Cardiovascular health behavior and cardiorespiratory fitness in adolescents: a longitudinal study

The Impact of Ideal Cardiovascular Health Behaviors on Mental Health and Well-Being Among Baltic Countries Adolescents: Findings from the HBSC Study

This study explored the association between ideal cardiovascular health behaviors (ICHBs) and mental health and well-being in Baltic adolescents using data from the 2018 HBSC survey. ICHBs included smoking status, body mass index, physical activity, and healthy diet adherence. Mental health included low mood, irritability, nervousness, and sleep difficulties, while well-being included life satisfaction and self-reported health. Multi-regression analyses were performed. The study included 12,934 adolescents (mean age: 13.6 ± 1.6 years). Non-smokers, non-overweight individuals, and physically active participants were more likely to report good mental health, higher life satisfaction, and better self-reported health. Adherence to a healthy diet was linked to improved self-reported health and greater life satisfaction. Compared to those with four ICHBs (reference), adolescents with only one ICHB had higher odds of feeling low (OR = 0.28, 95% CI: 0.13-0.62), irritability (OR = 0.35, 95% CI: 0.19-0.66), nervousness (OR = 0.26, 95% CI: 0.13-0.55), and sleep difficulties (OR = 0.29, 95% CI: 0.14-0.61). Adolescents with two ICHBs had higher odds of feeling low (OR = 0.45, 95% CI: 0.20-0.97) and nervousness (OR = 0.40, 95% CI: 0.19-0.83). These findings highlight the importance of promoting multiple ideal health behaviors to improve mental health and well-being among adolescents.

Steps per day and health-related quality of life in schoolchildren: the mediator role of cardiorespiratory fitness

To analyse the relationship between steps per day and health-related quality of life (HRQoL) and cardiorespiratory fitness (CRF) and to examine whether the relationship between steps per day and HRQoL is mediated by CRF in schoolchildren. This was a cross-sectional study including 501 schoolchildren (aged 9-12 years, 47% girls), from Cuenca, Spain. Steps per day were measured using the Xiaomi Mi Band 3 Smart Bracelet, HRQoL was estimated by the KIDSCREEN-27 questionnaire, and CRF was assessed using the 20-m shuttle run test. Analysis of covariance and multivariate analysis of covariance models showed that children with a higher mean number of steps per day (> 9000 steps/day) had better HRQoL (global score, and physical and psychological well-being) and higher CRF levels than their peers with a lower number of steps per day (p < 0.05); however, these differences were no longer significant when controlling for sex, age, mother's education level, and CRF (p > 0.05). Linear regression models estimated that each 1000-step increment was associated with better CRF (β = 0.350; 95% CI, 0.192 to 0.508). In addition, the relationship between steps per day and HRQoL was mediated by CRF (p < 0.05).    Conclusion: Steps per day are a good metric to estimate daily physical activity because of its positive relationship with CRF. Moreover, those children taking more than 9000 steps per day are associated with higher levels of physical and psychological well-being. Finally, a substantial part of the improvement in HRQoL achieved through the increase in physical activity (steps per day) is mediated by CRF. What is Known: • Physical activity is known to have a positive impact on health-related quality of life in children. Steps per day are commonly used as a measure of physical activity. • Cardiorespiratory fitness is a recognized indicator of overall health in youth. What is New: • Increments of steps per day were associated with better CRF, with a nonlinear association after approximately 9000 steps/day. • Schoolchildren with > 9000 steps/ day showed better HRQoL.

The relationships between body mass index, reciprocal ponderal index, waist-to-height ratio, and fitness in young adult males

Background

Anthropometric measures such as the body mass index (BMI), reciprocal ponderal index (RPI), and waist-to-height ratio (WHR) have been proposed as predictors of physical fitness. This study aimed to identify the differences in explanatory capacity and fit of BMI, RPI, and WHR on physical fitness, which involves jumping, sprinting, change of direction, and aerobic capacity, by adjusting the polynomial regression.

Methods

A sample of 297 healthy, recreationally active male university students between 18 and 20 years old was recruited for this study. Anthropometric measurements (height: 174.09 ± 6.27 cm, weight: 78.98 ± 20.27 kg, waist circumference: 93.74 ± 14.56 cm) were taken for each participant. Jumping tests (squat jump, countermovement jump), sprinting tests (20 m sprint), agility tests (agility T-test), and aerobic/endurance tests (6 min walk test, VAM-EVAL test) were performed. Nonlinear quadratic regression models were used to assess the relationship between the jump, sprint, and fitness test scores and the anthropometric indices. The models were compared based on R-squares and Bayesian Information Criterion (BIC). The significance level was set at p < 0.05.

Results

The results showed that all the indices predicted a portion of the variance because all variables and index relationships were significant. Regarding the fitted models, the Bayesian Information Criterion showed that BMI was the best indicator of performance, although the RPI was better for VO2max.

Conclusion

These findings may be of great interest to practitioners because it appears that anthropometric measures can be used to predict physical fitness in certain tests although the accuracy raises any concerns.

