Physical fitness and psychological health in overweight/obese children: A cross-sectional study from the ActiveBrains project

Childhood Obesity: A Narrative Review

Obesity among children has emerged as a worldwide health issue due to childhood obesity becoming a pandemic, and it is often linked to various illnesses, fatal outcomes, and disability in adulthood. Obesity has become an epidemic issue in both developed and developing countries, particularly among youngsters. The most common factors contributing to non-communicable diseases (NCDs) are unhealthy eating habits, desk-bound games, avoidance of physical activity-requiring activities, smoking, alcohol usage, and other added items. All these factors increase NCDs, including obesity, resulting in various morbidities and early death. Additionally, childhood obesity has psychological, emotional, cognitive, societal, and communicative effects. For example, it raises the possibility of issues related to physical appearance, self-esteem, confidence level, feelings of isolation, social disengagement, stigma, depression, and a sense of inequality. Children who consume more energy-dense, high-fat, low-fiber-containing food than they need usually store the excess as body fat. Standardizing indicators and terminology for obesity-related metrics is critical for better understanding the comparability of obesity prevalence and program effectiveness within and between countries. The underlying variables must be altered to reduce or avoid harm to the target organ in children. As a result, reducing childhood obesity is a considerable public health goal for the benefit of society and the long-term well-being of individuals.

Evaluating the impact of motor quotient physical fitness training on health-related fitness indicators and obesity risk in children aged 7-8 years in Tianjin, China

This study aimed to evaluate the impact of Motor Quotient (MQ) physical fitness training on health-related fitness indicators and obesity risk in children aged 7-8 years in Tianjin, China. A total of 60 obese participants were randomly divided into an experimental group (N = 30) and a control group (N = 30). The intervention program focused on improving children's physical, behavioral, and task-related capabilities through structured MQ training. Key results indicated that the experimental group demonstrated significant improvements in Body Mass Index (BMI), with a reduction from 21.28 ± 1.15 kg/m² to 18.86 ± 1.24 kg/m² for boys (p < 0.001) and from 21.04 ± 1.54 kg/m² to 17.47 ± 1.07 kg/m² for girls (p < 0.001). Physical performance metrics improved substantially, including enhanced 2 × 30 m Shuttle Run times (boys: +12.97%, girls: +13.96%, both p < 0.001) and increased Plank duration (boys: +41.36%, girls: +35.26%, both p < 0.01), reflecting improved cardiovascular endurance and core strength. Significant gains were also observed in task-related motor skills, such as Hand-eye Coordination, Behavior Imitation, and Reaction capability (all p < 0.001). Behavioral adaptations included higher scores in exercise behavior (p < 0.01), while strong correlations were found between BMI and cardiovascular fitness indicators, such as the 20 m Backward Run (r = 0.974, p < 0.001). These findings highlight the effectiveness of MQ training in reducing obesity risk and improving multidimensional fitness outcomes. The program demonstrates significant potential as a practical and evidence-based strategy to promote health-related fitness and motor development in children.

Longitudinal Associations Between Physical Activity and Sedentary Time and Cardiorespiratory and Muscular Fitness in Preschoolers

Background/Objectives: The impact of physical activity (PA) and sedentary time (ST) during preschool years on the physical fitness (PF) levels of school-aged children remains unaddressed. This study aimed to investigate the associations of objectively measured vigorous physical activity (VPA), moderate-to-vigorous physical activity (MVPA), total physical activity (TPA), and ST in the last year of preschool (age of 6-7 years; n = 77; 51% boys) with cardiorespiratory fitness (CRF) and muscular fitness (MF) in the first grade of school among Estonian children. Methods: We assessed PA (accelerometers), CRF (20 m shuttle run), and MF (z-score of relative upper- and lower-limb muscular strength). Results: In the unadjusted analysis, higher VPA, MVPA, and TPA in preschool were associated with a higher MF in school among boys, while a higher VPA in preschool was related to a higher CRF in school among girls. However, VPA, MVPA, TPA, and ST in preschool were unrelated to CRF and MF among boys and girls after adjustment for baseline age, accelerometer wear time, the corresponding PF item, and parent's education. In addition, a higher PF level in preschool was frequently related to a higher corresponding PF item in school among both genders. Conclusions: Moderate-to-vigorous and vigorous type of activities during final year of preschool, as well the amount of TPA that preschoolers are involved in, are not sufficient to affect their CRF and MF longitudinally. In addition, ST in preschool did not impact the CRF and MF of boys and girls in the first grade.

Grip strength and depressive symptoms in Chinese middle-aged and older adults: the mediating effects of cognitive function

Objective

This study investigates the associations and mediating pathways between grip strength, cognitive function, and depression in middle-aged and elderly individuals in China.

Methods

Utilizing data from the 2011 China Health and Retirement Longitudinal Study (CHARLS), we employed logistic regression and mediation analysis to examine the relationships and mediating factors between grip strength, cognitive function, and depression, while adjusting for potential confounders.

Results

The study included 6,841 participants, of whom 1,734 (25.35%) exhibited symptoms of depression. Our findings indicate that weak grip strength is significantly associated with an increased risk of depression (OR: 1.57, 95% CI: 1.32-1.87) among the middle-aged and elderly population. Conversely, good cognitive function was found to be protective against depression (OR: 0.94, 95% CI: 0.93-0.95). Grip strength indirectly affected depression through cognitive function, accounting for 9.4% of the total effect (β = -0.008, 95% CI [-0.013, -0.004]). This mediating effect was 23.8% in men (β = -0.013, 95% CI [-0.020, -0.007]); and 23.2% in those aged 60 years and over (β = -0.015, 95% CI [-0.022, -0.009]).

Conclusion

This study highlights that weak grip strength increases risk of depressive symptoms, and adequate cognitive function can mitigate the association between weak grip strength and an increased risk of depression among middle-aged and elderly individuals in China. Psychological care for elder adults with weak grip strength and poor cognitive function should be strengthened.

Effects of different parenting styles on the physical health of Chinese university students

Background

Annual declines in university students' physical health have an impact on social stability and the nation's long-term growth. Parenting style, which is crucial to a child's growth and development, may have a big influence on physical health. This study delves into the effects of different parenting styles on the physical fitness of Chinese college students under gender differences.

Methods

Through random allocation and stratified sampling methods, this study comprehensively investigated 3,151 undergraduate students (male = 1,365; female = 1786) with an average age of 18.44 years (SD = 1.46), from a university in Jiangsu Province, China. Parenting styles of college students were evaluated by the Parental Bonding Instrument (PBI). Physical fitness tests were based on the Chinese National Student Physical Fitness Standards including body mass index, lung capacity, standing-long-jump, bent-leg-sit-up, seated forward bend, pull-ups, 50 m sprint, and 800/1,000 m run. Further investigations focused on the relationship between parenting styles and physical health by statistical analysis methods such as Pearson correlation and multiple linear regression.

Results

Significant differences were identified in gender, family members, and academic majors in most of the correlation indicators between different parenting styles and physical health among college students. Further analysis showed that the parenting styles of democratic and authoritative mothers and democratic fathers were more conducive to the promotion of physical health among female university students. The combination of a democratic fathering style and a permissive mothering style is considered an ideal parenting model for male students.

Conclusion

This study confirmed that different parenting styles have a significant impact on the physical health of college students. Positive parenting styles may improve physical health, while negative ones are likely to have adverse effects, especially among female students. It is also important to notice differentiated parenting styles with respect to male and female university students. Therefore, more attention should be raised on parenting styles to enhance physical health of the student population.

Optimism, pessimism, and physical health among youth: a scoping review

OBJECTIVE

High levels of optimism (and low levels of pessimism) are associated with improved physical health in adults. However, relatively less is known about these relations in youth. The present study aimed to review the literature investigating optimism, pessimism, and physical health in children and adolescents from populations with and without health conditions.

