Distribution of health-related physical fitness in Texas youth: a demographic and geographic analysis

Development of a Fitness Surveillance System to Track and Evaluate Obesity in North Idaho

BACKGROUND

Internationally 18% of youth are obese. Fitness testing can be used to establish fitness surveillance, which can inform policy and targeted interventions aimed at addressing obesity. The purpose of this study was to estimate the prevalence of overweight, obesity, and low fitness in Idaho school-aged youth through a pilot study.

METHODS

A convenience sample of 13 teachers from 11 north Idaho rural schools collected FitnessGram fitness data: body composition (body mass index [BMI]), aerobic capacity (Progressive Aerobic Cardiovascular Endurance Run [PACER] test), muscular endurance (curl up), strength (pushup), and flexibility (sit and reach).

RESULTS

A total of 761 students (aged 9-18 years) from grades 3&5, 7, and 9 to 12 participated in the study. Approximately 24% of 3&5 and 22% of 7th, and 12% of 9 to 12th-grade students were categorized as Needs Improvement/Health Risk by FitnessGram standards for BMI. Similarly, approximately 25% of 3&5, and 22% of 7 and 9 to 12th-grade students were considered Needs Improvement/Health Risk for PACER.

IMPLICATIONS FOR SCHOOL HEALTH POLICY, PRACTICE, AND EQUITY

Results from fitness testing can provide school and public health representatives with a "needs assessment" of student health that can be used to help develop policies and practices to improve student health and wellbeing.

CONCLUSIONS

This study provides a model for statewide annual fitness testing surveillance and reporting within K-12 public school physical education classrooms.

Quantile Regression of Childhood Growth Trajectories: Obesity Disparities and Evaluation of Public Policy Interventions at the Local Level

Quantile regression applied to child growth trajectories has been proposed in the methodological literature but has only seen limited applications even though it is a promising framework for the evaluation of school-based policy interventions designed to address childhood obesity. Data that could be used to support such assessments, school-based collection of height and weight, has become increasingly common. Three states currently mandate annual collection and several other jurisdictions including California and New York City (NYC) collect BMI as part of physical fitness assessments. This has resulted in the establishment of extremely large databases that share important characteristics including the ability to define longitudinal growth curves by student with high coverage rates. In NYC public schools, starting in 2006, student records have been linked to registry, academic, and attendance data and across years resulting in a longitudinal dataset containing 9 cohorts with 2 million unique children. A high level of demographic and geographic detail allow for analysis of public policy at the local scale. We demonstrate the utility of quantile regression longitudinal growth curve models applied to BMI trajectories as a means of assessing policy interventions. Models consisting solely of age terms yield empirical curves similar to CDC growth charts; covariates modify these curves. Incorporating lag terms yields a distribution of possible growth trajectories and the effect of interventions can be explicitly quantified. We evaluate area-based and individual poverty measures, known strong correlates of child obesity, as a baseline assessment of the modeling framework. We then evaluate the impact of a real intervention (water jet installations). Our results indicate that students with access to water jets have a statistically significant leftward shift in the right tail of the BMI distribution relative to students without access to water jets. The absolute magnitude of the shift is comparable to the difference in BMI associated with student residential exposure to low versus extreme poverty.

The Roles of Sex and Minority Status in Children's Motivation and Psychomotor Learning

In this study, we had two inter-related goals: (a) to examine sex and minority status differences on children's motivation for physical education (PE; i.e., their expectancy beliefs, subjective task values, and situational interest) and their psychomotor learning outcomes (i.e., motor competence, cardiorespiratory fitness, and in-class physical activity); and (b) to examine the relationships between children's motivation and their psychomotor learning outcomes while testing the moderation effects of sex and minority status. We recruited 195 fourth and fifth-grade students (101 boys; 94 girls; M_age = 10.7, SD = 0.7 years) from three elementary schools in North Texas. Using multivariate analysis of variance, we identified a significant sex difference that favored boys in motivation and psychomotor learning outcomes, with no significant minority status difference in relation to these variables. Regression analysis revealed that children's expectancy beliefs were significantly associated with both motor competence (R² = 11%) and cardiorespiratory fitness (R² = 16%), while both situational interest and sex were associated with in-class physical activity (R² = 18%). Thus, improving children's expectancy beliefs may be a means of enhancing psychomotor learning outcomes in PE, especially for girls. Enhancing children's beliefs in their own ability and offering diversified PE content so as to generate greater interest may facilitate psychomotor learning.

US School-Based Physical Fitness Assessments and Data Dissemination

BACKGROUND

Low physical fitness (PF) levels during childhood affect healthy growth and development, and increase the risk of cardiovascular diseases. Physical education standards exist for nearly all states in the United States, but evaluation of PF in youth has yet to be systematic, reproducible, and harmonized. The purpose of this project was to describe publicly available data of school-based PF testing (SB-PFT).

METHODS

A list of state-mandated SB-PFT programs published by SHAPE 2016 was confirmed by contacting appropriate authorities. SB-PFT data were obtained through each state's department of education.

RESULTS

Sixteen states mandate SB-PFT, with 10 states providing publicly available data; 92% to 100% of states perform the pacer/mile, curl-up, and push-up; 54.2% to 78.5% of elementary and 44% to 66.5% of high-school youth are in the "healthy fitness zone" for aerobic capacity.

