Ultraviolet sun exposure and sun protection behaviors in outdoor rock climbers

BACKGROUND

Overexposure to sunlight and sunburn are the main preventable causes of skin cancer. Outdoor sports are associated with significant levels of sunlight exposure.

AIMS

We sought to quantify the sun radiation exposure received by outdoor rock climbers and assess their sun exposure habits, sun protection behaviors, attitudes, and knowledge regarding skin cancer.

METHODS

From April to June 2021, outdoor rock climbers contacted via email completed an online validated self-reported questionnaire on sun related habits, behaviors, attitudes and knowledge. As a pilot trial, ten participants wore a personal dosimeter during two outdoor climbing weekends in May and November 2021. Ambient ultraviolet radiation (UVR) was also recorded.

RESULTS

A total of 217 outdoor rock climbers (103 women), mean age 36.8 ± 8.8 years (range 20-70 years) and median climbing practice per week of 8 h (IQR 7.5) were studied. Two in three (65.9%) participants reported at least one sunburn event during the previous rock climbing season. Of the survey respondents, 49.3% reported using sunscreen with SPF ≥ 15, 47% wore sunglasses, and 14.3% indicated they reapplied sunscreen every two hours. The median personal UVR dose measured during the two outdoor climbing weekends analyzed was 5.2 (IQR 1.8) and 8.8 (IQR 1.1) standard erythemal doses, respectively.

CONCLUSIONS

The high rates of sunburn, the elevated personal UVR measured and the clearly insufficient sun protection practices followed during rock climbing together with unsatisfactory attitudes towards tanning reveal the need to develop explicit sun protection campaigns and educational strategies to reduce the risk of skin cancer among the athletes studied.

Fear of falling in women: A psychological training intervention improves climbing performance

The main purpose of this study was to determine the effect of a psychological training intervention based on emotional regulation on anxiety and climbing ability in women climbers with fear of falling. A secondary aim was to compare the outcomes of climbing ability, anxiety, self-confidence and interoceptive awareness (IA) between the psychological group (PG), a training (TG) and a control group. Self-reported climbing ability, anxiety and IA were assessed using Competitive State Anxiety Inventory-2 and the Multidimensional Assessment of Interoceptive Awareness questionnaire. Results indicated a significant improvement in climbing ability for both PG and TG. The PG showed a significant reduction in cognitive and somatic anxiety, while the TG only exhibited a reduction in cognitive anxiety. Moreover, the PG demonstrated a greater significant increase in self-confidence compared to the TG. IA improved in five subscales for the PG, whereas the TG changed in only two subscales. In conclusion, a psychological training intervention focusing on emotional regulation might contribute to improvements in IA, reduced anxiety levels, and enhancements in climbing ability and self-confidence among women climbers facing fear of falling.

Which is the most reliable edge depth to measure maximum hanging time in sport climbers?

BACKGROUND

The ability to generate high levels of force with the finger flexor muscles and sustain it for the maximum time was reported as a climbing performance factor. This study aimed to answer the question of which is the most reliable edge depth to measure maximum hanging time in non-elite and elite rock climbers: 6, 8, 10, 12 or 14 mm.

METHODS

Thirty-six climbers (10 female, 26 male; 6b-8c redpoint level) were assessed twice, one week apart.

RESULTS

Systematic bias (95 % limits of agreements) was -1.84 (6.31) for HT6, -0.26 (8.83) for HT8, -1.30 (8.72) for HT10, -4.37 (9.57) for HT12, and -2.94 (9.53) for HT14 at non-elite group (all P values > 0.05 but HT12 and HT14). Among elite group, -1.38 (7.58), 0.68 (12.09), -2.20 (13.35), -0.49 (9.80) and 0.73 (10.44) was found (all P > 0.05) for HT6, HT8, HT10, HT12 and HT14, respectively. No patterns of heteroscedasticity were observed for any of the trials for non-elite and elite climbers.

SIGNIFICANCE

Among all edge depths analysed, 8 mm seemed to be the most accurate edge to evaluate hanging time. Alternatively, a 10 mm hold depth could be recommended for climbers from 6b to 7c, and 12 mm for climbers from 7c+ to 8c.

Anthropometry and performance characteristics of recreational advanced to elite female rock climbers

Despite climbing's popularity and an increasing number of female participants, there are limited anthropometric and performance data for this population. This study compares the characteristics of 55 experienced female climbers, divided into three categories (lower [ADV-L] and higher advanced [ADV-H] and elite [ELT]) based on self-reported ability. Data on climbing experience, body dimensions, body composition, flexibility, lower and upper-body power and finger strength were assessed. ELT climbers differed significantly from the ADV groups in age (Mean Difference [MD] = 8.8-9.8 yrs; despite smaller differences in years climbing MD = 1.6-2.4 yrs), greater climbing and hours training per week (MD = 3.0-3.7 h & MD = 0.9-1.6 h, respectively), and greater upper-body power (MD = 12.9-16.6 cm) and finger strength (MD = 51.6-65.4 N). Linear regression analysis showed finger strength and upper body power to be associated with ability, particularly when adjusting for descriptive and anthropometric variables (finger strength R² = 53% and 45%; upper-body power R² = 60% and 39% for boulder and sport, respectively). The findings support the importance of finger strength and upper-body power; changes in female anthropometric data over the last decade provide insight into the changing nature of the sport.

