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The Health Benefits of Muscular Fitness for Children and Adolescents: A Systematic Review and Meta-Analysis

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Abstract

Background

Physical fitness during childhood and adolescence has been identified as an important determinant of current and future health status. While research has traditionally focused on the association between cardio-respiratory fitness and health outcomes, the association between muscular fitness (MF) and health status has recently received increased attention.

Objective

The aim of this systematic review and meta-analysis was to evaluate the potential physiological and psychological benefits associated with MF among children and adolescents.

Methods

A systematic search of six electronic databases (PubMed, SPORTDiscus, Scopus, EMBASE, PsycINFO and OVID MEDLINE) was performed on the 20th May, 2013. Cross-sectional, longitudinal and experimental studies that quantitatively examined the association between MF and potential health benefits among children and adolescents were included. The search yielded 110 eligible studies, encompassing six health outcomes (i.e., adiposity, bone health, cardiovascular disease [CVD] and metabolic risk factors, musculoskeletal pain, psychological health and cognitive ability). The percentage of studies reporting statistically significant associations between MF and the outcome of interest was used to determine the strength of the evidence for an association and additional coding was conducted to account for risk of bias. Meta-analyses were also performed to determine the pooled effect size if there were at least three studies providing standardised coefficients.

Results

Strong evidence was found for an inverse association between MF and total and central adiposity, and CVD and metabolic risk factors. The pooled effect size for the relationship between MF and adiposity was r = −0.25 (95 % CI −0.41 to −0.08). Strong evidence was also found for a positive association between MF and bone health and self-esteem. The pooled effect size for the relationship between MF and perceived sports competence was r = 0.39 (95 % CI 0.34–0.45). The evidence for an association between MF and musculoskeletal pain and cognitive ability was inconsistent/uncertain. Where evidence of an association was found, the associations were generally low to moderate.

Conclusion

The findings of this review highlight the importance of developing MF in youth for a number of health-related benefits.

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References

  1. Casazza K, Gower BA, Willig AL, et al. Physical fitness, activity, and insulin dynamics in early pubertal children. Pediatr Exerc Sci. 2009;21(1):63.

    PubMed Central  PubMed  Google Scholar 

  2. Ortega F, Ruiz J, Castillo M, et al. Physical fitness in childhood and adolescence: a powerful marker of health. Int J Obes. 2008;32(1):1–11.

    CAS  Google Scholar 

  3. Blair SN, Cheng Y, Holder JS. Is physical activity or physical fitness more important in defining health benefits? Med Sci Sports Exerc. 2001;33(6 Supp):S379–99.

    CAS  PubMed  Google Scholar 

  4. Caspersen CJ, Powell KE, Christenson GM. Physical activity, exercise, and physical fitness: definitions and distinctions for health-related research. Public Health Rep. 1985;100(2):126.

    CAS  PubMed Central  PubMed  Google Scholar 

  5. Freedson PS, Cureton KJ, Heath GW. Status of field-based fitness testing in children and youth. Prev Med. 2000;31(2):S77–85.

    Google Scholar 

  6. Trost S. Discussion paper for the development of recommendations for children’s and youth’s participation in health promoting physical activity. Queensland: School of Human Movement Studies; 2005.

    Google Scholar 

  7. Gallahue DL, Ozman JC. Understanding motor development: Infants, children, adolescents, adults. 6th ed. Boston: McGraw-Hill; 2006.

    Google Scholar 

  8. Jinguji T. Muscular strength and muscular endurance: What is the “true” definition for physical educators? In: Innovations 4 PE. Jinguji Consulting, LLC, Roseville; 2008. http://www.innovations4pe.com. Accessed 14 Jan 2013.

  9. Beunen G, Thomis M. Muscular strength development in children and adolescents. Pediatr Exerc Sci. 2000;12:174–97.

    Google Scholar 

  10. Malina RM, Bouchard C, Bar-Or O. Growth, maturation, and physical activity. 2nd ed. Champaign: Human Kinetics; 2004.

    Google Scholar 

  11. Faigenbaum AD, Myer GD. Resistance training among young athletes: safety, efficacy and injury prevention effects. Br J Sports Med. 2010;44(1):56–63.

    CAS  PubMed Central  PubMed  Google Scholar 

  12. WHO. Global recommendations on physical activity for health. Geneva: World Health Organization; 2010. p. 8–10.

  13. Lloyd RS, Faigenbaum AD, Stone MH, et al. Position statement on youth resistance training: the 2014 International Consensus. Br J Sports Med. 2014;48:498–505.

    PubMed  Google Scholar 

  14. Tomkinson GR, Olds TS. Secular changes in pediatric aerobic fitness test performance: the global picture. Basel: Karger Publishers; 2007.

    Google Scholar 

  15. Tomkinson GR, Olds TS. Secular changes in aerobic fitness test performance of Australasian children and adolescents in: pediatric fitness. Secular trends and geographic variability. Med Sports Sci. 2007;50:168–82.

    Google Scholar 

  16. Tomkinson GR, Léger LA, Olds TS, et al. Secular trends in the performance of children and adolescents (1980–2000). Sports Med. 2003;33(4):285–300.

    PubMed  Google Scholar 

  17. Pitetti KH, Beets MW. A comparison of shuttle-run performance between Midwestern youth and their national and international counterparts. Pediatr Exerc Sci. 2004;16(2):94–112.

    Google Scholar 

  18. Sandercock G, Voss C, McConnell D, et al. Ten year secular declines in the cardiorespiratory fitness of affluent English children are largely independent of changes in body mass index. Arch Dis Child. 2010;95(1):46–7.

    CAS  PubMed  Google Scholar 

  19. Adams J. Trends in physical activity and inactivity amongst US 14–18 year olds by gender, school grade and race, 1993–2003: evidence from the youth risk behavior survey. BMC Public Health. 2006;6(1):57.

    PubMed Central  PubMed  Google Scholar 

  20. Cohen DD, Voss C, Taylor MJD, et al. Ten-year secular changes in muscular fitness in English children. Acta Paediatr. 2011;100(10):e175–7. doi:10.1111/j.1651-2227.2011.02318.x.

    CAS  PubMed  Google Scholar 

  21. Moliner-Urdiales D, Ruiz J, Ortega F, et al. Secular trends in health-related physical fitness in Spanish adolescents: The AVENA and HELENA Studies. J Sci Med Sport. 2010;13(6):584–8.