CONCLUSIONS

SB-PFT provided PF data in children across the United States. The variability and inconsistency in reporting and in the values, however, raises questions about the current status of SB-PFT data and its utility in assessing PF in children. The critical nature of PF assessments is highlighted in the current COVID-19 pandemic, during which physical education has been curtailed, and emerging data demonstrate worsening of the already low levels of PF in youth.

AGREEMENT BETWEEN PHYSICAL BEST AND FITNESSGRAM CRITERION-REFERENCED STANDARDS FOR MUSCULAR STRENGTH AND ENDURANCE

OBJECTIVE

To verify the agreement between PHYSICAL BEST and FITNESSGRAM health-related criteria for muscle strength and endurance.

METHODS

This agreement study had a sample of 81 children and adolescents. Participants were submitted to the PHYSICAL BEST (Sit-up and Pull-up) and FITNESSGRAM (Curl-up and Modified Pull-up) test batteries. Additionally, FITNESSGRAM also proposed criteria for Pull-up test. Results of tests were classified in accordance with their respective criteria. Each group had an interval of seven days between the first and second battery of tests. Statistical analysis used the Kappa index (p<0.05).

RESULTS

Sit-up and Curl-up tests among the boys agreed in 72.2% (Kappa=0.368; p=0.004) of cases, and for the girls, in 64.4% (Kappa=0.130; p=0.076). Pull-up (PHYSICAL BEST versus FITNESSGRAM) agreed in 83.3% (Kappa=0.599; p<0.001) for boys. The agreement between Pull-up and Modified Pull-up (PHYSICAL BEST versus FITNESSGRAM) for boys was 47.2% (Kappa=0.071; p=0.533), and for girls, 44.5% (Kappa=0.102; p=0.120). The agreement between the Pull-up and Modified Pull-up tests (FITNESSGRAM) for boys was 58.4% (Kappa=0.215; p=0.143), and for girls, 44.5% (Kappa=0.102; p=0.120).

CONCLUSIONS

For individual analysis over time, as well as for the comparison of passing rates between different populations, caution is advised when using different criterion-referenced standards for strength and endurance, particularly if using different tests.

Disparities in physical fitness of 6-11-year-old children: the 2012 NHANES National Youth Fitness Survey

Background

Children’s physical fitness is an important predictor of metabolic health, physical function, and academic achievement. Although fitness is determined partially by heritable factors, it can be maintained and improved through regular physical activity. Because physical activity is known to vary by socioeconomic status, physical fitness may be expected to vary similarly. With this in mind, the purpose of this study was to examine disparities in physical fitness performance among a nationally-representative sample of 6–11 year-old children living in the United States.

Methods

We conducted secondary analysis of physical fitness data of children ages 6–11 years (n = 686) from the nationally representative National Health and Nutrition Survey (NHANES) Youth Fitness Survey (NNYFS) 2012. We estimated sex-stratified weighted means of four fitness performance tests: cardiorespiratory endurance, upper-, lower-, and core-muscular strength. The weighted mean for each fitness assessment was compared by income groups (federal income to poverty ratio – FIPR) accounting for complex sampling design and adjusting for age.

Results

Income disparities in physical fitness performance were evident among girls but not among boys. Girls from lower income groups (< 130% FIPR and 130–349% FIPR groups) showed significantly lower cardiorespiratory endurance and core muscle strength compared to those from the highest income group (≥ 350% FIPR).

Conclusion

These findings highlight the need to support health-promoting physical activity among girls from disadvantaged backgrounds prior to the adolescent period.

Profiling the health-related physical fitness of Irish adolescents: A school-level sociodemographic divide

Background and aims

Examining factors that may explain disparities in fitness levels among youth is a critical step in youth fitness promotion. The purpose of this study was twofold; 1) to examine the influence of school-level characteristics on fitness test performance; 2) to compare Irish adolescents’ physical fitness to European norms.

Methods

Adolescents (n = 1215, girls = 609) aged 13.4 years (SD .41) from a randomised sample of 20 secondary schools, stratified for gender, location and educational (dis)advantage, completed a series of field-based tests to measure the components of health-related physical fitness. Tests included: body mass index; 20 metre shuttle run test (20 m SRT); handgrip strength; standing broad jump (SBJ); 4 x 10 metre shuttle run; and back-saver sit-and-reach (BSR).

Results

Overall, boys outperformed girls in all tests, aside from the BSR (p < 0.005, t-test, Bonferroni correction). Participants in designated disadvantaged schools had significantly higher body mass index levels (p < 0.001), and significantly lower cardiorespiratory endurance (20 m SRT) (p < 0.001) and muscular strength (handgrip strength) (p = 0.018) levels compared to participants in non-disadvantaged schools. When compared to European norms, girls in this study scored significantly higher in the 20 m SRT, 4 x 10 metre shuttle run and SBJ tests, while boys scored significantly higher in the BSR test (Cohen’s d 0.2 to 0.6, p < 0.001). However, European adolescents had significantly higher handgrip strength scores (Cohen’s d 0.6 to 0.8, p < 0.001).

Conclusion

Irish adolescents compared favourably to European normative values across most components of HRPF, with the exception of muscular strength. School socioeconomic status was a strong determinant of performance among Irish adolescents. The contrasting findings for different fitness components reiterate the need for multi-component testing batteries for monitoring fitness in youth.