METHODS

We conducted a scoping review up until February 2024. Studies were included if they sampled youth (average age ≤18 years) and treated optimism or pessimism as predictors of health behaviors or outcomes. Data on study and sample characteristics, health outcome, optimism construct, and findings were extracted from eligible papers and results were synthesized.

RESULTS

Sixty studies were retained. Most studies were conducted in North America, with adolescents, and used cross-sectional designs and self-reported measures of health. Measures of optimism and pessimism differed across studies. Roughly one-third of studies sampled medical populations. Health categories included substance use, diet and physical activity, sexual health practices, medical adherence, other health behaviors, cardiometabolic health, subjective health/health-related quality of life, pain, sleep, and oral health. Generally, we observed adaptive associations between optimism and health. Higher optimism and lower pessimism were most consistently associated with lower rates of substance use and lower cardiometabolic risk.

CONCLUSIONS

The presence of optimism or the absence of pessimism appears to be associated with various adaptive health outcomes among youth with and without health conditions. Developmental, methodological, and clinical considerations for future research are discussed, such as conducting longitudinal studies with objective measures of health and psychometrically validated instruments.

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

BACKGROUND

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

OBJECTIVES

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

METHODS

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

RESULTS

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

CONCLUSION

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

Cardiorespiratory and Muscular Fitness in Children and Adolescents with Obesity

PURPOSE OF REVIEW

Examine the current state of literature related to the impact of obesity in children and adolescents on health-related physical fitness and the resultant cardiometabolic disease risk.

RECENT FINDINGS

Cardiorespiratory fitness of children and adolescents has declined over the past few decades which corresponds with an increase in obesity rates. Children with obesity are more likely to have low cardiorespiratory fitness which is associated with higher cardiometabolic disease risk and poorer mental health. The impact of obesity on muscular fitness in children and adolescents is more difficult to ascertain, but in general measures of physical function are lower in children with obesity which has also been associated with higher cardiometabolic disease risk. Components of health-related physical fitness are trending negatively in children and adolescents and appear to be related to the increase in prevalence of obesity. The resultant cardiometabolic disease risk has also risen which suggests a greater disease burden in the future. These disparaging findings highlight the need for aggressive interventions to improve physical fitness in children and adolescents.

Associations between muscular strength and mental health in cognitively normal older adults: a cross-sectional study from the AGUEDA trial

Objective

To examine the associations between muscular strength and mental health.

Design

We used baseline data of 91 cognitively healthy older adults (71.69 ± 3.91 years old, 57 % women) participating in the AGUEDA randomized controlled trial.

Methods

Muscular strength was assessed using both objective (i.e., handgrip strength, biceps curl, squats, and isokinetic test) and perceived (i.e., International Fitness Scale) indicators. Psychological ill-being indicators: anxiety, depression, stress, and loneliness; and psychological well-being indicators: satisfaction with life, self-esteem, and emotional well-being) were assessed using a set of valid and reliable self-reported questionnaires. Linear regression analyses were performed adjusting for sex, age, years of education, body mass index , alcohol, diet, and smoking (model 1), and additionally by cardiorespiratory fitness (model 2).

Results

Elbow extension was positively associated with stress in model 1 (β = 0.252, 95 % Confidence Interval [95 % CI] = 0.007 to 0.497, p = 0.044), and even after further adjustment for cardiorespiratory fitness (β = 0.282, 95 % CI = 0.032 to 0.532, p = 0.028). Perceived strength was negatively associated with depressive symptoms in model 1 (β = -0.271, 95 % CI = -0.491 to -0.049, p = 0.017) and model 2 reported associations tending towards significant (β = -0.220, 95 % CI = -0.445 to 0.005, p = 0.055). Handgrip strength was positively associated with self-esteem in model 1 (β = 0.558, 95 % CI = 0.168 to 0.949, p = 0.006) and model 2 (β = 0.546, 95 % CI = 0.135 to 0.956, p = 0.010). No further associations were found among other muscular strength and mental health variables.

Conclusion

Handgrip had a moderate association with self-esteem and there was a small association between perceived strength with depressive symptoms and elbow extension with stress. No other associations were observed between muscular strength and mental health outcomes in cognitively normal older adults.

Early morning physical activity is associated with healthier white matter microstructure and happier children: the ActiveBrains project

The background of this study is to examine the associations of individual and combined early morning patterns (i.e., active commuting to school, physical activity before school, having breakfast and good sleep) with white matter microstructure (WMM) and, whether the associated white mater microstructure outcomes were related to mental health outcomes in children with overweight or obesity. 103 children with overweight or obesity (10.0 ± 1.1 years old, 42 girls) from the ActiveBrains project participated in this cross-sectional study. Early morning patterns and mental health indicators (i.e., self-esteem, optimism, positive and negative affect, stress, depression and anxiety) were self-reported by the children using validated questionnaires. WMM was assessed by magnetic resonance imaging using diffusion tensor imaging. When examined independently, early morning patterns were not related with WMM (all P > 0.05). However, the combination of early morning patterns was related with WMM (P < 0.05). Specifically, physically active early morning patterns (i.e., active commuting to school and physical activity before school) were associated with global fractional anisotropy (FA) (β = 0.298, P = 0.013) and global radial diffusivity (RD) (β = - 0.272, P = 0.021), as well as with tract-specific FA (β = 0.314, P = 0.004) and RD (β = - 0.234, P = 0.032) in the superior longitudinal fasciculus (SLF). Furthermore, combined physically active early morning pattern-associated global (i.e., FA and RD) and tract-specific (i.e., FA and RD in the SLF) WMM indicators were positively associated with happiness (β absolute value range from 0.252 to 0.298, all P < 0.05). A combination of physically active early morning patterns may positively relate to white matter microstructure in children with overweight or obesity, and, in turn, happiness.

Exploring the interplay of frailty, physical function, physical activity, nutritional status, and their association with quality of life and depressive symptoms in older adults with the frailty phenotype

OBJECTIVE

This study aimed to explore the interplay between frailty, physical function, physical activity, nutritional status, and their impact on the quality of life and depressive status in older adults with frailty.

METHODS

A cross-sectional study involving 235 pre-frail/frail older adults residing in Spanish communities was conducted. Frailty was assessed using Fried's criteria, physical function was evaluated using the Short Physical Performance Battery, and physical activity levels were measured via wrist-worn accelerometers. Nutritional status was determined using the Mini-Nutritional Assessment alongside anthropometric measurements. Quality of life was gauged using the EuroQoL 5-Dimension 5-Level, while depressive status was assessed using the Yesavage 15-item Geriatric Depression Scale. Multivariate linear regression and logistic regression analyses were employed to elucidate the associations of these factors with quality of life and depression.

RESULTS

Our findings revealed significant correlations between various factors and quality of life. Notably, reported fatigue (β = -0.276, p = 0.002), performance in the 4-m gait test (β = -0.242, p = 0.001), the score on the short version of the Mini-Nutritional Assessment (β = 0.312, p = 0.002), and engagement in light physical activity (β = 0.180, p = 0.023) were all found to be associated with quality of life. In terms of depressive symptoms, the Mini-Nutritional Assessment score emerged as a protective factor (Odds ratio, OR: 0.812, p < 0.001), as did participation in moderate physical activity (OR: 0.988, p = 0.028). Conversely, fatigue (OR: 3.277, p = 0.003) and a slow gait speed (OR: 1.136, p = 0.045) were identified as risk factors for depressive symptoms.

CONCLUSIONS

This study underscores the detrimental association of fatigue and slow gait speed on both quality of life and depressive status among older adults with frailty. In contrast, engaging in physical activity and addressing malnutrition risk emerge as critical protective factors for enhancing quality of life and ameliorating depressive symptoms in this population.

