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Health-related fitness assessment in childhood and adolescence: a European approach based on the AVENA, EYHS and HELENA studies

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Abstract

Results from cross-sectional and longitudinal studies such as Alimentación y Valoración del Estado Nutricional en Adolescentes: Food and Assessment of the Nutritional Status of Spanish Adolescents (AVENA) and the European Youth Heart Study (EYHS) respectively, highlight physical fitness as a key health marker in childhood and adolescence. Moderate and vigourous levels of physical activity stimulate functional adaptation of all tissues and organs in the body (i.e. improve fitness), thereby also making them less vulnerable to lifestyle-related degenerative and chronic diseases. To identify children and adolescents at risk for these major public health diseases and to be able to evaluate the effects of alternative intervention strategies in European countries and internationally, comparable testing methodology across Europe has to be developed, tested, agreed upon and included in the health monitoring systems currently under development by the European Commission (EC): the Directorate General for Health and Consumer Affairs (DG SANCO); the Statistical Office of the European Communities (EUROSTAT), etc. The Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) study group plans, among other things, to describe the health-related fitness of adolescents in a number of European countries. Experiences from AVENA and EYHS will be taken advantage of. This review summarises results and experiences from the developmental work so far and suggests a set of health-related fitness tests for possible use in future health information systems.

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References

  • Arokoski JP, Valta T, Airaksinen O, Kankaanpaa M (2001) Back and abdominal muscle function during stabilization exercises. Arch Phys Med Rehabil 82:1089–1098

    Article  PubMed  CAS  Google Scholar 

  • Australian Sports Commission (1999) 20m shuttle run test: a progressive shuttle run test for measuring aerobic fitness. Belconnen (ACT): Australian Coaching Council

  • Baquet G, Twisk JW, Kemper HC, Van Praagh E, Berthoin S (2006) Longitudinal follow-up of fitness during childhood: interaction with physical activity. Am J Hum Biol 18:51–58

    Article  PubMed  CAS  Google Scholar 

  • Bosco C, Luhtanen P, Komi PV (1983) A simple method for measurement of mechanical power in jumping. Eur J Appl Physiol 50:273–282

    Article  CAS  Google Scholar 

  • Bouchard C (1986) Genetics of aerobic power and capacity. In Sports and Human Genetics. Human Kinetics, Champaign, IL

    Google Scholar 

  • Brewer J, Ramsbottom R, Williams C (1988) Multistage fitness test: a progressive shuttle-run test for the prediction of maximum oxygen uptake. National Coaching Foundation, Leeds

    Google Scholar 

  • Castillo Garzon MJ, Ortega Porcel FB, Ruiz Ruiz J (2005) [Improvement of physical fitness as anti-aging intervention]. Med Clin 124:146–155

    Article  Google Scholar 

  • Committee of Experts on Sports Research EUROFIT (1993) Handbook for the EUROFIT Tests of Physical Fitness. Council of Europe, Strasburg, GE

    Google Scholar 

  • Cooper Institute for Aerobics Research (1999) FITNESSGRAM test administration manual. Human Kinetics, Champaign

    Google Scholar 

  • Deforche B, Lefevre J, De Bourdeaudhuij I, Hills AP, Duquet W, Bouckaert J (2003) Physical fitness and physical activity in obese and nonobese Flemish youth. Obes Res 11:434–441

    Article  PubMed  Google Scholar 

  • Goldberg MS, Scott SC, Mayo NE (2000) A review of the association between cigarette smoking and the development of nonspecific back pain and related outcomes. Spine 25:995–1014

    Article  PubMed  CAS  Google Scholar 

  • Gonzalez-Gross M, Ruiz JR, Moreno LA, De Rufino-Rivas P, Garaulet M, Mesana MI, Gutierrez A; AVENA Group (2003) Body composition and physical performance of Spanish adolescents: the AVENA pilot study. Acta Diabetol 40:S299–S301

    Article  PubMed  Google Scholar 

  • Hansen HS, Froberg K, Nielsen JR, Hyldebrandt N (1989) A new approach to assessing maximal aerobic power in children: the Odense School Child Study. Eur J Appl Physiol Occup Physiol 58:618–624