Expectancy-Value Motivation and Physical Activity- and Health-Related Outcomes among At-Risk Children and Adolescents

Despite a large amount of research having been done to examine and promote physical activity and health among adolescents and children, relatively little attention has been paid attention to underrepresented populations. In this study, we investigated the relationships between expectancy-value motivation and physical activity- and health-related outcomes among a group of at-risk boys at a summer sports camp. The total participants included 107 boys (Mage = 11.78 years, SD = 1.20). The boys' perceived expectancy beliefs (EXP), importance (IMP), interest (INT), usefulness (USE), effort (EFT), and intention for future participation (IFP) were assessed using established questions on a five-point Likert scale, and a PACER test was performed to estimate their cardiovascular fitness (CVF). Through a path analysis, we found that EXP positively predicted CVF (β = 0.19, p < 0.01), IMP positively predicted EFT (β = 0.26, p < 0.01), and INT positively predicted both EFT (β = 0.34, p < 0.01) and IFP (β = 0.28, p < 0.01), while USE had no statistically significant effect on either EFT, IFP, or CVF. We discussed the limitations and implications of the present study. We recommend including a diverse sample and employing the expectancy-value model in future research, and advocating expectancy beliefs and task values, especially importance and interest, among participants during physical activity promotion.

Relationships of BMI, muscle-to-fat ratio, and handgrip strength-to-BMI ratio to physical fitness in Spanish children and adolescents

This study aimed to determine the relationship of body mass index (BMI), muscle-to-fat ratio (MFR), and handgrip strength-to-BMI ratio to physical fitness parameters in an active young population according to sex across four different time points. A total of 2256 Spanish children and adolescents (aged 5-18) from rural areas participating in an extracurricular sport in different municipal sports schools participated in this study. Participants were divided into children (5-10 years) and adolescents (11-18 years), boys and girls, and across four different time points (2018, 2019, 2020, 2021). Data on anthropometric measures (BMI, MFR, appendicular skeletal muscle mass) and physical fitness (handgrip strength, cardiorespiratory fitness, and vertical jump) were collected. Boys who were overweight, but especially boys with obesity, had higher absolute handgrip strength in children and adolescents than their normal weight counterparts in 2020 and 2021. Boys and girls with normal weight presented higher cardiorespiratory fitness and vertical jump than their overweight and obese peers over the years. The MFR was directly correlated with the cardiorespiratory fitness and vertical jump variables, but not with handgrip strength, in boys and girls. The handgrip strength-to-BMI ratio in both sexes was positively correlated to the different physical fitness parameters.  Conclusion: BMI, MFR, and handgrip strength-to-BMI can be used as health and physical fitness indicators in this population. What is Known: • BMI is the main indicator commonly used as a proxy for obesity for many years. Nevertheless, it cannot differentiate between fat mass and fat-free mass. • There are other indicators such as MFR and handgrip strength-to-BMI that might be more accurate and can serve to monitor the health and fitness of children and adolescents. What is New: • MFR showed a positive and significant correlation with cardiorespiratory fitness and vertical jump in both sexes. On the other hand, the handgrip strength-to-BMI presented a positive correlation with cardiorespiratory fitness, vertical jump, and handgrip strength. • The use of these indicators obtained through different parameters of body composition and physical fitness can serve as a tool to identify the relationships of the paediatric population with physical fitness.

An Investigation of the Utility of Waist Circumference Predicting Cardiorespiratory Fitness in School Children: A Cross-Sectional Study

The early identification of modifiable risk factors and their monitoring, also within school physical education (PE) classes, are becoming indispensable in the context of public health. The aim of this study was to test whether making use of waist circumference (WC) measurements increases the possibility of predicting the results of cardiorespiratory fitness (CRF) in school-age children, as compared with body mass index (BMI) and other somatic indicators related to body fat. The cross-sectional study covered 190 children aged 10 to 15 years, participating in school PE classes. Body height (BH), body weight (BW), WC, hip circumference (HC) and percentage of body fat (BF%) were measured. BMI, waist to hip ratio (WHR) and waist to height ratio (WHtR) were calculated, and a CRF test was performed by means of a 20 m shuttle run test (20mSRT). The peak heart rate (HR_peak) of the children was also measured. The regression model that was developed showed that WC (R² = 47.1%), beyond BF% (R² = 50.3%) and WHtR (R² = 50.0%), was a useful measure of CRF, and stronger than BMI (R² = 45.8%) or WHR (R² = 39.2%). The risk of obtaining the CRF result classified below a good level (below the percentile range of P60-P80) was significantly higher in children with a larger WC (odds ratio (OR) for the WC change of 1 cm equals 1.14 (95% CI: 1.09-1.20; p < 0.001)). The simplicity of measuring WC and the possibility of using this measurement in the calculation of WHtR with reference to CRF indicate its usefulness in the prophylactic exams of school children.

The Effect of Healthy Lifestyle Strategies on the Management of Insulin Resistance in Children and Adolescents with Obesity: A Narrative Review

Childhood obesity is characterized by an increased risk of several metabolic derangements including insulin resistance (IR). The strongest recommendations to prevent obesity and related complications are a balanced and adequate diet and practicing physical activity from early childhood. In this review, we propose to present the effects of healthy lifestyle strategies, including physical exercise and dietary approaches, on the management of IR and related metabolic derangements. All types of exercise (aerobic, resistance and combined training) effectively reduce IR in pediatric patients with obesity; it seems that aerobic and combined training stimulate greater improvements in IR compared to resistance training. Balanced normocaloric or hypocaloric dietary approaches are also valid strategies to address IR; it is not possible to assess the long-term impact of varying macronutrients on cardiometabolic risk. The glycemic index/load evaluation is a useful dietary approach to glucose metabolism control. Similarly, they should adopt the principle of the Mediterranean diet. Randomized studies with longer monitoring are needed to define the benefits of nutritional supplementation on IR. Considering that healthy style acquisition could track to later ages, programs of healthy lifestyle starting with children offer a better preventive strategy to preserve metabolic control and children's health.