Attentional Differences as a Function of Rock Climbing Performance

The purpose of this study was to investigate the relationship between attention (using two different attention tasks) and self-reported climbing ability while considering potential confounding factors (sex, age, climbing experience, and cardiorespiratory fitness) in a group of experienced climbers. Accuracy of response (AC) and reaction time (RT) from two different attention tasks using the Vienna Test System, along with self-reported on-sight and red-point climbing ability, were assessed in 35 climbers. Linear regression revealed that climbers with the highest self-reported on-sight grade had better AC during the attention task. Linear regression models revealed, after controlling for potential confounders, that AC, measured using two attention tasks, was positively related to climbers' highest self-reported on-sight climbing ability (β = 0.388; p = 0.031). No significant differences were found between AC and self-reported red-point climbing ability (β = 0.286; p = 0.064). No significant relationship was found between RT and climbing ability (β = -0.102 to 0.020; p = 0.064). In conclusion, higher-level rock climbers appear to have an enhanced attention, which is related to on-sight lead climbing style, and thus, it may be an important component of climbing performance. Coaches should consider incorporating techniques to train attention based on on-sight climbing style in climbers.

Hemodynamic and Cardiorespiratory Predictors of Sport Rock Climbing Performance

Fryer, SM, Giles, D, Garrido Palomino, I, de la O Puerta, A, and España-Romero, V. Hemodynamic and cardiorespiratory predictors of sport rock climbing performance. J Strength Cond Res 32(12): 3543-3550, 2018-Rock climbing performance has been suggested to involve a notable contribution from aerobic metabolism. Previously, it has been shown that forearm oxygenation kinetics can be used to distinguish ability groups and predict red-point sport climbing performance. Currently, it is not known if forearm oxygenation kinetics or a sport-specific assessment of cardiorespiratory fitness best predicts sport rock climbing performance. The aim of the study was to determine whether forearm oxidative capacity index, maximal deoxygenation (Δ score) during a treadwall V[Combining Dot Above]O2peak test, treadwall V[Combining Dot Above]O2peak, or running V[Combining Dot Above]O2max best predicts self-reported sport climbing performance. Twenty-one male sport rock climbers completed a treadwall V[Combining Dot Above]O2peak, running V[Combining Dot Above]O2max, and an assessment of near-infrared spectroscopy-derived oxidative capacity index. Linear regression, adjusted for age and experience (years), revealed that forearm oxidative capacity index, treadwall maximal deoxygenation (Δ), and treadwall V[Combining Dot Above]O2peak all significantly predicted self-reported red-point sport climbing ability (Adj R = -0.398, -0.255, and 0.374, respectively), whereas treadmill running V[Combining Dot Above]O2max did not (Adj R = -0.052). Additionally, multiple regression suggested that the combined significant aerobic predictors accounted for 67% of the variance in red-point climbing ability. Findings suggest that training for sport rock climbing performance should look to incorporate modalities that focus on (a) improving local forearm aerobic capacity and (b) improving whole-body aerobic capacity using sport-specific apparatus, such as treadwalls.

Correlates of ideal cardiovascular health in European adolescents: The HELENA study

BACKGROUND AND AIMS

The ideal cardiovascular health (iCVH) construct consists of 4 health behaviors (smoking status, body mass index, physical activity and diet) and 3 health factors (total cholesterol, blood pressure and fasting glucose). A greater number of iCVH components in adolescence are related to better cardiovascular health, but little is known about the correlates of iCVH in adolescents. Thus, the aim of the study was to examine correlates of iCVH in European adolescents.

METHODS AND RESULTS

The study comprised 637 European adolescents with complete iCVH data. Participants were part of the Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) study, a cross-sectional, multicenter study conducted in 9 different European countries. Correlates investigated were sex and age, family affluence scale, maternal education, geographic location, sleep time, television viewing, duration of pregnancy, birth weight and breastfeeding. Younger adolescents, those whose mothers had medium/high education or those who watched television less than 2 h per day had a greater number of iCVH components compared to those who were older, had a mother with low education or watched television 2 h or more daily (P ≤ 0.01).

CONCLUSION

Since in our study older adolescents had worse iCVH than younger adolescents, early promotion of cardiovascular health may be important. Future studies may also investigate the usefulness of limiting television viewing to promote iCVH. Finally, since adolescents of mothers with low education had poorer iCVH, it may be of special interest to tailor public health promotion to adolescents from families with low socioeconomic status.

Prevalence of ideal cardiovascular health in European adolescents: The HELENA study

BACKGROUND

The ideal cardiovascular health (iCVH) construct consists of 4 health behaviours and 3 health factors and is strongly related to later cardiovascular disease. However, the prevalence of iCVH in European adolescents is currently unknown.

METHODS

The Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) study is a cross-sectional, multicentre study conducted in 9 European countries during 2006-2007 and included 3528 adolescents (1683 boys and 1845 girls) between 12.5 and 17.5years of age. Status (ideal vs. non-ideal) for the health behaviours (smoking status, body mass index, physical activity and diet) and health factors (total cholesterol, blood pressure and fasting glucose) were determined.

RESULTS

Overall, the prevalence of ideal health behaviours was low; non-smoking (60.9% ideal), body mass index (76.8%), physical activity (62.1%), and diet (1.7%). The prevalence of ideal health factors was; total cholesterol (65.8%), blood pressure (62.0%) and plasma glucose (88.8%).

CONCLUSIONS

The low prevalence of iCVH behaviours, especially diet and physical activity, identified in European adolescents is likely to influence later cardiovascular health which strongly motivates efforts to increase ideal health behaviours in this population.

Differences in forearm strength, endurance, and hemodynamic kinetics between male boulderers and lead rock climbers

This study examined differences in the oxygenation kinetics and strength and endurance characteristics of boulderers and lead sport climbers. Using near infrared spectroscopy, 13-boulderers, 10-lead climbers, and 10-controls completed assessments of oxidative capacity index and muscle oxygen consumption (m⩒O₂) in the flexor digitorum profundus (FDP), and extensor digitorum communis (EDC). Additionally, forearm strength (maximal volitional contraction MVC), endurance (force-time integral FTI at 40% MVC), and forearm volume (FAV and ΔFAV) was assessed. MVC was significantly greater in boulderers compared to lead climbers (mean difference = 9.6, 95% CI 5.2-14 kg). FDP and EDC oxidative capacity indexes were significantly greater (p = .041 and .013, respectively) in lead climbers and boulderers compared to controls (mean difference = -1.166, 95% CI (-3.264 to 0.931 s) and mean difference = -1.120, 95% CI (-3.316 to 1.075 s), respectively) with no differences between climbing disciplines. Climbers had a significantly greater FTI compared to controls (mean difference = 2205, 95% CI= 1114-3296 and mean difference = 1716, 95% CI = 553-2880, respectively) but not between disciplines. There were no significant group differences in ΔFAV or m⩒O₂. The greater MVC in boulderers may be due to neural adaptation and not hypertrophy. A greater oxidative capacity index in both climbing groups suggests that irrespective of climbing discipline, trainers, coaches, and practitioners should consider forearm specific aerobic training to aid performance.

