.01), reflecting the higher accuracy of the SRT-20m test to estimate the VO 2 max in the sample evaluated. Conclusions: Our results suggested that SRT-20m predicted VO 2 max closely to data reported in ergospirometry in both men and women living at high altitude. Additional research with larger sample sizes is warranted. MÉD.UIS.2021;34(1): 19-26.
... 15 El grupo masculino obtuvo mayor CF en ambos grupos, lo que coincidió con varios estudios. 10,[16][17][18] Esta diferencia se debió a diversos factores: morfofuncionales, psicosociales y de hábitos de actividad física. 19,20 en correr ida y vuelta entre dos líneas separadas por 10 m, transportando 3 esponjas alternadamente en el menor tiempo posible. ...
... En cuanto al componente cardiorrespiratorio en los participantes masculinos y femeninos, fueron similares a 3 estudios, pertenecientes a Uruguay, Chile y Colombia, 16,23,24 e inferiores a 3 estudios, pertenecientes a Canadá, 25 Colombia (ajustado por la altitud) 17 y Colombia (etnia). 26 Por último, nos parece importante resaltar una limitación del estudio. ...
RESUMEN
Introducción. Actualmente, se desconocen las características de la condición física (CF) en
niños y adolescentes escolares de la provincia de Neuquén. Por eso, desde la Secretaría de
Deporte de dicha provincia, se desarrolló el Plan de Evaluación de la Condición Física. El
principal propósito del estudio fue aplicar la batería ALPHA-Fitness en escolares neuquinos,
con el objetivo de construir tablas normativas de referencia de la CF.
Población y métodos. 4487 alumnos neuquinos de ambos sexos, de entre 9 y 18,9 años de edad, fueron evaluados con la batería ALPHA-Fitness de alta prioridad en 4 componentes de la CF: 1) Morfológico: peso corporal y estatura para calcular el índice de masa corporal; 2) Muscular: salto en largo sin carrera previa; 3) Motor: 4 x 10 m para evaluar la velocidad/agilidad; y 4) Cardiorrespiratorio: test de ida y vuelta en 20 m (20 m-SRT; por shuttle run test). Resultados. El índice de masa corporal medio
obtenido fue 22,9 ± 4,7 kg/m2; se clasificó el 25 % en la categoría sobrepeso, y el 12,7 %, en
obesidad. Los valores medios obtenidos para la CF fueron componente cardiorrespiratorio:
4,3 ± 2,5 etapas, 10,1 ± 1,2 km/h, volumen de oxígeno máximo de 38,7 ± 6,7 ml/kg/min; salto
en largo: 147,3 ± 34,6 cm; motor: 13,0 ± 1,5 s. Los sujetos masculinos tuvieron mayor rendimiento en las pruebas de CF (p < 0,001). Conclusión. Los resultados de este estudio
proveen las primeras tablas normativas de CF en niños y adolescentes de ambos sexos para la provincia de Neuquén, Argentina. Palabras clave: prueba de esfuerzo, 20m-SRT,
valores de referencia, ALPHA-Fitness.
... 15 Males showed a better PF performance, which was consistent with several studies. 10,[16][17][18] Such difference was the result of various morphofunctional, psychosocial, and physical activity habit factors. 19,20 ...
... 16,23 The speed/agility levels in both male and female participants were similar to those found in a study from Uruguay. 23 The cardiorespiratory component outcomes in both male and female participants were similar to those of three studies from Uruguay, Chile, and Colombia, 16,23,24 but lower than those of three other studies from Canada, 25 Colombia (adjusted for altitude) 17 , and Colombia (ethnicity). 26 Lastly, it is worth noting a limitation of this study: rural schools were not included due to logistical reasons. ...
Introduction:
At present, there is no information about the physical fitness (PF) of children and adolescents attending school in the province of Neuquén. The provincial Department of Sports developed the Physical Fitness Assessment Plan. The main objective of this study was to administer the ALPHA-Fitness test battery to the students of Neuquén in order to develop PF reference standards.
Population and methods:
A total of 4487 male and female students of Neuquén aged 9-18.9 years were assessed based on four PF components of the high priority ALPHA-Fitness test battery: 1) morphological: body weight and height to estimate body mass index; 2) musculoskeletal: standing long jump test; 3) motor: 4 x 10 m speed/ agility test; and 4) cardiorespiratory: 20-m shuttle run test (SRT).
Results:
The mean body mass index was 22.9 ± 4.7 kg/m2; 25 % of participants were overweight and 12.7 %, obese. The mean values for the cardiorespiratory component were 4.3 ± 2.5 stages, 10.1 ± 1.2 km/h, maximal oxygen volume of 38.7 ± 6.7 mL/kg/min; standing long jump: 147.3 ± 34.6 cm; and for the motor component: 13.0 ± 1.5 s. Male participants had a better performance in PF tests (p < 0.001).
Conclusion:
The study results provide the first PF standards for male and female children and adolescents of the province of Neuquén, Argentina.
... They ran in a straight line between two lines 20 m apart, while keeping pace with pre-recorded audio signals. The initial speed was 8.5 km/h and was increased by 0.5 km/h per minute [25,26]. A detailed description of 20-m shuttle run, and to estimate VO 2 max using the formulas described by Leger et al. [25] can be found elsewhere [5]. ...
... By sex, the proportion of subjects with an unhealthy CRF were 3.8% in boys and 11.7% in girls (X 2 = 0.001). These results are substantially lower than those observed in previous international studies conducted with adolescents (26% of boys and 55% of girls in Chile [44]; 38% of boys and 43% of girls in the European Union [45]; 29% of boys and 23% of girls in Australia [46]; 29% of boys and 31% of girls in the United States [26]; and 11.5% of children and 49.1% of adolescents in Argentina [47]. ...
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 (X2 p = 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.
... The 50th percentiles of maximal oxygen uptake (VO2max) of Tunisian boy soccer players are compared with those of Greek boy soccer players [20] , as well as with those of untrained J o u r n a l P r e -p r o o f boy participants of Colombia [34], US [35], and with data sets of international 20m shuttle run test [36]. ...
This study aimed to develop reference curves of aerobic parameters of 20 m shuttle run test for Tunisian soccer players. The study was conducted in the 2022/2023 pre-season. The reference curves of the maximal aerobic speed (MAS) and the maximal oxygen uptake (VO2max) were developed according to the Lambda, Mu and Sigma (LMS) method, using data from 742 Tunisian premier league soccer players aged 11–18 years. Measured variables included: weight, height, body mass index and maximal heart rate (HRmax). HRmax was measured when the participants completed the maximal aerobic speed. VO2max was estimated using the 20 m shuttle run test protocol (speed increment every minute). Our results presented the smoothed percentiles (3rd, 10th, 25th, 50th, 75th, 90th and 97th) of MAS (km/h) and VO2max (ml/kg•min⁻¹) according to age. In addition, raw data showed that VO2 max was positively correlated with age (r = 0.333; P < 0.001), height (cm) (r = 0.279; P < 0.001), weight (kg) (r = 0.266; P < 0.001), practice period (years) (r = 0.324; P < 0.001) and BMI (kg/m²) (r = 0.10; P < 0.05). However, it was negatively correlated to HRmax (bpm) (r = −0.247; P < 0.001). Only the measurements within the age group [12–12.99] are significantly higher (p < 0.001; ES = 0.63) compared with the previous age group [11–11.99]. Finally, regarding prevalence, our findings showed that 15.5 % of the players in our sample had VO2max values above the 87.7th percentile cut-off, while only 0.3 % exceeded the 99.18th percentile. The development of normative curves could help coaches and physical trainers to more accurately detect weaknesses in the aerobic performance of their players in order to sustain high-intensity repetitive actions during a soccer match.
... Another mechanism for sex-related differences may be due to more pronounced activities of moderate and vigorous intensities performed by boys, while girls engage in lower intensity physical activity [35]. In boys, cardiorespiratory performance steadily increased, but was the steepest between the ages 11 and 14, which is similar to one other study [36]. The level of VO 2 max obtained in our study was similar to other findings from Portuguese [18] and Norwegian [35] adolescents. ...
Although defining normative values of cardiorespiratory fitness have been the topic of many Western societies, little evidence has been provided for less developed countries like Croa-tia. Since cardiorespiratory fitness rapidly declines in Croatian children and adolescents, the newly established normative values would help health-related professionals and physical education teachers to detect 'talented' groups and direct them towards sport and 'risky' groups for planning special interventions. Therefore, the main purpose of the study was to determine normative reference values of cardiorespiratory fitness. A total of 1,612 children and adolescents aged 7-14 years (mean±SD; age 9.7±2.4 years; stature 151.0±17.6 cm; body mass 45.1±19.1 kg; 52.5% girls) participated in this cross-sectional study. Cardiorespi-ratory fitness was assessed by the Maximal multistage 20-m shuttle run test and the performance was expressed as the number of stages. Maximal oxygen uptake (VO 2 max) was estimated by equations. Smoothed percentile curves were calculated. Boys outperformed girls in the maximal number of levels achieved after the 20-m shuttle run test and in the VO 2 max values at each age category. In boys, a gradually higher level of performance between ages 11 and 14 was observed, while in girls the values started to rise after the age of 8. Our study provides one of the first sex-and age-specific normative values for cardiore-spiratory fitness assessed by the 20-m shuttle run test in Croatian children and adolescents.
... Resistance training was effective in improving both aspects of fitness and components of body composition. Combined with epidemiological evidence suggesting that while the present population has both lower cardiorespiratory fitness [40] and strength [11,12], but have a relatively larger strength deficit than youth in high income countries, a higher priority should be given to reversing the historical under-promotion of resistance training in youth and providing access to resistance training programs to youth in Colombia and other countries with a similar profile. Nonetheless, more research is needed to evaluate means to deliver the resistance training stimulus within the school setting, such as integrating it within PE class, or before/after school. ...
The aim of this study was to evaluate the impact on muscle strength, aerobic fitness and body composition, of replacing the physical education (PE) class of Colombian adolescents with resistance or aerobic training. 120 tanner stage 3 adolescents attending a state school were randomized to resistance training, aerobic training, or a control group who continued to attend a weekly 2-hour PE class for 16 weeks. The resistance training and aerobic training groups participated in twice weekly supervised after-school exercise sessions of < 1 hour instead of their PE class. Sum of skinfolds, lean body mass (bioelectrical impedance analysis), muscular strength (6 repetition maximum (RM)) bench press, lateral pulldown and leg press) and estimated cardiorespiratory fitness (multistage 20 meter shuttle run) were assessed at pre and post intervention. Complete data were available for n = 40 of the resistance training group, n = 40 of the aerobic training group and n = 30 PE (controls). Resistance training attenuated increases in sum of skinfolds compared with controls (d = 0.27, [0.09-0.36]). We found no significant effect on lean body mass. Resistance training produced a positive effect on muscle strength compared with both controls (d = 0.66 [.49-.86]) and aerobic training (d = 0.55[0.28-0.67]). There was a positive effect of resistance training on cardiorespiratory fitness compared with controls (d = 0.04 [-0.10-0.12]) but not compared with aerobic training (d = 0.24 [0.10-0.36]). Replacing a 2-hour PE class with two 1 hour resistance training sessions attenuated gains in subcutaneous adiposity, and enhanced muscle strength and aerobic fitness development in Colombian youth, based on a median attendance of approximately 1 session a week. Further research to assess PLOS ONE
... The number of laps completed by all participants was recorded and the VO 2peak of Tibetan children and adolescents was estimated by using Leger's equation [38]. This approach has a moderate-to-high criterion-related validity (r p = 0. 78 [39] and a test-retest reliability coefficient of 0.89 for children; therefore, it is frequently used to estimate VO 2peak worldwide [26,40,41] MAS = 8 + 0.5×Stage VO 2peak = 31.025 + 3.238 � MAS-3.248 ...
Background
Cardiorespiratory fitness (CRF) is the core element of health-related physical fitness evaluation. High pressure and low oxygen in Tibet (over 3,500 m above sea level) may negatively impact the residents’ CRF. The 20-m shuttle run test (20mSRT) is the most popular field-based assessment and estimate of CRF in children and adolescents worldwide. However, normative CRF data for the children and adolescents residing in China’s plateau region are unavailable, which prevents comparability among those living at high-altitudes around the world.
Purpose
To measure the CRF of Chinese children and adolescents aged 9–18 years living in Tibet at altitudes exceeding 3,500 m, and to identify correlations between this metric and demographic characteristics (age, sex, and ethnicity). These data were then compared with those generated in the lowland (Shanghai, China) and various global regions.
Methods
20mSRT performance (number of completed laps) and predicted peak oxygen consumption (VO2peak) were used as indicators of CRF. We measured the CRF of 1,717 healthy children and adolescents aged 9–18 years living in Tibet. The CRF data from school-age subjects in Shanghai (2,437 boys and 2,396 girls) and worldwide (1,142,026 students from 50 countries/regions in Africa, Asia, Europe, Latin America, North America, and Oceania) were collated from published papers.