Socioeconomic status and physical fitness in youth: Findings from the NHANES National Youth Fitness Survey

This study examined the associations between socioeconomic status (SES) and musculoskeletal (MSF) and cardiorespiratory fitness (CRF) in youth.  The sample consisted of boys and girls between 3-15 years.  SES was categorized utilizing family-income-to-poverty ratio (FIPR).  All analyses were standardized for age and sex.  For each test of physical fitness, SES was used to estimate mean fitness test percentile and 95% confidence intervals, controlling for race/ethnicity and physical activity.  Odds ratios were calculated for the likelihood of having low fitness by SES category.  In general, the high SES group had a better composite MSF, body composition, and CRF profiles than low and moderate SES groups.  Statistically significant differences were identified for relative grip strength, plank, body mass index, and cardiovascular endurance time (all p < 0.05).  Additionally, the odds of low/poor MSF fitness were 1.7 and 1.6 times higher in the low and moderate SES groups (respectively) compared to the children from high SES families.  The moderate SES group had an odds of poor CRF 1.6 times higher than the high SES group as well.  Children and adolescents from high SES families tend to have higher mean fitness and were less likely to have low/poor fitness.

Physical Activity and Health-Related Fitness of Adolescents within the Juvenile Justice System

Background

The purpose of this study was to examine the physical activity patterns and health-related fitness levels of adolescents within the Juvenile Justice System.

Methods

Participants included 68 adolescents (Mean age = 17.1 ± 1.0 years) in two secure Juvenile Justice correctional facilities in the Western USA. Moderate-to-vigorous physical activity (MVPA) was monitored for one week using the ActiGraph GT9X accelerometer. Health-related fitness was measured using the FITNESSGRAM test battery.

Results

Adolescents averaged 43.3±21.6 minutes of MVPA per weekday compared to 42.7±27.5 per weekend day. During school hours, adolescents accumulated 17.1±9.0 minutes of MVPA compared to 5.9±3.4 minutes before school and 21.0±13.6 minutes after school. Adolescents averaged 18.9±11.0 push-ups, 44.5±26.4 curl-ups, 34.7±24.8 PACER laps, and 22.1%±10.0% body fat.

Conclusions

Adolescents within the Juvenile Justice System are falling short of the recommended 60 minutes of MVPA per day and 30 minutes of MVPA during school and also need to improve their health-related fitness, especially cardiorespiratory endurance.

The Association of Health-Related Fitness and Chronic Absenteeism Status in New York City Middle School Youth

BACKGROUND

Extensive research demonstrates the benefits of fitness on children's health and academic performance. Although decreases in health-related fitness may increase school absenteeism, multiple years of prospective, child-level data are needed to examine whether fitness changes predict subsequent chronic absenteeism status.

METHODS

Six cohorts of New York City public school students were followed from grades 5-8 (2006/2007-2012/2013; N = 349,381). A longitudinal 3-level logistic generalized linear mixed model with random intercepts was used to test the association of individual children's changes in fitness and 1-year lagged chronic absenteeism.

RESULTS

The odds of chronic absenteeism increased 27% [odds ratio (OR) 95% confidence interval (CI), 1.25-1.30], 15% (OR 95% CI, 1.13-1.18), 9% (OR 95% CI, 1.07-1.11), and 1% (OR 95% CI, 0.98-1.04), for students who had a >20% decrease, 10%-20% decrease, <10% increase or decrease, and 10%-20% increase in fitness, respectively, compared with >20% fitness increase.

CONCLUSION

These findings contribute important longitudinal evidence to a cross-sectional literature, demonstrating reductions in youth fitness may increase absenteeism. Given only 25% of youth aged 12-15 years achieve the recommended daily 60 minutes or more of moderate to vigorous physical activity, future work should examine the potential for youth fitness interventions to reduce absenteeism and foster positive attitudes toward lifelong physical activity.

Aggregation of risk indicators to cardiometabolic and musculoskeletal health in Brazilian adolescents in the periods 2008/09 and 2013/14

OBJECTIVE

To assess the occurrence of an aggregate risk to cardiometabolic and musculoskeletal health of Brazilian adolescents in the period 2008/09 and 2013/14 and to identify whether there are differences in risk between the genders and in these periods.

METHODS

This was a trend epidemiological study with a quantitative approach, consisting of a voluntary sample of adolescents from 16 Brazilian states. Data were extracted from the database of Brazil Sports Project (Projeto Esporte Brasil). Health-related physical fitness was evaluated based on body mass index, cardiorespiratory fitness, flexibility, and abdominal strength/resistance. Descriptive analysis, chi-squared test, and Poisson log regression were used for the statistical treatment.

RESULTS

In the years 2008/09, 14.6% of Brazilian youngsters showed an aggregate risk to cardiometabolic health and 17.1% an aggregate risk for musculoskeletal indicators, whereas in 2013/14, the values of the risk indicators were, respectively 40.0% and 22.4%. It was observed that, in the years 2013/14, the risk to the cardiometabolic health of boys was 2.51 times greater than in 2008/09, while for girls, a three-fold increase in risk was observed. Concerning musculoskeletal health, girls showed a 2.21 risk of being in the risk zone in 2013/14 when compared with 2008/09.