    CAS  PubMed  Google Scholar 

  22. Runhaar J, Collard D, Singh A, et al. Motor fitness in Dutch youth: differences over a 26-year period (1980–2006). J Sci Med Sport. 2010;13(3):323–8.

    CAS  PubMed  Google Scholar 

  23. Matton L, Duvigneaud N, Wijndaele K, et al. Secular trends in anthropometric characteristics, physical fitness, physical activity, and biological maturation in Flemish adolescents between 1969 and 2005. Am J Hum Biol. 2007;19(3):345–57.

    PubMed  Google Scholar 

  24. Aires L, Andersen LB, Mendonça D, et al. A 3-year longitudinal analysis of changes in fitness, physical activity, fatness and screen time. Acta Paediatr. 2010;99(1):140–4.

    CAS  PubMed  Google Scholar 

  25. Westerstahl M, Barnekow-Bergkvist M, Hedberg G, et al. Secular trends in body dimensions and physical fitness among adolescents in Sweden from 1974 to 1995. Scand J Med Sci Sports. 2003;13(2):128–37.

    CAS  PubMed  Google Scholar 

  26. Ruiz JR, Castro-Piñero J, España-Romero V, et al. Field-based fitness assessment in young people: the ALPHA health-related fitness test battery for children and adolescents. Br J Sports Med. 2011;45(6):518–24.

    PubMed  Google Scholar 

  27. Ortega FB, Artero EG, Ruiz JR, et al. Physical fitness levels among European adolescents: the HELENA study. Br J Sports Med. 2011;45(1):20–9.

    CAS  PubMed  Google Scholar 

  28. Ruiz JR, Sui X, Lobelo F, et al. Association between muscular strength and mortality in men: prospective cohort study. Br Med J. 2008;337(7661):92.

    Google Scholar 

  29. FitzGerald SJ, Barlow CE, Kampert JB, et al. Muscular fitness and all-cause mortality: prospective observations. J Phys Act Health. 2004;1:7–18.

    Google Scholar 

  30. Ortega FB, Silventoinen K, Tynelius P, et al. Muscular strength in male adolescents and premature death: Cohort study of one million participants. BMJ (Online). 2012;345(7884):1–12.

    Google Scholar 

  31. Ruiz JR, Castro-Piñero J, Artero EG, et al. Predictive validity of health-related fitness in youth: a systematic review. Br J Sports Med. 2009;43(12):909–23.

    CAS  PubMed  Google Scholar 

  32. Benson AC, Torode ME, Fiatarone Singh MA. Muscular strength and cardiorespiratory fitness is associated with higher insulin sensitivity in children and adolescents. Int J Pediatr Obes. 2006;1(4):222–31. doi:10.1080/17477160600962864.

    PubMed  Google Scholar 

  33. Vicente-Rodríguez G, Urzanqui A, Mesana MI, et al. Physical fitness effect on bone mass is mediated by the independent association between lean mass and bone mass through adolescence: a cross-sectional study. J Bone Miner Metab. 2008;26(3):288–94.

    PubMed  Google Scholar 

  34. Padilla-Moledo C, Ruiz JR, Ortega FB, et al. Associations of muscular fitness with psychological positive health, health complaints, and health risk behaviors in Spanish children and adolescents. J Strength Cond Res. 2012;26(1):167–73. doi:10.1519/JSC.0b013e31821c2433.

    PubMed  Google Scholar 

  35. Coe DP, Pivarnik JM, Womack CJ, et al. Health-related fitness and academic achievement in middle school students. J Sports Med Phys Fitness. 2012;52(6):654–60.

    CAS  PubMed  Google Scholar 

  36. Myer GD, Faigenbaum AD, Chu DA, et al. Integrative training for children and adolescents: techniques and practices for reducing sports-related injuries and enhancing athletic performance. Phys Sports Med. 2011;39(1):74.

    Google Scholar 

  37. Vaughn JM, Micheli L. Strength training recommendations for the young athlete. Phys Med Rehabil Clin N Am. 2008;19(2):235–45.

    PubMed  Google Scholar 

  38. Castillo-Garzon M, Ruiz J, Ortega F, et al. A mediterranean diet is not enough for health: physical fitness is an important additional contributor to health for the adults of tomorrow. World Rev Nutr Diet. 2006;97:114–38.

    Google Scholar 

  39. Grøntved A, Ried-Larsen M, Møller NC, et al. Muscle strength in youth and cardiovascular risk in young adulthood (the European Youth Heart Study). Br J Sports Med. 2013;. doi:10.1136/bjsports-2012-091907.

    Google Scholar 

  40. Moher D, Schulz KF, Altman DG. The CONSORT statement: revised recommendations for improving the quality of reports of parallel group randomized trials. BMC Med Res Methodol. 2001;1(1):2.

    CAS  PubMed Central  PubMed  Google Scholar 

  41. von Elm E, Altman DG, Egger M, et al. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Prev Med. 2007;45(4):247–51.

    Google Scholar 

  42. Sallis JF, Prochaska JJ, Taylor WC. A review of correlates of physical activity of children and adolescents. Med Sci Sports Exerc. 2000;32(5):963–75.

    CAS  PubMed  Google Scholar 

  43. Lubans DR, Morgan PJ, Cliff DP, et al. Fundamental movement skills in children and adolescents. Sports Med. 2010;40(12):1019–35.

    PubMed  Google Scholar 

  44. Borenstein M, Hedges L, Higgins J, et al. Comprehensive meta-analysis version 2. Englewood: Biostat; 2005.

    Google Scholar 

  45. Higgins JP, Thompson SG, Deeks JJ, et al. Measuring inconsistency in meta-analyses. Br Med J. 2003;327(7414):557.

    Google Scholar 

  46. Rosenthal R. The file drawer problem and tolerance for null results. Psychol Bull. 1979;86(3):638.

    Google Scholar 

  47. Duval S, Tweedie R. Trim and fill: a simple funnel-plot-based method of testing and adjusting for publication bias in meta-analysis. Biometrics. 2000;56(2):455–63.

    CAS  PubMed  Google Scholar 

  48. Safrit MJ, Wood TM. Introduction to measurement in physical education and exercise science. St-Louis: Times Mirror/Mosby; 1986.