Results
The average CRF of the participants from Tibet was 39.8 mL/kg/min. The male subjects (n = 876; 41.1 ± 4.42 mL/kg/min) had a higher average CRF than their female counterparts (n = 841; 37.8 ± 5.40 mL/kg/min). CRF decreased with age in both sexes at statistical significance (F = 1249.9, p for trend 0.05). The indigenous Tibetans (n = 1289; 40.1 ± 3.71 mL/kg/min) had a significant higher average CRF than those of Han descent (n = 394; 38.9 ± 4.70 mL/kg/min) ( p < 0.05).
Conclusions
Children and adolescents aged 7–18 years residing above 3,500 m in Tibet displayed lower CRF traits compared with their counterparts from the plains area and other high altitude places. CRF varied according to age, sex, and ethnic group. Given the importance of CRF in children and adolescents, effective intervention strategies should be implemented to improve CRF in children and adolescents on the plateau.
... Resistance training was effective in improving both aspects of fitness and components of body composition. Combined with epidemiological evidence suggesting that while the present population has both lower cardiorespiratory fitness [40] and strength [11,12], but have a relatively larger strength deficit than youth in high income countries, a higher priority should be given to reversing the historical under-promotion of resistance training in youth and providing access to resistance training programs to youth in Colombia and other countries with a similar profile. Nonetheless, more research is needed to evaluate means to deliver the resistance training stimulus within the school setting, such as integrating it within PE class, or before/after school. ...
The aim of this study was to evaluate the impact on muscle strength, aerobic fitness and body composition, of replacing the physical education (PE) class of Colombian adolescents with resistance or aerobic training. 120 tanner stage 3 adolescents attending a state school were randomized to resistance training, aerobic training, or a control group who continued to attend a weekly 2-hour PE class for 16 weeks. The resistance training and aerobic training groups participated in twice weekly supervised after-school exercise sessions of < 1 hour instead of their PE class. Sum of skinfolds, lean body mass (bioelectrical impedance analysis), muscular strength (6 repetition maximum (RM)) bench press, lateral pulldown and leg press) and estimated cardiorespiratory fitness (multistage 20 meter shuttle run) were assessed at pre and post intervention. Complete data were available for n = 40 of the resistance training group, n = 40 of the aerobic training group and n = 30 PE (controls). Resistance training attenuated increases in sum of skinfolds compared with controls (d = 0.27, [0.09-0.36]). We found no significant effect on lean body mass. Resistance training produced a positive effect on muscle strength compared with both controls (d = 0.66 [.49-.86]) and aerobic training (d = 0.55[0.28-0.67]). There was a positive effect of resistance training on cardiorespiratory fitness compared with controls (d = 0.04 [-0.10-0.12]) but not compared with aerobic training (d = 0.24 [0.10-0.36]). Replacing a 2-hour PE class with two 1 hour resistance training sessions attenuated gains in subcutaneous adiposity, and enhanced muscle strength and aerobic fitness development in Colombian youth, based on a median attendance of approximately 1 session a week. Further research to assess PLOS ONE
... Indeed, at its core the 20mSRT is not a direct measure of peak oxygen consumption (VO 2peak ) and as such, is not able to comment on the exact amount of oxygen a moving body can take in, transport and use. Some authors have criticized the test's ability to adequately estimate CRF, instead suggesting it better estimates body fatness Welsman and Armstrong, 2019), although this argument does not appear to consider that the 20mSRT can be an appropriate predictor of future health in its own right (García-Hermoso et al., 2020), and a suitable marker of current health status (Ramírez-Vélez et al., 2017;Lang et al., 2018a), independent of adiposity (Machado-Rodrigues et al., 2014). Thus, the 20mSRT remains a useful and widely accessible test for population health research, especially when it is conducted in a standardized way, and provided the resultant measurements are interpreted within the scope of the tool. ...
Objectives
Determine the temporal trends in cardiorespiratory fitness (CRF) and health risk of Slovenian schoolchildren across a 20-year span, assessed via 20-m shuttle run (20mSRT), including defining centile ranges and possible health risk(s) for each generation.
Methods
Nationally representative data from 9,426 healthy schoolchildren (6–14 years old) were used to determine changes in CRF across three generations, in 1993 (n = 3,174), 2003 (n = 3,457) and 2013 (n = 2,795) from a multistage, stratified, decennial study.
Results
20mSRT performance declined ∼2.8% from 1993 to 2003, independent of age or sex of the child. This trend was reversed in 2013, increasing by ∼8.2% across all age groups, for both girls and boys, for a net increase of 5.4%. The magnitude of improvement was similar for both sexes. Moreover, girls in the 2013 generation (for ages 10–13 year) completed more stages than their 2003 male counterparts. Across all generations, children achieved CRF values corresponding to low cardiovascular risk for future health outcomes. Centile values ranged from “low” to “very high” depending on age, sex, and generation of the sample.
Conclusion
Negative trends in CRF from Slovenian schoolchildren were reversed by 2013, indicating that Slovenia should continue implementing progressive national physical fitness strategies introduced between sampling periods (i.e., 2003–2013). Additionally, due to the universal nature of Slovenian schoolchildren achieving “healthy cut-off values” for 20mSRT (generation-inclusive), it is suggested that more specific cut-off criteria are developed, especially for younger children, and girls, so that future CRF results can be more accurately applied for both clinical and pedagogical users.
... by Ramírez-Vélez et al, (2017) showed that boys had a higher shuttle and VO2peak in all of the age groups rather than girls. 45 This gender differences in cardio-tness level could be because of the lower level of physical activity in girls rather than boys. A study result by Telford et al (2016) in 276 boys and 279 girls from 29 schools showed that girls 19% less active than boys and their cardio respiratory tness was 18% less than boys. ...
Background: Accelerometers are new but popular tools in measurement of physical activity level but most of them use the algorithms which are more suitable for adults rather than adolescents. Also accelerometers accuracy in assessing physical activity intensity in boys and girls is widely unknown. Therefore, purpose the current study was to evaluate the validity of the Axivity accelerometers in relation to establish algorithm in the measurement of physical activity intensity in boys and girls.
Methods: A total of 143 participants recruited from a local school in Oxfordshire and 119 of them (84 boys and 35 girls, age (12.71 ± 0.46)) completed the shuttle run test while wearing an AX3 accelerometer. Signal Vector Magnitude (gravity-subtracted) (SVMgs) and Metabolic equivalent (MET) values were calculated for both of boys and girls.
Results: The study result showed that girls had significantly higher SVMgs value (P< 0.05) while according to the standard equations, girls have lower VO2max and MET in each shuttle run lap.
Conclusion: This study result suggest that different algorithms might be necessary to measure physical activity in different genders.
... However, a linear adjustment of 13% in the PFA-PAR estimation greatly improved the test's calibration. Analogous adjustments for altitude have also been applied to CRF cutoffs in large epidemiological studies (Ramirez-Velez et al., 2017). Altitude-adjusted PFA-PAR showed an intermediate degree of agreement when compared with the 20-MST and the UKK walk test, a remarkable finding given its nonexercise nature. ...
Aim:
To study the criterion validity of three indirect maximal oxygen uptake ([Formula: see text]O2max) assessment equations at altitude.
Methods:
We studied 64 young adults (53% men) at Bogota, Colombia (2600 m altitude). Direct [Formula: see text]O2max was measured by indirect calorimetry using a maximal incremental treadmill protocol. Indirect [Formula: see text]O2max was estimated by two exercise field tests (the 20-m shuttle-run test [20-MST] and the 2-km walking test (UKK)) and one nonexercise method (the perceived functional ability-physical activity rating questionnaire [PFA-PAR]). Altitude-adjusted PFA-PAR was estimated as a 13% linear reduction in PFA-PAR. We calculated Lin concordance coefficients (LCC) and standard error of the estimates (SEEs), and we performed Bland-Altman analyses for each indirect method.
Results:
Mean [Formula: see text]O2max was 41.2 ± 5.8 mL/kg/min in men and 32.2 ± 3.6 mL/kg/min in women. We found the highest agreement with direct [Formula: see text]O2max for the 20-MST (LCC = 0.79, SEE = 3.91 mL/kg/min), followed in order by the altitude-adjusted PFA-PAR (LCC = 0.71, SEE = 4.12 mL/kg/min), the UKK (LCC = 0.67, SEE = 5.48 mL/kg/min), and the unadjusted PFA-PAR (LCC = 0.57, SEE = 4.75 mL/kg/min). The unadjusted PFA-PAR tended to overestimate [Formula: see text]O2max, but Bland-Altman analysis showed that this bias disappeared after altitude adjustment.
Conclusion:
Several maximal, submaximal, and nonexercise methods provide estimates of [Formula: see text]O2max with acceptable validity for use in epidemiological studies of populations living at moderate altitude.
... Boys covered a greater shuttle run distance than girls as expected. This could be attributed to a greater muscle mass, higher muscle strength in boys as compared to girls 16,17 which is in agreement with the previous trials. The positive influence of increasing age in children with shuttle run distance might be explained by the biological maturation occurring as the child grows leading to a greater muscle mass and strength. ...
Objectives:To frame individualized gender – specific prediction equations for shuttle run distance using 20 metre shuttle run test in healthy, Indian children aged between 7 to 19 years and to correlate shuttle run distance with age, height, weight & body mass index. Methods: 494 subjects between the age group of 7 to 19 years were recruited in this study. Demographic details like age, gender, height, weight and body mass index were noted. 20 metre shuttle run test was performed and shuttle run distance was calculated for all participants. Results: Shuttle run distance significantly correlated with age (r =0.303), height (r =0.357), weight (r =0.294), and body mass index (r =0.126). The gender specific reference equation generated forboys is -367.724 + (27.225 x Age) + (487.457 x Height) – (3.213 x Weight) and for girls is 153.689 +(10.306 x Age) +(118.113 x Height) – (1.421 x Weight). Conclusion: The established prediction equation can be used as a reference to evaluate exercise capacity for children and adolescents and to improve the applicability of the 20 metre shuttle run test in clinical practice
... Future research should further evaluate whether normativereferenced standards should be corrected for testing conditions. For example, the Colombian norms presented by Ramírez-Vélez et al (103) adjusted 20mSRT performances by a factor of 1.11 to account for the 2625 m elevation of Bogotá-the city in which the majority of data were collected. There is also a need to facilitate the rapid update of national, regional, and international normative-referenced values to help accommodate temporal trends in CRF (127). ...
Cardiorespiratory fitness (CRF) is a good summative measure of the body’s ability to perform continuous, rhythmic, dynamic,
large-muscle group physical activity, and exercise. In children, CRF is meaningfully associated with health, independent of
physical activity levels, and it is an important determinant of sports and athletic performance. Although gas-analyzed peak
oxygen uptake is the criterion physiological measure of children’s CRF, it is not practical for population-based testing. Field
testing offers a simple, cheap, practical alternative to gas analysis. The 20-m shuttle run test (20mSRT)—a progressive aerobic
exercise test involving continuous running between 2 lines 20 m apart in time to audio signals—is probably the most widely used
field test of CRF. This review aims to clarify the international utility of the 20mSRT by synthesizing the evidence describing
measurement variability, validity, reliability, feasibility, and the interpretation of results, as well as to provide future directions for
international surveillance. The authors show that the 20mSRT is an acceptable, feasible, and scalable measure of CRF and
functional/exercise capacity, and that it has moderate criterion validity and high to very high reliability. The assessment is
pragmatic, easily interpreted, and results are transferable to meaningful and understandable situations. The authors recommend
that CRF, assessed by the 20mSRT, be considered as an international population health surveillance measure to provide
additional insight into pediatric population health.
... For instance, some of the included articles reported on boys and girls separately, while others corrected for sex in their models. The sex difference in CRF and prevalence of CVD risk factors would justify reporting separately for boys and girls [87]. Furthermore, differences in baseline age and duration of follow-up both could have interfered with whether significant associations were found, since CRF constantly changes during the life course [68,88,89]. ...
Background
Although cardiorespiratory fitness (CRF) in childhood and adolescence may be linked to future cardiovascular health, there is currently limited evidence for a longitudinal association.
Objectives
To provide a systematic review on the prospective association between CRF in childhood and adolescence and cardiovascular disease (CVD) risk factors at least 2 years later.
Methods
Using a systematic search of Medline, Embase, and SPORTDiscus, relevant articles were identified by the following criteria: generally healthy children and adolescents between 3 and 18 years of age with CRF assessed at baseline, and a follow-up period of ≥ 2 years. The outcome measures were CVD risk factors. We appraised quality of the included articles with STROBE and QUIPS checklists.