CONCLUSION

The occurrence of an aggregate risk to the cardiometabolic and musculoskeletal health of Brazilian adolescents increased in the 2008/09 and 2013/14 periods. Regarding gender, an increase in the cardiometabolic and musculoskeletal risk between these periods was observed in girls. As for boys, an increase was observed only in cardiometabolic risk.

The Intersections of Science and Practice: Examples From FitnessGram® Programming

The FitnessGram® program has provided teachers with practical tools to enhance physical education programming. A key to the success of the program has been the systematic application of science to practice. Strong research methods have been used to develop assessments and standards for use in physical education, but consideration has also been given to ensure that programming meets the needs of teachers, students, parents, and other stakeholders. This essay summarizes some of these complex and nuanced intersections between science and practice with the FitnessGram® program. The commentaries are organized into 5 brief themes: science informing practice; practice informing science; balancing science and practice; promoting evidence-based practice; and the integration of science and practice. The article draws on personal experiences with the FitnessGram® program and is prepared based on comments shared during the 37th Annual C. H. McCloy Research Lecture at the 2017 SHAPE America - Society of Health and Physical Educators Convention.

Impact of NFL PLAY 60 Programming on Elementary School Children's Body Mass Index and Aerobic Capacity: The NFL PLAY 60 FitnessGram Partnership Project

BACKGROUND

We examined the impact of the Fuel Up to Play 60 (FUTP60) program on children's body mass index (BMI) and aerobic capacity (AC).

METHODS

Participation in the FUTP60 and both BMI and AC profiles were collected through the NFL PLAY 60 FitnessGram Partnership Project involving over 100 schools from 22 US states. We specifically examined the distributions of BMI and AC among participating versus nonparticipating schools in the 2012-2013 school year. Hierarchical linear models tested the impact of participation and availability of additional funding for program implementation on the proportions of youth meeting FitnessGram health-related fitness standards (ie, Needs Improvement-Health Risk [NIHR] and Healthy Fitness Zone [HFZ] categories).

RESULTS

After 1 year implementing the program, participating schools had lower proportions of boys (-4.1 ± 2.0%, p = .04) and girls (-4.5 ± 2.0%, p = .03) in the NIHR for BMI, and lower proportion of girls (-9.7 ± 4.0%, p = .02) in the NIHR for AC. There were no differences in the distributions for the HFZ and the availability of additional funding did not alter the relationships (p > .05).

CONCLUSIONS

This study provides preliminary evidence that participation in the FUTP60 is associated with improved profiles of health-related fitness.

The Psychological Effects of Playing Exergames: A Systematic Review

Successful exergames should lead players not only to achieve enough level of energy expenditure but also to engage in the play itself. The aim of this study is to review studies that explored the psychological effects of playing exergames, from the viewpoint of player engagement. Peer-reviewed journal articles in English collected via database search (Science Direct, Web of Science, ACM Digital Library) from 2011 to 2015 were considered, and 45 experimental studies were selected out of 911 studies. The results show that a variety of psychological effects of engagement including enjoyment, immersion, and flow were measured in the exergame studies. In addition, physiological variables (e.g., energy expenditure), feedback modality (e.g., auditory and tactile), and play modes (e.g., solitary or group play mode) are related to psychological effects of playing exergames. Finally, salient methodological issues (e.g., validated measurement, sample size calculation) in the studies are identified and discussed.

School and Neighborhood Predictors of Physical Fitness in Elementary School Students

BACKGROUND

We assessed the associations of 5 school and 7 neighborhood variables with fifth-grade students achieving Healthy Fitness Zone (HFZ) or Needs Improvement-Health Risk (NI-HR) on aerobic capacity (AC) and body composition (BC) physical fitness components of the state-mandated FITNESSGRAM^® physical fitness test.

METHODS

Data for outcome (physical fitness) and predictor (school and neighborhood) variables were extracted from various databases (eg, Data Quest, Walk Score^® ) for 160 schools located in San Diego, California. Predictor variables that were at least moderately correlated (|r| ≥ .30) with ≥1 outcome variables in univariate analyses were retained for ordinary least squares regression analyses.

RESULTS

The mean percentages of students achieving HFZ AC (65.7%) and BC (63.5%) were similar (t = 1.13, p = .26), while those for NI-HR zones were significantly different (AC = 6.0% vs BC = 18.6%; t = 12.60, p < .001). Correlations were greater in magnitude for school than neighborhood demographics and stronger for BC than AC. The school variables free/reduced-price lunch (negative) and math achievement (positive) predicted fitness scores. Among neighborhood variables, percent Hispanic predicted failure of meeting the HFZ BC criterion.

CONCLUSIONS

Creating school and neighborhood environments conducive to promoting physical activity and improving fitness is warranted.

A Review of the Promotion of Fitness Measures and Health Outcomes in Youth

The relationship between physical fitness and health in adults is well established, yet until recently, empirical support for the impact of physical fitness levels on health markers in children has not been thoroughly documented. The aim of this review was to provide a summary of current literature that has examined the linkage between measures of health-related physical fitness (ie, cardiorespiratory fitness, musculoskeletal fitness, flexibility, and body composition) and health markers in youth. Specifically, this review focused on the findings from the recent 2012 Institutes of Medicine report on Fitness Measures in Youth as well as other subsequent review articles related to the topic. In addition, recommendations for health-related fitness assessments in youth populations are presented.