CLINICAL TRIAL REGISTRATION

This is a study that uses cross-sectional data from a trial registered at ClinicalTrials.gov (Identifier: NCT05610605).

Body Mass Index (BMI) Is the Strongest Predictor of Systemic Hypertension and Cardiac Mass in a Cohort of Children

BACKGROUND

Hypertension (HTN) is a well-established cardiovascular (CV) risk factor in adults. The presence of HTN in children appears to predict its persistence into adulthood. Early diagnosis of HTN is crucial to reduce CV morbidity before the onset of organ damage.

AIM

The aim of this study is to investigate cardiac damage in HTN, its risk factors (RFs), and evolution.

METHODS

We conducted a prospective/retrospective study involving children referred to the Childhood Hypertension Outpatient Clinic. This study included clinical and echocardiographic assessments of cardiac morphology and function at three time points: enrollment (T0) and follow-up (T1 and T2).

RESULTS

Ninety-two patients (mean age 11.4 ± 3 years) were enrolled. Cardiac eccentric and concentric hypertrophy were present in 17.9% and 9%, respectively, with remodeling in 10.5%. Overweight/obese subjects exhibited significantly higher systolic blood pressure (SBP), frequency of HTN, and body mass index (BMI) at T0 compared with patients with chronic kidney disease (CKD). SBP and BMI persisted more during follow-up. Normal-weight vs. overweight/obese patients were significantly more likely to have normal geometry. Positive correlations were found between BMI and left ventricular (LV) mass at T0, BMI and SBP at T0 and T1. Gender, BMI, SBP, and diastolic blood pressure (DBP) significantly predicted LV mass index (LVMI), but only BMI added significance to the prediction. During follow-up, the variation of BMI positively correlated with the variation of SBP, but not with LVMI.

CONCLUSIONS

In our cohort, body weight is strongly associated with HTN and cardiac mass. Importantly, the variation in body weight has a more significant impact on the consensual variation of cardiac mass than blood pressure (BP) values. A strict intervention on weight control through diet and a healthy lifestyle from early ages might reduce the burden of CV morbidity in later years.

Influence of physical fitness components on personality factors and risk perception of children and adolescents: a cross-sectional study

OBJECTIVES

To examine the associations of cardiorespiratory fitness (VO2 max) and muscular strength with indicators related to the risk scale, such as perceived competence, sensation seeking, competitiveness, risk taking and risk perception in sports.

DESIGN

Cross-sectional study.

SETTING

High schools from the Region of Murcia (Spain).

PARTICIPANTS

Three-hundred-and-seventeen adolescents participated (mean age: 13.69±1.2 years old).

PRIMARY AND SECONDARY OUTCOME MEASURES

Body mass, body height, Course-Navette test, upper limb strength and psychoeducational factors that determine the propensity towards sports accidents in school children, the Sports Accident Propensity Scale were evaluated. It was performance t-test for independent samples, stepwise multiple linear regression models and a multiple mediation analysis.

RESULTS

The analysis showed significant differences with respect to sex in height, VO2 max, handgrip strength and in all factors of the questionnaire (p=0.02-<0.01). Adolescents who presented greater VO2 max, strength in the handgrip test and age showed a higher score in factors 1 and 3. Higher scores in factor 2 were associated with better VO2 max and strength in handgrip test. Youngers and better values of strength in the handgrip showed higher score in factors 4 and 5. The mediation analysis with two mediating variables (handgrip strength and VO2 max) showed a significant indirect effect. When handgrip strength and VO2 max were included in the equations, the association between sex and each factor ceased to be significant.

CONCLUSION

This study highlights the potential benefits of muscular strength (handgrip) and VO2 max in the perceived risk scale, and the variable of age on this.

TRIAL REGISTRATION NUMBER

Clinical trial: NCT05544370 (pre-results).

Role of physical activity and health-related fitness on self-confidence and interpersonal relations in 14-year-old adolescents from secondary school settings: DADOS study

BACKGROUND

The effect of physical activity (PA) and physical fitness (PF) on self-confidence and interpersonal relations in adolescents is uncertain.

AIM

To analyzed the associations of PA and PF with self-confidence and interpersonal relations in adolescents.

SAMPLE

A total of 268 (138 boys) adolescents (13.9 ± 0.3 years) from the DADOS study were included in the analysis.

METHODS

PA was evaluated using GENEActiv accelerometers and the health-related PF components by the ALPHA health-related fitness test battery. The levels of self-confidence and interpersonal relations were determined by the Behavior Assessment System for Children Level 3.

RESULTS

The associations of PA levels and PF components with self-confidence reported positive associations of moderate-vigorous PA (MVPA), standing long jump, and 20-m shuttle run (shuttle run test) tests (all p < 0.05), and negative association of 4 × 10-m shuttle run test (4 × 10-m test), but only the 4 × 10-m test remained significant in the adjusted model for the whole sample and only in boys (p ≤ 0.01) when analyzed by sex. Regarding interpersonal relations, positive associations of standing long jump and shuttle run test (all p < 0.05), and negative association of 4 × 10-m test were found in all the adolescents. The shuttle run test was associated with interpersonal relations in boys independently of confounders. PA levels were not associated with interpersonal relations.

CONCLUSION

A higher level of lower-limb muscle strength, speed-agility, and cardiorespiratory fitness might improve self-confidence and interpersonal relations in adolescents, but these relationships seem to be influenced by sex, body mass index, and pubertal status. Speed-agility and cardiorespiratory fitness seem to have a stronger impact on boys. MVPA may improve self-confidence in adolescents.

Association of muscular strength and targeted proteomics involved in brain health in children with overweight/obesity

Muscular strength has been positively associated with better brain health indicators during childhood obesity. However, the molecular mechanisms underlying the positive impact of muscular strength in brain health are poorly understood. We aimed to study the association of muscular strength with neurology-related circulating proteins in plasma in children with overweight/obesity and to explore the role of cardiorespiratory fitness (CRF) as a confounder. The participants were 86 Caucasian children (10.1 ± 1.1 years old; 41% girls) from the ActiveBrains project. Muscular strength was measured by field and laboratory tests. CRF was assessed with an incremental treadmill test. Olink's technology was used to quantify 92 neurology-related proteins in plasma. Protein-protein interactions were computed using the STRING website. Muscular strength was positively associated with 12 proteins (BetaNGF, CDH6, CLEC10A, CLM1, FcRL2, HAGH, IL12, LAIR2, MSR1, SCARB2, SMOC2, and TNFRSF12A), and negatively associated with 12 proteins (CLEC1B, CTSC, CTSS, gal-8, GCP5, NAAA, NrCAM, NTRK2, PLXNB3, RSPO1, sFRP3, and THY1). After adjustment for CRF, muscular strength was positively associated with eight proteins (BetaNGF, CDH6, CLEC10A, FcRL2, LAIR2, MSR1, SCARB2, and TNFRSF12A) and negatively associated with two proteins (gal-8 and NrCAM). After applying FDR correction, only CLEC10A remained statistically significant. In conclusion, muscular strength was associated with blood circulating proteins involved in several biological processes, particularly anti-inflammatory response, lipid metabolism, beta amyloid clearance, and neuronal action potential propagation. More powered studies are warranted in pediatric populations to contrast or confirm our findings.

