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

Healthy fitness zone prevalence and age-specific fitness profile of young people in seven European countries in 2022: The EUFITMOS project

BACKGROUND

Physical fitness is a health marker in youth and is associated with current and future health.

OBJECTIVE

Present the healthy fitness zone (HFZ) prevalence and age-specific fitness profile of young people from seven European countries.

METHODS

This study used data from the European Fitness Monitoring System project. The sample comprised 4965 (51.4% boys) youths aged 9 to 18 years. Fitness data were collected by physical education teachers using field-based tests. Raw data from the fitness tests were used to calculate the prevalence and 95% confidence intervals (CI) of participants in the HFZ.

RESULTS

The overall prevalence of boys and girls in the HFZ for all tests was 16.6% (95% CI = 14.7, 18.1) and 14.9% (95% CI = 13.2, 16.6), respectively. Boys have a mainly positive HFZ profiles, except for the 9-year-olds in the sit and reach (z-score difference = -1.20) and the 20 m run for boys 13-18-year-olds (z-score difference range: -0.09 to -0.01). Girls have worse HFZ profiles than boys, being out of the HFZ in several tests. Furthermore, a decreasing trend in z-score difference from the HFZ with age was observed in VO2 peak for boys and girls and sit and reach for girls. Notwithstanding, several country-related, sex and age differences were observed.

CONCLUSIONS

Boys presented mostly healthy age-specific fitness profiles in several fitness tests and ages. These differences should be considered when promoting youth's health through physical activity and fitness, as different fitness levels may require different approaches to implementing health-enhancing physical activity policies.

Examination of Physical Activity Patterns of Children, Reliability and Structural Validity Testing of the Hungarian Version of the PAQ-C Questionnaire

INTRODUCTION

Several studies report on the importance of physical activity (PA) in childhood, which influences attitudes towards health in adulthood. For monitoring PA, trustworthy measurement tools are needed. The study aimed to adapt the Physical Activity Questionnaire for Children (PAQ-C) to the Hungarian language and assess its validity, reliability, and factor structure.

METHODS

A total of 620 children (the average age was 10.62 (SD 2.36)) participated in the cross-sectional study. To assess physical activity, the PAQ-C questionnaire was used. The collected data were analysed using IBM SPSS version 28.0 and IBM SPSS AMOS 29.0 software.

RESULTS

The internal consistency was acceptable (alpha = 0.729) and the test-retest reliability showed acceptable agreement (ICC = 0.772). The confirmatory factor favoured a one-factor structure of the questionnaire. The average PAQ-C score for girls was 2.87 (SD 1.07), and for boys it was 3.00 (SD 1.05), which showed a significant difference (p = 0.005).

DISCUSSION

Based on our findings, our study tested the validity and reliability of the one-factor PAQ-C questionnaire, a valid and reliable measurement tool to test the physical activity patterns of primary school children in a Hungarian sample. Further research is needed to develop physical activity monitoring of Hungarian children.

Longitudinal Associations Between Neighborhood Child Opportunity and Physical Fitness for New York City Public School Youth

Neighborhood environments can support fitness-promoting behavior, yet little is known about their influence on youth physical fitness outcomes over time. We examined longitudinal associations between neighborhood opportunity and youth physical fitness among New York City (NYC) public school youth. The Child Opportunity Index (COI), a composite index of 29 indicators measuring neighborhood opportunity at the census-tract level, along with scores on 4 selected COI indicators were linked to NYC FITNESSGRAM youth data at baseline. Fitness outcomes (measured annually, 2011-2018) included body mass index, curl-ups, push-ups, and Progressive Aerobic Cardiovascular Endurance Run (PACER) laps. Unstratified and age-stratified, adjusted, 3-level generalized linear mixed models, nested by census tract and time, estimated the association between COI and fitness outcomes. The analytical sample (n = 204,939) lived in very low (41%) or low (30%) opportunity neighborhoods. Unstratified models indicated that overall COI is modestly associated with improved youth physical fitness outcomes. The strongest opportunity-fitness associations were observed for PACER. Stratified models show differences in associations across younger vs. older youth. We find that neighborhood factors are associated with youth fitness outcomes over time, with the strength of the associations dependent on age. Future implications include better informed place-based interventions tailored to specific life stages to promote youth health.