Health-Related Physical Fitness among Young Goalball Players with Visual Impairments

Introduction

The purpose of our study was to determine the passing rates on health-related physical fitness tests of young goalball players. More specifically, we compared their passing rates according to gender and visual impairment classification.

Methods

Participants included 40 Brazilian goalball players with visual impairments (20 female [B1 = 7, B2 = 8, B3 = 5]; 20 male [B1 = 6, B2 = 4, B3 = 10]), with a mean age 17.3 (SD = 1.6). The Brockport Physical Fitness Test, a health-related, criterion-referenced protocol, was employed to evaluate percentage of body fat, shoulder stretch, back-saver sit and reach, trunk lift, curl-ups, push-ups, and the one-mile run or walk.

Results

A significant difference was found in passing rates between genders only in the one-mile run or walk. More than half the participants were able to pass in at least four out of the seven tests. No significant differences were found between groups regarding the proportion of athletes who reached the protocol standards.

Discussion

Irrespective of gender or visual impairment classification, the participants of this study had high passing rates on most tests. Nonetheless, athletes had low passing rates on specific areas (cardiovascular and muscular strength), which need to be acknowledged. Future studies with a bigger sample could seek to determine the effects of specific training regimens not only on youths, but also on adult groups.

Implications for practitioners

As a Paralympic sport likely to be of interest to visually impaired children and adolescents, goalball seems to be a feasible game to support the achievement of ideal physical activity levels in this population, leading to higher levels of health-related physical fitness.

Prevalence of Youth Fitness in the United States: Baseline Results from the NFL PLAY 60 FITNESSGRAM Partnership Project

OBJECTIVE

To assess age- and sex-specific patterns of 6 health-related fitness components in youth, baseline data from the NFL PLAY 60 FITNESSGRAM Partnership Project were analyzed.

STUDY DESIGN

A total of 192,848 students from 1st through 12th grade in 725 schools completed the standard FITNESSGRAM testing in 2010-2014, including assessments of aerobic capacity (AC), body mass index (BMI), upper body strength and endurance, trunk extensor strength and flexibility, abdominal strength and endurance, and flexibility. Individual data were aggregated by grade and sex. Age- and sex-specific health-related criterion-referenced standards were used to classify fitness results into the healthy fitness zone (HFZ), needs improvement zone, or needs improvement health risk.

RESULTS

The proportion of youth meeting the HFZ for AC varied considerably by grade for both boys (62.1%-37.6%) and girls (49.1%-26.1%) among 1st-12th grade. There was less variability by age and sex for achievement of the BMI HFZ (ranged from 52.7%-65.0%). The prevalence of achievement was similar for the remaining fitness components. Significantly lower achievement was found in the middle school years for BMI HFZ in both sexes and for AC HFZ achievement in boys. Continuous age-related lower HFZ achievement was evident in girls for AC.

CONCLUSIONS

The results provide updated health-related fitness profiles for US youth and identify the critical ages when youth fitness levels start to decline.

Cardiorespiratory Fitness May Help in Protecting Against Depression Among Middle School Adolescents

PURPOSE

Cross-sectional studies demonstrate a robust association between depression, physical activity, and cardiorespiratory fitness in adolescents, but longitudinal evidence that can better parse the direction of these effects is scarce and conflicting, and no such studies in adolescents have considered the importance of fitness (as opposed to physical activity per se) for preventing depression. Therefore, the present study sought to determine if cardiorespiratory fitness in the first year of middle school (sixth grade) would protect against developing depression a year later (seventh grade), even after controlling for other risk factors (i.e., preexisting depression levels and weight status).

METHODS

Participants (N = 437 with 54.9% female) were recruited from six different middle schools during their sixth-grade year and reassessed during the seventh grade. At each assessment, participants completed self-report measures of depression and fitness. Participants were also weighed and were asked to complete a shuttle-run at both points.

RESULTS

A cross-lagged panel model indicated that cardiorespiratory fitness in the sixth grade was associated with significantly less depression by the seventh grade in girls, even after controlling for preexisting depression and weight. The effect was in the same direction for boys, but was nonsignificant. In both cases, effects were modest to small.

CONCLUSIONS

Cardiorespiratory fitness had a small, but significant protective effect against developing depression in middle school girls, and may have a similar but smaller effect in boys. Promotion of cardiorespiratory fitness can be an important strategy for preventing depression in middle school adolescents, but needs to be coupled with interventions that more directly address symptom treatment.

Health-Related Physical Fitness in Hungarian Youth: Age, Sex, and Regional Profiles

PURPOSE

The purpose of this study was to examine region, age, and sex profiles of physical fitness in Hungarian youth.

METHOD

A sample of 2,602 Hungarian youth aged 10 to 18 years old completed a series of physical fitness field tests: the Progressive Aerobic Cardiorespiratory Endurance Run (PACER) fitness test, body mass index (BMI), percent body fat (%BF), waist circumference (WC), curl-ups (CU), pushups (PU), trunk extension (TE), back-saver sit-and-reach (SR), handgrip (HG), and standing broad jump. Physical fitness scores were classified using FITNESSGRAM® standards, and trends for region, age, and sex were examined using logistic regression. The outcome variable represented the likelihood that a child would meet the recommended levels of fitness for health.