Results
After screening 7524 titles and abstracts, we included 38 articles, assessing 44,169 children and adolescents followed up for a median of 6 years. Eleven articles were of high quality. There was considerable heterogeneity in methodology, measurement of CRF, and outcomes, which hampered meta-analysis. In approximately half of the included articles higher CRF in childhood and adolescence was associated with lower body mass index (BMI), waist circumference, body fatness and lower prevalence of metabolic syndrome in later life. No associations between CRF in childhood and adolescence and future waist-to-hip ratio, blood pressure, lipid profile, and glucose homeostasis were observed.
Conclusion
Although about half of the included articles reported inverse associations between CRF in childhood and adolescence and future BMI, body fatness, and metabolic syndrome, evidence for other CVD risk factors was unconvincing. Many articles did not account for important confounding factors such as adiposity. Recommendations for future research include standardizing the measurement of CRF, i.e. by reporting VO2max, using standardized outcome assessments, and performing individual patient data meta-analyses.
... The Léger equation was used to determine VO 2 peak (ml·kg·min − 1 ) in each participant. The test was performed in according to the standardized protocol and the detailed description of this test can be found elsewhere [23]. The reproducibility (R) of our data was R = 0.84. ...
Background: There is increasing recognition that sleep is a risk factor for metabolic syndrome (MetS). The aim of the present study was to analyze the relationship between self-reported sleep duration, sleep-related problems and the presence of MetS in children and adolescents from Bogotá, D.C., Colombia.
Methods: This is a cross-sectional analysis from the FUPRECOL study (2014-15). Participants included 2,789 (54.2% girls) youth from Bogota (Colombia). MetS was defined as the presence of ≥3 of the metabolic abnormalities (hyperglycemia, hypertriglyceridemia, low high-density lipoprotein cholesterol [HDL-c], hypertension, and increased waist circumference) according to the criteria of de Ferranti/Magge and colleges. Self-reported sleep duration and sleep-related problems were assessed with the BEARS questionnaire.
Results: Logistic regression analysis showed that boys who meet recommended duration of sleep had a decreased risk of elevated blood glucose levels (Odds Ratio [OR]=0.71, 95%CI [0.40–0.94]; p=0.031) compared to boys who have short-long sleep duration. Also, compared to young without sleep problems, excessive sleepiness during the day was related to low HDL-c levels in boys (OR=1.36, 95%CI [1.02–1.83]; p=0.036) and high triglyceride levels in girls (OR=1.28, 95%CI [1.01–1.63]; p=0.045). Girls with irregular sleep patterns had decreased HDL-c levels (OR=0.71, 95%CI [0.55–0.91]; p=0.009).
Conclusions: Recommended sleep duration was associated with a decreased risk of elevated fasting glucose levels in boys, and sleep problems was related to lower HDL-c in girls and higher triglyceride levels in boys. These findings suggested the clinical importance of improving sleep hygiene to reduce metabolic risk factors in children and adolescents.
... Cardiorespiratory fitness was assessed with the 20-meter shuttle run test (20mSRT). 19 This test requires participants to run back and forth between 2 lines set 20 meters apart. Running speed started at 8.5 km/hour and was increased by 0.5 km/ hour each minute, reaching 18.0 km/hour per minute. ...
Objective: To analyse the association between cycling to/from school and body composition, physical fitness, and metabolic syndrome among a sample of Colombian children and adolescents.
Study design: During the 2014–2015 school years, we examined a cross-sectional component of the FUPRECOL study. Participants included 2,877 youths (54.5% girls) from Bogota (Colombia). A self-reported questionnaire was used to measure frequency and mode of commuting to school. Four components of physical fitness were measured: (1) anthropometric parameter (height, weight, body mass index, and waist circumference); (2) musculoskeletal parameters (handgrip and standing long jump test); (3) motor parameter (speed-agility test; 4 × 10 m shuttle run); and (4) cardiorespiratory parameter (20mSRT: 20 m shuttle run test). The prevalence of metabolic syndrome was determined by the definitions provided by the International Diabetes Federation.
Results: Twenty-three percent of the sample reported commuting by cycle. Active commuting boys showed lower likelihood (OR) of having unhealthy 4 x 10 m levels (OR = 0.72; 95% CI 0.53 to 0.98, p = 0.038) compared to the reference group (passive commuters). Active commuting girls showed a lower likelihood of having unhealthy 20mSRT levels (OR = 0.81; 95% CI 0.56 to 0.99, p = 0.047) and metabolic syndrome (OR = 0.61; 95%CI 0.35 to 0.99, p = 0.048) compared to passive commuters.
Conclusion: Our results provide some evidence that regular cycling to school may to be associated to greater physical fitness and lower metabolic syndrome than passive transport, especially in girls.
... levels. Difference between our results from Colombia and other studies from Europe or Australia could be due to Bogota's altitude (2625 m over sea level) [39]; however, for example unhealthy cardiorespiratory fitness levels are similar to those reported in a representative sample of 13to 17-year olds in Chile [40]. Despite biological differences or the difference in fitness/fatness distributions by sex, our findings remained Figure 1 Combined effects of cardiorespiratory fitness (CRF) and adiposity parameters on high-sensitivity C-reactive protein levels in children and adolescents. ...
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.
... Furthermore, despite their larger burden of chronic disease and the alarming increase in the prevalence of obesity in children in Colombia, [69] for example, LMICs are also substantially underrepresented in physical activity intervention research [71,72]. Previously, in indigenous populations, we have reported that children living in rural areas and in geographic regions with lower economic and structural development generally have lower serum concentrations of micronutrients than in children from urban areas [73][74][75][76]. Likewise, in the dietary study we conducted in Villamor [77], only 13.4 % of the protein in the diets of children was derived from eggs and milk, with 40 % of protein coming from meat. ...
Background
Substantial evidence indicates that children’s physical fitness levels are markers of their lifestyles and their cardio-metabolic health profile and are predictors of the future risk of chronic diseases such as obesity, cardiometabolic disease, skeletal health and mental health. However, fitness reference values for ethnic children and adolescents have not been published in a Latin-American population. Therefore, the aim of the study was to provide sex- and age-specific physical fitness and anthropometric reference standards among Colombian-Indian schoolchildren. MethodsA sample of 576 participants (319 boys and 257 girls) aged 10 to 17 years old was assessed using the FUPRECOL test battery. Four components of physical fitness were measured: 1) morphological component: height, weight, body mass index (BMI), waist circumference (WC), triceps skinfold, subscapular skinfold, and body fat (%); 2) musculoskeletal component: handgrip and standing long jump test; 3) motor component: speed/agility test (4 × 10 m shuttle run); and 4) cardiorespiratory component: course-navette 20 m, shuttle run test and estimation of maximal oxygen consumption by VO2max indirect. Centile smoothed curves for the 3rd, 10th, 25th, 50th, 75th, 90th and 97th percentiles were calculated using Cole’s LMS method. ResultsOur results show that weight, height and BMI in each age group were higher in boys than in girls. In each groups, age showed a significant effect for BMI and WC. Boys showed better than girls in cardiorespiratory fitness, lower- and upper-limb strength and speed/agility and girls performed better in low back flexibility. Conclusion
Our results provide for the first time sex- and age-specific physical fitness and anthropometric reference values for Colombian Nasa Indian children and adolescents aged 10–17.9 years.
... levels. Difference between our results from Colombia and other studies from Europe or Australia could be due to Bogota's altitude (2625 m over sea level) [39]; however, for example unhealthy cardiorespiratory fitness levels are similar to those reported in a representative sample of 13to 17-year olds in Chile [40]. Despite biological differences or the difference in fitness/fatness distributions by sex, our findings remained Figure 1 Combined effects of cardiorespiratory fitness (CRF) and adiposity parameters on high-sensitivity C-reactive protein levels in children and adolescents. ...
Introducción: El síndrome metabólico (SM), es la asociación de varios trastornos metabólicos y en estudios epidemiológicos se ha demostrado la estrecha relación con una menor condición física, desde la infancia y la adolescencia.
Objetivo: Establecer la relación entre el síndrome metabólico y la condición física en niños y adolescentes de Bogotá, Colombia, pertenecientes al estudio FUPRECOL.
Métodos: Se ha utilizado la batería ALPHA-FITNESS para evaluar la condición física en una muestra de 1.371 niños y adolescentes colombianos (720 varones y 651 mujeres) entre los 9 y 17 años de edad, procedentes del estudio FUPRECOL. Se diagnosticó SM si se presentaban tres o más de los siguientes componentes: glicemia ≥ 100 mg/dL, triglicéridos ≥ 110 mg/dL, c-HDL ≤ 40 mg/dL, tensión arterial sistólica o diastólica > percentil 90 y circunferencia de la cintura > percentil 75.
Resultados: La prevalencia de SM fue de 4,1%; sin diferencias entre varones y mujeres (3,6% frente a 4,6%; p=0,213). Cerca de 1/4 de la población general, tenía uno o más componentes del SM. El componente más frecuentemente encontrado fue la alteración del c-HDL (24,9%), seguido de la glucosa alterada (18,7%), la tensión arterial elevada (14,7%), los triglicéridos altos (9,0%) y la circunferencia de la cintura > percentil 75 (3,7%). Por último, diferencias significativas fueron observadas entre el grupo con SM y el que no presentaba este síndrome en la capacidad aeróbica (37,8±4,1 frente a 39,3±5,0; p=0,028), fuerza prensil ajustada (0,377±0,115 frente a 0,447±0,119; p=0,0001) y salto vertical (5,8±0,7 frente a 6,4±0,1; p=0,011).
Conclusión: Concluimos que uno o más componentes del SM afectan al 25% de la población y la condición física en especial la capacidad aeróbica y muscular es significativamente mejor en el grupo sin diagnóstico de SM. Estos resultados indican la necesidad de mejorar el nivel de condición física de los escolares de Bogotá, Colombia.
La condición física está relacionada estrechamente con la salud, con la actividad física y la práctica de deportes; incluye múltiples atributos multisistémicos como la potencia aeróbica, la fuerza muscular, la agilidad y el equilibrio. La evaluación de la condición física es esencial para la identificación de la situación de salud, potencial atlético deportivo y clasificación de deficiencias psicomotoras en niños. Las pruebas que permiten su evaluación clasifican los niños de acuerdo con valores de referencia internacionales que difieren de las características antropométricas, biológicas y socioculturales de las diferentes naciones y regiones. El objetivo del presente estudio es construir las primeras cartas percentílicas de cuatro pruebas que reflejan algunos de los componentes de la CF en niños de 6 a 10 años de la ciudad de Barranquilla. Se presenta como un estudio descriptivo de corte transversal, realizado en 3333 niños con edades comprendidas desde los 6 a 10 años. Se evaluaron las características antropométricas y se realizaron 4 pruebas de condición física específicas para la fuerza muscular de extremidades superiores e inferiores, agilidad y potencia aeróbica. Los resultados permitieron consolidar las primeras tablas normativas percentílicas para la clasificación de la condición física de niños y niñas residentes en el caribe colombiano.
Background: Prevalence of obesity among 5- to 19-year-old Indian children, is 3.6 and 11.7%. Being an obese child increases the likelihood of being an obese adult and there by leading to obesity related complications. School going children are in an important age of cognitive and motor development. So, the study mainly aimed to find the correlation of physical fitness, executive functions and academic performance with body mass index in school going children. Methodology: This cross-sectional study was performed with 120 children with age group of 9 to 13 years. Height, weight, BMI was taken. 20 metre multistage fitness test was performed for physical fitness, trial making test for executive functions and academic performance scale for academic performance were taken. Results: Data was analysed using Spearman correlation coefficient which showed that BMI had positive corelation with physical fitness and executive functions p value (<0.01) and not with academic performance. Conclusion: Thus, result shows that good physical fitness is very important for better physical and mental growth especially for obese children and schools should include the fitness testing and physical activities as guided by the expert physiotherapist as the part of curriculum and simultaneously parental awareness for physical exercises should also be done to prevent their child form serious complications of obesity. Key words: Academic performance, Body mass index, Executive functions, Obesity
Objetivo: determinar los valores percentílicos de la condición física saludable en escolares colombianos entre 12 y 18 años. Materiales y métodos: estudio cuantitativo de tipo descriptivo observacional transversal. La muestra estuvo constituida por 3458 escolares de colegios públicos y privados con edades comprendidas entre 12 y 18 años seleccionados mediante muestreo aleatorio simple. Para la recolección de información se utilizó la batería Alpha fitness versión extendida. El análisis estadístico se realizó en el software SPSS versión 24. Resultados: se establecen valores normativos por edad y sexo, expresados en percentiles P3, P10, P25, P50, P75, P90 y P97. La media del IMC en los hombres fue de 21,0 ± 3,2 Kg/cm2 siendo inferior que el de las mujeres. El perímetro de cintura (cms) y la media del test de velocidad (segundos) fueron superiores en mujeres, mientras que el porcentaje graso (%), la capacidad aeróbica (mts), la media de la prensión manual de la mano (kg) y la media de salto longitudinal (cms) fue superior en los hombres; se encontraron diferencias estadísticamente significativas p<0,05 por edad y sexo en la mayoría de los componentes de la condición física saludable Conclusiones: con este estudio se plantean valores percentílicos de referencia para la condición física saludable por edad y sexo para escolares colombianos, lo que deja a los participantes en el estudio en zonas saludable o de riesgo de salud, lo cual se convierte en una herramienta adaptada al contexto latinoamericano, útil para la diagnóstico de los componentes de la condición física y su relación con elementos de salud y educativos. Abstract. Objective: to determine the percentile values of healthy physical condition in Colombian schoolchildren between 12 and 18 years old. Materials and methods: cross-sectional observational descriptive quantitative study. The sample consisted of 3458 schoolchildren from public and private schools aged between 12 and 18 years selected by simple random sampling. The Alpha fitness extended version battery was used to collect information. Statistical analysis was performed in SPSS version 24 software. Results: normative values for age and sex are established, expressed in percentiles P3, P10, P25, P50, P75, P90 and P97. The mean BMI in men was 21.0 ± 3.2 Kg / cm2, being lower than that of women. The waist circumference and the mean of the speed test were higher in women, while the fat percentage, the aerobic capacity, the mean of the manual grasp of the hand and the mean of the longitudinal jump were higher in the men; Statistically significant differences were found p <0.05 for age and sex in most of the components of healthy physical condition. Conclusions: with this study, percentile reference values for healthy physical condition by age and sex for Colombian schoolchildren are proposed, which which becomes a tool adapted to the Latin American context, useful for the diagnosis of the components of physical condition and their relationship with health and educational elements.