Assessment of physical activity among adolescents: a guide to the literature

Purpose

The aim of this article is to systematically review articles and annual reports concerning young peoples' physical activity (PA) and linking this to considerations of the state and national defense.

Method

A systematic search of the literature included an analysis of publications accessible in global databases and other available books, student papers, and projects. The articles and reports were categorized based on year of publication, methods used, age of respondents, sample size, country, and digital object identifier (DOI).

Results

The result of this search is an overview of the extent and manner in which the worldwide scientific community is addressing the current situation and the long-term development of the physical fitness of adolescents. This publication also maps to what extent professional publications and articles are addressing PA from the perspective of the needs of armies and armed forces of various countries around the world.

Conclusions

The article provides a systematic overview of methods used to measure PA, and an overview of articles dealing with assessing PA. The examined articles indicate that from the perspective of not only national defense, but also health and overall quality of life, in particular, we need initiatives to encourage and motivate young people to increase their everyday PA. The research therefore also includes an overview of factors that may considerably influence PA. The results ascertained in this publication will be used, i.a. for investigating a longitudinal defense research project of the Ministry of Defense of the Czech Republic in which the authors are participating.

Top 10 International Priorities for Physical Fitness Research and Surveillance Among Children and Adolescents: A Twin-Panel Delphi Study

BACKGROUND

The measurement of physical fitness has a history that dates back nearly 200 years. Recently, there has been an increase in international research and surveillance on physical fitness creating a need for setting international priorities that could help guide future efforts.

OBJECTIVE

This study aimed to produce a list of the top 10 international priorities for research and surveillance on physical fitness among children and adolescents.

METHODS

Using a twin-panel Delphi method, two independent panels consisting of 46 international experts were identified (panel 1 = 28, panel 2 = 18). The panel participants were asked to list up to five priorities for research or surveillance (round 1), and then rated the items from their own panel on a 5-point Likert scale of importance (round 2). In round 3, experts were asked to rate the priorities identified by the other panel.

RESULTS

There was strong between-panel agreement (panel 1: r_s = 0.76, p < 0.01; panel 2: r_s = 0.77, p < 0.01) in the priorities identified. The list of the final top 10 priorities included (i) "conduct longitudinal studies to assess changes in fitness and associations with health". This was followed by (ii) "use fitness surveillance to inform decision making", and (iii) "implement regular and consistent international/national fitness surveys using common measures".

CONCLUSIONS

The priorities identified in this study provide guidance for future international collaborations and research efforts on the physical fitness of children and adolescents over the next decade and beyond.

Normative Data for Musculoskeletal Fitness in 13,217 Children and Adolescents: The Croatian Fitness (CROFIT) Study

Purpose: The main purpose of the study was to establish normative data for health-related musculoskeletal fitness. Method: We recruited 13,217 children and adolescents aged 11-18 years (6,181 boys and 7,036 girls; 57% of girls). To evaluate musculoskeletal fitness, the following field tests were applied: standing broad jump (cm), sprint 20 m (sec), medicine-ball throw (dm), sit-ups in one minute (#), sit-ups in one minute (short, #), and squats in one minute (#). Curves for the 10th, 20th, 30th, 40th, 50th (median), 60th, 70th, 80th, and 90th percentiles were calculated using the Lambda (L), Mu (M), and Sigma (S) method. The LMS method assumes that the data can be normalized by using a power transformation and removing the skewness. Results: Median scores for standing broad jump, sprint 20 m, medicine-ball throw, sit-ups in one minute, sit-ups in one minute (short) and squats in one minute were 185.00 cm, 3.66 sec, 80.00 dm, 46.00 x, 56.00 x and 49 x in boys and 160.00 cm, 4.01 sec, 60.00 dm, 40.00 x, 49.00 and 43 x in girls. Effect sizes (ES) showed that boys performed better in all physical fitness tests (ES = 0.50-1.05), compared to girls. In general, age-related physical fitness changes showed the plateau between ages 15 and 16 in boys, while in girls, the plateau was reached at the age of 14. Conclusions: This study shows standards for musculoskeletal tests in youth.