Cardiorespiratory Fitness and Risk of Sudden Cardiac Death in Men and Women in the United States: A Prospective Evaluation From the Aerobics Center Longitudinal Study

OBJECTIVES

To examine the relation between cardiorespiratory fitness (CRF) and sudden cardiac death (SCD) in a large US adult population and to study the effects of hypertension, obesity, and health status on the relation of CRF with SCD.

PATIENTS AND METHODS

A total of 55,456 individuals (mean age, 44.2 years; 13,507 women) from the Aerobics Center Longitudinal Study, a prospective observational investigation (from January 2, 1974, through December 31, 2002), were included. Cardiorespiratory fitness was assessed by a maximal treadmill test, and baseline assessment included an extensive set of measurements.

RESULTS

There were 109 SCDs. An inverse risk of SCD was found across incremental CRF levels after adjusting for potential confounders. Participants with moderate and high CRF levels had 44% (hazard ratio, 0.56; 95% CI, 0.35-0.90) and 48% (hazard ratio, 0.52; 95% CI, 0.30-0.92) significantly lower risk of SCD, respectively, than did those with low CRF levels (P<.001). The risk of SCD decreased by 14% (hazard ratio, 0.86; 95% CI, 0.77-0.96) per 1-metabolic equivalent increase in the fully adjusted model. Hypertensive, overweight, or unhealthy individuals with moderate to high CRF levels had lower risks of SCD (ranging from 58% to 72% of lower risk) than did those with the same medical conditions and low CRF levels.

CONCLUSION

The risk of SCD in US men and women could be partially reduced by ensuring moderate to high levels of CRF independently of other risk factors and especially in those who are hypertensive, overweight, or unhealthy.

Forearm muscle oxidative capacity index predicts sport rock-climbing performance

Rock-climbing performance is largely dependent on the endurance of the forearm flexors. Recently, it was reported that forearm flexor endurance in elite climbers is independent of the ability to regulate conduit artery (brachial) blood flow, suggesting that endurance is not primarily dependent on the ability of the brachial artery to deliver oxygen, but rather the ability of the muscle to perfuse and use oxygen, i.e., skeletal muscle oxidative capacity.

PURPOSE

The aim of the study was to determine whether an index of oxidative capacity in the flexor digitorum profundus (FDP) predicts the best sport climbing red-point grade within the last 6 months. Participants consisted of 46 sport climbers with a range of abilities.

METHODS

Using near-infrared spectroscopy, the oxidative capacity index of the FDP was assessed by calculating the half-time for tissue oxygen resaturation (O2HTR) following 3-5 min of ischemia.

RESULTS

Linear regression, adjusted for age, sex, BMI, and training experience, revealed a 1-s decrease in O2HTR was associated with an increase in red-point grade by 0.65 (95 % CI 0.35-0.94, Adj R (2)  = 0.53).

CONCLUSIONS

Considering a grade of 0.4 separated the top four competitors in the 2015 International Federation Sport Climbing World Cup, this finding suggests that forearm flexor oxidative capacity index is an important determinant of rock-climbing performance.

Reliability and Validity of Different Models of TKK Hand Dynamometers

OBJECTIVE. We examined the reliability and validity of the analog and digital models of TKK handgrip dynamometers using calibrated known weights.

METHOD. A total of 6 dynamometers (3 digital and 3 analog; 2 new and 1 old for each model) were used in this study.

RESULTS. Intrainstrument reliability was very high; systematic error for test–retest reliability was ≤|0.3 kg|. The systematic error among different instruments (same model) and between different models (digital vs. analog) ranged between |0.4 kg| and |0.6 kg|. The systematic error between new and old dynamometers ranged from |0.8 kg| to |1 kg|. All dynamometers provided lower values for the same known weights than a SECA scale, with a systematic error ranging from −0.94 to −2.64 kg.

CONCLUSION. This study indicates that clinicians and investigators who provide treatment to address handgrip strength should use the same instrument and model for repeated measures. Distinguishing meaningful change from dynamometer variability is discussed.

Physical fitness and future cardiovascular risk in argentine children and adolescents: an introduction to the ALPHA test battery

INTRODUCTION

A high level of physical fitness is associated with cardiovascular health in children and adolescents. At present, there is no systematic implementation of a test battery to assess physical fitness at schools in Argentina. The main objective of this study was to implement the ALPHA test battery to determine the physical fitness of a sample made up of Argentine children and adolescents and to establish the proportion of subjects whose aerobic capacity is indicative of future cardiovascular risk.

POPULATION AND METHODS

A sample of 1867 participants (967 girls) aged 6 to 19.5 years old assessed using the ALPHA test battery. Four components of physical fitness were measured: 1) morphological component: height, body weight, and waist circumference; 2) musculoskeletal component: standing long jump test; 3) motor component: speed/agility test (4x10 m shuttle run); 4) cardiorespiratory component: course-navette 20 m, shuttle run test and estimation of maximal oxygen consumption. The 5th, 25th, 50th, 75th, and 95th percentiles were estimated for the main tests.