    Google Scholar 

  49. Ransdell LB, Detling NJ, Taylor A, et al. Effects of Home- and University-based programs on physical self-perception in mothers and daughters. Women Health. 2004;39(2):63–81. doi:10.1300/J013v39n02_05.

    PubMed  Google Scholar 

  50. Moliner-Urdiales D. Associations of muscular and cardiorespiratory fitness with total and central body fat in adolescents: the HELENA Study. Br J Sports Med. 2011;45(2):101–8.

    CAS  PubMed  Google Scholar 

  51. Clark EM, Tobias JH, Murray L, et al. Children with low muscle strength are at an increased risk of fracture with exposure to exercise. J Musculoskelet Neuronal Interact. 2011;11(2):196–202.

    CAS  PubMed  Google Scholar 

  52. Cheng JCY, Maffulli N, Leung SSSF, et al. Axial and peripheral bone mineral acquisition: a 3-year longitudinal study in Chinese adolescents. Eur J Pediatr. 1999;158(6):506–12. doi:10.1007/s004310051131.

    CAS  PubMed  Google Scholar 

  53. Wang Q, Alen M, Nicholson P, et al. Weight-bearing, muscle loading and bone mineral accrual in pubertal girls—a 2-year longitudinal study. Bone. 2007;40(5):1196–202. doi:10.1016/j.bone.2006.12.054.

    PubMed  Google Scholar 

  54. Barnekow-Bergkvist M, Hedberg G, Pettersson U, et al. Relationships between physical activity and physical capacity in adolescent females and bone mass in adulthood. Scand J Med Sci Sports. 2006;16(6):447–55.

    CAS  PubMed  Google Scholar 

  55. Weeks BK, Young CM, Beck BR. Eight months of regular in-school jumping improves indices of bone strength in adolescent boys and girls: the POWER PE study. J Bone Miner Res. 2008;23(7):1002–11. doi:10.1359/jbmr.080226.

    PubMed  Google Scholar 

  56. Artero EG, Ruiz JR, Ortega FB, et al. Muscular and cardiorespiratory fitness are independently associated with metabolic risk in adolescents: the HELENA study. Pediatr Diabetes. 2011;12(8):704–12. doi:10.1111/j.1399-5448.2011.00769.x.

    PubMed  Google Scholar 

  57. Steene-Johannessen J, Anderssen SA, Kolle E, et al. Low muscle fitness is associated with metabolic risk in youth. Med Sci Sports Exerc. 2009;41(7):1361–7. doi:10.1249/MSS.0b013e31819aaae5.

    PubMed  Google Scholar 

  58. Artero E, España-Romero V, Jiménez-Pavón D et al. Muscular fitness, fatness and inflammatory biomarkers in adolescents. Pediatr Obes. 2013.

  59. Martinez-Gomez D, Eisenmann JC, Gomez-Martinez S, et al. Associations of physical activity and fitness with adipocytokines in adolescents: The AFINOS study. Nutr Metab Cardiovasc Dis. 2012;22(3):252–9. doi:10.1016/j.numecd.2010.07.010.

    CAS  PubMed  Google Scholar 

  60. Martinez-Gomez D, Gomez-Martinez S, Ruiz JR, et al. Objectively-measured and self-reported physical activity and fitness in relation to inflammatory markers in European adolescents: the HELENA Study. Atherosclerosis. 2012;221(1):260–7. doi:10.1016/j.atherosclerosis.2011.12.032.

    CAS  PubMed  Google Scholar 

  61. Ruiz JR, Ortega FB, Wärnberg J, et al. Inflammatory proteins and muscle strength in adolescents: the AVENA study. Arch Pediatr Adolesc Med. 2008;162(5):462–8.

    PubMed  Google Scholar 

  62. Steene-Johannessen J, Kolle E, BoAndersen L, et al. Adiposity, aerobic fitness, muscle fitness, and markers of inflammation in children. Med Sci Sports Exerc. 2013;45(4):714–21. doi:10.1249/MSS.0b013e318279707a.

    CAS  PubMed  Google Scholar 

  63. Ortega FB, Silventoinen K, Tynelius P et al. Muscular strength in male adolescents and premature death: cohort study of one million participants. Br Med J. 2012;345(7884).

  64. Barnekow-Bergkvist M, Hedberg GE, Janlert U, et al. Determinants of self-reported neck-shoulder and low back symptoms in a general population. Spine. 1998;23(2):235–43. doi:10.1097/00007632-199801150-00017.

    CAS  PubMed  Google Scholar 

  65. Mikkelsson LO, Nupponen H, Kaprio J, et al. Adolescent flexibility, endurance strength, and physical activity as predictors of adult tension neck, low back pain, and knee injury: a 25 year follow up study. Br J Sports Med. 2006;40(2):107–13.

    CAS  PubMed Central  PubMed  Google Scholar 

  66. Sjölie AN, Ljunggren AE. The significance of high lumbar mobility and low lumbar strength for current and future low back pain in adolescents. Spine. 2001;26(23):2629–36.

    PubMed  Google Scholar 

  67. Harter S. Manual for the self-perception profile for adolescents. Denver: University of Denver; 1988.

    Google Scholar 

  68. Whitehead JR. A study of children’s physical self-perceptions using an adapted physical self-perception profile questionnaire. Pediatr Exerc Sci. 1995;7:132.

    Google Scholar 

  69. Haugen T, Ommundsen Y, Seiler S. The relationship between physical activity and physical self-esteem in adolescents: the role of physical fitness indices. Pediatr Exerc Sci. 2013;25(1):138–53.

    PubMed  Google Scholar 

  70. Morano M, Colella D, Robazza C, et al. Physical self-perception and motor performance in normal-weight, overweight and obese children. Scand J Med Sci Sports. 2011;21(3):465–73.

    CAS  PubMed  Google Scholar 

  71. Marsh HW. Construct validity of physical self-description questionnaire responses: Relations to external criteria. J Sport Exerc Psychol. 1996;18:111–31.

    Google Scholar 

  72. Lubans DR, Cliff DP. Muscular fitness, body composition and physical self-perception in adolescents. J Sci Med Sport. 2011;14(3):216–21. doi:10.1016/j.jsams.2010.10.003.