RESULTS

Achievement rates varied considerably by region, age, and sex. The likelihood of achieving the Healthy Fitness Zone (HFZ) varied among Hungarian regions and on all the assessments (p <  .05) with exception of the CU, PU, and HG tests (p > .05). The likelihood of achieving the HFZ was linearly related with age based on PACER, BMI, WC, %BF, CU, and SR scores (p <  .05). There were statistically significant gender differences and boys were more likely to achieve the HFZ based on PACER, WC, CU, PU, TE, and SR scores (p <  .05).

CONCLUSIONS

The likelihood of achieving the recommended levels of fitness for youth varies between regions in Hungary, in most cases decreases with age, and tends to be higher in boys. This study is one of the few that provides evidence of regional, age, and sex patterns of health-related fitness using a representative sample of youth.

Physical fitness levels of adolescents in the Ile de France region: comparisons with European standards and relevance for future cardiovascular risk

The aim was to assess physical fitness in French schoolchildren in the region of Ile de France and to compare the results with European countries. The relationship between physical fitness and future health profile was of particular interest. Participants were 1851 French youth in the Ile de France region. Cardiorespiratory fitness, muscular endurance, speed, flexibility and speed agility were tested. Independent t-tests were used to compare differences between different variables. Spearman's rho correlation coefficients assessed the relationship between body mass index, socio-economic status and physical fitness. Boys were physically fitter than girls with the most significant difference being in agility. Subjects of normal weight have significantly better results than overweight or obese adolescents (+10·9% to 56·1%) (P<0·05). Subjects with high socio-economic status had better physical fitness than those with low socio-economic status (+0·5% to 9·4%) (P<0·05). Results also showed that the percentage of adolescents at increased future cardiovascular risk was 15·3% and 10·2% for boys and girls, respectively. Physical fitness in French schoolchildren living in the region of Ile de France is relatively low and unfavourable, especially in girls, when compared with existing European test results. In contrast, the adolescent boys are generally fitter and also above the average of the European data. Introducing a health promotion curriculum in the schools of Ile de France is suggested to improve health and physical fitness.

Aerobic fitness, micronutrient status, and academic achievement in Indian school-aged children

Aerobic fitness has been shown to have several beneficial effects on child health. However, research on its relationship with academic performance has been limited, particularly in developing countries and among undernourished populations. This study examined the association between aerobic fitness and academic achievement in clinically healthy but nutritionally compromised Indian school-aged children and assessed whether micronutrient status affects this association. 273 participants, aged 7 to 10.5 years, were enrolled from three primary schools in Bangalore, India. Data on participants’ aerobic fitness (20-m shuttle test), demographics, anthropometry, diet, physical activity, and micronutrient status were abstracted. School-wide exam scores in mathematics and Kannada language served as indicators of academic performance and were standardized by grade level. The strength of the fitness/achievement association was analyzed using Spearman’s rank correlation, multiple variable logistic regression, and multi-level models. Significant positive correlations between aerobic capacity (VO2 peak) and academic scores in math and Kannada were observed (P < 0.05). After standardizing scores across grade levels and adjusting for school, gender, socioeconomic status, and weight status (BMI Z-score), children with greater aerobic capacities (mL * kg-1 * min-1) had greater odds of scoring above average on math and Kannada exams (OR=1.08, 95% CI: 1.02 to 1.15 and OR=1.11, 95% CI: 1.04 to 1.18, respectively). This association remained significant after adjusting for micronutrient deficiencies. These findings provide preliminary evidence of a fitness/achievement association in Indian children. While the mechanisms by which aerobic fitness may be linked to academic achievement require further investigation, the results suggest that educators and policymakers should consider the adequacy of opportunities for physical activity and fitness in schools for both their physical and potential academic benefits.

The association between physical fitness and academic achievement in Texas state house legislative districts: an ecologic study

BACKGROUND

The association of physical fitness with cognitive function in children and adolescents is unclear. The purpose of this ecological study was to describe the association between academic achievement, body mass index (BMI), and cardiovascular fitness (CVF) in a large sample of elementary, middle, and high school students in Texas.

METHODS

FITNESSGRAM(®) results for 2,550,144 students were matched with standardized composite academic test (TAKS) results from 2008 to 2009. Analyses were conducted on the percent of students meeting TAKS standards by BMI and CVF quintiles. Analyses of variance with Tukey adjustment examined differences between the most favorable 5th quintile (referent) and all other quintiles.

RESULTS

The prevalence of students meeting the TAKS standard was significantly higher in the highest fitness category for BMI and CVF compared to all other categories, regardless of sex or grade category (p < .05). Linear modeling suggested a 5% increase in the prevalence of students meeting healthy BMI and CVF standards would result in a 2.25% and 0.65% increase in the prevalence of students meeting the TAKS standard (both p < .05).

CONCLUSION

Findings suggest a healthy BMI and CVF are associated with higher academic achievement, and the need for additional research examining the role of potential confounders and/or effect modifiers longitudinally.

Current Evidence for the Impact of Physical Fitness on Health Outcomes in Youth

Physical fitness is tightly linked to our ability to be physically active, and poor fitness is tied to increased risk of lifestyle diseases such as diabetes and cardiovascular disease in adulthood. In 2011, the Institute of Medicine appointed an expert committee to review the evidence between physical fitness and health outcomes in youth. Specifically, experimental and longitudinal studies published between 2000 and 2010 were reviewed in the areas of body composition, cardiorespiratory fitness, musculoskeletal fitness, and flexibility. Specific fitness tests that were linked to health risk factors or health outcomes in each of these areas were identified. Recommendations for the best fitness test items for use in schools and also for a national survey were given. In addition, guidance was provided for interpretation of fitness test scores along with recommendations for areas of needed future research. Key findings from the final report “Fitness Measures and Health Outcomes in Youth” will be reviewed.