Psychological Health and Drugs: Data-Driven Discovery of Causes, Treatments, Effects, and Abuses

Mental health issues can have significant impacts on individuals and communities and hence on social sustainability. There are several challenges facing mental health treatment; however, more important is to remove the root causes of mental illnesses because doing so can help prevent mental health problems from occurring or recurring. This requires a holistic approach to understanding mental health issues that are missing from the existing research. Mental health should be understood in the context of social and environmental factors. More research and awareness are needed, as well as interventions to address root causes. The effectiveness and risks of medications should also be studied. This paper proposes a big data and machine learning-based approach for the automatic discovery of parameters related to mental health from Twitter data. The parameters are discovered from three different perspectives: Drugs and Treatments, Causes and Effects, and Drug Abuse. We used Twitter to gather 1,048,575 tweets in Arabic about psychological health in Saudi Arabia. We built a big data machine learning software tool for this work. A total of 52 parameters were discovered for all three perspectives. We defined six macro-parameters (Diseases and Disorders, Individual Factors, Social and Economic Factors, Treatment Options, Treatment Limitations, and Drug Abuse) to aggregate related parameters. We provide a comprehensive account of mental health, causes, medicines and treatments, mental health and drug effects, and drug abuse, as seen on Twitter, discussed by the public and health professionals. Moreover, we identify their associations with different drugs. The work will open new directions for a social media-based identification of drug use and abuse for mental health, as well as other micro and macro factors related to mental health. The methodology can be extended to other diseases and provides a potential for discovering evidence for forensics toxicology from social and digital media.

The effects of a 20-week exercise program on blood-circulating biomarkers related to brain health in overweight or obese children: The ActiveBrains project

BACKGROUND

Emerging research supports the idea that exercise positively affects neurodevelopment. However, the mechanisms linking exercise with brain health are largely unknown. We aimed to investigate the effect of exercise on (a) blood biomarkers selected based on previous evidence (brain-derived neurotrophic factor, β-hydroxybutyrate (BHB), cathepsin B (CTSB), kynurenine, fibroblast growth factor 21 (FGF21), soluble vascular cell adhesion molecule-1 (sVCAM-1)); and (b) a panel of 92 neurology-related proteins (discovery analysis). We also investigated whether changes in these biomarkers mediate the effects of exercise on brain health (hippocampal structure and function, cognitive performance, and mental health).

METHODS

We randomized 81 overweight/obese children (10.1 ± 1.1 years, 41% girls) into 2 groups: either 20 weeks of aerobic plus resistance exercise or control. Candidate biomarkers were assessed using enzyme-linked immunosorbent assay (ELISA) for kynurenine, FGF21, and CTSB; colorimetry for β-hydroxybutyrate; and XMap for brain-derived neurotrophic factor and soluble vascular cell adhesion molecule-1. The 92 neurology-related proteins were analyzed by an antibody-based proteomic analysis.

RESULTS

Our intervention had no significant effect on candidate biomarkers (all p > 0.05). In the discovery analysis, a reduction in circulating macrophage scavenger receptor type-I was observed (standardized differences between groups = -0.3, p = 0.001). This effect was validated using ELISA methods (standardized difference = -0.3, p = 0.01). None of the biomarkers mediated the effects of exercise on brain health.

CONCLUSIONS

Our study does not support a chronic effect of exercise on candidate biomarkers. We observed that while chronic exercise reduced the levels of macrophage scavenger receptor type-I, it did not mediate the effects of exercise on brain health. Future studies should explore the implications of this novel biomarker for overall health.

Dose-response association of handgrip strength and risk of depression: a longitudinal study of 115 601 older adults from 24 countries

BACKGROUND

Prior research has solely focused on the association between handgrip strength and risk of depression in single countries or general populations, but more knowledge is required from wider-spread cohorts and target populations.

AIMS

This study aimed to investigate the association between handgrip strength and risk of depression using repeated measures in adults aged 50 years and over.

METHOD

Data on handgrip strength and risk of depression were retrieved from the Survey of Health, Ageing and Retirement in Europe (SHARE) waves 1, 2, 4, 5, 6 and 7, using a hand dynamometer (Smedley, S Dynamometer, TTM) and the EURO-D 12-item scale, respectively. Time-varying exposure and covariates were modelled using both Cox regression and restricted cubic splines.

RESULTS

A total of 115 601 participants (mean age 64.3 years (s.d. = 9.9), 54.3% women) were followed-up for a median of 7.3 years (interquartile range: 3.9-11.8) and 792 459 person-years. During this period, 30 208 (26.1%) participants experienced a risk of depression. When modelled as a continuous variable, we observed an inverse significant association for each kg increase of handgrip strength and depression up to 40 kg in men and up to 27 kg in women.

CONCLUSIONS

Being physically strong may serve as a preventive factor for depression in older adults, but this is limited up to a maximum specific threshold for men and women.

IMPACTS OF RESISTANCE TRAINING ON PHYSICAL FITNESS AND INJURY PREVENTION IN CHILDREN AND ADOLESCENTS

ABSTRACT Introduction: An adequate physical intervention program can improve the physical level of adolescents, promoting their interest in sports learning and socialization, factors that indirectly contribute to academic performance. Despite having a positive impact on athlete performance, cardiopulmonary resistance training has received few studies related to its benefits in children and adolescents. Objective: Explore the effect of resistance training on the physical fitness of children and adolescents and the prevention of their sports injuries. Methods: The statistical method was used in a situational analysis of injuries in different sports of 455 young people. In a second moment, 20 volunteers divided into groups by sex were submitted to resistance training exercises involving aerobic (30 minutes) and anaerobic (15 minutes) activity, under 45 minutes daily, three times a week, for ten weeks. Pertinent data were collected before, during, and after the intervention. They were submitted for analysis and consideration and performed statistical treatment on the data. Results: The frequency of sports injuries in adolescents was high, especially the mild injuries related to the characteristics of adolescents. Under the same intensity of resistance training, there was an improvement in running performance. There was a significant improvement in lung capacity, with relatively small differences between males and females. Conclusion: Resistance training can effectively improve the fitness level of children and adolescents, and its promotion is strongly recommended. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

Muscle-strengthening exercise and positive mental health in children and adolescents: An urban survey study

Background

Much evidence has indicated that physical activity is associated with mental health benefits, such as fewer depression symptoms. Psychological resilience captures a broader mental health phenomenon that may be influenced by other factors as well. Yet, there are few studies examining the association between muscle-strengthening exercises (MSEs) with mental health outcomes, especially positive outcomes (e.g., subjective wellbeing). The study aimed to test the association between MSE with subjective wellbeing and resilience among a large sample of Chinese adolescents.

Materials and methods

A cross-sectional study was conducted among primary and middle school students in Shenzhen, China. MSE frequency, subjective wellbeing, and resilience were measured. Data from a total of 67,281 children and adolescents aged 10–17 years (51.9% men and 48.1% women) were included in the analysis. Mixed effect models were performed to assess how weekly MSE frequency (0–7 days) related to the levels of subjective wellbeing and resilience, adjusting for potential confounding variables (e.g., sex and grade). Sensitivity analyses were also conducted.

Results

Compared to participants with no MSE, the levels of subjective wellbeing were higher in those with higher MSE frequencies [range of β: 0.29 (1 day per week) to 1.98 (7 days per week)]. The frequency of MSE was also positively correlated to better resilience [range of β: 0.50 (1 day per week) to 4.40 (7 days per week)]. All associations remained significant in sensitivity analyses.

Conclusion

More frequent MSE was associated with superior subjective wellbeing and resilience of Chinese children and adolescents. Increasing MSE may be beneficial for promoting positive mental health outcomes among children and adolescents.

Physical Fitness and Dietary Intake Improve Mental Health in Chinese Adolescence Aged 12-13

Background

Mental health has become a major public health issue worldwide. Biological and epidemiological studies have suggested that diet and physical fitness play a role in the prevention or cure of mental disorders. However, further research is required to elucidate the relationship between diet, physical fitness, and mental health. The study aims to provide a theoretical basis for promoting an adolescent healthy lifestyle and preventing mental problems by exploring the relationship between physical fitness, calcium intake, calorie intake, and adolescent mental health.