RESULTS

The mean body mass index was 20.8 kg/m2, and 7.8% of participants were classified as obese. In ddition, male participants had a better performance in all physical fitness tests when compared to girls (p< 0.001). An aerobic capacity indicative of cardiovascular risk was observed in 31.6% of all participants.

CONCLUSIONS

Argentine male children and adolescents included in the sample showed higher levels of physical fitness. Such differences increase with age. Approximately one every three participants had an aerobic capacity indicative of future cardiovascular risk.

Physical Activity Is Associated with Attention Capacity in Adolescents

OBJECTIVE

To assess the relationships among physical activity, measured objectively, and attention capacity in European adolescents.

STUDY DESIGN

The study included 273 adolescents, aged 12.5-17.5 years, who participated in the Healthy Lifestyle in Europe by Nutrition in Adolescence Study. Participants wore a uniaxial accelerometer for 7 days to measure physical activity. The d2 Test of Attention was administered to assess attention capacity. Multivariate analyses were used to study the association of attention capacity with each measure of physical activity. Receiver operating characteristic analysis was performed to determine thresholds that best discriminate between low and good attention capacity.

RESULTS

After controlling for potential confounding variables (age, sex, body mass index, parental educational level, fat mass, aerobic fitness, and center), adolescents' attention capacity test performances were significantly and positively associated with longer time spent in moderate or moderate-to-vigorous physical activity (MVPA) in free-living conditions (P < .05). Receiver operating characteristic curve analyses revealed that the physical activity thresholds that best discriminated between low/good attention capacities were ≥41 min·day(-1) for moderate, ≥12 min·day(-1) for vigorous, and ≥58 min·day(-1) for MVPA.

CONCLUSION

These findings suggest that promoting MVPA may be have a beneficial effect on attention capacity, an important component of cognition, in adolescents.

Muscular fitness, fatness and inflammatory biomarkers in adolescents

BACKGROUND

Muscular fitness, cardiorespiratory fitness (CRF) and fatness are mutually related with chronic inflammation.

PURPOSE

To examine the independent association of muscular fitness with inflammatory biomarkers in adolescents from nine European countries.

METHODS

A total of 639 adolescents (296 boys) aged from 12.5 to 17.5 year were included in this report. Data collection took place in 2006-2007 and analyses in 2012. A muscular fitness score was computed from handgrip strength and standing long jump. CRF was measured using the 20 m shuttle run test. Z-scores of C-reactive protein, complement factors C3 and C4, leptin and white blood cell counts were summed to create a cluster of inflammatory biomarkers. Sex, age, pubertal stage and centre were used as main confounders. Additional models were further adjusted for insulin resistance (HOMA-IR) and sum of four skinfolds.

RESULTS

Muscular fitness was negatively associated with single and clustered inflammatory biomarkers (standardized β from -0.399 to -0.100, all P-values < 0.05). Additional adjustments for CRF and HOMA-IR weakened the associations, but they still remained significant. The association was no longer significant when adjusting for skinfolds. Decreasing values of inflammatory score were observed across incremental levels of muscular fitness in both non-overweight and overweight adolescents (P ≤ 0.05).

CONCLUSIONS

Adolescents with higher levels of muscular fitness present a lower chronic inflammation, and this seems to be explained by lower levels of fatness. Yet, overweight and obese adolescents may exhibit a less adverse profile if they maintain appropriate levels of muscular fitness.

Body adiposity index and incident hypertension: the Aerobics Center Longitudinal Study

BACKGROUND AND AIM

The body adiposity index (BAI) has been recently proposed as a new method to estimate the percentage of body fat. The association between BAI and hypertension risk has not been investigated yet. The aim of our study was to evaluate the ability of BAI to predict hypertension in males and females compared with traditional body adiposity measures.

METHODS AND RESULTS

The present follow-up analysis comprised 10,309 individuals (2259 females) free of hypertension from the Aerobics Center Longitudinal Study, who completed a baseline examination between 1988 and 2003. Body adiposity measures included BAI, body mass index (BMI), waist circumference, hip circumference, percentage of body fat and waist to hip ratio (WHR). Incident hypertension was ascertained from responses to mail-back surveys between 1990 and 2004. During an average of 9.1 years of follow-up, 872 subjects (107 females) became hypertensive. Hazard ratios (HRs) and 95% confidence intervals (95% CI) showed that males in the highest categories of all body adiposity measures showed a higher incident risk of hypertension (HRs ranged from 1.37 to 2.09). Females showed a higher incident risk of hypertension only in the highest categories of BAI, BMI and WHR (HRs ranged from 1.84 to 3.36).

CONCLUSION

Our results suggest that in order to predict incident hypertension BAI could be considered as an alternative to traditional body adiposity measures.

Breastfeeding attenuates the effect of low birthweight on abdominal adiposity in adolescents: the HELENA study

The aim of this study was to examine whether breastfeeding may reduce the programming effect of birthweight on abdominal adiposity. Abdominal (in three regions: R1, R2 and R3) adiposity was measured by dual energy x-ray absorptiometry in 314 adolescents. Breastfeeding duration, birthweight, duration of gestation and maternal educational level were obtained from questionnaire. Physical activity was objectively measured. We detected significant interactions between breastfeeding and birthweight on abdominal adiposity (Ps = 0.02-0.07). We observed that birthweight was associated with abdominal adiposity in the group who had never been breastfed (β = -0.19 to -0.23; Ps < 0.05), while no association was found in adolescents who had breastfeeding for ≥3 months (β = -0.03 to -0.07). The results were independent of duration of gestation, age, sex, maternal educational level and physical activity. Breastfeeding may reduce the adverse influence conferred by low birthweight on abdominal adiposity in adolescents.

Physical fitness and future cardiovascular risk in argentine children and adolescents: an introduction to the ALPHA test battery

INTRODUCTION

A high level of physical fitness is associated with cardiovascular health in children and adolescents. At present, there is no systematic implementation of a test battery to assess physical fitness at schools in Argentina. The main objective of this study was to implement the ALPHA test battery to determine the physical fitness of a sample made up of Argentine children and adolescents and to establish the proportion of subjects whose aerobic capacity is indicative of future cardiovascular risk.