El objetivo del estudio fue reportar los valores de referencia para el VO2máx indirecto obtenido en las pruebas de Cooper Run Test (CRT) y Shuttle Run Test (SRT-20m) en población adulta entrenada que reside a una altitud entre los 2600 y 3700 msnm. Un total de 614 sujetos físicamente activos (118 mujeres, 496 hombres; 20.2±2.3 años; 65.3±10.3 kg; 169.1 ± 7.8 cm; 22.7±2.8 kg·m-2) residentes en la ciudad de Bogotá, o municipios del área metropolitana, participaron en este estudio de tipo descriptivo transversal. Se establecieron los percentiles de VO2máx para las pruebas CRT y SRT-20m en la población de estudio, resaltando que los registros obtenidos en el SRT-20m fueron mayores que CRT. Los valores de VO2máx en los sujetos que habitan a <3000 msnm fueron menores en comparación con los residentes a 3001 – 4000 msnm (p=0.01); asimismo, las mujeres reportaron un menor nivel de aptitud física cardiorrespiratoria (AFC) que los hombres (p<0.01). En conclusión, estos valores reportados pueden ser empleados para la evaluación de la AFC de poblaciones con características similares. Por otra parte, las variaciones encontradas en los valores de VO2máx podrían estar asociadas a variantes genéticas (e.g. polimorfismos) o a las adaptaciones propias del entrenamiento (e.g., especificidad del entrenamiento, técnica de carrera); no obstante, se requiere más investigación sobre estos aspectos en este tipo de población.
Background/Objective
The aim of the study was to analyze the relationship between being bullied and the physical fitness components, and to determine whether a healthy physical fitness level is related with lower victimization in children and adolescents with overweight and obesity compared to unfit overweight/obese peers. Method:The present cross-sectional study included a total of 7,714 youths (9-17 years), categorized as normal-weight or overweight/obese and fit or unfit according to sex-specific handgrip strength and cardiorespiratory fitness (CRF) cut-points. Bullying (physical, verbal, social exclusion, sexual harassment, and cyberbullying) was assessed through the Standard Health Behavior in School-aged Children survey questions. Results:Boys and girls that were categorized as fit (healthy level of CRF) showed lower traditional bullying compared to unfit counterparts. Also, a healthy level of CRF could be a protective factor of traditional bullying among overweight/obese youths compared to unfit overweight/obese peers. Conclusions:CRF is related with lower risk for experiencing traditional bullying in Latino youths with and without obesity, thus emphasizing the role of fitness even among youth with excess of adiposity.
Abstract
Substantial evidence indicates that youth physical fitness levels are an important marker of lifestyle and cardio-metabolic health profiles and predict future risk of chronic diseases. The reliability physical fitness tests have not been explored in Latino-American youth population. This study’s aim was to examine the reliability of health-related physical fitness tests that were used in the Colombian health promotion “Fuprecol study”. Participants were 229 Colombian youth (boys n=124 and girls n=105) aged 9 to 17.9 years old. Five components of health-related physical fitness were measured: 1) morphological component: height, weight, body mass index (BMI), waist circumference, triceps skinfold, subscapular skinfold, and body fat (%) via impedance; 2) musculoskeletal component: handgrip and standing long jump test; 3) motor component: speed/agility test (4x10 m shuttle run); 4) flexibility component (hamstring and lumbar extensibility, sit-and-reach test); 5) cardiorespiratory component: 20-meter shuttle-run test (SRT) to estimate maximal oxygen consumption. The tests were performed two times, 1 week apart on the same day of the week, except for the SRT which was performed only once. Intra-observer technical errors of measurement (TEMs) and inter-rater (reliability) were assessed in the morphological component. Reliability for the Musculoskeletal, motor and cardiorespiratory fitness components was examined using Bland–Altman tests. For the morphological component, TEMs were small and reliability was greater than 95% of all cases. For the musculoskeletal, motor, flexibility and cardiorespiratory components, we found adequate reliability patterns in terms of systematic errors (bias) and random error (95% limits of agreement). When the fitness assessments were performed twice, the systematic error was nearly 0 for all tests, except for the sit and reach (mean difference: -1.03 % [95% CI= -4.35 % to -2.28 %]. The results from this study indicate that the “Fuprecol study” health-related physical fitness battery, administered by physical education teachers, was reliable for measuring health-related components of fitness in children and adolescents aged 9–17.9 years old in a school setting in Colombia.
This study examined the independent relationships between cardiorespiratory and muscular fitness with cardiometabolic risk in adolescents. Subjects were 192 adolescents (118 boys), aged 15-17.5 years. The 2 m multi-stage fitness test assessed cardiorespiratory fitness and the counter movement jump assessed muscular fitness. Additional measures included interleukin-6, C-reactive protein, adiponectin, fibrinogen and plasminogen activator inhibitor-1. Regression analysis revealed that cardiorespiratory fitness was negatively related to cardiometabolic risk (β = -0.014, p < 0.001). With additional adjustment for muscular fitness the relationship remained significant (β = -0.015, p < 0.001). Muscular fitness was negatively related to cardiometabolic risk (β = -0.021, p < 0.001) and remained significant after adjustment for cardiorespiratory fitness. Participants in the least-fit quartile for both cardiorespiratory and muscular fitness had significantly poorer cardiometabolic risk scores than those in the other quartiles. Findings revealed that muscular and cardiorespiratory fitness are significantly associated with cardiometabolic risk independently of one another.
We compared values of BMI and cardiorespiratory fitness (20 m shuttle-run test) of n=157 boys and n=150 girls aged 10-11 measured in 2014 with measures from 2008 and 1998. Boys' fitness was lower (d=0.68) in 2014 than 2008, despite a small (d=0.37) decline in BMI. Girl's BMI changed trivially (d=0.08) but cardiorespiratory fitness was lower (d=0.47) lower in 2014 than 2008. This study suggests fitness is declining at 0.95% per year, which exceeds the 0.8% rate of decline we reported between 1998 and 2008 and double the global average of 0.43%. Declines in fitness were independent of changes in BMI suggesting continued reductions English children's habitual physical activity levels.International Journal of Obesity accepted article preview online, 04 June 2015. doi:10.1038/ijo.2015.105.
The aim of this cross-sectional study was to examine the influence of muscular strength on carotid intima-media thickness (cIMT) in children, controlling for the effect of cardiorespiratory fitness (CRF) and central adiposity and to examine if differences among muscular strength tertiles translate to physiological differences. We assessed cIMT of the common carotid artery in 366 children between 11-12 years of age (191 girls). Measures included cIMT assessed with high-resolution ultrasonography, a maximal handgrip strength test, body fat mass and lean mass from DXA and CRF determined using a maximal cycle ergometer test. Association between muscular strength and cIMT adjusted for CRF and central adiposity, as measured by trunk fat, was tested with multiple linear regression analysis. Differences in risk factors among muscular strength groups were tested with ANOVA. The Muscular Strength Index (MSI) was inversely associated with cIMT independently of CRF and central adiposity (p<0.05). The low MSI group had the highest values of cIMT, waist circumference and systolic blood pressure and the lowest CRF (p<0.05). There was an inverse and independent association between muscular strength and cIMT. Low muscular strength was associated with higher levels of cardiovascular disease risk factors in children.
© Georg Thieme Verlag KG Stuttgart · New York.
Introducción. Muchos estudios han mostrado la relación entre la condición física durante la infancia y adolescencia y el riesgo cardiovascular en la edad adulta.
Objetivos. Determinar los valores por edad y sexo de la condición física de niños y adolescentes de 10 a 16 años de Cali, Colombia.
Materiales y métodos. Se llevó a cabo un estudio descriptivo en 1.773 niños y adolescentes de ambos sexos, 865 niños y 908 niñas, pertenecientes al estudio Identificación de factores de riesgo de enfermedades crónicas no transmisibles del adulto en la población escolarizada de 10 a 16 años en el Municipio de Cali, Colombia (IFRECNTEC), a quienes se les determinó la condición física con la prueba de capacidad física de trabajo a una frecuencia cardiaca de 170 por minuto (Physical Working Capacity, the workload at a heart rate of 170 bpm, PWC170), como marcador del volumen máximo de oxígeno (VO2máx). Se calcularon los valores percentiles (5, 25, 50, 75, 90 y 95) con el método de los mínimos cuadrados (Least Mean Squares, LMS) por curvas centiles que representan la asimetría, la mediana y la viariabilidad, utilizando el paquete estadístico Growth Analyzer®.
Resultados. Se presentan los datos percentiles de la condición física en menores de 10 a 16 años, por primera vez en esta población. En los de sexo masculino, el percentil 50 medido con la prueba de PWC170 (VO2máx) se situó entre 49 y 43 ml/kg por minuto, y en las de sexo femenino, entre 52 y 40 ml/kg por minuto. Por otro lado, hay una tendencia a la disminución (~10 %) en el percentil 50, en en adolescentes de ambos sexos de 16 años de edad por VO2máx estimado. En general, en el sexo masculino hay más heterogeneidad que en el femenino, en términos de condición física mediante el VO2máx.
Conclusión. Los resultados obtenidos en el presente estudio permiten evaluar e interpretar correctamente la condición física de niños y adolescentes de 10 a 16 años. También, indican que la condición física de este grupo de edad en Colombia, se debe mejorar para ayudar a protegerlos contra las enfermedades cardiovasculares en la edad adulta.
Overweight and underweight increase the risk of metabolic impairments and chronic disease. Interventions at the household level require the diagnosis of nutritional status among family members. The aim of this study was to describe the prevalence and patterns of various anthropometric typologies over a decade in Colombia using a novel approach that considers all children in the household as well as the mother. This approach also allows identifying a dual burden of malnutrition within a household, where one child may be overweight and another one undernourished.
This study used data from the Demographic and Health Survey and the Colombian National Nutrition Survey [2000 n = 2,876, 2005 n = 8,598, and 2010 n = 11,349]. Four mutually exclusive household (HH) anthropometric typologies - normal, undernourished, overweight/obese, and dual burden - were created. Anthropometric information of height-for-age Z-scores (HAZ) and body-mass-index-for-age Z-scores (BMIz) in children under the age of 5 y, and on body mass index (BMI) in mothers, 18-49 y was used.
Prevalence of overweight/obese HHs increased between 2000 (38.2%) and 2010 (43.1%) (p < 0.05), while undernourished and dual burden HHs significantly decreased between 2005 (13.7% and 10.6%, respectively) and 2010 (3.5% and 5.1%, respectively) (p < 0.05). A greater increase of overweight/obesity was observed for the lowest quintile of wealth index (WI), with an increase of almost 10% between 2000 and 2010, compared to 2% and 4% for the fourth and highest WI, respectively. Although in 2010 there is still a higher prevalence of overweight/obesity HHs in urban areas (43.7%), the prevalence of overweight/obesity HHs in rural areas increased sharply between 2000 (34.3%) and 2010 (41.6%) (p < 0.05).
The observed prevalence of dual burden households was not different from the expected prevalence. Results from this study indicate that although overweight/obesity continues to be more prevalent among high-income Colombian households, it is growing at a faster pace among the most economically disadvantaged.