Methods

A cross-sectional study of a sample of adolescents (N = 253, 12-13 years) was conducted. The study involved adolescents from three middle schools in Central Jiangsu Province, including 136 boys and 117 girls. Weight, height, and body mass index were measured. Physical fitness was scored using the Chinese National Student Physical Fitness Standard. Diet data were collected using a weighed 7-day food diary to estimate energy intake and dietary calcium intake. The mental health status of the participants was assessed using the Chinese Middle School Student Mental Health Scale. A T-test and analysis of variance were used to analyze the differences of variables between different genders and body mass index, and Pearson correlation and stepwise multiple regression were used to explore the relationship between physical fitness, dietary intake, and mental health.

Results

The height (165.13 ± 8.07), weight (55.24 ± 13.00), and strength quality (64.93 ± 21.66) of boys are higher than those of girls (161.67 ± 6.44,48.99 ± 8.97, 58.40 ± 23.75, P < 0.05), and the flexibility quality (74.59 ± 14.75) of girls is higher than that of boys (68.30 ± 20.84) (P < 0.05). There were significant differences in the total scores of speed and physical fitness (F values were 4.02187.73, 3.07, 5.95, 10.33, and 9.52, respectively, P < 0.05). There was a significant positive correlation between calcium intake, cardiopulmonary fitness, and mental health (r = 0.276, P < 0.01; r = 0.159, P < 0.05). Calcium intake and cardiopulmonary fitness could explain 8.4% of the changes in the mental health of adolescents aged 12-13(ΔR2 = 0.084, P < 0.05).

Conclusion

Adequate calcium intake and the improvement of cardiopulmonary fitness in adolescents aged 12-13 are essential for the good development of their mental health. Future research in this field should examine the prospective associations between multiple measures of physical fitness composition and other nutrients ingested and mental health outcomes, as well as intervention studies that seek to provide evidence of causality.

Negative Physical Self-Concept Is Associated to Low Cardiorespiratory Fitness, Negative Lifestyle and Poor Mental Health in Chilean Schoolchildren

Background: Evidence suggests that physical self-concept (PSC) is linked to well-being in children and adolescents. Objective: The objective was to investigate the association of PSC with mental health (i.e., depression and body image), physical status (i.e., fitness and weight status) and lifestyle (physical activity (PA) patterns and nutritional level) in Chilean schoolchildren. Methods: A total of 617 schoolchildren (n = 271 girls and n = 346 boys) aged 10−14 years participated in this study. Self-concept, depression and body image dissatisfaction were determined by questionnaires. Physical fitness, PA, screen time (ST), Mediterranean diet (MD) adherence and anthropometric parameters were also included. Results: Poor PSC was linked to bad cardiorespiratory fitness (CRF) (<42 VO2max) (OR 1.64; 95%CI 1.12−2.34; p = 0.01), severe body image dissatisfaction (OR 2.51, 95%CI 0.99−6.35; p = 0.05), ST of more than two hours a day (OR 2.1; 95%CI 1.41−3.12; p < 0.001), PA after school of no more than two hours per week (OR 1.52; 95%CI 1.08−2.13; p = 0.015) and depression (OR 1.80; 95%CI 1.1−2.92; p = 0.017). High nutritional level showed an association with general PSC and general self-concept (p < 0.05). Absence of body image dissatisfaction was related to general self-concept (p < 0.01) and physical condition dimensions (p < 0.05). Conclusions: PSC is associated with CRF, PA after school, ST and nutritional level. According to mental health variables, poor PSC is related to depression in Chilean schoolchildren. Therefore, promoting a healthy lifestyle among children should be a target of community- and school-based interventions to promote PSC.

Effects of Sand-Based Plyometric-Jump Training in Combination with Endurance Running on Outdoor or Treadmill Surface on Physical Fitness in Young Adult Males

This study aimed at examining the effects of nine weeks of sand-based plyometric-jump training (PJT) combined with endurance running on either outdoor or treadmill surface on measures of physical fitness. Male participants (age, 20.1 ± 1.7 years) were randomly assigned to a sand-based PJT combined with endurance running on outdoor surface (OT, n = 25) or treadmill surface (TT, n = 25). The endurance running intervention comprised a mixed training method, i.e., long slow distance, tempo, and interval running drills. A control group was additionally included in this study (CG, n = 25). Participants in CG followed their regular physical activity as OT and TT but did not receive any specific intervention. Individuals were assessed for their 50-m linear sprint time, standing long jump (SLJ) distance, cardiorespiratory fitness (i.e., Cooper test), forced vital capacity (FVC), calf girth, and resting heart rate (RHR). A three (groups: OT, TT, CG) by two (time: pre, post) ANOVA for repeated measures was used to analyze the exercise-specific effects. In case of significant group-by-time interactions, Bonferroni adjusted paired (within-group) and independent (between-group comparisons at post) t-tests were used for post-hoc analyses. Significant group-by-time interactions were found for all dependent variables (p < 0.001 - 0.002, ɳ_p ² = 0.16 - 0.78). Group-specific post-hoc tests showed improvements for all variables after OT (p < 0.001, Hedges'g effect size [g] = 0.05 - 1.94) and TT (p < 0.001, g = 0.04 - 2.73), but not in the CG (p = 0.058 - 1.000, g = 0.00 - 0.34). Compared to CG, OT showed larger SLJ (p = 0.001), cardiorespiratory fitness (p = 0.004), FVC (p = 0.008), and RHR (p < 0.001) improvements. TT showed larger improvements in SLJ (p = 0.036), cardiorespiratory fitness (p < 0.001), and RHR (p < 0.001) compared with CG. Compared to OT, TT showed larger improvements for SLJ (p = 0.018). In conclusion, sand-based PJT combined with either OT or TT similarly improved most measures of physical fitness, with greater SLJ improvement after TT. Coaches may use both concurrent exercise regimes based on preferences and logistical constrains (e.g., weather; access to treadmill equipment).

The relationship between physical fitness and academic performance among Chinese college students

OBJECTIVE

The present study aimed to examine the relationship between physical fitness and academic performance, after controlling for potential confounds.

PARTICIPANTS

The sample comprised 2,324 college students representing three Chinese universities.

METHODS

Physical fitness was measured using the Chinese National Student Physical Fitness Standard; academic performance (ie, Grade Point Average) and lifestyle behaviors were assessed using questionnaires. Academic performance and overall physical fitness were used to divide participants into three categories: low, moderate, and high.

RESULTS

Several physical fitness indicators systematically differed across the three academic performance categories. Additionally, overall physical fitness was positively associated with academic performance, even after controlling for the effects of lifestyle behaviors; those who belonged to the high overall physical fitness group had lower odds ratios of low academic performance than those belonging to the low overall physical fitness group.

CONCLUSIONS

Poor academic performance was related to low overall physical fitness . The probability of having poor academic performance was significantly lower among students with high physical fitness than those with low physical fitness.

Predicting Psychosocial Health of Children and Adolescents with Obesity in Germany: The Underappreciated Role of Physical Fitness

Background: The aim of this study was to analyze the inhibitory and promotive factors of psychosocial health in the context of childhood obesity, incorporating physical fitness as an additional, potentially relevant predictor. Methods: The sample comprised cross-sectional data of 241 children and adolescents with obesity and overweight from the German Children's Health InterventionaL TriaL III program (12.5 ± 2.1 years; 51.9% girls). Demographics and lifestyle patterns were assessed via parent reports. Anthropometric data and physical fitness in relation to body weight (W/kg) were measured. Children and adolescents completed standardized questionnaires (GW-LQ-KJ, FSK-K) to assess health-related quality of life (HRQOL) and five dimensions of self-concept (scholastic, social, physical, behavioral, and self-worth). Results: Multiple linear regression analysis showed that HRQOL was significantly related to relative physical fitness (W/kg; β = 0.216, p = 0.011) as were scholastic (β = 0.228, p = 0.008) and social self-concept (β = 0.197, p = 0.023). Increasing body mass index (BMI) Z-scores, age, physical activity (hours/day), low parental educational levels, and/or migration background were negatively associated with three subdomains of self-concept (physical, behavioral, self-worth; all p < 0.05). Conclusion: The results emphasize BMI Z-scores, age, physical activity, migration background, and parents' educational level as relevant predictors of psychosocial health in the context of childhood obesity. Additionally, this study adds physical fitness as a key determinant of HRQOL and self-concept. To enable the development of more effective weight management, therapeutic strategies should therefore consider addressing these aspects and improving physical fitness in particular not only for weight loss but also to strengthen psychosocial health.