POPULATION AND METHODS

A sample of 1867 participants (967 girls) aged 6 to 19.5 years old assessed using the ALPHA test battery. Four components of physical fitness were measured: 1) morphological component: height, body weight, and waist circumference; 2) musculoskeletal component: standing long jump test; 3) motor component: speed/agility test (4x10 m shuttle run); 4) cardiorespiratory component: course-navette 20 m, shuttle run test and estimation of maximal oxygen consumption. The 5th, 25th, 50th, 75th, and 95th percentiles were estimated for the main tests.

RESULTS

The mean body mass index was 20.8 kg/m2, and 7.8% of participants were classified as obese. In ddition, male participants had a better performance in all physical fitness tests when compared to girls (p< 0.001). An aerobic capacity indicative of cardiovascular risk was observed in 31.6% of all participants.

CONCLUSIONS

Argentine male children and adolescents included in the sample showed higher levels of physical fitness. Such differences increase with age. Approximately one every three participants had an aerobic capacity indicative of future cardiovascular risk.

Comparison of the EPIC Physical Activity Questionnaire with combined heart rate and movement sensing in a nationally representative sample of older British adults

Objectives

To compare physical activity (PA) subcomponents from EPIC Physical Activity Questionnaire (EPAQ2) and combined heart rate and movement sensing in older adults.

Methods

Participants aged 60–64y from the MRC National Survey of Health and Development in Great Britain completed EPAQ2, which assesses self-report PA in 4 domains (leisure time, occupation, transportation and domestic life) during the past year and wore a combined sensor for 5 consecutive days. Estimates of PA energy expenditure (PAEE), sedentary behaviour, light (LPA) and moderate-to-vigorous PA (MVPA) were obtained from EPAQ2 and combined sensing and compared. Complete data were available in 1689 participants (52% women).

Results

EPAQ2 estimates of PAEE and MVPA were higher than objective estimates and sedentary time and LPA estimates were lower [bias (95% limits of agreement) in men and women were 32.3 (−61.5 to 122.6) and 29.0 (−39.2 to 94.6) kJ/kg/day for PAEE; −4.6 (−10.6 to 1.3) and −6.0 (−10.9 to −1.0) h/day for sedentary time; −171.8 (−454.5 to 110.8) and −60.4 (−367.5 to 246.6) min/day for LPA; 91.1 (−159.5 to 341.8) and 55.4 (−117.2 to 228.0) min/day for MVPA]. There were significant positive correlations between all self-reported and objectively assessed PA subcomponents (rho  = 0.12 to 0.36); the strongest were observed for MVPA (rho = 0.30 men; rho = 0.36 women) and PAEE (rho = 0.26 men; rho = 0.25 women).

Conclusion

EPAQ2 produces higher estimates of PAEE and MVPA and lower estimates of sedentary and LPA than objective assessment. However, both methodologies rank individuals similarly, suggesting that EPAQ2 may be used in etiological studies in this population.

Body adiposity index and all-cause and cardiovascular disease mortality in men

OBJECTIVE

To evaluate the association of body adiposity index (BAI) with all-cause and cardiovascular disease (CVD) mortality risk.

DESIGN AND METHODS

The current analysis comprised 19,756 adult men who enrolled in the Aerobics Centre Longitudinal Study and completed a baseline examination during 1988-2002. All-cause and CVD mortality was registered till December 31, 2003.

RESULTS

During an average follow-up of 8.3 years (163,844 man-years), 353 deaths occurred (101 CVD deaths). Age- and examination year-adjusted hazard ratios (HRs) and 95% confidence intervals (95% CIs) for all-cause mortality risk were higher for men with high values of BMI (HR = 1.63, 95% CI = 1.19-2.23), waist circumference (1.55, 1.22-1.96), and percentage of body fat (%BF) (1.36, 1.04-1.31), but not for men with high values of BAI (1.28, 0.98-1.66). The HRs for CVD mortality risks were higher for men with high values in all adiposity measures (HRs ranged from 1.73 to 2.06). Most of these associations, however, became nonsignificant after adjusting for multiple confounders including cardiorespiratory fitness.

CONCLUSION

BAI is not a better predictor of all-cause and CVD mortality risk than BMI, waist circumference, or %BF.

Moderate-to-vigorous physical activity is associated with decreases in body mass index from ages 9 to 15 years

OBJECTIVE

The purpose of this study is to determine whether time spent in objectively measured physical activity is associated with change in body mass index (BMI) from ages 9 to 15.

DESIGN AND METHODS

The participants were enrolled in the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development (n = 938). At ages 9, 11, 12, and 15 the time spent in moderate-to-vigorous physical activity (MVPA) was objectively measured, and BMI was calculated (kg/m(2) ). Longitudinal quantile regression was used to analyze the data. The 10th, 25th, 50th, 75th, and 90th BMI percentiles were modeled as the dependent variables with age and MVPA (h/day) modeled as predictors. Adjustment was also made for gender, race, sleep, healthy eating score, maternal education, and sedentary behavior.

RESULTS

A negative association between MVPA and change in BMI was observed at the 90th BMI percentile (-3.57, 95% CI -5.15 to -1.99 kg/m(2) per hour of MVPA). The negative association between time spent in MVPA and change in BMI was progressively weaker toward the 10th BMI percentile (-0.27, 95% CI -0.62 to 0.07 kg/m(2) per hour of MVPA). The associations remained similar after adjusting for the covariates, and when the analyses were stratified by gender.

CONCLUSION

Time spent in MVPA was negatively associated with change in BMI from age 9 to 15. The association was strongest at the upper tail of the BMI distribution, and increasing time spent in MVPA could help reduce the prevalence of childhood obesity.