Correlations between Physical Fitness and Body Composition among Boys Aged 14–18—Conclusions of a Case Study to Reverse the Worsening Secular Trend in Fitness among Urban Youth Due to Sedentary Lifestyles

A secular trend can be observed throughout the world with an increase in childhood obesity and a decrease in fitness. The research aimed to examine the results of tests measuring the conditional abilities of young boys aged 14–18 in fitness tests and their correlations with body composition indicators. That was supported by research that has been prepared in Hungary so far. This research focuses on the results of fitness tests conducted on 14- to 18-year-old boys, presented along with body composition data. The authors sought to describe the development of the fitness profiles of males at a Budapest secondary school participating in the research, based on the results of the Hungarian National Student Fitness Test (NETFIT®), and also how their physical characteristics affect the results of NETFIT® tests in the sample measured. A total of 735 male high school students at a Budapest secondary school (14–18 years old) (mean ± SD, 16.05 ± 1.18 years) participated in the survey. The data were collected in the 2018/2019 academic year, and it was compared with the national data. The correlation between the performance indicators of the NETFIT® tests and the physical characteristic indicators was analyzed using the two-block Partial Least Squares method. In the resulting groups, Kruskal–Wallis variance analysis was performed to investigate the differences in performance. In contrast, pairs of group differences were tested with the Mann–Whitney test. Boys with a short physique were at some advantage in trunk-lifts and push-ups, compared to taller boys. It was also obvious that being overweight is a hindrance regarding the PACER test or the standing broad jump. The handgrip in the left and right hand was mostly of similar strength or weakness. Tall-heavy children performed better in this test. The grip strength of tall-thin students was also strong, but not as strong as in the tall-heavy group. Reducing the percentage of body fat (PBF) and creating the optimal BMI index is important for the younger age group, as our results have clearly demonstrated that overweight is a hindrance in the PACER, VO2 max, standing broad jump, back-saver sit-and-reach, and push-up tests.

Physical fitness reference standards for Chinese children and adolescents

To develop age- and sex-specific physical fitness reference standards and express the age- and sex-related differences using standardized effect sizes for Chinese children and adolescents. A total of 85,535 children and adolescents (48.7% girls) aged 7–18 years were recruited from six geographical divisions of China using a stratified randomized cluster sampling method. Seven physical fitness items including grip strength, standing long jump, 30-s sit-ups, sit and reach, 50-m dash, 20-s repeated straddling, and 20-m SRT were measured following a standardized procedure. Percentile curves for each physical fitness test were calculated using the LMS. Age- and sex-related differences were expressed as standardized effect sizes. We observed that the performance improved with age along with the analyzed percentiles in all tests. Boys had higher values compared to girls in all the physical fitness items except for sit and reach test, where girls showed better performance in all analyzed percentiles. Also, the sex differences increased with ages except sit and reach. There is a need for a differentiated approach in the physical education class in terms of adjustment of physical activity based on sex, level of fitness abilities in China.

Relationship between cardiorespiratory fitness and latitude in children and adolescents: Results from a cross-sectional survey in China

Background

This study assessed the correlation between latitude and the cardiorespiratory fitness (CRF) of children and adolescents.