We studied in European adolescents (i) the association between cardiorespiratory fitness and ideal cardiovascular health as defined by the American Heart Association and (ii) whether there is a cardiorespiratory fitness threshold associated with a more favourable cardiovascular health profile.
Participants included 510 (n=259 girls) adolescents from 9 European countries. The 20 m shuttle run test was used to estimate cardiorespiratory fitness. Ideal cardiovascular health was defined as meeting ideal levels of the following components: four behaviours (smoking, body mass index, physical activity and diet) and three factors (total cholesterol, blood pressure and glucose).
Higher levels of cardiorespiratory fitness were associated with a higher number of ideal cardiovascular health components in both boys and girls (both p for trend ≤0.001). Levels of cardiorespiratory fitness were significantly higher in adolescents meeting at least four ideal components (13% higher in boys, p<0.001; 6% higher in girls, p=0.008). Receiver operating characteristic curve analyses showed a significant discriminating accuracy of cardiorespiratory fitness in identifying the presence of at least four ideal cardiovascular health components (43.8 mL/kg/min in boys and 34.6 mL/kg/min in girls, both p<0.001).
The results suggest a hypothetical cardiorespiratory fitness level associated with a healthier cardiovascular profile in adolescents. The fitness standards could be used in schools as part of surveillance and/or screening systems to identify youth with poor health behaviours who might benefit from intervention programmes.
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Background/objectives:
A low fitness status during childhood and adolescence is associated with important health-related outcomes, such as increased future risk for obesity and cardiovascular diseases, impaired skeletal health, reduced quality of life and poor mental health. Fitness reference values for adolescents from different countries have been published, but there is a scarcity of reference values for pre-pubertal children in Europe, using harmonised measures of fitness in the literature. The IDEFICS study offers a good opportunity to establish normative values of a large set of fitness components from eight European countries using common and well-standardised methods in a large sample of children. Therefore, the aim of this study is to report sex- and age-specific fitness reference standards in European children.
Subjects/methods:
Children (10,302) aged 6-10.9 years (50.7% girls) were examined. The test battery included: the flamingo balance test, back-saver sit-and-reach test (flexibility), handgrip strength test, standing long jump test (lower-limb explosive strength) and 40-m sprint test (speed). Moreover, cardiorespiratory fitness was assessed by a 20-m shuttle run test. Percentile curves for the 1st, 3rd, 10th, 25th, 50th, 75th, 90th, 97th and 99th percentiles were calculated using the General Additive Model for Location Scale and Shape (GAMLSS).
Results:
Our results show that boys performed better than girls in speed, lower- and upper-limb strength and cardiorespiratory fitness, and girls performed better in balance and flexibility. Older children performed better than younger children, except for cardiorespiratory fitness in boys and flexibility in girls.
Conclusions:
Our results provide for the first time sex- and age-specific physical fitness reference standards in European children aged 6-10.9 years.
Aim:
The present study aims (1) to provide reference percentile charts for the following measures of Physical Fitness (PF): the sit-and-reach, handgrip, standing long jump, 50 yards' dash, 4x10m shuttle run and 1-mile run/walk tests in children aged 6 to 10 years, and (2) to compare the performance of the Portuguese children with their age- and sex peers.
Methods:
A total of 3804 Portuguese children (1985 boys and 1819 girls) aged 6-10 years old participated in this study. The sample was stratified from 20 public elementary schools and children were randomly selected in each school. Charts were separately built for each sex using the LMS method.
Results:
Boys showed better results than girls in handgrip, standing long jump, 50 yards' dash, 4x10 m shuttle run and 1-mile run/walk, while girls are better performers than boys in sit-and-reach.
Conclusion:
Age- and gender- percentiles for a set of physical fitness tests for 6-10 year old (primary school) Portuguese children have been established. Boys showed greater overall PF than girls, except in the flexibility test, in which girls performed better. The reported normative values provide ample opportunities to accurately detect individual changes during childhood. These reference values are especially important in healthcare and educational settings, and can be added to the worldwide literature on physical fitness values in children.
Purpose
In addition to excess adiposity, low cardiorespiratory fitness (CRF) and low musculoskeletal fitness (MSF) are important independent risk factors for future cardio-metabolic disease in adolescents, yet global fitness surveillance in adolescents is poor. The objective of this study was to describe and investigate geographical variation in levels of health-related physical fitness, including CRF, MSF, body mass index (BMI), and waist circumference (WC) in Chilean 8th graders.
Methods
This cross-sectional study was based on a population-based, representative sample of 19,929 8th graders (median age = 14 years) in the 2011 National Physical Education Survey from Chile. CRF was assessed with the 20-meter shuttle run test, MSF with standing broad jump, and body composition with BMI and WC. Data were classified according to health-related standards. Prevalence of levels of health-related physical fitness was mapped for each of the four variables, and geographical variation was explored at the country level by region and in the Santiago Metropolitan Area by municipality.
Results
Girls had significantly higher prevalence of unhealthy CRF, MSF, and BMI than boys (p<0.05). Overall, 26% of boys and 55% of girls had unhealthy CRF, 29% of boys and 35% of girls had unhealthy MSF, 29% of boys and 44% of girls had unhealthy BMI, and 31% of adolescents had unhealthy WC. High prevalence of unhealthy fitness levels concentrates in the northern and middle regions of the country and in the North and Southwest sectors for the Santiago Metropolitan Area.
Conclusion
Prevalence of unhealthy CRF, MSF, and BMI is relatively high among Chilean 8th graders, especially in girls, when compared with global estimates. Identification of geographical regions and municipalities with high prevalence of unhealthy physical fitness presents opportunity for targeted intervention.
Abstract This study aimed to produce age- and sex-specific physical fitness reference data for Portuguese youth; to report the prevalence of youth in the healthy zone of physical fitness according to the FITNESSGRAM(®) criteria; to verify the agreement between the Portuguese physical fitness percentiles and the FITNESSGRAM(®) healthy zones. In 2008, 22,048 Portuguese children and adolescents (10-18 years) were evaluated. Physical fitness (curl-ups, push-ups, 20-m shuttle run and modified-back-saver-sit-and-reach tests) was evaluated using the FITNESSGRAM(®) Test Battery 8.0. Smoothed percentile curves were estimated using Cole's LMS method. Boys consistently outperformed girls in every physical fitness test, except for the modified-back-saver-sit-and-reach tests. In both sexes and for all physical fitness tests, higher percentile values were observed at older ages. The 50th percentile of all physical fitness tests had the highest accuracy to discriminate between under healthy zone and healthy zone of the FITNESSGRAM(®). Portuguese schools and physical education teachers may considerer the 50th percentile for age and sex or the FITNESSGRAM(®) criteria for classifying participants in the healthy zone as acceptable cut-offs, above which youth should be considered fit. These reference values can be used as normative data and for baseline values for subsequent surveillance of the physical fitness of Portuguese youth.
Background:
Although the prevalence of metabolic syndrome (MetS) has increased in youth, the potential independent contribution of cardiorespiratory fitness (CRF) to the clustering of metabolic risk factors has received relatively little attention.
Aim:
This study evaluated associations between the clustering of metabolic risk factors and CRF in a sample of youth.
Subjects and methods:
Height, weight, BMI, fasting glucose, insulin, HDL-cholesterol, triglycerides and blood pressures were measured in a cross-sectional sample of 924 youth (402 males, 522 females) of 11-17 years. CRF was assessed using the 20-metre shuttle run test. Physical activity (PA) was measured with a 3-day diary. Outcome variables were statistically normalized and expressed as Z-scores. A MetS risk score was computed as the mean of the Z-scores. Multiple linear regression was used to test associations between CRF and metabolic risk, adjusted for age, sex, BMI, PA and parental education.
Results:
CRF was inversely associated with MetS after adjustment for potential confounders. After adjusting for BMI, the relationship between CRF and metabolic risk has substantially improved.
Conclusion:
CRF was independently associated with the clustering of metabolic risk factors in youth of 11-17 years of age.
INTRODUCCIÓN Altos niveles de condición física están relacionados con la salud cardiovascular de niños y adolescentes. Actualmente, en Argentina no existe una aplicación sistemática de una batería de condición física en el ámbito escolar. Por esta razón, hay una carencia de valores de referencia. El propósito principal del estudio fue aplicar la batería ALPHA para presentar valores de referencia y comparar los niveles de condición física de niños y adolescentes argentinos. En segundo lugar se estableció la proporción de sujetos con nivel de capacidad aeróbica indicativo de riesgo cardiovascular futuro. La figura 1 presenta las curvas de percentiles para los tests de condición física evaluados. El percentil 5 para el test Course Navette de 20-m (etapa y ½ completa) osciló entre 1,5 – 3,6 y 1,3 – 1,6 para varones y mujeres respectivamente. Aproximadamente 1 de cada 3 sujetos (31,6%) tuvo un nivel de capacidad aeróbica indicativo de riesgo cardiovascular futuro. Este es el primer trabajo de investigación publicado que presentó los valores de referencia de condición física relacionada a la salud utilizando la batería ALPHA en población pediátrica argentina. La batería ALPHA y los valores de referencia obtenidos en este estudio pueden ser utilizados como una herramienta para monitorear los niveles de salud en población escolar argentina. Los niños y adolescentes argentinos se ubicaron entre los países con niveles de condición física más bajos.
INTRODUCCIÓN Altos niveles de condición física están relacionados con la salud cardiovascular de niños y adolescentes. Actualmente, en Argentina no existe una aplicación sistemática de una batería de condición física en el ámbito escolar. Por esta razón, hay una carencia de valores de referencia. El propósito principal del estudio fue aplicar la batería ALPHA para presentar valores de referencia y comparar los niveles de condición física de niños y adolescentes argentinos. En segundo lugar se estableció la proporción de sujetos con nivel de capacidad aeróbica indicativo de riesgo cardiovascular futuro. La figura 1 presenta las curvas de percentiles para los tests de condición física evaluados. El percentil 5 para el test Course Navette de 20-m (etapa y ½ completa) osciló entre 1,5 – 3,6 y 1,3 – 1,6 para varones y mujeres respectivamente. Aproximadamente 1 de cada 3 sujetos (31,6%) tuvo un nivel de capacidad aeróbica indicativo de riesgo cardiovascular futuro. Este es el primer trabajo de investigación publicado que presentó los valores de referencia de condición física relacionada a la salud utilizando la batería ALPHA en población pediátrica argentina. La batería ALPHA y los valores de referencia obtenidos en este estudio pueden ser utilizados como una herramienta para monitorear los niveles de salud en población escolar argentina. Los niños y adolescentes argentinos se ubicaron entre los países con niveles de condición física más bajos.
It is widely believed that the performance of children and adolescents on aerobic fitness tests is declining. To test this hypothesis, this meta-analysis compared the results of 55 reports of the performance of children and adolescents aged 6–19 years who have used the 20m shuttle run test (20mSRT). All data were collected in the period 1981–2000.
Following corrections for methodological variation, the results of all studies were expressed using the common metric of running speed (km/h) at the last completed stage. Raw data were combined with pseudodata generated from reported means and standard deviations using Monte Carlo simulation. Where data were available on children and adolescents from the same country of the same age and sex, but tested at different times, linear regression was used to calculate rates of change. This was possible for 11 (mainly developed) countries, representing a total of 129 882 children and adolescents in 151 age × sex × country slices.
There has been a significant decline in performance in the 11 countries where data were available, and in most age × sex groups, with a sample-weighted mean decline of 0.43% of mean values per year. The decline was most marked in older age groups and the rate of decline was similar for boys and girls.
There has been a very rapid secular decline in the 20mSRT performance of children and adolescents over the last 20 years, at least in developed countries. The rate of decline is not related to the change in the country’s relative wealth, as quantified by per capita gross domestic product (GDP).
Aim:
The purpose of the present study was to 1) provide normative data quantifying the physical fitness level and body mass index of 13-15-year-old Norwegian adolescents using a multi-component fitness assessment, and 2) compare the physical fitness of Norwegian teenagers with available European and International fitness data.
Methods:
1059 adolescents (529 males, 530 females) from 12 public schools in Kristians and were invited to testing at age 13, 14, and 15 years (Grades 8-10). Test participation was 75%-80%. The participants performed objectively anthropometrical measures (height and weight) and six field-based physical fitness tests.
Results and conclusions:
As expected, sex differences in physical fitness expanded from age 13 to 15. Strength and power increased more in males than females. Aerobic capacity increased slightly in males while remaining stable or tending to decline in females. Balance and gross motor coordination improved identically in males and females from age 13 to 15. Compared to European and International reference data, the sample performed superior in endurance and balance, slightly above median in lower-body strength, but inferior in flexibility.
