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Enrique G Artero,
Jonatan R Ruiz,
Francisco B Ortega,
Vanesa España-Romero,
Germán Vicente-Rodríguez,
Dénes Molnar,
Frederic Gottrand,
Marcela González-Gross,
Christina Breidenassel,
Luis A Moreno, Angel Gutiérrez
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ABSTRACT: To examine the independent associations of muscular and cardiorespiratory fitness with clustered metabolic risk in adolescents.
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.
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).
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.
Pediatric Diabetes 04/2011; 12(8):704-12. · 2.16 Impact Factor
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ABSTRACT: To examine the combined influence of four lifestyle risk factors related to physical activity, television viewing, sleep duration, and meal frequency on body fat (BF) in adolescents.
This cross-sectional study comprised 1,310 Spanish adolescents (age 13-18.5 years). Lifestyle variables were self-reported and BF indicators (weight, height, six skinfold thicknesses, waist circumference) measured during the years 2000-2002. Lifestyle risk factors were: physically inactive, ≥ 3 h/day watching television, <8 h/day sleep duration, and <5 meals a day. The number of lifestyle risk factors was calculated for each participant, ranging from 0 to 4.
The number of lifestyle risk factors was positively associated with sum of six skinfolds, %BF, waist circumference, and waist-height ratio (all p < 0.001). The odds ratios (95% confidence interval) of overweight (including obesity) for groups with 1, 2, and 3-4 lifestyle risk factors compared with those with 0 were 2.86 (1.77-4.62), 3.61 (2.16-6.04), and 5.81 (3.07-10.99), respectively (p for trend <0.001). All the observations were independent of age, gender, race, socioeconomic status, and fat free mass.
The combined influence of four lifestyle risk factors is positively associated with BF and an approximately sixfold risk of overweight in adolescents.
Obesity Facts 01/2011; 4(2):105-11. · 1.86 Impact Factor
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Jonatan R Ruiz,
José Castro-Piñero,
Vanesa España-Romero,
Enrique G Artero,
Francisco B Ortega,
Magdalena M Cuenca,
David Jimenez-Pavón,
Palma Chillón,
María J Girela-Rejón,
Jesús Mora, Angel Gutiérrez,
Jaana Suni,
Michael Sjöström,
Manuel J Castillo
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ABSTRACT: 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.
British journal of sports medicine 10/2010; 45(6):518-24. · 2.55 Impact Factor
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F B Ortega,
E G Artero,
J R Ruiz,
V España-Romero,
D Jiménez-Pavón,
G Vicente-Rodriguez,
L A Moreno,
Y Manios,
L Béghin,
C Ottevaere,
D Ciarapica,
K Sarri,
S Dietrich,
S N Blair,
M Kersting,
D Molnar,
M González-Gross, A Gutiérrez,
M Sjöström,
M J Castillo
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ABSTRACT: To report sex- and age-specific physical fitness levels in European adolescents.
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.
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.
The normative values hereby provided will enable evaluation and correct interpretation of European adolescents' fitness status.
British journal of sports medicine 09/2009; 45(1):20-9. · 2.55 Impact Factor
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Beatriz Tresaco,
Luis A Moreno,
Jonatan R Ruiz,
Francisco B Ortega,
Gloria Bueno,
Marcela González-Gross,
Julia Wärnberg, Angel Gutiérrez,
Miguel García-Fuentes,
Ascensión Marcos,
Manuel J Castillo,
Manuel Bueno
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ABSTRACT: We examined whether abdominal and truncal adiposity, assessed with simple anthropometric indices, determines serum triglycerides and high-density lipoprotein (HDL)-cholesterol levels independently of total adiposity amount in adolescents. A total of 547 Spanish adolescents (284 males and 263 females) aged 13-18.5 years were included in this study. Measures of truncal adiposity included subscapular to triceps ratio, and trunk-to-total skinfolds ratio (TTS%). Waist circumference was used as a surrogate of abdominal adiposity, and BMI was used as a measure of total adiposity. The results of the regression models indicated that levels of triglycerides were positively associated with waist circumference and TTS% after controlling for age and Tanner stage in both sexes. Once BMI was entered in the model, these associations remained significant for waist circumference in females. HDL-cholesterol levels were negatively associated with waist circumference in both sexes, and with subscapular to triceps ratio and TTS% in males, after controlling for age and Tanner stage. Once BMI was entered in the model, these associations remained significant for subscapular to triceps ratio and for TTS% in males. The results of this study suggest that in male adolescents, truncal adiposity is negatively associated with levels of HDL-cholesterol, whereas in females, abdominal adiposity is positively associated with levels of triglycerides independently of total adiposity. These findings highlight the deleterious effect of both truncal and abdominal fat depots on the lipid profile already from the first decades of life.
Obesity 02/2009; 17(5):1086-91. · 4.28 Impact Factor
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Francisco B Ortega,
Idoia Labayen,
Jonatan R Ruiz,
Miguel Martin-Matillas,
Germán Vicente-Rodríguez,
Carlos Redondo,
Julia Wärnberg, Angel Gutiérrez,
Michael Sjöström,
Manuel J Castillo,
Luis A Moreno
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ABSTRACT: To determine whether birth weight is associated with handgrip strength and cardiovascular fitness in adolescence and, if so, how these associations are influenced by current body composition.