Health-related fitness of American Indian youth

A physically fit lifestyle is important for American Indian (AI) youth who are at risk for hypokinetic diseases, particularly type 2 diabetes. Some evidence exists on the physical activity patterns of AI youth, but there is little information on their health-related fitness.

PURPOSE

The purpose of this study was to describe the health-related fitness levels of youth living in an AI community.

METHOD

Participants included youth from 5th to 9th grade (N = 85) in a Southwestern U.S. AI community. Youth were of AI descent and were 12.36 +/- 1.68 years of age. Participants completed 5 parts of the FITNESSGRAM fitness test during physical education. The tests included the Progressive Aerobic Cardiorespiratory Endurance Run fitness test (cardiovascular fitness), curl-up (muscular endurance), pushup (muscular strength), sit-and-reach (flexibility), and body mass index (estimated body composition).

RESULTS

Results were similar to other youth studies with some of the students reaching the healthy fitness zone for muscular strength (28%), body composition (30%), flexibility (60%), aerobic fitness (63%), and muscular endurance (74%).

CONCLUSIONS

Findings highlight the capacity for improvement for students across all of the components of health-related fitness.

Measurement agreement between estimates of aerobic fitness in youth: the impact of body mass index

PURPOSE

The purpose of this study was to examine the impact of body mass index (BMI) on the agreement between aerobic capacity estimates from different Progressive Aerobic Cardiorespiratory Endurance Run (PACER) equations and the Mile Run Test.

METHOD

The agreement between 2 different tests of aerobic capacity was examined on a large data set from 2 suburban school districts (n = 1,686 youth in Grades 3-10). Difference estimates between the Mile Run Test and several PACER equations were computed, and residuals were examined using cluster analysis. The implication of the discrepancy between these tests was also examined using FITNESSGRAM health-related standards for BMI. Comparisons were made against corresponding estimates of peak oxygen consumption from the Mile run because this equation is more established.

RESULTS

Results supported a 2-cluster solution. The discrepancy between tests was higher in participants with higher BMI scores (Z scores for residuals in this group ranged from -0.07 to 1.57). BMI was able to explain 30% to 34% of the disagreement between the Mile and different PACER equations of aerobic fitness. Classification analyses revealed that kappa scores were lower among PACER equations that do not include a BMI term (kappa = .12-.34 vs. .59-.81). Overall, the test-equating approach used in the Fitnessgram program to process PACER data had better agreement than alternative PACER equations that included BMI.

CONCLUSION

The results support the inclusion of BMI in prediction equations used to estimate aerobic capacity from the PACER.

Physical fitness, academic achievement, and socioeconomic status in school-aged youth

BACKGROUND

This study examined the association between physical fitness and academic achievement and determined the influence of socioeconomic status (SES) on the association between fitness and academic achievement in school-aged youth.

METHODS

Overall, 1,701 third-, sixth-, and ninth-grade students from 5 school districts participated in the assessments. Fitness was assessed using FITNESSGRAM (aerobic fitness, muscular strength, muscular endurance, flexibility, and body composition). Results were used to determine individual fitness scores. Academic achievement was measured by standardized tests for Math (all grades), English (all grades), and Social Studies (sixth and ninth grades only). The SES was determined using eligibility for free and reduced lunch program.

RESULTS

There were no significant differences between fitness groups for Math and English in third-grade students. Sixth- and ninth-grade students with high fitness scored significantly better on Math and Social Studies tests compared with less fit students. Lower SES students scored significantly worse on all tests. Muscular strength and muscular endurance were significantly associated with academic achievement in all grades.

CONCLUSIONS

Compared with all other variables, SES appears to have the strongest association with academic achievement. However, it also appears that high fitness levels are positively associated with academic achievement in school-aged youth.

Aptidão física relacionada à saúde de escolares: programa fitnessgram

O estudo identificou a proporção de crianças e adolescentes da população escolar de Montes Claros, Minas Gerais, Brasil, que atendem aos critérios referenciados para a saúde a partir de escores equivalentes aos componentes de aptidão física. A amostra foi constituída por 2.849 sujeitos (1.457 moças e 1.392 rapazes), com idades entre seis e 18 anos. Os componentes da aptidão física foram avaliados mediante bateria de testes composta por cinco itens: "sentar-e-alcançar" alternado, abdominal modificado, elevação do tronco, puxada em suspensão na barra modificado e caminhada/corrida de "vai-e-vem", adotando-se pontos de corte para gênero e idade sugeridos pelo Fitnessgram. Mediante análise dos resultados foi possível observar que a proporção de escolares que atenderam às exigências motoras mínimas estabelecidas que possam satisfazer aos critérios referenciados para a saúde não foi maior que 8%, e a quantidade de jovens que alcançaram os critérios foi menor a partir dos 10 anos de idade em ambos os sexos. Os dados mostram, ainda, que grande parte dos jovens estudados demonstrou componentes de aptidão física que podem comprometer melhor estado de saúde, apontando para urgente necessidade de implementar programas de intervenção direcionados ao incremento da prática de exercício físico na população escolar.