The aim of this study was to analyze the validity of four regression equations to estimate the peak oxygen consumption (VO2peak) from the 20-m shuttle run test in adolescents aged 11-13 years. One hundred and fifteen adolescents, 61 boys (mean ± SD: age = 12.3 ± 0.9 years) and 54 girls (age = 12.1 ± 0.7 years) performed the 20-m shuttle run test and an incremental progressive maximal test for direct VO2peak analysis. Four linear regression equations were used to estimate the VO2peak: Barnett et al. (EQ1), Léger et al. (EQ2), Mahar et al. (EQ3), and Matsuzaka et al. (EQ4). For boys, only the VO2peak estimated by EQ3 did not differ from the value directly measured (P > 0.05). The EQ1, EQ2, and EQ4 underestimated the VO2peak, whereas the EQ3 overestimated, particularly in girls (P < 0.05). Large limits of agreement were found between the reference method and the four equations, with higher estimated values by EQ2 for boys (8.36 ± 15.24 mL.kg-1.min-1) and girls (2.45 ± 12.63 mL.kg-1.min-1). The highest correlation values were observed by EQ4 for boys (r = 0.80), EQ1 for girls (r = 0.72), and EQ3 for total sample (r = 0.80). The equations analyzed were not precise for individual VO2peak prediction, however, the EQ3 revealed better agreement, particularly for boys. Considering the data obtained in the boys and total sample, our results suggest that the EQ3 may provide the best predictive measure of VO2peak from the 20-m shuttle run test in adolescents aged 11-13 years.
Background:Screen time (ST) is associated with Physical activity (PA) levels. We aim to investigate the relationship between ST and fitness.Methods
Cross-section of schoolchildren from the East of England. Fitness and daily ST were assessed in 7,466 10-16 year-olds. Differences in fitness between ST groups, the association between ST and fitness were assessed.Results:ST was negatively associated with fitness in boys of all ages (p<0.001) and girls in grades 6 - 9 (p<0.005). Boys were less likely to be fit if they reported high (OR: 0.70, 95%CI 0.58-0.85) or very high (OR: 0.45, 95%CI 0.35-0.57) ST as were girls reporting very high ST (OR: 0.58, 95%CI 0.43-0.78). Controlling for PA levels attenuated these odds in boys: high (OR: 0.81, 95%CI 0.66-0.91) or very high ST (OR: 0.65, 95%CI 0.50-0.84) and in girls reporting very high ST (OR: 0.68, 95%CI 0.50-0.93).Conclusion:These first English data shows a negative association between ST and fitness in youth. Importantly, very high levels of daily ST (>4h) are associated with poor fitness. Some of the associations were mediated by PA levels. Our data support international recommendations to limit ST to <2 hours and believe such guidance should be issued in the UK.Pediatric Research (2013); doi:10.1038/pr.2013.37.
To explore the extent to which muscular strength in adolescence is associated with all cause and cause specific premature mortality (<55 years).
Prospective cohort study.
Sweden.
1 142 599 Swedish male adolescents aged 16-19 years were followed over a period of 24 years.
Baseline examinations included knee extension, handgrip, and elbow flexion strength tests, as well as measures of diastolic and systolic blood pressure and body mass index. Cox regression was used to estimate hazard ratios for mortality according to muscular strength categories (tenths).
During a median follow-up period of 24 years, 26 145 participants died. Suicide was a more frequent cause of death in young adulthood (22.3%) than was cardiovascular diseases (7.8%) or cancer (14.9%). High muscular strength in adolescence, as assessed by knee extension and handgrip tests, was associated with a 20-35% lower risk of premature mortality due to any cause or cardiovascular disease, independently of body mass index or blood pressure; no association was observed with mortality due to cancer. Stronger adolescents had a 20-30% lower risk of death from suicide and were 15-65% less likely to have any psychiatric diagnosis (such as schizophrenia and mood disorders). Adolescents in the lowest tenth of muscular strength showed by far the highest risk of mortality for different causes. All cause mortality rates (per 100 000 person years) ranged between 122.3 and 86.9 for the weakest and strongest adolescents; corresponding figures were 9.5 and 5.6 for mortality due to cardiovascular diseases and 24.6 and 16.9 for mortality due to suicide.
Low muscular strength in adolescents is an emerging risk factor for major causes of death in young adulthood, such as suicide and cardiovascular diseases. The effect size observed for all cause mortality was equivalent to that for well established risk factors such as elevated body mass index or blood pressure.
The purpose of this study was to calculate and validate reference standards for the 20-m shuttle run test (SR) in youths aged 10-18 years. Reference standards based on the number of completed SR laps were calculated by LMS method in a reference group of 5559 students. Cut-off values for SR laps were determined and tested by ROC curve analysis in a validation group (633 students), from which waist circumference, HDL-cholesterol, triglycerides, fasting glucose and mean arterial pressure were assessed to calculate a metabolic risk score, later dichotomized in low and high metabolic risk (HMRS). The accuracy of SR laps standards was significant for girls (AUC = 0.66; 95% CI = 0.58-0.74; p < .001) and boys (AUC = 0.71; 95% CI = 0.62-0.79; p < .001) for identifying subjects at HMRS. The 40th percentile was the best cut-off for SR laps in girls (SENS = 0.569; 1-SPEC = 0.330) and boys (SENS = 0.634; 1-SPEC = 0.266). New SR laps reference standards are able to discriminate metabolic risk levels, and may provide a valuable tool for early prevention of cardiovascular risk factors.
The aim of this study was to provide normative data for performance on the 20 m shuttle-run test of cardiorespiratory fitness in English schoolchildren. A total of 7366 10-16 year olds completed the 20 m shuttle-run test. We expressed performance as the number of shuttles completed, test score (shuttles and levels) and estimated peak oxygen consumption (VO2peak). We calculated descriptive statistics for each age-sex group to construct percentile curves and tables. To assess the cardiorespiratory fitness of our sample, we calculated the number of participants who fell below proposed cut-offs for low cardiorespiratory fitness based on either completed shuttles or VdotO2peak. These cut-offs did not agree in terms of frequency of classification. The classification based on estimated VO2peak suggested low fitness was more prevalent in males and that the incidence of low fitness increased with age in both sexes. These are the first normative data for shuttle-run performance in English youth and can now be used to interpret data from this cardiorespiratory fitness test. The two cut-offs used for low fitness did not agree and future research should establish a cut-off for test performance which can predict present or future ill-health.
Baseline data for physical condition are not available for adolescents in Cali, Colombia.
This study aimed to develop representative age- and sex- specific percentile baseline data for physical condition (mL.kg-1.min-¹) for urban adolescents aged 10-16 years. Materials and methods. The sample (n=1,773) consisted of 865 males and 908 females from the cross-sectional population survey, the IFRECNTEC Study (Identification of Risk Factors of Non-Transmissible Adult Chronic Diseases in School-age Populations in the City of de Cali), for whom the data for physical condition were recorded. Smoothed age- and sex- specific 5th, 25th, 50th, 75th, 90th and 95th centile values where derived using least mean squares regression analysis.
Percentile-based reference data for physical condition were presented for adolescent Colombian boys and girls for the first time. In males, the p50 of the PWC-170 (VO2max) ranged 49-43, and in females 52-40. A decreasing trend (~10%) in the p50 was seen in both sexes over 16 years of age. In general, more heterogeneity was present among males than females in terms of physical aptitude through VO2max test.
The results established a baseline level of physical condition in adolescents that can be interpreted as an indicator of future cardiovascular health. They also recommend that the physical condition of Colombian adolescents must be improved to protect against cardiovascular disease in adulthood.
Objectives To provide sex- and age-specific normative values for health-related fitness of 9–17-year-old Australians.
Methods A systematic literature search was undertaken to identify peer-reviewed studies reporting health-related fitness data on Australian children since 1985—the year of the last national fitness survey. Only data on reasonably representative s amples of apparently healthy (free from known disease or injury) 9–17-year-old Australians, who were tested using field tests of health-related fitness, were included. Both raw and pseudo data (generated using Monte Carlo simulation) were combined with sex- and age-specific normative centile values generated using the Lambda Mu and Sigma (LMS) method. Sex- and age-related differences were expressed as standardised effect sizes.
Results Normative values were displayed as tabulated percentiles and as smoothed centile curves for nine health-related fitness tests based on a dataset comprising 85347 test performances. Boys typically scored higher than girls on cardiovascular endurance, muscular strength, muscular endurance, speed and power tests, but lower on the flexibility test. The magnitude of the age-related changes was generally larger for boys than for girls, especially during the teenage years.
Conclusion This study provides the most up-to-date sex- and age-specific normative centile values for the health-related fitness of Australian children that can be used as benchmark values for health and fitness screening and surveillance systems.
We examined the association of cardiorespiratory fitness and fatness with health complaints and health risk behaviors in 691 (323 girls) Spanish children aged 6 to 17.9.
Health complaints and health risk behaviors were self-reported using items of the Health Behavior in School-aged Children questionnaire. Weight and height were measured and body mass index was computed. Cardiorespiratory fitness was measured by the 20-m shuttle-run test, and youth categorized as fit/unfit.
Unfit youth were more likely to report health complaints sometime (OR: 2.556, 95% CI: 1.299-5.031; and OR: 1.997, 95% CI: 1.162-3.433, respectively) and health risk behaviors such as drinking alcohol sometime (OR: 5.142, 95% CI: 1.214-21.783; and OR: 2.413, 95% CI: 1.484-3.923) than their fit counterparts. Overweight-obese youth were more likely to report health complaints (OR: 1.732, 95% CI: 1.019-2.945; and OR: 1.983, 95% CI: 1.083-3.629, respectively). The analysis of the combined influence of fitness and fatness revealed that fit youth had lower health complaints index than the fat-unfit and unfat-unfit groups (all P < .05).
Low fitness and overweight-obesity increased the risk of having health complaints in youth, yet high levels of cardiorespiratory fitness might overcome deleterious effects of overweight-obesity on health complaints.
The age-specific reference interval is a commonly used screening tool in medicine. It involves estimation of extreme quantile curves (such as the 5th and 95th centiles) of a reference distribution of clinically normal individuals. It is crucial that models used to estimate such intervals fit the data extremely well. However, few procedures to assess goodness-of-fit have been proposed in the literature, and even fewer have been evaluated systematically. Here we consider procedures based on the distribution of the Z-scores (standardized residuals) from a model and on Pearson χ² statistics for observed and expected counts in groups defined by age and the estimated reference centile curves. Two of the procedures (Q and grid tests) are mainly inferential, whereas the third (permutation bands and B-tests) is essentially graphical. We obtain approximations to the null distributions of several relevant test statistics and examine their size and power for a range of models based on real data sets. We recommend Q-tests in all situations where Z-scores are available since they are general, simple to calculate and usually have the highest power among the three classes of test considered. For the cases considered the grid tests are always inferior to the Q- and B- tests. Copyright © 2000 John Wiley & Sons, Ltd.
Objective To report sex- and age-specific physical fitness levels in European adolescents.Methods A sample of 3428 adolescents (1845 girls) aged 12.5–17.49 years from 10 European cities in Austria, Belgium, France, Germany, Greece (an inland city and an island city), Hungary, Italy, Spain and Sweden was assessed in the Healthy Lifestyle in Europe by Nutrition in Adolescence study between 2006 and 2008. The authors assessed muscular fitness, speed/agility, flexibility and cardiorespiratory fitness using nine different fitness tests: handgrip, bent arm hang, standing long jump, Bosco jumps (squat jump, counter movement jump and Abalakov jump), 4×10-m shuttle run, back-saver sit and reach and 20-m shuttle run tests.Results The authors derived sex- and age-specific normative values for physical fitness in the European adolescents using the LMS statistical method and expressed as tabulated percentiles from 10 to 100 and as smoothed centile curves (P5, P25, P50, P75 and P95). The figures showed greater physical fitness in the boys, except for the flexibility test, and a trend towards increased physical fitness in the boys as their age increased, whereas the fitness levels in the girls were more stable across ages.Conclusions The normative values hereby provided will enable evaluation and correct interpretation of European adolescents' fitness status.
Objetivo: Determinar los valores del índice cintura/cadera (ICC) en una población escolar de Bogotá, Colombia, pertenecientes al estudio FUPRECOL.
Métodos: Estudio descriptivo y transversal, realizado en 3.005 niños y 2.916 adolescentes de entre 9 y 17,9 años de edad, pertenecientes a instituciones educativas oficiales de Bogotá, Colombia. Se tomaron medidas de peso, talla, circunferencia de cintura, circunferencia de cadera y estado de maduración sexual por auto-reporte. Se calcularon los percentiles (P3, P10, P25, P50, P75, P90 y P97) según sexo y edad y se realizó una comparación entre los valores del ICC observados con estándares internacionales.