A total of 1801 adolescents (983 females), age 13 to 18.5 years, from the AVENA (Alimentación y Valoración del Estado Nutricional de los Adolescentes Españoles [Food and Assessment of the Nutritional Status of Spanish Adolescents]) study were evaluated. Handgrip strength and cardiovascular fitness were assessed using the handgrip test and the 20-m shuttle run test, respectively.
Birth weight was positively associated with handgrip strength in females after controlling for current age, gestational age, breast-feeding, and adolescent body mass index (P = .002), body fat percentage (P < .001), or waist circumference (P = .005), but not after controlling for fat-free mass. The associations were similar yet weaker in males. Females with high birth weight (>90th percentile) had greater handgrip strength than those with normal (10th to 90th percentile) or low (<10th percentile) birth weight, after adjusting for body fat percentage (P = .004). All of the differences became nonsignificant after adjusting for adolescent fat-free mass. Birth weight was not associated with cardiovascular fitness.
High birth weight is associated with greater handgrip strength in adolescents, especially in females, yet these associations seem to be highly explained by fat-free mass.
The Journal of pediatrics 10/2008; 154(1):61-66.e1. · 4.02 Impact Factor
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ABSTRACT: To determine whether the level of physical activity or physical fitness (i.e., aerobic capacity and muscle strength) in Spanish adolescents influences lipid and metabolic profiles.
From a total of 2859 Spanish adolescents (age 13.0-18.5 years) taking part in the AVENA (Alimentación y Valoración del Estado Nutricional en Adolescentes) study, 460 (248 male, 212 female) were randomly selected for blood analysis. Their level of physical activity was determined by questionnaire. Aerobic capacity was assessed using the Course-Navette test. Muscle strength was evaluated using manual dynamometry, the long jump test, and the flexed arm hang test. A lipid-metabolic cardiovascular risk index was derived from the levels of triglycerides, low-density lipoprotein cholesterol (LDLC), high-density lipoprotein cholesterol (HDLC), and glucose.
No relationship was found between the level of physical activity and lipid-metabolic index in either sex. In contrast, there was an inverse relationship between the lipid-metabolic index and aerobic capacity in males (P=.003) after adjustment for physical activity level and muscle strength. In females, a favorable lipid-metabolic index was associated with greater muscle strength (P=.048) after adjustment for aerobic capacity.
These results indicate that, in adolescents, physical fitness, and not physical activity, is related to lipid and metabolic cardiovascular risk. Higher aerobic capacity in males and greater muscle strength in females were associated with lower lipid and metabolic risk factors for cardiovascular disease.
Revista Espa de Cardiologia 07/2007; 60(6):581-8. · 2.53 Impact Factor
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ABSTRACT: We explored the associations between aerobic physical fitness with blood lipids and a composite index of blood lipids and fasting glycaemia in adolescents, analysing possible interactions with weight status.
Body mass index and aerobic physical fitness was measured in 2090 adolescents (1034 males and 1056 females) 13-18.5 years by using the 20-m shuttle run test. Plasma glucose, total, high density lipoprotein (HDL) and low density lipoprotein (LDL) cholesterol, triglycerides, apolipoprotein (apo) A-I, apo B-100 and lipoprotein(a) [Lp(a)] were measured in 460 of the 2090 subjects. After adjustment for confounding factors, a continuously distributed summary score for blood lipids and fasting glycaemia was significantly related to aerobic fitness in males (P=0.018) and females (P=0.045, from the 2nd to the 4th quartile of aerobic fitness). After adjustment for gender, age, sexual maturation and economic status, aerobic fitness was related to the composite index of blood lipids and glycaemia in both overweight and non-overweight adolescents (P< 0.05). However, for the same level of aerobic fitness, the composite index of blood lipids and glycaemia was significantly higher in overweight adolescents (P=0.001). After setting the minimal aerobic fitness standards to present a healthy lipid profile, about 50% of males did not reach such values.
Our data suggest that both aerobic fitness and weight management are associated with a composite index of blood lipids and glycaemia in adolescents. Our study also provides the minimal levels of aerobic physical fitness associated with a favourable lipid profile in male adolescents, a new tool which should be adopted by schools as "aerobic fitness standards".
Nutrition Metabolism and Cardiovascular Diseases 05/2006; 16(4):285-93. · 3.73 Impact Factor
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ABSTRACT: Physical exercise is proposed as a highly effective means of treating and preventing the main causes of morbidity and mortality--most of which are associated with aging--in industrialized countries. Low physical fitness is an important risk factor for cardiovascular and all-causes morbidity and mortality; indeed, it is even a predictor of these problems. When properly measured, the assessment of physical fitness can be a highly valuable indicator of health and life expectancy and, therefore, should be performed routinely in the clinical setting. Individually adapted training programs could be prescribed based on fitness assessment results and an adequate knowledge of patient lifestyle and daily physical activity. Such training programs would allow people to develop their maximum physical potential, improve their physical and mental health, and attenuate the negative consequences of aging.