    PubMed  Google Scholar 

  73. Smith AJ, O’Sullivan PB, Campbell AC, et al. The relationship between back muscle endurance and physical, lifestyle, and psychological factors in adolescents. J Orthop Sports Phys Ther. 2010;40(8):517–23. doi:10.2519/jospt.2010.3369.

    PubMed  Google Scholar 

  74. Hasselstrom H, Hansen SE, Froberg K, et al. Physical fitness and physical activity during adolescence as predictors of cardiovascular disease risk in young adulthood. Danish Youth and Sports study. An eight-year follow-up study. Int J Sports Med. 2002;23(1):S27–31.

    PubMed  Google Scholar 

  75. Janz KF, Dawson JD, Mahoney LT. Increases in physical fitness during childhood improve cardiovascular health during adolescence: the Muscatine Study. Int J Sports Med. 2002;23(Suppl 1):S15–21.

    PubMed  Google Scholar 

  76. Freitas D, Beunen G, Maia J, et al. Tracking of fatness during childhood, adolescence and young adulthood: a 7-year follow-up study in Madeira Island, Portugal. Ann Hum Biol. 2012;39(1):59–67.

    PubMed  Google Scholar 

  77. Hruby A, Chomitz VR, Arsenault LN, et al. Predicting maintenance or achievement of healthy weight in children: the impact of changes in physical fitness. Obesity. 2012;20(8):1710–7. doi:10.1038/oby.2012.13.

    PubMed  Google Scholar 

  78. Hill JO. Understanding and addressing the epidemic of obesity: an energy balance perspective. Endocr Rev. 2006;27(7):750–61.

    PubMed  Google Scholar 

  79. Bouchard C, Blair SN, Haskell WL. Physical activity and health. 2nd ed. Champaigne: Human Kinetics; 2012.

    Google Scholar 

  80. Castelli DM, Valley JA. Chapter 3: The relationship of physical fitness and motor competence to physical activity. J Teach Phys Educ. 2007;26(4):358–74.

    Google Scholar 

  81. Fogelholm M, Stigman S, Huisman T, et al. Physical fitness in adolescents with normal weight and overweight. Scand J Med Sci Sports. 2008;18(2):162–70. doi:10.1111/j.1600-0838.2007.00685.x.

    CAS  PubMed  Google Scholar 

  82. Deforche B, Lefevre J, De Bourdeaudhuij I, et al. Physical fitness and physical activity in obese and nonobese Flemish youth. Obes Res. 2003;11(3):434–41.

    PubMed  Google Scholar 

  83. Artero EG, España-Romero V, Ortega FB, et al. Health-related fitness in adolescents: underweight, and not only overweight, as an influencing factor. The AVENA study. Scand J Med Sci Sports. 2010;20(3):418–27. doi:10.1111/j.1600-0838.2009.00959.x.

    CAS  PubMed  Google Scholar 

  84. Milliken LA, Faigenbaum AD, Loud RL, et al. Correlates of upper and lower body muscular strength in children. J Strength Cond Res. 2008;22(4):1339–46.

    PubMed  Google Scholar 

  85. Rizzoli R, Bianchi ML, Garabédian M, et al. Maximizing bone mineral mass gain during growth for the prevention of fractures in the adolescents and the elderly. Bone. 2010;46(2):294–305.

    PubMed  Google Scholar 

  86. Eisman J, Kelly P, Morrison N, et al. Peak bone mass and osteoporosis prevention. Osteoporos Int. 1993;3(1):56–60.

    PubMed  Google Scholar 

  87. Clark EM, Ness AR, Bishop NJ, et al. Association between bone mass and fractures in children: a prospective cohort study. J Bone Miner Res. 2006;21(9):1489–95.

    PubMed Central  PubMed  Google Scholar 

  88. Kelly P, Eisman J, Sambrook P. Interaction of genetic and environmental influences on peak bone density. Osteoporos Int. 1990;1(1):56–60.

    CAS  PubMed  Google Scholar 

  89. Vicente-Rodriguez G, Jimenez-Ramirez J, Ara I, et al. Enhanced bone mass and physical fitness in prepubescent footballers. Bone. 2003;33(5):853–9.

    CAS  PubMed  Google Scholar 

  90. Vicente-Rodriguez G, Dorado C, Perez-Gomez J, et al. Enhanced bone mass and physical fitness in young female handball players. Bone. 2004;35(5):1208–15.

    CAS  PubMed  Google Scholar 

  91. Babaroutsi E, Magkos F, Manios Y, et al. Body mass index, calcium intake, and physical activity affect calcaneal ultrasound in healthy Greek males in an age-dependent and parameter-specific manner. J Bone Miner Metab. 2005;23(2):157–66.

    PubMed  Google Scholar 

  92. Pollitzer WS, Anderson JJ. Ethnic and genetic differences in bone mass: a review with a hereditary vs environmental perspective. Am J Clin Nutr. 1989;50(6):1244–59.

    CAS  PubMed  Google Scholar 

  93. Gilsanz V, Roe TF, Mora S, et al. Changes in vertebral bone density in black girls and white girls during childhood and puberty. N Engl J Med. 1991;325(23):1597–600.

    CAS  PubMed  Google Scholar 

  94. Foo LH, Zhang Q, Zhu K, et al. Influence of body composition, muscle strength, diet and physical activity on total body and forearm mass in Chinese adolescent girls. Br J Nutr. 2007;98:1281–7.

    CAS  PubMed  Google Scholar 

  95. Vicente-Rodríguez G. How does exercise affect bone development during growth? Sports Med. 2006;36(7):561–9.

    PubMed  Google Scholar 

  96. Srinivasan SR, Berenson GS. Childhood lipoprotein profiles and implications for adult coronary artery disease: the Bogalusa Heart Study. Am J Med Sci. 1995;310(6):S68.

    Google Scholar 

  97. McGill HC, McMahan CA, Zieske AW, et al. Association of coronary heart disease risk factors with microscopic qualities of coronary atherosclerosis in youth. Circulation. 2000;102(4):374–9.

    PubMed  Google Scholar 

  98. Kemper HC, Snel J, Verschuur R, et al. Tracking of health and risk indicators of cardiovascular diseases from teenager to adult: Amsterdam Growth and Health Study. Prev Med. 1990;19(6):642–55.