    Article  PubMed  CAS  Google Scholar 

  • Hildebrandt VH, Bongers PM, Dul J, van Dijk FJ, Kemper HC (2000) The relationship between leisure time, physical activities and musculoskeletal symptoms and disability in worker populations. Int Arch Occup Environ Health 73:507–518

    Article  PubMed  CAS  Google Scholar 

  • Izaak SI, Panasiuk TV (2005) [The age- and sex specificity of physical development of schoolchildren]. Gig Sanit 5:61–64

    PubMed  Google Scholar 

  • Jonker JT, De Laet C, Franco OH, Peeters A, Mackenbach J, Nusselder WJ (2006) Physical activity and life expectancy with and without diabetes: life table analysis of the Framingham Heart Study. Diabetes Care 29:38–43

    Article  PubMed  Google Scholar 

  • Kemper HC, Twisk JW, van Mechelen W, Post GB, Roos JC, Lips P (2000) A fifteen-year longitudinal study in young adults on the relation of physical activity and fitness with the development of the bone mass: The Amsterdam growth and health longitudinal study. Bone 27:847–853

    Article  PubMed  CAS  Google Scholar 

  • Keyserling WM (2000) Workplace risk factors and occupational musculoskeletal disorders: Part 1. A review of biomechanical and psychophysical research on risk factors associated with low-back pain. Am Ind Hyg Assoc J 61:39–50

    CAS  Google Scholar 

  • Kibler WB, Goldberg C, Chandler TJ (1991) Functional biomechanical deficits in running athletes with plantar fasciitis. Am J Sports Med 266:185–196

    Google Scholar 

  • Klasson-Heggebo L, Andersen LB, Wennlof AH, Sardinha LB, Harro M, Froberg K, Anderssen SA (2006) Graded associations between cardiorespiratory fitness, fatness, and blood pressure in children and adolescents. Br J Sports Med 40:25–29

    Article  PubMed  CAS  Google Scholar 

  • Koutedakis Y, Bouziotas C (2003) National physical education curriculum: motor and cardiovascular health related fitness in Greek adolescents. Br J Sports Med 37:311–314

    Article  PubMed  CAS  Google Scholar 

  • Leach RE, James S, Wasilewski S (1981) Achilles tendinitis. Am J Sports Med 9:93–98

    PubMed  CAS  Google Scholar 

  • Leboeuf-Yde C (2000) Body weight and low back pain: a systematic literature review of 56 journal articles reporting on 65 epidemiologic studies. Spine 25:226–237

    Article  PubMed  CAS  Google Scholar 

  • Léger LA, Lambert A, Goulet A, Rowan C, Dinelle Y (1984) Capacity aerobic des Quebecois de 6 a 17 ans - test Navette de 20 metres avec paliers de 1 minute. Can J Appl Sport Sci 9:64–69

    PubMed  Google Scholar 

  • Liu NYS, Plowman SA, Looney MA (1992) The reliability and validity of the 20-meter shuttle test in American students 12 to 15 years old. Res Q Exerc Sport 63:360–365

    PubMed  CAS  Google Scholar 

  • McHugh M, Connolly D, Eston R, Kremenic IJ, Nicholas SJ, Gleim GW (1999) The role of passive stiffness in symptoms of exercise-induced muscle damage. Am J Sports Med 27:594–599

    PubMed  CAS  Google Scholar 

  • Mesa JL, Ruiz JR, Ortega FB, Warnberg J, Gonzalez-Lamuno D, Moreno LA, Gutierrez A, Castillo MJ (2006a) Aerobic physical fitness in relation to blood lipids and fasting glycaemia in adolescents: Influence of weight status. Nutr Metab Cardiovasc Dis 16:285–293

    Article  PubMed  CAS  Google Scholar 

  • Mesa JL, Ortega FB, Ruiz JR, Castillo MJ, Hurtig Wennlöf A, Gutiérrez A (2006b) The importance of cardiorespiratory fitness for healthy metabolic traits in children and adolescents. The AVENA Study. J Public Health 14:178–180

    Article  Google Scholar 

  • Metter EJ, Talbot LA, Schrager M, Conwit R (2002) Skeletal muscle strength as a predictor of all-cause mortality in healthy men. J Gerontol A Biol Sci Med Sci 57:B359–B365