Resultados: De la población general (n=5.921), el 57,0% eran chicas (promedio de edad 12,7 ± 2,3 años). En todas las edades el ICC fue mayor en los chicos que en las chicas, observándose un descenso en la media de los valores obtenidos desde los 9 hasta los 17,9 años. En chicos, los valores del ICC mayores del P90 (asociados a riesgo cardiovascular) estuvieron en el rango 0,87 y 0,93 y en las chicas entre 0,85 y 0,89. Al comparar los resultados de este estudio, por grupos de edad y sexo, con trabajos internacionales de niños y adolescentes de Europa, Suramérica, Asia y África, se observa que los valores del ICC fueron menores en este estudio en ambos sexos, con excepción de los escolares originarios de Grecia y Venezuela.
Conclusiones: Se presentan percentiles del ICC según edad y sexo que podrán ser usados de referencia en la evaluación del estado nutricional y en la predicción del riesgo cardiovascular desde edades tempranas.
Objetivo: Examinar la relación entre los niveles de actividad física (AF) de forma objetiva, la condición física (CF) y el tiempo de exposición a pantallas en niños y adolescentes de Bogotá, Colombia.
Métodos: Estudio descriptivo y transversal, realizado en 149 niños y adolescentes en edad escolar entre 9 y 17 años de Bogotá, Colombia. Los niveles de AF se valoraron con acelerómetro durante 7 días. El tipo y tiempo de exposición a pantallas, se registró mediante por auto-reporte. Se midió el estado de maduración, el peso, la estatura, la circunferencia de cintura/cadera y los pliegues trícipital/subescapular. La capacidad aeróbica, la fuerza prensil, el salto de longitud y vertical, la velocidad/agilidad y la flexibilidad fueron usados como indicadores de la CF.
Resultados: Las mujeres clasificadas en la categoría de AF vigorosa, mostraron una relación lineal con la capacidad aeróbica (r=0,366), y una relación inversa con el pliegue trícipital (r=-0,257) y subescapular (r=-0,237), p<0,05. En varones, los niveles de AF vigorosa se relacionaron con mayores valores de flexibilidad (r=0,277), mientras que los niveles de AFMV, se relacionaron positivamente con la capacidad aeróbica (r=0,347), p<0,05. Por último, los escolares que permanecieron por menos de 2h/día frente a pantallas de TV, mostraron 1,819 veces de (IC 95% 1,401-2,672) oportunidad para cumplir las recomendaciones de AF.
Conclusiones: Los escolares que registraron valores de AF moderado y vigoroso de forma objetiva, presentaron mejores niveles en la CF especialmente en la capacidad aeróbica y la flexibilidad y menores valores en los pliegues cutáneos.
Physical activity (PA) is central to the global agenda for the prevention on noncommunicable diseases (NCDs). Although 80% of NCDs occur in low-to-middle-income countries, the evidence on PA comes mainly from high-income countries. In this context, the report card for Colombia is an advocacy tool to help in the translation of evidence into concrete actions. The aims of this paper were two-fold: to present the methodology used to develop the first Report Card on Physical Activity in Colombian Children and Youth and to summarize the results.
Twelve indicators of PA were graded using numerical grades (5, highest, to 1, lowest) based on data from national surveys and policy documents.
National policy and obesity indicators were graded "4," while departmental policy and overweight indicators were graded "3." Overall PA levels, sports participation, sedentary behaviors and nongovernment initiatives were graded "2," and school influence was graded "1." Active transportation, active play, low cardiorespiratory fitness, and family and community influence received an incomplete.
PA levels are low and sedentary behaviors are high in Colombian children and youth. Although the prevalence of obesity in Colombia is lower compared with other Latin American countries, it is increasing. A rich legal framework and availability of institutional arrangements provide unique opportunities to bridge the gap between knowledge and practice that need to be evaluated.
The report card presents available evidence on the physical activity (PA) and body weight status of Kenyan children and youth. It highlights areas where Kenya is succeeding and those in which more action is needed.
Comprehensive review and analysis of available data on core indicators for Kenyan children and youth 5-17 years were conducted. The grading system used was based on a set of specific criteria and existing grading schemes from similar report cards in other countries.
Of the 10 core indicators discussed, body composition was favorable (grade B) while overall PA levels, organized sport participation, and active play were assigned grades of C. Active transportation and sedentary behaviors were also favorable (grade B). Family/peers, school, governmental and nongovernmental strategies were graded C.
The majority of Kenyan children and youth have healthy body composition levels and acceptable sedentary time, but are not doing as well in attaining the World Health Organization (WHO) recommendation on PA. Although Kenya seems to be doing well in most indicators compared with some developed countries, there is a need for action to address existing trends toward unhealthy lifestyles. More robust and representative data for all indicators are required.
Background:
Physical fitness is considered an important indicator of health in children. The aims of this study were to (1) provide sex- and age-specific EUROFIT battery levels of fitness in Spanish children; (2) compare Spanish children's fitness levels with those of children from other countries; and (3) determine the percentage of Spanish children with cardiovascular risk associated with low cardiorespiratory fitness (CRF).
Methods:
Physical fitness was assessed using the EUROFIT tests in 1725 children, aged 6 to 12, from Castilla-La Mancha, Spain. We derived specific values for physical fitness using LMS method. FITNESSGRAM 2010 criteria were used to estimate the percentage of children with cardiovascular risk associated with low CRF.
Results:
Boys scored higher in all the physical fitness tests, except for the flexibility test. Physical fitness improved as age increased, except for flexibility, which worsened in boys, and VO2max, which decreased in both sexes. The prevalence of boys and girls with cardiovascular risk associated to low CRF was 13% and 26%, respectively.
Conclusions:
Specific fitness test scores for children and adolescents can represent the fitness status of schoolchildren accurately. Schools need to make efforts to improve the fitness level of the schoolchildren to prevent cardiovascular risk.
The number of children and adolescents who are overweight or obese worldwide is alarming. We did a systematic review to estimate the prevalence of overweight and obesity in children aged 0-19 years in Latin America. We searched specialised databases and seven books for relevant studies that were done in Spanish-speaking and Portuguese-speaking Latin American and Caribbean countries and published in peer-reviewed journals between January 2008, and April 2013. Indicators used were BMI (kg/m(2)) in all age groups and weight-for-height in children younger than 5 years. We identified 692 publications and included 42. Estimated prevalence of overweight in children younger than 5 years in Latin America was 7·1% with the weight-for-height WHO 2006 classification method. National combined prevalences of overweight and obesity with the WHO 2007 classification method ranged from 18·9% to 36·9% in school-age children (5-11 years) and from 16·6% to 35·8% in adolescents (12-19 years). We estimated that 3·8 million children younger than 5 years, 22·2-25·9 million school-age children, and 16·5-21·1 million adolescents were overweight or obese. Overall, between 42·5 and 51·8 million children aged 0-19 years were affected-ie, about 20-25% of the population. Although undernutrition and obesity coexist in the region, policies in most countries favour prevention of undernutrition, and only a few countries have implemented national policies to prevent obesity. In view of the number of children who are overweight or obese, the associated detrimental effects on health, and the cost to health-care systems, implementation of programmes to monitor and prevent unhealthy weight gain in children and adolescents are urgently needed throughout Latin America.
INTRODUCCIÓN Altos niveles de condición física están relacionados con la salud cardiovascular de niños y adolescentes. Actualmente, en Argentina no existe una aplicación sistemática de una batería de condición física en el ámbito escolar. Por esta razón, hay una carencia de valores de referencia. El propósito principal del estudio fue aplicar la batería ALPHA para presentar valores de referencia y comparar los niveles de condición física de niños y adolescentes argentinos. En segundo lugar se estableció la proporción de sujetos con nivel de capacidad aeróbica indicativo de riesgo cardiovascular futuro. La figura 1 presenta las curvas de percentiles para los tests de condición física evaluados. El percentil 5 para el test Course Navette de 20-m (etapa y ½ completa) osciló entre 1,5 – 3,6 y 1,3 – 1,6 para varones y mujeres respectivamente. Aproximadamente 1 de cada 3 sujetos (31,6%) tuvo un nivel de capacidad aeróbica indicativo de riesgo cardiovascular futuro. Este es el primer trabajo de investigación publicado que presentó los valores de referencia de condición física relacionada a la salud utilizando la batería ALPHA en población pediátrica argentina. La batería ALPHA y los valores de referencia obtenidos en este estudio pueden ser utilizados como una herramienta para monitorear los niveles de salud en población escolar argentina. Los niños y adolescentes argentinos se ubicaron entre los países con niveles de condición física más bajos.
There is increasing evidence that the aerobic fitness performance of children is declining, at least in developed countries. To see if there was evidence of similar trends in a non-Western country, this study analysed data on 6-18-year-old Koreans tested between 1968 and 2000 using distance runs ranging from 600 to 1200 m. All existing data on the results of children's aerobic fitness tests in Korea were collated. In addition to six individual studies, very large datasets were available from the Korean Ministries of Education, and the Ministry of Culture and Tourism. Data on a total of 22,127,265 6-18-year-old children were available in the form of group means and standard deviations. Data were collated for each age x sex x test group, and performances were expressed as percentages of the fitted values for the year 1992 to standardise across tests, ages and sexes. All age x sex x test groups were then combined, and curves were fitted using weighted regression. A two-linear segment model best described the pattern of change (r = 0.83, p < 0.001). There was a relatively slow decline (0.26 % per year) in the aerobic performance of Korean children between 1968 and 1984. After 1984, however, there was a steep decline in performance, averaging 0.80 % per year. The rate of decline was greater in boys, younger children and children from outside the capital Seoul. Changes in running performance showed a similar pattern to changes in estimated body mass index. Compared to other countries, there has been a sharp decline in Korean children's performance on tests of aerobic fitness, which has been concurrent with increases in estimated body mass index.
Aims/hypothesis High levels of cardiorespiratory fitness (CRF) and physical activity (PA) are associated with a favourable metabolic risk profile. However, there has been no thorough exploration of the independent contributions of cardiorespiratory fitness and subcomponents of activity (total PA, time spent sedentary, and time spent in light, moderate and vigorous intensity PA) to metabolic risk factors in children and the relative importance of these factors. Methods We performed a population-based, cross-sectional study in 9-to 10-and 15-to 16-year-old boys and girls from three regions of Europe (n=1709). We examined the independent associations of subcomponents of PA and CRF with metabolic risk factors (waist circumference, BP, fasting glucose, insulin, triacylglycerol and HDL-cholesterol levels). Clustered metabolic risk was expressed as a continuously distributed score calculated as the average of the standardised values of the six subcomponents. Results CRF (standardised β=−0.09, 95% CI −0.12, −0.06), total PA (standardised β=−0.08, 95% CI −0.10, −0.05) and all other subcomponents of PA were significantly associated with clustered metabolic risk. After excluding waist circumference from the summary score and further adjustment for waist circumference as a confounding factor, the magnitude of the association between CRF and clustered metabolic risk was attenuated (standardised β=−0.05, 95% CI −0.08, −0.02), whereas the association with total PA was unchanged (standardised β=−0.08 95% CI −0.10, −0.05). Conclusions/interpretation PA and CRF are separately and independently associated with individual and clustered metabolic risk factors in children. The association between CRF and clustered risk is partly mediated or confounded by adiposity, whereas the association between activity and clustered risk is independent of adiposity. Our results suggest that fitness and activity affect metabolic risk through different pathways.
The recent 2012 update of the Heart Disease and Stroke Statistics from the American Heart Association (AHA) emphasizes the continuing burden of cardiovascular disease (CVD) in the United States, with a prevalence of CVD nearing 40% in those approaching 60 years of age and exceeding 70% in older ages.1 Direct and indirect costs of CVD in the United States exceeded $300 billion in 2008, and the projected total costs of CVD in 2015 and 2030 are more than $500 billion and nearly $1200 billion, respectively.2 Recently, the AHA developed year 2020 impact goals to achieve ideal cardiovascular health, which is influenced greatly by key health behaviors of being physically active, maintaining appropriate dietary habits, and not smoking.3 The obesity epidemic in the United States has been a substantial contributor to the CVD burden, with current estimates of obesity prevalence being ≈20% in US children and adolescents and >33% in adults 20 to 74 years of age. It is well accepted that for most people, obesity is a direct outcome of an energy-rich diet, lack of sufficient physical activity (PA), or both. Another consequence of both obesity and insufficient PA is a reduction in cardiorespiratory (or aerobic) fitness (CRF) levels. Collectively, this evidence emphasizes that an individual’s health behaviors have a major role in the prevention of CVD, which is of critical importance in the United States and worldwide from a medical and economic perspective.