The Moderating Role of Sociodemographic Factors in the Relationship between Physical Activity and Subjective Well-Being in Chilean Children and Adolescents

Background: The relationship between physical activity habits and well-being is widely recognized; however, the interaction that these variables have with sociodemographic factors throughout life is only partially addressed in the literature, particularly in children and adolescents. The aim of this article is to analyze the moderating effect of sociodemographic factors and the possible interaction of these moderations in the relationship between physical activity and subjective well-being in children and adolescents. Methods: This cross-sectional study considered a sample of 9572 children and adolescents from 10 to 19 years of age, students of primary and secondary schools in all regions of Chile. Subjective well-being and physical activity habits were measured using self-report questionnaires. Socioeconomic level was established from the school vulnerability index (SVI) of each student’s school. Results: Simple moderation analyses revealed that the higher the age and the lower the SVI, the stronger the relationship between physical activity habits and subjective well-being. From a double moderation analysis, it could be observed that the age of the subjects is the most relevant moderator in the relationship between physical activity habits and perceived well-being in young people. Conclusions: This study highlights the importance of considering these factors and their interaction when generating programs or public policies to improve physical activity habits and well-being in children and adolescents.

Potential Predictors of Psychological Wellbeing in Elementary School Students

BACKGROUND

This study aimed to investigate the association of elementary school students' manipulative skill competency, cardiorespiratory fitness, and cognitive function with psychological wellbeing (PWB), as well as whether the association had gender differences.

METHODS

Participants were 291 fourth-grade students (166 boys vs. 125 girls; mean age = 9.770 years old; SD = 0.584) at two elementary schools from the province of Henan in China. The students' soccer skills in manipulative skill competency were assessed using the PE Metric Assessment Rubric, cardiorespiratory fitness was assessed by means of the PACER 15 m test, and cognitive function and PWB were assessed using the d2 test of attention and Warwick-Edinburgh Mental Wellbeing Scale, respectively. Data were analyzed with descriptive statistics and multiple linear regression models.

RESULTS

The result of linear regression models showed that soccer skills, cardiorespiratory fitness, and cognitive function were collectively associated with PWB for the total sample (F (5, 285) = 3.097, p < 0.01), boys (F (5, 160) = 1.355, p < 0.01), and girls (F (5, 119) = 2.132, p < 0.01). Furthermore, the standardized regression coefficients (β) indicated that cardiorespiratory fitness was the only significant contributor to PWB for the total sample (β = 0.119, t = 2.021, p < 0.05), but not for boys and girls. Soccer skills and cognitive function were not individual significant contributors to PWB for the total sample, boys, and girls.

CONCLUSIONS

Cardiorespiratory fitness was significantly associated with PWB, and there were no gender differences in the relationship of manipulative skill competency, cardiorespiratory fitness, and cognitive function with PWB in elementary school students. This study provides empirical evidence that improving cardiorespiratory fitness is an important intervention strategy to promote elementary school students' PWB.

Physical Exercise and Psychological Distress: The Mediating Roles of Problematic Mobile Phone Use and Learning Burnout among Adolescents

Psychological distress among adolescents adversely affects their development and negatively impacts them later in life. The aim of the present study was to determine whether an association exists between physical exercise and psychological distress and to explore the roles of problematic mobile phone use and learning burnout with respect to this association. A total of 2077 Chinese adolescents were evaluated by using the Physical Exercise Questionnaire, the Self-rating Questionnaire for Adolescent Problematic Mobile Phone Use, the Learning Burnout Questionnaire, and the Depression Anxiety Stress Scale-21. A serial multiple mediation model was constructed using the SPSS PROCESS macro. The results showed that physical exercise was negatively associated with psychological distress in this Chinese adolescent population. Serial multiple mediation analysis revealed that problematic mobile phone use and learning burnout both independently and serially mediated the association between physical exercise and psychological distress. These findings provide evidence suggesting that increased attention should be given to problematic mobile phone use and learning burnout when establishing and implementing specific strategies that leverage greater participation in physical exercise to decrease psychological distress in adolescents.

Examination of Construct Validity and Criterion-Related Validity of the German Motor Test in Egyptian Schoolchildren

Physical fitness is an indicator for children’s public health status. Therefore, the aim of this study was to examine the construct validity and the criterion-related validity of the German motor test (GMT) in Egyptian schoolchildren. A cross-sectional study was conducted with a total of 931 children aged 6 to 11 years (age: 9.1 ± 1.7 years) with 484 (52%) males and 447 (48%) females in grades one to five in Assiut city. The children’s physical fitness data were collected using GMT. GMT is designed to measure five health-related physical fitness components including speed, strength, coordination, endurance, and flexibility of children aged 6 to 18 years. The anthropometric data were collected based on three indicators: body height, body weight, and BMI. A confirmatory factor analysis was conducted with IBM SPSS AMOS 26.0 using full-information maximum likelihood. The results indicated an adequate fit (χ² = 112.3, df = 20; p < 0.01; CFI = 0.956; RMSEA = 0.07). The χ²-statistic showed significant results, and the values for CFI and RMSEA showed a good fit. All loadings of the manifest variables on the first-order latent factors as well as loadings of the first-order latent factors on the second-order superordinate factor were significant. The results also showed strong construct validity in the components of conditioning abilities and moderate construct validity in the components of coordinative abilities. GMT proved to be a valid method and could be widely used on large-scale studies for health-related fitness monitoring in the Egyptian population.

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

BACKGROUND

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

OBJECTIVE

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

DESIGN

Systematic review and meta-analysis.

DATA SOURCES

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

ELIGIBILITY CRITERIA

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

RESULTS

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

CONCLUSION

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

TRIAL REGISTRATION

PROSPERO registration number CRD42017080005.

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

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

Mental Health and Physical Activity among Children and Adolescents during the COVID-19 Pandemic

Coronavirus disease 2019 (COVID-19) is causing disruptions in the global social system. Japanese children and adolescents have had their schools closed, government-mandated activity restrictions imposed, and interactions outside the home reduced. These restrictions can have a considerable psychological impact on children and adolescents. This review aims to describe the impacts of COVID-19 pandemic on physical activity and psychological status of this population. The review was conducted by searching PubMed for information on the impact of COVID-19-related activity restrictions on children and adolescents. The search identified 11 articles, three of which contained data on anxiety and psychological problems due to physical inactivity. Next, a PubMed search was conducted about physical activity and psychological status in children and adolescents under psychological stress. The search identified 368 articles, 28 of which were included in the review. For children, data that revealed a correlation between physical activity and psychological health and sedentary time leading to mood disorders were included. For adolescents, there were nine studies that reported a correlation between physical activity and psychological health and four studies that reported no correlation between physical activity and psychological health. Of the studies that reported a correlation, seven reported that physical activity improves psychological health. The impact of psychologically stressful situations such as COVID-19 on children and adolescents has been experienced worldwide. Physical activity has been correlated with psychological health, and it may improve psychological status; physical activity should be recommended to better support the psychological health of children and adolescents under the influence of COVID-19.