    PubMed  Google Scholar 

  • Mikkelsson L, Kaprio J, Kautiainen H, Kujala U, Mikkelsson M, Nupponen H (2006) School fitness tests as predictors of adult health-related fitness. Am J Hum Biol 18:342–349

    Article  PubMed  Google Scholar 

  • Mokdad AH, Marks JS, Stroup DF, Gerberding JL (2004) Actual causes of death in the United States, 2000. JAMA 291:1238–1245

    Article  PubMed  Google Scholar 

  • Monyeki MA, Koppes LL, Kemper HC, Monyeki KD, Toriola AL, Pienaar AE, Twisk JW (2005) Body composition and physical fitness of undernourished South African rural primary school children. Eur J Clin Nutr 59:877–883

    Article  PubMed  CAS  Google Scholar 

  • Myers J, Prakash M, Froelicher V, Do D, Partington S, Atwood JE (2002) Exercise capacity and mortality among men referred for exercise testing. N Engl J Med 346:793–801

    Article  PubMed  Google Scholar 

  • Nourbakhsh MR, Arab AM (2002) Relationship between mechanical factors and incidence of low back pain. J Orthop Sports Phys Ther 32:447–460

    PubMed  Google Scholar 

  • Ortega FB, Ruiz JR, Castillo MJ, Moreno LA, Gonzalez-Gross M, Warnberg J, Gutierrez A; Grupo AVENA (2005) [Low level of physical fitness in Spanish adolescents. Relevance for future cardiovascular health (AVENA study)]. Rev Esp Cardiol 58:898–909

    Article  PubMed  Google Scholar 

  • Ortega FB, Ruiz JR, Gutiérrez A, Moreno LA, Tresaco B, Martínez JA, González-Lamuño D, Wärnberg J, Castillo MJ, and the AVENA Study group (2004) Is physical fitness a good predictor of cardiovascular disease risk factors in normal-weight and overweight or obese adolescents? The AVENA Study. [abstract] Int J Obes Relat Metab Disord 28:S120

    Article  Google Scholar 

  • Ortega FB, Tresaco B, Ruiz JR, Moreno LA, Martin-Matillas M, Warnberg J, Bueno M, Tercedor P, Gutierrez A, Castillo MJ (2006) Cardiorespiratory fitness and sedentary activity are associated with adiposity in adolescents. Obesity (in press)

  • Pope R, Herbert R, Kirwan J, Grahan BJ (2000) A randomized trial of pre-exercise stretching for prevention of lower limb injury. Med Sci Sports Exer 32:271–277

    Article  CAS  Google Scholar 

  • Richards LG, Olson B, Palmiter-Thomas P (1996) How forearm position affects grip strength. Am J Occup Ther 50:133–138

    PubMed  CAS  Google Scholar 

  • Riddoch CJ (1990) The Northern Ireland health and fitness survey -1989: the fitness, physical activity, attitudes and lifestyles of Northern Ireland post-primary schoolchildren. The Queen’s University of Belfast, Belfast

    Google Scholar 

  • Ruiz JR, Rizzo N, Wennlof A, Ortega FB, Harro M, Sjostrom M (2006a) Relations of total physical activity and intensity to fitness and fatness in children; The European Youth Heart Study. Am J Clin Nutr 84:299–303

    PubMed  CAS  Google Scholar 

  • Ruiz JR, Ortega FB, Meusel D, Harro M, Oja P, Sjöström M (2006b) Cardiorespiratory fitness is associated with features of metabolic risk factors in children. Should cardiorespiratory fitness be assessed in a European health monitoring system? The European Youth Heart Study. J Public Health 14:94–102

    Article  Google Scholar 

  • Ruiz JR, España-Romero V, Ortega FB, Sjöström M, Castillo MJ, Gutiérrez A on behalf of the HELENA Study (in press) Hand-size influences optimal grip span in male and female adolescents. J Hand Surgery (Am)

  • Ruiz-Ruiz J, Mesa JLM, Gutiérrez A, Castillo MJ (2002) Hand size influences optimal grip span in women but not in men. J Hand Surg 27A:897–901

    Google Scholar 

  • Strong WB, Malina RM, Blimkie CJ, Daniels SR, Dishman RK, Gutin B, Hergenroeder AC, Must A, Nixon PA, Pivarnik JM, Rowland T, Trost S, Trudeau F (2005) Evidence based physical activity for school-age youth. J Pediatr 146:732–737