A systematic review of associations between the primary school built environment and childhood overweight and obesity

This systematic review considers current literature on the association between childhood overweight and obesity and the primary school built environment. Bibliographic databases from the fields of medicine, social science, exercise science and education were systematically searched. The following elements of the built environment were found to have been investigated: playground availability and adequacy; gymnasium availability and adequacy; school field, showers and covered playground availability. One intervention study was identified which utilized the built environment as an adjunct to a behavior change intervention. This systematic review identified minimal research upon the association between the school built environment and weight status and the current results are inconclusive.

Field evaluation of the new FITNESSGRAM® criterion-referenced standards

BACKGROUND

The Cooper Institute established new criterion-referenced standards for the body composition and cardiovascular fitness standards for the FITNESSGRAM(®) program.

PURPOSE

The purpose of this study was to evaluate differences in the achievement of standards and classification agreement between the old and new standards.

METHODS

Fitness data were collected during the 2009-2010 school year from 1686 youth (grades 3-12) from six schools (two districts) in a small Midwestern town. Data analyses were completed during the 2010 and 2011 school year. Descriptive statistics were computed to determine the percentage of students classified into the various fitness classifications using both the old and new standards. Classification agreement was examined for alternative tests of cardiovascular fitness (Progressive Aerobic Cardiovascular Endurance Run [PACER] and 1-mile run) and body composition (skinfold determination of body fat and BMI) using both the old and new standards.

RESULTS

The descriptive results reveal important age and gender differences in reported levels of fitness levels in school-aged youth. For body composition, the percentage of youth achieving the healthy fitness zone (HFZ) was about 10% lower with the new standards than the old ones. For aerobic capacity, a larger percentage of young boys and a smaller percentage of older boys achieved the new HFZ for aerobic capacity. However, a smaller percentage of girls achieved the new HFZ at all ages. The use of test-equating in the revised standards led to significant improvements in the classification agreement between 1-mile run and the PACER.

CONCLUSIONS

The large data set provided a useful sample to examine the impact of the new fitness standards on the documentation of youth fitness levels in schools. The new standards address a number of measurement issues with the old standards and provide a more appropriate way to evaluate levels of health-related fitness in youth.

Reflections on the Texas Youth Evaluation Project and implications for the future

The passage of Senate Bill 530 in June 2007 increased visibility about the importance of health-related fitness in Texas. As a result of the mandate, more than 2.6 million 3rd- through 12th-grade students from all Texas counties were evaluated between January 1, 2008, and June 1, 2008, using a standardized test of health-related physical fitness (FITNESSGRAM). This number represented 84.8% of all public school districts in Texas. In the subsequent 2 years, 2.8 and 2.9 million children were tested, which represents more than 90% of all public school districts in Texas. This summary provides reflections on the test results and implications for future school-based fitness initiatives, both in Texas and in other states.

Reliability and validity of the FITNESSGRAM: quality of teacher-collected health-related fitness surveillance data

The purpose of this study was to investigate the quality (reliability and validity) of large-scale fitness testing in Texas and determine if reliabilities and validities were related to potential confounding variables. Four test administration scenarios were conducted to investigate the quality of data collected statewide as part of the Texas Youth Evaluation Project. Teachers and/or expert test administrators tested individual students (N=1010) on two occasions. Criterion-referenced reliabilities were very good to generally acceptable for all FITNESSGRAM test items, with musculosheletal items having the lowest reliabilities. The validity of teacher-administered tests was good. Reliability and validity of teacher-obtained health-related fitness measures were generally unrelated to potentially confounding student or school characteristics. Administrators, teachers, parents, and students can feel comfortable with the reliability and validity of the statewide health-related fitness testing in Texas.

Texas Youth Fitness Study: a commentary

When institutional testing is done well, there are many potential benefits; however, it is not without its negatives. The TYEP is an example of large scale institutional testing that yielded more than a few benefits as described in this supplement. However, results reported some problems as well. We have learned much from the TYEP, including what works and what does not when conducting large-scale fitness testing projects. Questions that need answers include: (a) How often must similar testing be done to achieve the intended goals? (b) Can alternative forms of testing be used to meet our goals? (c) How can we improve the next institutional testing to accentuate the positives and diminish the negatives? (d) How do we acquire the necessary funding and adequate teacher support for future institutional testing? and (e) How can we best obtain the necessary funding and support for quality physical education, including already approved but unfunded mandates? Support for quality physical education is necessary if we are to increase youth activity levels, improve youth fitness, and help reduce the risk for childhood obesity-all important goals of the TYEP.

Physical education and school contextual factors relating to students' achievement and cross-grade differences in aerobic fitness and obesity

Using two major data sets from the Texas Youth Fitness Study, ordinary least squares regression, and hierarchical linear modeling, we examined the impact of hey correlates in school physical education programs and policies on students'fitness status and cross-grade differences. While a number of factors, such as teachers' training/updates, recess time, available physical activity space, a school wellness policy, and fitness testing before administration, were confirmed, these correlates can explain only limited variance. Other aspects, such as socioeconomic status and community confounding factors, were recognized and illustrated. Future studies should include more factors such as these in data collection and analysis.