Association between cardiorespiratory fitness and depressive symptoms in children and adolescents: A systematic review and meta-analysis

Background Higher cardiorespiratory fitness (CRF) is associated with lower depressive symptoms in adults. However, no systematic review with meta-analysis assessed the cross-sectional associations between CRF and depressive symptoms in children and adolescents. Therefore, this meta-analysis assessed the relationship between CRF and depressive symptom in these populations. Methods Cross-sectional data evaluating the correlation between CRF and depression were searched, from database inception through 21/05/2020, on PubMed, PsycINFO, Web of Science, and SPORTDiscus. Age, sex, CRF and depression assessments, and correlations were extracted. A random-effects meta-analysis was conducted, and the potential sources of heterogeneity were also explored through meta-regression analysis. Results Across 14 effects of 11 unique studies, including a total of 7,095 participants (median age=12.49) with nearly equal sex distribution (median=53% females), it was found that higher CRF was associated with lower depressive symptoms in children and adolescents (r =-0.174, 95%CI -0.221 to -0.126, p<0.001, I²=75.09, Q value=52.19). No moderators were identified. Conclusion Available evidence supports the notion that higher CRF is inversely associated with depressive symptoms in children and adolescents. Physical activity and exercise interventions targeting improving CRF should be promoted for these populations. Further studies, including clinical populations, should be conducted to assess objective measures of aerobic fitness and body composition, while controlling for puberty status, to better characterize this association.

Active Time in Cooperative Activities, Quality of Life and Body Mass Index in Individuals with Intellectual Disabilities. A Model of Structural Equations

Current research shows that individuals with intellectual disabilities do not engage in enough physical activity to acquire health benefits. However, cooperative learning has been shown to be an effective tool for inclusion and for improving healthy physical habits. The aim of this study is to contrast an explanatory model which incorporates quality of life, active time in cooperative activities, body mass index and age, as well as to analyze, using multi-group structural equations, the existing associations according to the sex of subjects with intellectual disabilities. The convenience sampling used allowed the collection of data from a total of 156 subjects in Granada (Spain), aged between 18–55 years. In terms of gender, the sample was homogeneous, representing 52.6% (n = 82) for women and 47.4% (n = 74) for men. The active time during the cooperative learning was recorded with the Xiaomi Mi Band 2 activity band, for the quality of life scale (GENCAT) was used, and the body mass index was calculated through its standardized equation. Age was directly associated with body mass index in both sexes. Likewise, age was positively related to the active time of women. Quality of life was directly associated with active time and body mass index was inversely related to active time. This study shows the importance of active time during work and cooperative learning in individuals with intellectual disabilities, as it is associated with an improvement in the quality of life and a reduction in the problems of sedentarism, overweight, and obesity.

Muscular Strength of Upper and Lower Limbs and Self-Esteem in Chilean SchoolChildren: Independent Associations with Body Composition Indicators

The aim of this study was to analyze the relationship between muscular strength from upper and lower limbs with self-esteem among Chilean schoolchildren, drawing independent associations with body composition indicators. The sample consisted of 1078 schoolchildren. The muscular strength of the upper and lower limbs was evaluated using a digital dynamometer and long jump performance. The general strength index was calculated based on Z-score values. Rosenberg’s test was used to determine the level of self-esteem of participants. Body fat and body mass index were employed as body composition indicators. Boys had significantly more upper and lower strength, and a general strength index higher than girls (11.7 vs. 10.6; 109.7 vs. 97.4; 0.19 vs. −0.24, respectively). For boys and girls combined, there were no significant associations between all muscular strength variables and self-esteem. In boys, upper and lower limb strength was positively associated with self-esteem. In girls, no association between muscular strength and self-esteem was found. In both sexes, the general strength index was not associated with self-esteem. Strategies and programs that promote mental health and muscular strength among schoolchildren, specifically in boys, are needed.

The association of physical fitness with mental health in children: A serial multiple mediation model

There is growing interest in the association between physical fitness and mental health. This study aimed to extend current knowledge by investigating the potential mediating roles of resilience and anxiety in the association between physical fitness and mental health in children. A total of 269 children were selected by stratified random sampling from three primary schools in China. Physical fitness was scored using the Chinese National Student Physical Fitness Standard. Resilience, anxiety, and mental health data were collected using the following questionnaires: Resilience Scale for Chinese Adolescents, Multidimensional Anxiety Scale for Children, and the Mental Health Test. The PROCESS macro developed by Hayes was used to conduct serial multiple mediation analysis. We found that physical fitness, resilience, anxiety, and mental health were significantly correlated. Children with higher physical fitness had lower mental health problems; however, this statistical significance was not detectable after controlling for resilience and anxiety. Serial multiple mediation analysis revealed that the association of physical fitness with mental health was partially mediated by resilience and anxiety. These results indicate that the positive association of physical fitness with mental health in children may be changed through resilience and anxiety, which appear to play serial multiple mediating roles in this association. These findings contribute to deeper understanding of the associations between these factors and suggest that promoting physical fitness independent of considering resilience and anxiety may be insufficient to achieve good mental health in children.

Relationship between Smoking, Physical Activity, Screen Time, and Quality of Life among Adolescents

Background: Quality of life (QOL) is a crucial part of evaluating health conditions IN adolescents. The purposes of this study were to (1) examine the relationship of QOL and smoking, physical activity (PA) and screen time (ST) among Chinese adolescents, (2) explore the relationship between PA-ST combination and QOL of adolescents, and (3) investigate the dose-response relationship between PA-ST and QOL. Methods: This study randomly selected 12,900 adolescents (11–18 years) from 13 administrative regions in Shandong Province, China. The data gathering tools for Smoking (tobacco), PA (PAQ-A) and ST (average daily time for ST) and QOL questionnaire (child and adolescent quality of life scale) were completed among all adolescents. Statistical analysis was performed by T test, chi-square test and multiple linear regression. Results: 12,641 adolescents (aged 12–18) completed the study. In multiple linear regression models, the result demonstrated that the adolescents from rural areas, with high ST, low PA, and smoking, with older age and low socioeconomic status, showed a lower QOL score. First-time smokers under 10 years revealed the lowest QOL, and PA > 30 min five days per week have the highest QOL. In addition, boys and girls with PA > 30 min three to four days per week in high ST group obtain the higher scores (boys β = 5.951, girls β = 3.699) than low PA-low ST groups. Conclusions: Adolescents from rural areas suffer from a relatively poorer QOL. More than 30 min of PA five or more days for boys and three or four days per week for girls could decrease negative effects of ST and improve QOL.

Association Between Physical Fitness and Anxiety in Children: A Moderated Mediation Model of Agility and Resilience

Background: Anxiety is one of the most prevalent mental health problems in children. Although physical fitness as a predictor of mental health, the mechanisms underlying any association between physical fitness and anxiety in children have been understudied. Thus, the aim of the present study was to determine whether an association exists between physical fitness and anxiety and to explore the roles of agility and resilience in such an association. Methods: This cross-sectional study investigated 269 children aged 7 to 12 years from three public primary schools in Shanghai (China). Physical fitness and agility were objectively measured, and resilience and anxiety were assessed using self-reported questionnaires. The moderated mediation model was examined using the SPSS PROCESS macro, in which the moderator variable was agility, and the mediator variable was resilience. Results: Physical fitness was inversely associated with anxiety. Resilience partially and indirectly mediated this association, and agility moderated the association between physical fitness and resilience. Physical fitness had a greater impact on resilience in children with higher agility levels. Conclusions: Agility moderated the mediation of resilience on the indirect, inverse association between physical fitness and anxiety; thus, incorporating methods to develop agility and resilience may lead to better outcomes for physical fitness programs designed to prevent or alleviate anxiety in children.