    Article  PubMed  Google Scholar 

  • Trainor TJ, Trainor MA (2004) Etiology of low back pain in athletes. Curr Sports Med Rep 3:41–46

    PubMed  Google Scholar 

  • Vicente-Rodriguez G, Jimenez-Ramirez J, Ara I, Serrano-Sanchez JA, Dorado C, Calbet JA (2003) Enhanced bone mass and physical fitness in prepubescent footballers. Bone 33:853–859

    Article  PubMed  CAS  Google Scholar 

  • Vicente-Rodriguez G, Ara I, Perez-Gomez J, Serrano-Sanchez JA, Dorado C, Calbet JA (2004a) High femoral bone mineral density accretion in prepubertal soccer players. Med Sci Sports Exerc 36:1789–1795

    Article  PubMed  Google Scholar 

  • Vicente-Rodriguez G, Dorado C, Perez-Gomez J, Gonzalez-Henriquez JJ, Calbet JA (2004b) Enhanced bone mass and physical fitness in young female handball players. Bone 35:1208–1215

    Article  PubMed  CAS  Google Scholar 

  • Wärnberg J (2006) Inflammatory status in adolescents; the impact of health determinants such as overweight and fitness. Thesis for doctoral degree, Karolinska University Press, Stockholm

  • Watanabe T, Owashi K, Kanauchi Y, Mura N, Takahara M, Ogino T (2005) The short-term reliability of grip strength measurement and the effects of posture and grip span. J Hand Surg 30:603–609

    Article  Google Scholar 

  • Witvrouw E, Lysens R, Bellemans J, Cambier D, Vanderstraeten G (2000) Intrinsic risk factors for the development of anterior knee pain in an athletic population: a two year prospective study. Am J Sports Med 28:480–489

    PubMed  CAS  Google Scholar 

  • Witvrouw E, Bellemans J, Lysens R, Danneels L, Cambier D (2001) Intrinsic risk factors for the development of patellar tendinitis in the athletic population. Am J Sports Med 29:190–195

    PubMed  CAS  Google Scholar 

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Acknowledgements

The AVENA study was funded by the Spanish Ministry of Health, FEDER-FSE funds FIS no. 00/0015, CSD grants 05/UPB32/0, 109/UPB31/03 and 13/UPB20/04, the Spanish Ministry of Education (AP2003-2128; AP-2004-2745), and scholarships from Panrico S.A., Madaus S.A. and Procter and Gamble S.A. The Swedish part of the EYHS was supported by grants from the Stockholm County Council (MS), and the Estonian part of EYHS was supported by a grant from the Estonian Science Foundation No. 3277 and 5209 and by the Estonian Centre of Behavioural and Health Sciences. The HELENA study takes place with the financial support of the European Community Sixth RTD Framework Programme (Contract FOOD-CT-2005-007034). The content of this article reflects only the authors’ views, and the European Community is not liable for any use that may be made of the information contained therein. The authors of the present paper are responsible partners of the physical activity and fitness assessment in the HELENA Study.

Conflict of interest statement

No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article. None of the authors had any conflict of interest.

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Authors and Affiliations

  1. Department of Physiology, School of Medicine, University of Granada, Granada, Spain

    Jonatan R. Ruiz, Francisco B. Ortega, Angel Gutierrez & Manuel J. Castillo

  2. Research Association Public Health Institute of Clinical Pharmacology, Medical Faculty, Technische Universität, Dresden, Germany

    Dirk Meusel

  3. Unit for Preventive Nutrition, Department of Biosciences and Nutrition at NOVUM, Karolinska Institutet, Huddinge, Sweden

    Jonatan R. Ruiz, Francisco B. Ortega & Michael Sjöström

  4. Department of Physiology, School of Medicine, University of Granada, Granada, Spain

    Manuel J. Castillo

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  1. Jonatan R. Ruiz
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Correspondence to Manuel J. Castillo.

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On behalf of the HELENA Study Group

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Ruiz, J.R., Ortega, F.B., Gutierrez, A. et al. Health-related fitness assessment in childhood and adolescence: a European approach based on the AVENA, EYHS and HELENA studies. J Public Health 14, 269–277 (2006). https://doi.org/10.1007/s10389-006-0059-z

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