    CAS  PubMed  Google Scholar 

  99. Mota J, Vale S, Martins C, et al. Influence of muscle fitness test performance on metabolic risk factors among adolescent girls. Diabetol Metab Syndr. 2010;2(42):1–7. doi:10.1186/1758-5996-2-42.

    Google Scholar 

  100. Eisenmann JC, Welk GJ, Wickel EE, et al. Combined influence of cardiorespiratory fitness and body mass index on cardiovascular disease risk factors among 8–18 year old youth: the Aerobics Center Longitudinal Study. Int J Pediatr Obes. 2007;2(2):66–72.

    PubMed  Google Scholar 

  101. Gutin B, Yin Z, Humphries MC, et al. Relations of body fatness and cardiovascular fitness to lipid profile in black and white adolescents. Pediatr Res. 2005;58(1):78–82.

    CAS  PubMed  Google Scholar 

  102. Schranz N, Tomkinson G, Olds T. What is the effect of resistance training on the strength, body composition and psychosocial status of overweight and obese children and adolescents? A systematic review and meta-analysis. Sports Med. 2013;43(9):893–907.

    PubMed  Google Scholar 

  103. Shaibi GQ, Cruz ML, Ball GD, et al. Effects of resistance training on insulin sensitivity in overweight Latino adolescent males. Med Sci Sports Exerc. 2006;38(7):1208–15.

    CAS  PubMed  Google Scholar 

  104. McGuigan MR, Tatasciore M, Newton RU, et al. Eight weeks of resistance training can significantly alter body composition in children who are overweight or obese. J Strength Cond Res. 2009;23(1):80–5.

    PubMed  Google Scholar 

  105. Leboeuf-Yde C, Kyvik KO. At what age does low back pain become a common problem? A study of 29,424 individuals aged 12–41 years. Spine. 1998;23(2):228–34.

    CAS  PubMed  Google Scholar 

  106. Harreby M, Kjer J, Hesselsøe G, et al. Epidemiological aspects and risk factors for low back pain in 38-year-old men and women: a 25-year prospective cohort study of 640 school children. Eur Spine J. 1996;5(5):312–8.

    CAS  PubMed  Google Scholar 

  107. King S, Chambers CT, Huguet A, et al. The epidemiology of chronic pain in children and adolescents revisited: a systematic review. Pain. 2011;152(12):2729–38. doi:10.1016/j.pain.2011.07.016.

    PubMed  Google Scholar 

  108. Newcomer K, Sinaki M. Low back pain and its relationship to back strength and physical activity in children. Acta Paediatr. 1996;85(12):1433–9.

    CAS  PubMed  Google Scholar 

  109. Perry M, Straker L, O’Sullivan P, et al. Fitness, motor competence, and body composition are weakly associated with adolescent back pain. J Orthop Sports Phys Ther. 2009;39(6):439–49.

    PubMed  Google Scholar 

  110. Cardon G, De Bourdeaudhuij I, De Clercq D, et al. Physical fitness, physical activity, and self-reported back and neck pain in elementary schoolchildren. Pediatr Exerc Sci. 2004;16(2):147–57.

    Google Scholar 

  111. Viner R, Booy R. ABC of adolescence: epidemiology of health and illness. Br Med J. 2005;330(7488):411–4.

    Google Scholar 

  112. Biddle SJ, Mutrie N. Psychology of physical activity: determinants, well-being and interventions. 2nd ed. Abingdon: Routledge; 2008.

    Google Scholar 

  113. Fox KR. Self-esteem, self-perceptions and exercise. Int J Sport Psychol. 2000;31(2):228–40.

    Google Scholar 

  114. Harter S. Manual for the self-perception profile for children. Denver: University of Denver; 1985.

    Google Scholar 

  115. Stodden DF, Goodway JD, Langendorfer SJ, et al. A developmental perspective on the role of motor skill competence in physical activity: an emergent relationship. Quest. 2008;60(2):290–306.

    Google Scholar 

  116. Biddle SJ, Asare M. Physical activity and mental health in children and adolescents: a review of reviews. Br J Sports Med. 2011;45(11):886–95.

    PubMed  Google Scholar 

  117. Dwyer T, Sallis JF, Blizzard L, et al. Relation of academic performance to physical activity and fitness in children. Pediatr Exerc Sci. 2001;13(3):225–37.

    Google Scholar 

  118. Du Toit D, Pienaar AE, Truter L. Relationship between physical fitness and academic performance in South African children. S Afr J Res Sport Phys Educ. 2011;33(3):23–35.

    Google Scholar 

  119. Edwards JU, Mauch L, Winkelman MR. Relationship of nutrition and physical activity behaviors and fitness measures to academic performance for sixth graders in a midwest city school district. J Sch Health. 2011;81(2):65–73. doi:10.1111/j.1746-1561.2010.00562.x.

    PubMed  Google Scholar 

  120. Castelli DM, Hillman CH, Buck SM, et al. Physical fitness and academic achievement in third- and fifth-grade students. J Sport Exerc Psychol. 2007;29(2):239–52.

    PubMed  Google Scholar 

  121. Ruiz JR, Ortega FB, Castillo R, et al. Physical activity, fitness, weight status, and cognitive performance in adolescents. J Pediatr. 2010;157(6):917–22. doi:10.1016/j.jpeds.2010.06.026.

    PubMed  Google Scholar 

  122. Hillman CH, Castelli DM, Buck SM. Aerobic fitness and neurocognitive function in healthy preadolescent children. Med Sci Sports Exerc. 2005;37(11):1967–74.

    PubMed  Google Scholar 

  123. Coe DP, Pivarnik JM, Womack CJ, et al. Effect of physical education and activity levels on academic achievement in children. Med Sci Sports Exerc. 2006;38(8):1515–9.

    PubMed  Google Scholar 

  124. Cotman CW, Berchtold NC. Exercise: a behavioral intervention to enhance brain health and plasticity. Trends Neurosci. 2002;25(6):295–301.

    CAS  PubMed  Google Scholar 

  125. Hillman CH, Buck SM, Themanson JR, et al. Aerobic fitness and cognitive development: Event-related brain potential and task performance indices of executive control in preadolescent children. Dev Psychol. 2009;45(1):114–29.