Ideal cardiovascular health and mortality: Aerobics Center Longitudinal Study

OBJECTIVE

To analyze the relationship of ideal cardiovascular health to disease-specific death.

PATIENTS AND METHODS

We used data from the Aerobics Center Longitudinal Study from October 9, 1987, to March 3, 1999, to estimate the prevalence of ideal cardiovascular health in 11,993 individuals (24.3% women) and to examine its relationship with deaths from all causes, cardiovascular disease (CVD), and cancer.

RESULTS

During a mean follow-up of 11.6 years, 305 deaths occurred: 70 (23.0%) from CVD and 127 (41.6%) from cancer. In the entire cohort, only 29 individuals (0.2%) had 7 ideal metrics. After adjusting for age, sex, examination year, alcohol intake, and parental history of CVD, risk of death due to CVD was 55% lower in those participants who met 3 or 4 ideal metrics (hazard ratio, 0.45; 95% confidence interval, 0.27-0.77) and 63% lower in those with 5 to 7 ideal metrics (hazard ratio, 0.37; 95% confidence interval, 0.15-0.95), compared with those who met 0 to 2 ideal metrics. Although not significant, there was also a trend toward lower risk of death due to all causes across incremental numbers of ideal metrics. No association was observed for deaths due to cancer.

CONCLUSION

The prevalence of ideal cardiovascular health was extremely low in a middle-aged cohort of men and women recruited between 1987 and 1999. The American Heart Association construct reflects well the subsequent risk of CVD, as reflected by graded CVD mortality in relation to the number of ideal metrics.

Criterion-related validity of field-based muscular fitness tests in youth

AIM

The purpose of the present study was to analyze the association between isokinetic strength and field-based muscular fitness tests in youth.

METHODS

One hundred twenty-six adolescents (14.4±1.7 y) participated in the study. Upper and lower body isokinetic strength were measured at preset angular velocities of 90 º/s and 60 º/s, respectively. Muscular fitness was also assessed by means of field-based tests: handgrip strength, bent and extended arm hang tests, standing long jump, squat jump, countermovement jump and Abalakov jump. Height, weight and skinfold thickness were used to estimate body composition.

RESULTS

All field-based tests were significantly associated with isokinetic peak torque and power (P<0.001 in all cases). Handgrip strength and standing long jump showed the highest associations with the isokinetic parameters (0.61≤r≤0.87; 0.39≤R2≤0.76). Weight-bearing field tests increased on average 20 % their association (R2) with isokinetic parameters when standardized by individual's body weight (test score × weight), while the average increase was 16 % when standardized by fat-free mass (test score × fat-free mass).

CONCLUSION

Handgrip strength and standing long jump tests seem to be the most valid field-based muscular fitness tests when compared to isokinetic strength. These tests can be useful to assess muscular fitness in young people when laboratory methods are not feasible.

The obesity paradox, cardiorespiratory fitness, and coronary heart disease

OBJECTIVE

To investigate associations of cardiorespiratory fitness (CRF) and different measures of adiposity with cardiovascular disease (CVD) and all-cause mortality in men with known or suspected coronary heart disease (CHD).

PATIENTS AND METHODS

We analyzed data from 9563 men (mean age, 47.4 years) with documented or suspected CHD in the Aerobics Center Longitudinal Study (August 13, 1977, to December 30, 2002) using baseline body mass index (BMI) and CRF (quantified as the duration of a symptom-limited maximal treadmill exercise test). Waist circumference (WC) and percent body fat (BF) were measured using standard procedures.

RESULTS

There were 733 deaths (348 of CVD) during a mean follow-up of 13.4 years. After adjustment for age, examination year, and multiple baseline risk factors, men with low fitness had a higher risk of all-cause mortality in the BMI categories of normal weight (hazard ratio [HR], 1.60; 95% confidence interval [CI], 1.24-2.05), obese class I (HR, 1.38; 95% CI, 1.04-1.82), and obese class II/III (HR, 2.43; 95% CI, 1.55-3.80) but not overweight (HR, 1.09; 95% CI, 0.88-1.36) compared with the normal-weight and high-fitness reference group. We observed a similar pattern for WC and percent BF tertiles and for CVD mortality. Among men with high fitness, there were no significant differences in CVD and all-cause mortality risk across BMI, WC, and percent BF categories.

CONCLUSION

In men with documented or suspected CHD, CRF greatly modifies the relation of adiposity to mortality. Using adiposity to assess mortality risk in patients with CHD may be misleading unless fitness is considered.

Muscular and cardiorespiratory fitness are independently associated with metabolic risk in adolescents: the HELENA study

OBJECTIVE

To examine the independent associations of muscular and cardiorespiratory fitness with clustered metabolic risk in adolescents.

METHODS

Participants were 709 adolescents (346 boys) from 10 European centers, aged 12.5-17.5 yr, evaluated as a part of the Healthy Lifestyle in Europe by Nutrition in Adolescents cross-sectional study (HELENA-CSS). A muscular fitness score was computed using handgrip strength and standing long jump. Cardiorespiratory fitness was measured using the 20-m shuttle run test. Age- and gender-specific z-scores of waist circumference, systolic blood pressure, triglycerides, ratio total cholesterol/high-density lipoprotein cholesterol, and insulin resistance (homeostasis model assessment) were summed to create a metabolic risk score.

RESULTS

Muscular fitness was negatively associated with clustered metabolic risk independent of cardiorespiratory fitness (β = -0.249, p < 0.001). Independent of muscular fitness, an inverse association was also found between cardiorespiratory fitness and clustered metabolic risk (β = 0.264, p < 0.001). The odds ratios for having a high clustered risk (above or equal 1 standard deviation) were 5.3 [95% confidence interval (CI) = 2.6-10.6] and 4.3 (95% CI = 2.0-9.3) in the least fit quartile compared with the most fit quartile for muscular and cardiorespiratory fitness, respectively. Significant differences in metabolic risk between muscular fitness levels persisted among non-overweight (p = 0.012) and overweight participants (p = 0.011).