Methods

In 16 provinces and autonomous regions in China, 25,941 children and adolescents aged 10–18 were included. CRF was measured using the 20 m shuttle run test (20 m SRT) and estimated peak oxygen uptake (VO_2peak). One-way ANOVA and multiple regression analysis were used to explore the correlation between CRF and latitude in children and adolescents.

Results

The VO_2peak values of the low (south), middle, and high (north) latitude groups for boys were 43.1, 43.1, and 40.7 mL/kg/min, respectively, and 40.0, 40.0, and 38.5 mL/kg/min for girls, respectively. After adjusting for confounding factors, the regression coefficients (β) between VO_2peak-Z and both latitude-Z and (latitude-Z)² for boys were −0.151 and −0.043, respectively. For girls, they were −0.142 and −0.020, respectively. The Partial correlation coefficient (r) for latitude-Z and (latitude-Z)² were −0.14 and −0.04 for boys, and −0.13 and −0.02 for girls, respectively.

Conclusion

The CRF among children and adolescents in high latitude regions is significantly lower than that in middle and low latitude region, and it generally shows a “parabolic” trend between Latitude-Z and VO_2peak-Z.

Physical fitness disparities among New York City public school youth using standardized methods, 2006-2017

Standardized physical fitness monitoring provides a more accurate proxy for youth health when compared with physical activity. Little is known about the utilization of broad-scale individual-level youth physical fitness testing to explore health disparities. We examined longitudinal trends in population-level fitness for 4^th-12^th grade New York City youth during 2006/7-2016/17 (average n = 510,293 per year). Analyses were performed in 2019. The primary outcome was whether or not youth achieved sex-/age-specific performance levels (called the Healthy Fitness Zone) on the aerobic capacity, muscular strength and muscular endurance tests using the NYC FITNESSGRAM. The Cooper Institute’s most recent Healthy Fitness Zone criteria were applied to all tests and years. Prevalence estimates were weighted, accounted for school clustering, adjusted for student-level sociodemographics, and run by sociodemographic subgroups and year. The overall prevalence for meeting 3 Healthy Fitness Zones increased from 15.5% (95%CI: 13.9%-17.0%) in 2006/7 to 23.3% (95%CI: 22.2%-24.4%) in 2016/17 for students in grades 4–12. Fitness for all student groups increased over time, although Hispanic and non-Hispanic black girls consistently had the lowest prevalence of meeting 3 Healthy Fitness Zones as compared to all other race/sex subgroups. Also, 9^th-12^th graders had a lower prevalence of meeting 3 Healthy Fitness Zones as compared to 4^th-8^th graders. Given forecasted sharp increases in cardiovascular disease prevalence, routine youth fitness surveillance using standardized, criterion referenced methods can identify important fitness disparities and inform interventions.

Physical Fitness and Metabolic Syndrome in Brazilian Adolescents: Validity of Diagnostic Health Criteria

We tested health criteria cutoff points from physical fitness variables proposed by the Fitnessgram program for detecting metabolic syndrome ( MetS) in a representative sample of 1,035 Brazilian adolescents (565 girls and 470 boys) aged 12-20 years. We studied five fitness tests: (a) back-saver sit and reach, (b) trunk lift, (c) curl-up, (d) push-up, and (e) progressive aerobic cardiovascular endurance run ( PACER), and we defined MetS through the criteria of the International Diabetes Federation. We described the predictive performance of each fitness test in terms of sensitivity, specificity, and area under the curve ( AUC) estimates of the receiver operating characteristic method. The AUCs for four tests ( back-saver sit and reach, trunk lift, curl-up, and push-up) revealed low accuracy for identifying MetS in both sexes (0.50 ≥ AUC ≤ 0.60), but AUCs for the PACER test demonstrated good accuracy values between 0.72 (0.68-0.76) and 0.83 (0.78-0.89). Thus, cutoff points proposed in the Fitnessgram program for the PACER test offer an effective means of screening adolescents at higher cardiometabolic risk, which, for the age-group used in this study, should be from 40.3-44.3 ml/kg/min for boys and 38.6-40.1 ml/kg/min for girls.