    PubMed  Google Scholar 

  126. Bloemers F, Collard D, Paw MCA, et al. Physical inactivity is a risk factor for physical activity-related injuries in children. Br J Sports Med. 2012;46(9):669–74.

    PubMed  Google Scholar 

  127. Schwingshandl J, Sudi K, Eibl B, et al. Effect of an individualised training programme during weight reduction on body composition: a randomised trial. Arch Dis Child. 1999;81(5):426–8.

    CAS  PubMed Central  PubMed  Google Scholar 

  128. Watts K, Beye P, Siafarikas A, et al. Exercise training normalizes vascular dysfunction and improves central adiposity in obese adolescents. J Am Coll Cardiol. 2004;43(10):1823–7.

    PubMed  Google Scholar 

  129. Velez A, Golem DL, Arent SM. The impact of a 12-week resistance training program on strength, body composition, and self-concept of Hispanic adolescents. J Strength Cond Res. 2010;24(4):1065–73.

    PubMed  Google Scholar 

  130. Woods JA, Pate RR, Burgess ML. Correlates to performance on field tests of muscular strength. Pediatr Exerc Sci. 1992;4(4):302–11.

    Google Scholar 

  131. Almuzaini KS. Muscle function in Saudi children and adolescents: Relationship to anthropometric characteristics during growth. Pediatr Exerc Sci. 2007;19(3):319–33.

    PubMed  Google Scholar 

  132. Annesi JJ, Pierce LL, Bonaparte WA, et al. Preliminary effects of the Youth Fit For Life protocol on body mass index in Mexican American children in YMCA before- and after-school care programs. Hisp Health Care Int. 2009;7(3):123–9. doi:10.1891/1540-4153.7.3.123.

    Google Scholar 

  133. Ara I, Vicente-Rodriguez G, Jimenez-Ramirez J, et al. Regular participation in sports is associated with enhanced physical fitness and lower fat mass in prepubertal boys. Int J Obes. 2004;28(12):1585–93. doi:10.1038/sj.ijo.0802754.

    CAS  Google Scholar 

  134. Bovet P, Auguste R, Burdette H. Strong inverse association between physical fitness and overweight in adolescents: a large school-based survey. Int J Behav Nutr Phys Act. 2007;4:24–8. doi:10.1186/1479-5868-4-24.

    PubMed Central  PubMed  Google Scholar 

  135. Brunet M, Chaput JP, Tremblay A. The association between low physical fitness and high body mass index or waist circumference is increasing with age in children: the ‘Québec en Forme’ Project. Int J Obes. 2007;31(4):637–43. doi:10.1038/sj.ijo.0803448.

    CAS  Google Scholar 

  136. Butterfield SA, Lehnhard RA, Coladarci T. Age, sex, and body mass index in performance of selected locomotor and fitness tasks by children in grades K-2. Percept Mot Skills. 2002;94(1):80–6.

    Google Scholar 

  137. Castro-Piñero J, González-Montesinos JL, Mora J, et al. Percentile values for muscular strength field tests in children aged 6 to 17 years: Influence of weight status. J Strength Cond Res. 2009;23(8):2295–310.

    PubMed  Google Scholar 

  138. Chen LJ, Fox KR, Haase A, et al. Obesity, fitness and health in Taiwanese children and adolescents. Eur J Clin Nutr. 2006;60(12):1367–75. doi:10.1038/sj.ejcn.1602466.

    CAS  PubMed  Google Scholar 

  139. Chen W, Lin CC, Peng CT, et al. Approaching healthy body mass index norms for children and adolescents from health-related physical fitness. Obes Rev. 2002;3(3):225–32. doi:10.1046/j.1467-789X.2002.00064.x.

    CAS  PubMed  Google Scholar 

  140. Cureton KJ, Boileau RA, Lohman Tg. Relationship between body composition measures and AAHPER test performances in young boys. Res Q. 1975;46(2):218–29.

    CAS  PubMed  Google Scholar 

  141. Gonzalez-Suarez CB, Caralipio N, Gambito E, et al. The association of physical fitness with body mass index and waist circumference in Filipino preadolescents. Asia Pac J Public Health. 2013;25(1):74–83. doi:10.1177/1010539511412764.

    PubMed  Google Scholar 

  142. Gonzalez-Suarez CB, Grimmer-Somers K. The association of physical activity and physical fitness with pre-adolescent obesity: an observational study in Metromanila, Philippines. J Phys Act Health. 2011;8(6):804–10.

    PubMed  Google Scholar 

  143. Heroux M, Onywera V, Tremblay MS, et al. The relation between aerobic fitness, muscular fitness, and obesity in children from three countries at different stages of the physical activity transition. ISRN Obes. 2013;2013:134835. doi:10.1155/2013/134835.

    CAS  PubMed Central  PubMed  Google Scholar 

  144. Huang YC, Malina RM. Body mass index and individual physical fitness tests in Taiwanese youth aged 9–18 years. Int J Pediatr Obes. 2010;5(5):404–11. doi:10.3109/17477160903497902.

    PubMed  Google Scholar 

  145. Huberty JL, Rosenkranz RR, Balluff MA, et al. Describing weight status and fitness in a community sample of children attending after-school programming. J Sports Med Phys Fitness. 2010;50(2):217–28.

    CAS  PubMed  Google Scholar 

  146. Joshi P, Bryan C, Howat H. Relationship of body mass index and fitness levels among schoolchildren. J Strength Cond Res. 2012;26(4):1006–14. doi:10.1519/JSC.0b013e31822dd3ac.

    PubMed  Google Scholar 

  147. Lloyd LK, Bishop PA, Walker JL, et al. The influence of body size and composition on FITNESSGRAM test performance and the adjustment of FITNESSGRAM test scores for skinfold thickness in youth. Meas Phys Educ Exerc Sci. 2003;7(4):205–26.

    Google Scholar 

  148. Malina RM, Beunen GP, Classens AL, et al. Fatness and physical fitness of girls 7 to 17 years. Obes Res. 1995;3(3):221–31.

    CAS  PubMed  Google Scholar 

  149. Malina RM, Reyes MEP, Tan SK, et al. Physical fitness of normal, stunted and overweight children 6–13 years in Oaxaca, Mexico. Eur J Clin Nutr. 2011;65(7):826–34. doi:10.1038/ejcn.2011.44.