CONCLUSION

Muscular and cardiorespiratory fitness are independently associated with metabolic risk in adolescents. These results support current physical activity recommendations for youth, which include muscle strengthening activities in addition to aerobic exercise.

The International Fitness Scale (IFIS): usefulness of self-reported fitness in youth

BACKGROUND

We examined: (i) the usefulness of the International Fitness Scale (IFIS) to correctly rank adolescents into physical fitness levels; (ii) the capacity of the IFIS for predicting cardiovascular disease (CVD) risk; and (iii) the reliability of the IFIS in adolescents.

METHODS

The study comprised 3059 adolescents (aged 12.5-17.5 years) from nine European countries (HELENA study). Blood samples were collected in one-third of the participants (randomly selected, n = 981). Test-retest reliability of the IFIS was studied in a separate sample of 277 adolescents. Physical fitness-cardiorespiratory fitness (CRF), muscular fitness (MF), speed-agility (SP-AG), flexibility and overall fitness-was self-reported using 5-point Likert-scale questions (1 = very poor, 5 = very good) and measured using standard field-based tests. The CVD risk factors measured included total/central adiposity indices and mean arterial pressure, total and high density lipoprotein cholesterol, triglycerides, insulin resistance (HOMA) and C-reactive protein.

RESULTS

Analysis of covariance showed that adolescents reporting better fitness had higher measured fitness levels for all the variables studied (all P < 0.001), regardless of gender, age and weight status. Adolescents reporting very good overall fitness, CRF and SP-AG had a healthier cardiovascular profile in eight out of nine CVD risk factors studied. Perfect agreement (same test-retest answer) was observed in 65% of the adolescents and perfect-acceptable agreement (same answer or ±1) in 97% of the adolescents.

CONCLUSIONS

(i) The IFIS is able to correctly rank adolescents according to their measured physical fitness levels; (ii) adolescents reporting a good/very good overall fitness, CRF or SP-AG have a more favorable cardiovascular profile; and (iii) The IFIS is reliable in adolescents.

Reliability of field-based fitness tests in youth

The objective of this systematic review was to study the reliability of the existing field-based fitness tests intended for use with children and adolescents. The medical electronic databases MEDLINE, SCOPUS and SPORTS DISCUS were screened for papers published from January 1990 to December 2009. Each study was classified as high, low or very low quality according to the description of the participants, the time interval between measurements, the description of the results and the appropriateness of statistics. 3 levels of evidence were constructed according to the number of studies and the consistency of the findings. 32 studies were finally included in the present review. The reliability of tests assessing cardiorespiratory fitness (9 studies), musculoskeletal fitness (12 studies), motor fitness (3 studies), and body composition (10 studies) was investigated. Although some fitness components warrant further investigation, this review provides an evidence-based proposal for most reliable field-based fitness tests for use with children and adolescents: 20-m shuttle run test to measure cardiorespiratory fitness; handgrip strength and standing broad jump tests to measure musculoskeletal fitness; 4×10 m shuttle run test for motor fitness; and height, weight, BMI, skinfolds, circumferences and percentage body fat estimated from skinfold thickness to measure body composition.

Longer breastfeeding is associated with increased lower body explosive strength during adolescence

Our aim in this study was to examine the association between breastfeeding duration and cardiorespiratory fitness, isometric strength, and explosive strength during adolescence. A total of 2567 adolescents (1426 girls) from the Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) cross-sectional study aged 12.5-17.5 y were included. Information about duration of any and exclusive breastfeeding was obtained retrospectively by means of a parental questionnaire. The 20-m shuttle run, handgrip strength, and standing long jump tests were used to assess physical fitness. Significant differences among the categories of breastfeeding duration were tested using ANCOVA after adjusting for a set of potential confounders: gestational and current age, birth weight, sexual maturation, fat mass, fat-free mass, maternal education, parental weight status, country, smoking behavior, and days of vigorous physical activity. Longer breastfeeding (either any or exclusive) was associated with a higher performance in the standing long jump test in both boys and girls (P < 0.001), regardless of fat mass, fat-free mass, and the rest of potential confounders. In adolescents who were breastfed for 3-5 mo or ≥6 mo, the risk of having a standing long jump performance below the 5th percentile was reduced by half compared with those who were never breastfed [odds ratio (OR) = 0.54, 95% CI = 0.30-0.96, P < 0.05; and OR = 0.40, 95% CI = 0.22-0.74, P < 0.01, respectively). These findings suggest a role of breastfeeding in determining lower body explosive strength during adolescence.

Field-based fitness assessment in young people: the ALPHA health-related fitness test battery for children and adolescents

The present study summarises the work developed by the ALPHA (Assessing Levels of Physical Activity) study and describes the procedures followed to select the tests included in the ALPHA health-related fitness test battery for children and adolescents. The authors reviewed physical fitness and health in youth findings from cross-sectional studies. The authors also performed three systematic reviews dealing with (1) the predictive validity of health-related fitness, (2) the criterion validity of field-based fitness tests and (3) the reliability of field-based fitness tests in youth. The authors also carried out 11-methodological studies to determine the criterion validity and the reliability of several field-based fitness tests for youth. Finally, the authors performed a study in the school setting to examine the reliability, feasibility and safety of the selected tests. The selected fitness tests were (1) the 20 m shuttle run test to assess cardiorespiratory fitness; (2) the handgrip strength and (3) standing broad jump to assess musculoskeletal fitness, and (4) body mass index, (5) skinfold thickness and (5) waist circumference to assess body composition. When there are time limits, the authors propose the high-priority ALPHA health-related fitness test battery, which comprises all the evidence-based fitness tests except the measurement of the skinfold thickness. The time required to administer this battery to a group of 20 youth by one physical education teacher is less than 2 h. In conclusion, the ALPHA fitness tests battery is valid, reliable, feasible and safe for the assessment of health-related physical fitness in children and adolescents to be used for health monitoring purposes at population level.