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.

Review of criterion-referenced standards for cardiorespiratory fitness: what percentage of 1 142 026 international children and youth are apparently healthy?

PURPOSE

To identify criterion-referenced standards for cardiorespiratory fitness (CRF); to estimate the percentage of children and youth that met each standard; and to discuss strategies to help improve the utility of criterion-referenced standards for population health research.

METHODS

A search of four databases was undertaken to identify papers that reported criterion-referenced CRF standards for children and youth generated using the receiver operating characteristic curve technique. A pseudo-dataset representing the 20-m shuttle run test performance of 1 142 026 children and youth aged 9-17 years from 50 countries was generated using Monte Carlo simulation. Pseudo-data were used to estimate the international percentage of children and youth that met published criterion-referenced standards for CRF.

RESULTS

Ten studies reported criterion-referenced standards for healthy CRF in children and youth. The mean percentage (±95% CI) of children and youth that met the standards varied substantially across age groups from 36%±13% to 95%±4% among girls, and from 51%±7% to 96%±16% among boys. There was an age gradient across all criterion-referenced standards where younger children were more likely to meet the standards compared with older children, regardless of sex. Within age groups, mean percentages were more precise (smaller CI) for younger girls and older boys.

CONCLUSION

There are several CRF criterion-referenced standards for children and youth producing widely varying results. This study encourages using the interim international criterion-referenced standards of 35 and 42 mL/kg/min for girls and boys, respectively, to identify children and youth at risk of poor health-raising a clinical red flag.

A multilevel analysis of health-related physical fitness. The Portuguese sibling study on growth, fitness, lifestyle and health

This study investigates biological, behavioural and sociodemographic correlates of intra-pair similarities, and estimates sibling resemblance in health-related physical fitness (PF). The sample comprises 1101 biological siblings (525 females) aged 9–20 years. PF components and markers were: morphological [waist circumference (WC) and %body fat (%BF)], muscular [handgrip strength (GS) and standing long jump (SLJ)], motor [50-yard dash (50YD) and shuttle run (SR)], and cardiorespiratory (1-mile run). Biological maturation was assessed; physical activity (PA), TV viewing and socioeconomic status (SES) information was obtained. On average, older and more mature subjects are better performers in all PF components; PA was negatively associated with SR, while SES was negatively associated with SLJ and SR. A pattern was observed in the intraclass correlations (ρ) wherein same sex siblings demonstrate greater resemblance for most PF components (sister-sister: 0.35≤ ρ≤0.55; brother-brother: (0.25≤ρ≤0.60) than brother-sister pairs (BS) (0≤ρ≤0.15), except for %BF (ρBB>ρSS>ρBS), and the 1-mile run (ρSS>ρBS>ρBB). In conclusion, behavioural and sociodemographic correlates play different roles in siblings PF expression. Further, a significant familial PF resemblance was observed with different trends in different sibling types, probably due to variations in shared genetic factors and sociodemographic conditions.

International variability in 20 m shuttle run performance in children and youth: who are the fittest from a 50-country comparison? A systematic literature review with pooling of aggregate results

OBJECTIVES

To describe and compare 20 m shuttle run test (20mSRT) performance among children and youth across 50 countries; to explore broad socioeconomic indicators that correlate with 20mSRT performance in children and youth across countries and to evaluate the utility of the 20mSRT as an international population health indicator for children and youth.

METHODS

A systematic review was undertaken to identify papers that explicitly reported descriptive 20mSRT (with 1-min stages) data on apparently healthy 9-17 year-olds. Descriptive data were standardised to running speed (km/h) at the last completed stage. Country-specific 20mSRT performance indices were calculated as population-weighted mean z-scores relative to all children of the same age and sex from all countries. Countries were categorised into developed and developing groups based on the Human Development Index, and a correlational analysis was performed to describe the association between country-specific performance indices and broad socioeconomic indicators using Spearman's rank correlation coefficient.