    CAS  PubMed  Google Scholar 

  150. Minck MR, Ruiter LM, Van Mechelen W, et al. Physical fitness, body fatness, and physical activity: the Amsterdam Growth and Health Study. Am J Hum Biol. 2000;12:593–9.

    PubMed  Google Scholar 

  151. Pate RR, Slentz CA, Katz DP. Relationships between skinfold thickness and performance of health related fitness test items. Res Q Exerc Sport. 1989;60(2):183–9.

    CAS  PubMed  Google Scholar 

  152. Pino-Ortega J, De la Cruz-Sanchez E, Martinez-Santos R. Health-related fitness in school children: compliance with physical activity recommendations and its relationship with body mass index and diet quality. Arch Latinoam Nutr. 2010;60(4):374–9.

    PubMed  Google Scholar 

  153. Pissanos BW, Moore JB, Reeve TG. Age, sex, and body composition as predictors of children’s performance on basic motor abilities and health-related fitness items. Percept Mot Skills. 1983;56(1):71–7.

    CAS  PubMed  Google Scholar 

  154. Pongprapai S, Mo-suwan L, Leelasamran W. Physical fitness of obese school children in Hat Yai, southern Thailand. Southeast Asian J Trop Med. 1994;25(2):354–60.

    CAS  Google Scholar 

  155. Sacchetti R, Ceciliani A, Garulli A, et al. Physical fitness of primary school children in relation to overweight prevalence and physical activity habits. J Sports Sci. 2012;30(7):633–40. doi:10.1080/02640414.2012.661070.

    PubMed  Google Scholar 

  156. Slaughter MH, Lohman TG, Misner JE. Relationship of somatotype and body composition to physical performance in 7- to 12- year old boys. Res Q. 1977;48(1):159–68.

    CAS  PubMed  Google Scholar 

  157. Tokmakidis SP, Kasambalis A, Christodoulos AD. Fitness levels of Greek primary schoolchildren in relationship to overweight and obesity. Eur J Pediatr. 2006;165(12):867–74. doi:10.1007/s00431-006-0176-2.

    PubMed  Google Scholar 

  158. Ara I, Moreno LA, Leiva MT, et al. Adiposity, physical activity, and physical fitness among children from Aragón, Spain. Obesity. 2007;15(8):1918–24. doi:10.1038/oby.2007.228.

    PubMed  Google Scholar 

  159. Huotari PRT, Nupponen H, Laakso L, et al. Secular trends in muscular fitness among Finnish adolescents. Scand J Public Health. 2010;38(7):739–47. doi:10.1177/1403494810384425.

    PubMed  Google Scholar 

  160. Raudsepp L, Jurimae T. Relationships between somatic variables, physical activity, fitness and fundamental motor skills in prepubertal boys. Biol Sport. 1996;13(4):279–89.

    Google Scholar 

  161. Grund A, Dilba B, Forberger K, et al. Relationships between physical activity, physical fitness, muscle strength and nutritional state in 5- to 11-year-old children. Eur J Appl Physiol. 2000;82(5–6):425–38. doi:10.1007/s004210000197.

    CAS  PubMed  Google Scholar 

  162. Kim J, Must A, Fitzmaurice GM, et al. Relationship of physical fitness to prevalence and incidence of overweight among schoolchildren. Obes Res. 2005;13(7):1246–54.

    PubMed  Google Scholar 

  163. Raudsepp L, Jurimae T. Physical activity, fitness, and adiposity of prepubertal girls. Pediatr Exerc Sci. 1996;8(3):259–67.

    Google Scholar 

  164. Slaughter MH, Lohman TG, Misner JE. Association of somatotype and body composition to physical performance in 7-12 year-old-girls. J Sports Med Phys Fitness. 1980;20(2):189–98.

    CAS  PubMed  Google Scholar 

  165. Andersen LB. Changes in physical activity are reflected in changes in fitness during late adolescence: a 2-year follow-up study. J Sports Med Phys Fitness. 1994;34(4):390–7.

    CAS  PubMed  Google Scholar 

  166. Benson AC, Torode ME, Fiatarone Singh MA. The effect of high-intensity progressive resistance training on adiposity in children: a randomized controlled trial. Int J Obes. 2008;32(6):1016–27. doi:10.1038/ijo.2008.5.

    CAS  Google Scholar 

  167. Afghani A, Xie B, Wiswell RA, et al. Bone mass of Asian adolescents in China: influence of physical activity and smoking. Med Sci Sports Exerc. 2003;35(5):720–9. doi:10.1249/01.mss.0000064940.76574.bd.

    PubMed  Google Scholar 

  168. Cheng JCY, Leung SSSF, Lee WTK, et al. Determinants of axial and peripheral bone mass in Chinese adolescents. Arch Dis Child. 1998;78:524–30.

    CAS  PubMed Central  PubMed  Google Scholar 

  169. Fonseca RMC, De Franca NM, Van Praagh E. Relationship between indicators of fitness and bone density in adolescent Brazilian children. Pediatr Exerc Sci. 2008;20(1):40–9.

    PubMed  Google Scholar 

  170. Ginty F, Rennie KL, Mills L, et al. Positive, site-specific associations between bone mineral status, fitness, and time spent at high-impact activities in 16- to 18-year-old boys. Bone. 2005;36(1):101–10. doi:10.1016/j.bone.2004.10.001.

    CAS  PubMed  Google Scholar 

  171. Gracia-Marco L, Vicente-Rodríguez G, Casajús J, et al. Effect of fitness and physical activity on bone mass in adolescents: the HELENA Study. Eur J Appl Physiol. 2011;111(11):2671–80.

    CAS  PubMed  Google Scholar 

  172. Kardinaal AF, Hoorneman G, Väänänen K, et al. Determinants of bone mass and bone geometry in adolescent and young adult women. Calcif Tissue Int. 2000;66(2):81–9.

    CAS  PubMed  Google Scholar 

  173. van Langendonck L, Claessensy AL, Lysensz R, et al. Association between bone, body composition and strength in premenarcheal girls and postmenopausal women. Ann Hum Biol. 2004;31(2):228–44.