Extracurricular physical activity participation modifies the association between high TV watching and low bone mass

OBJECTIVES

To examine whether different sedentary behaviours are associated with the risk of low bone mineral content in adolescents, and if so, whether extracurricular physical-sporting activity influences this association.

MATERIALS AND METHODS

A total of 277 adolescents from Zaragoza (168 females and 109 males) aged 13.0-18.5 yr within frame work of the multicentre AVENA study participated in this study. Bone mineral content (BMC), lean mass, and fat mass were measured with DXA. Physical activity and sedentary independent variables: participation in extracurricular physical-sporting activity (PA), h/d of television watching, playing video/computer games during school days and on weekend days and doing homework/studying. They all were assessed by questionnaire. The main outcome was low BMC, as defined by BMC Z-score for age and sex < percentile 10. Logistic regression was used to test the interaction and association of PA and sedentary variables with low BMC, after controlling for confounders like height, maturational status or lean mass.

RESULTS

Among the sedentary variables studied, only television watching > or =3 h/d was associated with an increased risk for low BMC in males (OR, 95% CI: 7.01, 1.73 to 28.40), after controlling for sexual maturation. When PA was in the models, television watching was not any longer associated with low BMC, while PA was so (OR, 95% CI: 0.23, 0.09 to 0.55). Involvement in such activity reduced the risk of low bone mass by 76% (P<0.01) independently of body mass, height and fat mass, but not of the lean mass.

CONCLUSION

Watching television for 3 or more h/d seems to be associated with an increased risk for low BMC in male adolescents. However, this association is mediated by participation in PA, suggesting that negative consequences of excessive television watching on adolescent bone health could be counteracted by sport participation. Longitudinal data and randomized controlled trials will confirm or contrast our findings.

Physical fitness levels among European adolescents: the HELENA study

OBJECTIVE

To report sex- and age-specific physical fitness levels in European adolescents.

METHODS

A sample of 3428 adolescents (1845 girls) aged 12.5-17.49 years from 10 European cities in Austria, Belgium, France, Germany, Greece (an inland city and an island city), Hungary, Italy, Spain and Sweden was assessed in the Healthy Lifestyle in Europe by Nutrition in Adolescence study between 2006 and 2008. The authors assessed muscular fitness, speed/agility, flexibility and cardiorespiratory fitness using nine different fitness tests: handgrip, bent arm hang, standing long jump, Bosco jumps (squat jump, counter movement jump and Abalakov jump), 4×10-m shuttle run, back-saver sit and reach and 20-m shuttle run tests.

RESULTS

The authors derived sex- and age-specific normative values for physical fitness in the European adolescents using the LMS statistical method and expressed as tabulated percentiles from 10 to 100 and as smoothed centile curves (P₅, P₂₅, P₅₀, P₇₅ and P₉₅). The figures showed greater physical fitness in the boys, except for the flexibility test, and a trend towards increased physical fitness in the boys as their age increased, whereas the fitness levels in the girls were more stable across ages.

CONCLUSIONS

The normative values hereby provided will enable evaluation and correct interpretation of European adolescents' fitness status.

Associations of muscular and cardiorespiratory fitness with total and central body fat in adolescents: the HELENA study

OBJECTIVE

to examine the association of healthrelated physical fitness with total and central body fat in adolescents.

PARTICIPANTS/METHODS

the present cross-sectional study comprises 363 Spanish adolescents (186 female participants) aged 12.5-17.5 years. We assessed fitness by the 20-m shuttle run test (cardiorespiratory fitness); the handgrip strength, the standing broad jump and the Abalakov tests (muscular strength); and the 4 × 10-m shuttle run test (speed-agility). Total body fat was measured by dual energy x-ray absorptiometry (DXA), BodPod and sum of six skinfolds, and central body fat was measured by DXA at three regions (R1, R2 and R3) and waist circumference.

RESULTS

the Abalakov, the standing broad jump, the 4 × 10-m shuttle run and the 20-m shuttle run tests were negatively associated with all markers of total and central body fat in men and women after controlling for age, pubertal status and objectively assessed physical activity (p<0.01). Handgrip strength test was positively associated with waist circumference (p<0.01).

CONCLUSIONS

lower body muscular strength and cardiorespiratory fitness are negatively and consistently associated with total and central body fat in adolescents, whereas levels of upper body muscular strength were superior in adolescents with higher levels of central body fat.

Criterion-related validity of field-based fitness tests in youth: a systematic review

The objective of this systematic review was to comprehensively study the criterion-related validity of the existing field-based fitness tests used in children and adolescents. The studies were scored according to the number of subjects, description of the study population and statistical analysis. Each study was classified as high, low and very low quality. Three levels of evidence were constructed: strong evidence, when consistent findings were observed in three or more high quality studies; moderate evidence, when consistent findings were observed in two high quality studies; and limited evidence when consistency of findings and/or the number of studies did not achieve the criteria for moderate. The results of 73 studies (50 of high quality) addressing the criterion-related validity of field-based fitness tests in children and adolescents indicate the following: that there is strong evidence indicating that the 20 m shuttle run test is a valid test to estimate cardiorespiratory fitness, that the hand-grip strength test is a valid measure of musculoskeletal fitness, that skin fold thickness and body mass index are good estimates of body composition, and that waist circumference is a valid measure to estimate central body fat. Moderate evidence was found that the 1-mile run/walk test is a valid test to estimate cardiorespiratory fitness. A large number of other field-based fitness tests presented limited evidence, mainly due to a limited number of studies (one for each test). The results of the present systematic review should be interpreted with caution due to the substantial lack of consistency in reporting and designing the existing validity studies.