RESULTS

Performance indices were calculated for 50 countries using collated data on 1 142 026 children and youth aged 9-17 years. The best performing countries were from Africa and Central-Northern Europe. Countries from South America were consistently among the worst performing countries. Country-specific income inequality (Gini index) was a strong negative correlate of the performance index across all 50 countries.

CONCLUSIONS

The pattern of variability in the performance index broadly supports the theory of a physical activity transition and income inequality as the strongest structural determinant of health in children and youth. This simple and cost-effective assessment would be a powerful tool for international population health surveillance.

[Analysis of adiposity and physical fitness in young Colombian students]

INTRODUCTION

Body mass index and physical fitness are important markers of a healthy life style. Objective: To analyze adiposity and physical fitness in young students from public schools in Armenia, Colombia, and examine differences between sex and age groups. Materials and methods: We analyzed 1,150 students: 46.6% (n=536) males and 53.4% (n=614) females, with an age range of 10 to 20 years (15.45 ± 2.52). Physical fitness was evaluated by the Course-Navette test, the Horizontal Jump test, the 20-meter run test and the Sit-and-Reach test. Body mass index and body fat were also assessed. Results: Compared with males, females had significantly higher adiposity levels, body mass index (20.4 vs. 19.5) and body fat (23% vs. 11%). Males had higher levels of physical fitness in all the variables analyzed, with statistically significant differences (p<0.001), except in flexibility, where females achieved better results (3.1cm vs.1 3cm; p=0.003). In both sexes, body mass index increased with age (p<0.001). However, body fat decreased with age in males (p<0.001) and increased in females (p<0.001). In males, physical fitness improved with age in all variables. In females, no significant differences were found between age groups except in the maximal oxygen uptake (VO2max, p<0.001). Conclusion: Adiposity was significantly higher in women than in men. Males had a better level of physical fitness than females, except in flexibility. Physical fitness improved significantly with age in males, but did not change in females.

International normative 20 m shuttle run values from 1 142 026 children and youth representing 50 countries

OBJECTIVE

To develop sex-specific and age-specific international norms for the 20 m shuttle run test (20mSRT) in children and youth (aged 9-17 years), and to estimate the prevalence meeting the FITNESSGRAM criterion-referenced standards for healthy cardiorespiratory endurance (CRE).

METHODS

A systematic review was undertaken to identify papers explicitly reporting descriptive 20mSRT (with 1 min stages) data on children and youth since 1981. Data were included on apparently healthy (free from known disease/injury) 9-17 years old. Following standardisation to a common metric and for protocol differences, pseudo data were generated using Monte Carlo simulation, with population-weighted sex-specific and age-specific normative centiles generated using the Lambda Mu and Sigma (LMS) method. Sex-related and age-related differences were expressed as per cent and standardised differences in means. The prevalence with healthy CRE was estimated using the sex-specific and age-specific FITNESSGRAM criterion-referenced standards for [Formula: see text].

RESULTS

Norms were displayed as tabulated centiles and as smoothed centile curves for the 20mSRT using 4 common metrics (speed at the last completed stage, completed stages/minutes, laps and relative [Formula: see text]). The final data set included 1 142 026 children and youth from 50 countries, extracted from 177 studies. Boys consistently outperformed girls at each age group (mean difference±95% CI: 0.86±0.28 km/h or 0.79±0.20 standardised units), with the magnitude of age-related increase larger for boys than for girls. A higher proportion of boys (mean±95% CI: 67±14%) had healthy CRE than girls (mean±95% CI: 54±17%), with the prevalence of healthy CRE decreasing systematically with age.

CONCLUSIONS

This study provides the most comprehensive and up-to-date set of international sex-specific and age-specific 20mSRT norms for children and youth, which have utility for health and fitness screening, profiling, monitoring and surveillance.