    PubMed  Google Scholar 

  174. Duppe H, Gardsell P, Johnell O, et al. Bone mineral density, muscle strength and physical activity: a population-based study of 332 subjects aged 15–42 years. Acta Orthop Scand. 1997;68(2):97–103.

    CAS  PubMed  Google Scholar 

  175. Rice S, Blimkie CJR, Webber CE, et al. Correlates and determinants of bone mineral content and density in healthy adolescent girls. Can J Physiol Pharmacol. 1993;71(12):923–30.

    CAS  PubMed  Google Scholar 

  176. Witzke KA, Snow CM. Lean body mass and leg power best predict bone mineral density in adolescent girls. Med Sci Sports Exerc. 1999;31(11):1558–63.

    CAS  PubMed  Google Scholar 

  177. García-Artero E, Ortega FB, Ruiz JR, et al. Lipid and metabolic profiles in adolescents are affected more by physical fitness than physical activity (AVENA study). Rev Esp Cardiol. 2007;60(6):581–8.

    PubMed  Google Scholar 

  178. Magnussen C, Schmidt M, Dwyer T, et al. Muscular fitness and clustered cardiovascular disease risk in Australian youth. Eur J Appl Physiol. 2012;112(8):3167–71.

    PubMed  Google Scholar 

  179. Ortega FB, Ruiz JR, Castillo MJ, et al. Low level of physical fitness in Spanish adolescents. Relevance for future cardiovascular health (AVENA study). Rev Esp Cardiol. 2005;58(8):898–909.

    Google Scholar 

  180. Thorsen K, Nordstrom P, Lorentzon R, et al. The relation between bone mineral density, insulin-like growth factor I, lipoprotein (a), body composition, and muscle strength in adolescent males. J Clin Endocrinol Metab. 1999;84(9):3025–9.

    CAS  PubMed  Google Scholar 

  181. Barnekow-Bergkvist M, Hedberg G, Janlert U, et al. Adolescent determinants of cardiovascular risk factors in adult men and women. Scand J Public Health. 2001;29(3):208–17.

    CAS  PubMed  Google Scholar 

  182. Brandon LJ, Fillingim J. Health fitness training responses of normotensive and elevated normotensive children. Am J Health Promot. 1990;5(1):30–5.

    CAS  PubMed  Google Scholar 

  183. Hoekstra T, Boreham CA, Murray LJ, et al. Associations between aerobic and muscular fitness and cardiovascular disease risk: the Northern Ireland young hearts study. J Phys Act Health. 2008;5(6):815–29.

    PubMed  Google Scholar 

  184. Andersen L, Wedderkopp N, Leboeuf-Yde C. Association between back pain and physical fitness in adolescents. Spine. 2006;31(15):1740–4. doi:10.1097/01.brs.0000224186.68017.e0.

    Google Scholar 

  185. Johnson OE, Mbada CE, Agbeja OB, et al. Relationship between physical activity and back extensor muscles’ endurance to the risk of low-back pain in school-aged adolescents. TAF Prev Med Bull. 2011;10(4):415–20.

    Google Scholar 

  186. Johnson OE, Mbada CE, Akosile CO, et al. Isometric endurance of the back extensors in school-aged adolescents with and without low back pain. J Back Musculoskelet Rehabil. 2009;22(4):205–11. doi:10.3233/bmr-2009-0.

    PubMed  Google Scholar 

  187. Mafanya C, Rhoda A. Predictors of neck pain among South African youth. Afr J Phys Health Educ Recreat Dance. 2011:82–9.

  188. O’Sullivan PB, Smith AJ, Beales DJ, et al. Association of biopsychosocial factors with degree of slump in sitting posture and self-report of back pain in adolescents: a cross-sectional study. Phys Ther. 2011;91(4):470–83. doi:10.2522/ptj.20100160.

    PubMed  Google Scholar 

  189. Salminen JJ, Maki P, Oksanen A, et al. Spinal mobility and trunk muscle strength in 15-year-old schoolchildren with and without low-back pain. Spine. 1992;17(4):405–11.

    CAS  PubMed  Google Scholar 

  190. Feldman DE, Shrier I, Rossignol M, et al. Risk factors for the development of low back pain in adolescence. Int J Epidemiol. 2000;154:30–6.

    Google Scholar 

  191. Salminen JJ, Erkintalo M, Laine M, et al. Low back pain in the young. A prospective three-year follow-up study of subjects with and without low back pain. Spine. 1995;20(19):2101–7.

    CAS  PubMed  Google Scholar 

  192. Hands B, Larkin D, Parker H, et al. The relationship among physical activity, motor competence and health-related fitness in 14-year-old adolescents. Scand J Med Sci Sports. 2009;19(5):655–63. doi:10.1111/j.1600-0838.2008.00847.x.

    CAS  PubMed  Google Scholar 

  193. Sallis JF, McKenzie TL, Alcaraz JE. Habitual physical activity and health-related physical fitness in fourth-grade children. Am J Dis Child. 1993;147(8):890–6.

    CAS  PubMed  Google Scholar 

  194. Salminen JJ, Oksanen A, Maki P, et al. Leisure time physical activity in the young. Correlation with low-back pain, spinal mobility and trunk muscle strength in 15-year-old school children. Int J Sports Med. 1993;14(7):406–10.

    CAS  PubMed  Google Scholar 

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Acknowledgments

Thank you to Ruth Talbot-Stokes, academic librarian at the University of Newcastle, for her assistance with the database searching. RCP is supported by a National Health and Medical Research Council Senior Research Fellowship. No funding was received to produce this systematic review and the authors have no relevant conflicts of interest to declare.

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Authors and Affiliations

  1. Priority Research Centre for Physical Activity and Nutrition, School of Education, University of Newcastle, Callaghan Campus, Newcastle, NSW, Australia

    Jordan J. Smith, Narelle Eather, Philip J. Morgan, Ronald C. Plotnikoff & David R. Lubans

  2. Department of Health and Exercise Science, The College of New Jersey, Ewing, NJ, USA

    Avery D. Faigenbaum

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  1. Jordan J. Smith
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Smith, J.J., Eather, N., Morgan, P.J. et al. The Health Benefits of Muscular Fitness for Children and Adolescents: A Systematic Review and Meta-Analysis. Sports Med 44, 1209–1223 (2014). https://doi.org/10.1007/s40279-014-0196-4

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