Early Individual and Family Predictors of Weight Trajectories From Early Childhood to Adolescence: Results From the Millennium Cohort Study

Background: Early infancy and childhood are critical periods in the establishment of lifelong weight trajectories. Parents and early family environment have a strong effect on children's health behaviors that track into adolescence, influencing lifelong risk of obesity. Objective: We aimed to identify developmental trajectories of body mass index (BMI) from early childhood to adolescence and to assess their early individual and family predictors. Methods: This was a secondary analysis of the Millennium Cohort Study and included 17,165 children. Weight trajectories were estimated using growth mixture modeling based on age- and gender-specific BMI Z-scores, followed by a bias-adjusted regression analysis. Results: We found four BMI trajectories: Weight Loss (69%), Early Weight Gain (24%), Early Obesity (3.7%), and Late Weight Gain (3.3%). Weight trajectories were mainly settled by early adolescence. Lack of sleep and eating routines, low emotional self-regulation, child-parent conflict, and low child-parent closeness in early childhood were significantly associated with unhealthy weight trajectories, alongside poverty, low maternal education, maternal obesity, and prematurity. Conclusions: Unhealthy BMI trajectories were defined in early and middle-childhood, and disproportionally affected children from disadvantaged families. This study further points out that household routines, self-regulation, and child-parent relationship are possible areas for family-based obesity prevention interventions.

Physical fitness and white matter microstructure in children with overweight or obesity: the ActiveBrains project

Recent studies investigated the association of cardiorespiratory fitness with white matter microstructure in children, yet little work has explored to what extent other components of physical fitness (i.e., muscular or motor fitness) are associated with white matter microstructure. Indeed, this association has not been previously explored in children with overweight/obesity who present a different white matter development. Therefore, we aimed to examine associations between physical fitness components and white matter microstructure in children with overweight/obesity. In total, 104 (10.04 ± 1.15 years old; 43 girls) children were included in this cross-sectional study. Physical fitness was assessed using the ALPHA-fitness test battery. Fractional anisotropy (FA) and mean diffusivity were derived from diffusion tensor imaging (DTI). No association was found between physical fitness and global DTI metrics (all P > 0.082). Within individual tracts, all associations became non-significant when analyses were adjusted for multiple comparisons. Using the voxel-wise approach, we identified a small cluster in the left lateral frontal lobe where children with greater upper-body muscular fitness showed higher FA (P_{FWE-corrected} = 0.042). Although our results cannot conclude physical fitness is related to white matter microstructure in children with overweight/obesity; those findings indicate that the association of muscular fitness with white matter microstructure might be more focal on frontal areas of the brain, as opposed to global differences.

Cardiorespiratory Fitness in Youth: An Important Marker of Health: A Scientific Statement From the American Heart Association

Cardiorespiratory fitness (CRF) refers to the capacity of the circulatory and respiratory systems to supply oxygen to skeletal muscle mitochondria for energy production needed during physical activity. CRF is an important marker of physical and mental health and academic achievement in youth. However, only 40% of US youth are currently believed to have healthy CRF. In this statement, we review the physiological principles that determine CRF, the tools that are available to assess CRF, the modifiable and nonmodifiable factors influencing CRF, the association of CRF with markers of health in otherwise healthy youth, and the temporal trends in CRF both in the United States and internationally. Development of a cost-effective CRF measurement process that could readily be incorporated into office visits and in field settings to screen all youth periodically could help identify those at increased risk.

Growing up strong: The importance of physical, mental, and emotional strength during childhood and adolescence with focus on dietary factors

Childhood and adolescence are critical time periods for growth and development. Given the current physical and psychological health concerns affecting United States youth, an emerging area of interest exists supporting the importance of physical and psychological aspects of strength for health, resilience, and well-being through these life stages. This synopsis highlights the key concepts that were presented within the 2018 Strength Summit conference, entitled The Role of Strength in Optimal Health and Well-being. During the conference, strength was broadly defined as the ability to successfully respond to a challenge. Although much of the current research focuses on strength from a muscle function and performance perspective, mental and emotional strength are also important components of overall health and well-being, especially in children and adolescents. This paper provides a brief overview of the clinical and/or research-based strength outcomes, summarizes the relationship between strength and health, and discusses evidence-based dietary factors that promote strength in children and adolescents. Novelty Building physical, mental, and emotional strength during childhood and adolescence lays the foundation for health and well-being. Emerging evidence indicate positive associations between diet quality and strength in children and adolescents. Promising areas include the promotion of family-based meals, with focus on breakfast, for improved strength in United States youth.

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

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

Does Emotion Regulation Predict Gains in Exercise-Induced Fitness? A Prospective Mixed-Effects Study with Elite Helicopter Pilots

Emotion regulation (ER) is a strong predictor of different aspects of mental health and wellbeing. However, only recently has ER been examined in relation to physical activity and its effects on fitness. In the present study, 26 elite helicopter pilots, serving in the Spanish Air Force, were physically trained for 6 months, and their level of fitness (maximum oxygen consumption and time to exhaustion in a treadmill-running test) was assessed before and after that period. Additionally, two indices of emotion regulation (general adaptiveness of ER strategies, as measured by the Emotion Regulation Questionnaire (ERQ), and negative urgency, as measured by the UPPS-P questionnaire) measured at baseline were used as prospective predictors of fitness improvement. After controlling for individual features, baseline fitness, and type of training, better emotion regulation strategies (more cognitive reappraisal plus less expressive suppression) predicted larger fitness gains (p = 0.028). Incidental emotion regulation, as measured by the negative urgency index, failed to predict pre–post-fitness changes (p = 0.734). These results suggest that fostering emotion regulation skills may improve the effectiveness of fitness training programs.

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

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

Perceived Well-Being and Quality of Life in People with Typical and Atypical Development: The Role of Sports Practice

Sports and physical activity are recognized as a source of psycho-physical well-being. Therefore, practicing sports can improve the perception of the quality of life (QoL). The study investigated in adults with atypical development (AD) and typical development (TD) if the perceptions of well-being and QoL may depend on the frequency of practicing sports. Participants were 51 AD (age M = 32.98, SD = 7.81; 45.1% female) and 270 TD adults (age M = 26.50, SD = 6.52; 79.3% female) subsequently divided into three groups: 1) people not practicing sports, or 2) practicing it occasionally, or 3) practicing it regularly. We adopted general self-efficacy, life satisfaction, positive well-being, and psychological distress related to physical exercise as measures of well-being, WHOQOL-BREF as QoL, and I-TIPI-R as indicators of Big Five personality factors. Questionnaires were completed online. Practicing sports influenced the perception of well-being and QoL. For the AD group, sporting practice seems to have assumed an equalization effect, eliminating the statistical differences between well-being and QoL measures of AD and TD groups. Associations emerged between Big Five and well-being and QoL indices with some differences as a function of group characteristics. In summary, results suggest that practicing sports is strongly associated with improvements in perceptions of well-being and QoL, especially in disabled persons.

Improving the Metabolic and Mental Health of Children with Obesity: A School-Based Nutrition Education and Physical Activity Intervention in Wuhan, China

This study aimed to evaluate the effectiveness of a school-based nutrition education and physical activity intervention on cardiovascular risk profile and mental health outcomes among Chinese children with obesity. Two primary schools were randomly allocated to the control group (CG) and the intervention group (IG). We selected children with obesity from 1340 students in the third and fourth grades as participants. The IG received 8 months of nutrition education and physical activity intervention, while the CG was waitlisted. A generalized estimating equation model was applied to assess repeated variables over time. A total of 171 children with obesity (99 IG and 72 CG) aged 9.8 ± 0.7 years completed the post-intervention stage. Compared with baseline, significant reductions were observed within the IG for depression and fasting plasma glucose at post-intervention. After adjusting for confounders, group and time interaction effects showed that the IG achieved improvements in the risk of poor well-being (p = 0.051) and social anxiety (p = 0.029), had decreased diastolic blood pressure (p = 0.020) and fasting plasma glucose (p < 0.001), and had significantly increased high-density lipoprotein (p < 0.001) from baseline to post-intervention relative to the CG. The effects of school-based nutrition education and physical activity intervention on children with obesity are diverse, including not only the improvement of metabolic health but also mental health promotion.