Increasing attention is being given to the importance of PA and physical fitness (PF), both muscular fitness and especially CRF, for decreasing chronic diseases, promoting overall cardiovascular and general health, improving quality of life, and delaying CVD and mortality in the US population.4,5 Clearly, PF and CRF in particular are an underpinning for academic achievement, job productivity, and overall maintenance …
This study considered the concordance of self-assessment and physician assessment of sexual maturity status; breasts, and pubic hair in girls, and genitals and pubic hair in boys. The subjects were Brazilian children, youth and young adults, 174 females and 178 males, 6–26 years of age. Each subject evaluated his/her level of sexual maturation and then was examined by a physician. The sexual maturity ratings of the subjects and physicians were compared. Overall, the results showed moderate to high concordance (60.9–71.3%) for both assessments of secondary sex characteristics; better concordance was found for pubic hair (69.7–71.3%) than for the breasts or genitals (60%). Age did not appear to influence the accuracy of self-evaluation; rather, accuracy was more dependent on stage of maturation of the subject. Correlations between self- and physician assessments, and replicate self- and physician assessments were relatively high. © 1994 Wiley-Liss, Inc.
The question as to whether fitness should be assessed in a European health monitoring system, perhaps from the early stages of life onwards, remains to be answered. We aimed to examine the associations between cardiorespiratory fitness and metabolic risk factors in children. A total of 873 healthy children from Sweden and Estonia aged 9–10 years (444 girls and 429 boys) were randomly selected. A maximal ergometer bike test was used to estimate cardiorespiratory fitness. Additional cardiovascular risk factors were assessed. Significant differences among cardiorespiratory fitness quartiles for the sum of five skinfolds, insulin resistance, triglycerides, and total cholesterol (TC) and high-density lipoprotein cholesterol (HDLc) ratio were shown in girls whereas in boys, the sum of five skinfolds and insulin resistance were significantly different. The lowest sum of five skinfolds and insulin resistance was shown in the highest cardiorespiratory fitness quartile in girls and boys, and the lowest values of triglyceride and TC/HDLc values in the highest cardiorespiratory fitness quartile was observed only in girls. Cardiorespiratory fitness was negatively associated with a clustering of metabolic risk factors in girls and boys. The results add supportive evidence to the body of knowledge suggesting that cardiorespiratory fitness in children is an important health marker and thus should be considered to be included in a pan-European health monitoring system.
Public health surveillance systems often monitor physical activity trends, but fitness assessment is relatively rare. This study investigated secular changes in aerobic fitness among Canadian adults and children. Participants aged 8-69 years were from 2 nationally representative surveys, conducted in-home in 1981 and in mobile examination centers in 2007-2009. In both surveys, submaximal step tests using progressive age- and sex-specific exercise stages were completed after initial screening (Physical Activity Readiness Questionnaire, heart rate, blood pressure). Between surveys, the step-test protocol had been modified to reduce underestimation of fitness among fitter and older individuals. Maximal oxygen uptake was estimated for adults using validated historical and updated prediction equations, adjusted to reflect protocol differences. Because these equations are not validated for young people, maximal aerobic power was predicted at a heart rate of 200 beats·min(-1) by regressing observed heart rates on the oxygen costs of stepping for children and youth who completed at least 2 exercise stages. Overall, despite protocol differences, we found that the aerobic fitness levels of Canadians were lower in 2007-2009 than in 1981, with declines apparent in all age and both sex groups, thereby increasing the number of those at risk of adverse health outcomes. Future work is required to validate prediction equations of aerobic fitness for young people to make it possible to compare fitness levels over the lifespan and across time.
Objective
To develop an internationally acceptable definition of child overweight and obesity, specifying the measurement, the reference population, and the age and sex specific cut off points.
Design
International survey of six large nationally representative cross sectional growth studies.
Setting
Brazil, Great Britain, Hong Kong, the Netherlands, Singapore, and the United States
Subjects
97 876 males and 94 851 females from birth to 25 years of age
Main outcome measure
Body mass index (weight/height2).
Results
For each of the surveys, centile curves were drawn that at age 18 years passed through the widely used cut off points of 25 and 30 kg/m2 for adult overweight and obesity. The resulting curves were averaged to provide age and sex specific cut off points from 2-18 years.
Conclusions
The proposed cut off points, which are less arbitrary and more internationally based than current alternatives, should help to provide internationally comparable prevalence rates of overweight and obesity in children.
Introduction and objectives:
Cardiovascular fitness (CVF) has been considered a health marker at all ages. The main purpose of this study was to examine whether meeting the current physical activity (PA) recommendations is associated with a healthier CVF level in adolescents.
Methods:
A total of 472 adolescents (14-16 years-old) were studied. CVF was estimated from a maximal bike test and PA was objectively assessed by accelerometry. Subjects were classed as high/low-CVF level, according to the Cooper Institute's cut-offs, and having a high/low-PA level depending on if the adolescents were engaged in at least 60 min per day at moderate-vigorous PA intensity level. Body fat was estimated from skinfold thicknesses.
Results:
Binary logistic regression showed that adolescent girls meeting the current PA recommendations (> or = 60 min/day of moderate-vigorous PA) were three times more likely to have a high-CVF level than girls that did not meet the recommendations, after controlling for sexual maturation status (Tanner stages) and body fat. Likewise, adolescent boys meeting the PA recommendations were eight times more likely to have a high-CVF level than boys that did not meet the recommendations.
Conclusions:
The results suggest that devoting 60 min or more to moderate-vigorous PA daily is associated with a healthier CVF level in adolescents, independent of maturation status and adiposity. The patterns of the association were similar in girls and boys, but the fact that the associations were weaker in girls is of concern.
Field tests measuring the same construct, in this case, aerobic capacity, use different scales, which makes fitness assessment of children and youth potentially confusing. The Primary Field Test Centered Equating Method has been developed to set tests on the same scale, as illustrated by the conversion of Progressive Aerobic Capacity Endurance Run (PACER) scores to 1-mile run/walk times to estimate VO(2)max.
The purpose of this study was to cross-validate the Primary Field Test Centered Equating Method by using a data set of middle school students to assess its effectiveness.
PACER scores of 135 middle school students were converted to 1-mile run/walk times (Mile PEQ) using the proposed method. Several estimates of VO(2)max using PACER scores were then compared to estimated VO(2)max using Mile PEQ and measured VO(2)max. The obtained measures were classified according to the healthy fitness zone (HFZ; FITNESSGRAM(®), version 9) and compared to measured VO(2)max. BMI estimates based on the sample data and the national average also were considered to assess the method's flexibility.
Agreement levels with actual values were similar for VO(2)max predicted using Mile PEQ and predictions using PACER laps and speed (73%-75%). The t-tests showed no significant difference between actual VO(2)max (M=44.43, SD= 8.36) and VO(2)max predicted using Mile PEQ (M=44.33, SD=5.88). Using BMI averages from sample data and the national data to estimate VO(2)max using Mile PEQ also yields high agreement levels, 70% and 73%, respectively.
The Primary Field Test Centered Equating Method performs as well or better in estimating VO(2)max as several other models using PACER scores, especially for boys, and thus may be successfully used in practice. More research is needed to understand the relatively low prediction and classification accuracy in girls.
Cardiovascular fitness has important implications for current and future health in children.
In this paper, criterion-referenced standards are developed for aerobic capacity (an indicator of cardiovascular fitness) based on receiver operating characteristic (ROC) curves.
The sample was drawn from participants aged 12-18 years in the National Health and Nutrition Examination Survey (1999-2002, N=1966). Subjects completed a treadmill exercise test from which maximal oxygen uptake (VO(2)max) was estimated from heart rate response. Metabolic syndrome was classified using previously published standards based on the National Cholesterol Education Program/Adult Treatment Panel III adult values at age 20 years. Using aerobic fitness z-scores as the test and metabolic syndrome as the criterion, ROC curve analysis was used to identify aerobic-capacity thresholds.
The area under the curve (AUC) value for boys (83.1%) was high, indicating good utility for detecting risk of metabolic syndrome with aerobic fitness values. The AUC for girls (77.2%) was slightly below the recommended value of 80%. Although the ROC plots identified a defensible point for classifying levels of fitness, the approach in the present study was to establish two independent thresholds, one aimed at high specificity and one aimed at high sensitivity. The resulting z values for the low- and higher-risk threshold lines were then converted back to VO(2)max estimates using published LMS (L=skewness, M=median, and S=coefficient of variation) parameters. Values at the low-risk threshold ranged from 40 to 44 mL/kg/min for boys and from 38 to 40 mL/kg/min for girls.
In summary, aerobic fitness can be used with moderate accuracy to differentiate between adolescents with and without metabolic syndrome. Age- and gender-specific aerobic-capacity thresholds for creating separate risk groups were identified using nationally representative growth percentiles.
To develop a statewide school-based program of measuring and reporting cardiovascular fitness levels in children, and to create age- and sex-specific cardiovascular fitness percentile-based distribution curves.
A pilot study validated cardiovascular fitness assessment with Progressive Aerobic Cardiovascular Endurance Run (PACER) testing as an accurate predictor of cardiovascular fitness measured by maximal oxygen consumption treadmill testing. Schools throughout the state were then recruited to perform PACER and body mass index (BMI) measurement and report de-identified data to a centralized database.
Data on 20 631 individual students with a mean age 12.1 ± 2.0 years, BMI of 21.4 ± 5.1, and a cardiovascular fitness measured with PACER of 29.7 ± 18.2 laps (estimated maximal oxygen consumption of 36.5 mL/kg/min) were submitted for analysis. Standardized fitness percentiles were calculated for age and sex.
This study demonstrates the feasibility of performing, reporting, and recording annual school-based assessments of cardiovascular fitness to develop standardized childhood fitness percentiles on the basis of age and sex. Such data can be useful in comparing populations and assessing initiatives that aim to improve childhood fitness. Because health consequences of obesity result from both adiposity and physical inactivity, supplementation of BMI measurement with tracking of cardiovascular fitness adds a valuable tool for large-scale health assessment.
To study the association between the cardiorespiratory fitness (CRF) distribution and cardiovascular disease (CVD) risk measured as continuous scores for individual and clustered CVD risk factors and to explore the potential effect modification of this association exerted by weight status among adolescents.
Cross-sectional study based on 1,247 youths aged 12-19 years in the 1999-2002 National Health and Nutrition Examination Surveys. CRF was estimated by a treadmill test and categorized into age- and sex-specific quintiles. Five established CVD risk factors - an adiposity index (sum of triceps and subscapular skinfolds), the homeostatic model assessment of insulin resistance, systolic blood pressure, triglycerides, and total cholesterol/high-density lipoprotein cholesterol - were standardized for age and gender and a clustered score calculated as their average. Regression analyses adjusted for race/ethnicity and family socioeconomic status assessed differences in CVD risk across CRF quintiles for the overall sample and after stratification by weight status.
The mean clustered risk score decreased with increasing CRF in both males and females (p for trend <.001 and .004, respectively). The most significant decline in the clustered CVD risk score across CRF quintiles was observed from the first to the second quintiles (53.6% and 37.5%, in males and females, respectively). The association remained significant in both overweight and normal weight males and in normal weight females (p < .05).
Most of the excess clustered CVD risk is found among adolescents within the lowest quintile of the CRF distribution. Among adolescents, very low fitness states should be avoided or intervened upon for purposes of primordial CVD prevention.
There is increasing evidence that cardiorespiratory fitness (CRF) is an important health marker already in youth. This study aimed to determine the ability of five VO(2max) equations to discriminate between low/high Metabolic Risk in 450 Portuguese adolescents aged 10-18. We measured waist and hip circumferences, fasting glucose, total cholesterol, HDL-cholesterol, LDL-cholesterol, triglycerides, and blood pressure. For each of these variables, a Z-score was computed. The HDL-cholesterol was multiplied by -1. A metabolic risk score was constructed by summing the Z scores of all individual risk factors. High risk was considered when the individual had ≥1 SD of this score. Cardiorespiratory fitness (CRF) was measured with the 20-m shuttle run test. We estimated VO(2max) from the CRF tests using five equations. ROC analyses showed a significant discriminatory accuracy for the Matsuzaka and Barnett(a) equations in identifying the low/high metabolic risk in both genders (Matsuzaka girls: AUC=0.654, 95%CI: 0.591-0.713, p<0.001, VO(2max)=39.5 mL kg⁻¹min⁻¹; boys: AUC=0.648, 95%CI: 0.576-0.716, p<0.001, VO(2max)=41.8 mL kg⁻¹min⁻¹; Barnett(a) girls: AUC=0.620, 95%CI: 0.557-0.681, p<0.001, VO(2max)=46.4 mL kg⁻¹min⁻¹; boys: AUC=0.628, 95%CI: 0.555-0.697, p=0.04, VO(2max)=42.6 mL kg⁻¹min⁻¹), and the Ruiz equation in boys (AUC=0.638, 95%CI: 0.565-0.706, p<0.001, VO(2max)=47.1 mL kg⁻¹min⁻¹). The VO(2max) values found require further testing in other populations as well as in longitudinal studies; the identification of adolescents who have low CRF levels can help detect youth with an increased risk of metabolic disease.
Previously published as an Appendix to the World development report. Incl. users guide, list of acronyms, bibl., index. The Little data book is a pocket edition of WDI