Clinical Interventions in Aging 02/2006; 1(3):213-20. · 2.08 Impact Factor
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ABSTRACT: To explore in adolescents the associations between simple anthropometric variables with a continuously distributed summary score for lipid-related metabolic risk in both overweight and non-overweight adolescents, and to test whether these associations are modified by the level of cardiorespiratory fitness.
Cardiorespiratory fitness, BMI, skinfold thicknesses, body circumferences, and a continuously distributed clustering of lipid- related metabolic risk (calculated from LDL and HDL cholesterol, triglycerides, and glucose) were measured in 524 adolescents (265 males, 259 females, 15.3 +/- 1.4 years) from the cross-sectional multicentric AVENA study. Participants were classified as overweight (including obesity) or non-overweight.
Most anthropometric parameters were univariately related to the continuous lipid-related metabolic risk. However, after multicollinear analysis and generalized linear modelling, suprailiac skinfold thickness in males (p < 0.001, explained variance 12.2%) and waist-to-height ratio in females (p < 0.001, explained variance 10.0%) were the best determinants of the continuous metabolic risk score, after adjustment for age, sexual maturation, and economic status. These associations were slightly weakened in overweight males (p = 0.034) and females (p = 0.087), and did not interact with cardiorespiratory fitness.
Our data emphasize the usefulness of suprailiac skinfold thickness in males and waist-to-height ratio in females as simple anthropometric measurements associated to an overall lipid-related metabolic risk, mainly in non-overweight adolescents and regardless their cardiorespiratory status.
Annals of Nutrition and Metabolism 01/2006; 50(6):519-27. · 2.26 Impact Factor
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ABSTRACT: Several studies have demonstrated that physical fitness in childhood and adolescence is related to cardiovascular risk in adulthood. Current data on the physical fitness of Spanish adolescents are not available. Therefore, the aims of this study were: a) to assess the physical fitness of Spanish adolescents and establish reference values for use in health and educational settings as indicators of cardiovascular health, and b) to determine the percentage of Spanish adolescents below the minimum level of aerobic fitness needed to guarantee future cardiovascular health.
The modified EUROFIT battery of tests was used to assess physical fitness in a representative sample of Spanish adolescents (n=2859; 1357 boys and 1502 girls) taking part in the AVENA (Alimentación y Valoración del Estado Nutricional de los Adolescentes) study.
Standard parameters for the physical condition of Spanish adolescents are reported in this study. The 5th percentile for maximum aerobic capacity (Course Navette test) ranged from 2.0-3.3 palier in boys and from 1.4-1.9 palier in girls. The findings indicate that, on the basis of aerobic fitness, approximately 20% of Spanish adolescents have an increased risk of future cardiovascular disease. This subgroup also performed poorly in all other tests of physical fitness used.
The results reported in this study enable the level of physical fitness in adolescents to be interpreted as an indicator of future cardiovascular health. They also indicate that the physical fitness of Spanish adolescents must be improved to help protect against cardiovascular disease in adulthood.
Revista Espa de Cardiologia 09/2005; 58(8):898-909. · 2.53 Impact Factor
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ABSTRACT: This study investigates which position (grip span) on the standard grip dynamometer results in maximum grip strength. Our null hypotheses included (1) no optimal grip span exists for measuring grip strength and (2) optimal grip span is unrelated to hand size. We also intended to derive a simple mathematical algorithm to adapt grip span to hand size. Seventy healthy subjects (40 women/30 men; mean age, 40 years; range; 20-80 years) free of upper-limb lesions were evaluated. Each hand was randomly tested on 10 occasions using 5 different grip spans. Our findings showed that (1) optimal grip span was identified for both genders and (2) hand size and optimal grip span correlated in women but not in men. When measuring handgrip strength in women, hand size must be taken into consideration. We provide a mathematical equation (y = x/5 + 1.5 cm) to adapt optimal grip span (y) to hand size (x) in women. In adult men, optimal grip span can be set at a fixed value (5.5 cm).
The Journal Of Hand Surgery 10/2002; 27(5):897-901. · 1.35 Impact Factor
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ABSTRACT: The purposes were: (1) to determine the influence of sexual maturation status and body composition by comparing cardiovascular fitness (CVF) level in two adolescent populations from the south and the north of Europe; (2) to describe the associations between CVF and sexual maturation status in adolescence. A total of 1,867 Spanish adolescents from the AVENA study and 472 from the Swedish part of the EYHS were selected for this report (aged 14-16 years). CVF (expressed by the maximal oxygen consumption) was estimated from 20 m shuttle run test in the AVENA study and from a maximal ergometer cycle test in the EYHS. Sexual maturation status was classified according to Tanner stages. Body fat percentage (BF%) was estimated from skinfold thicknesses. Expressing CVF in different ways (in absolute value and in relation to weight or fat free mass; FFM) resulted in two different results with regard to CVF interpretation and comparison between the study populations. A higher CVF, as expressed in relation to FFM, was observed in the Spanish when compared to Swedish adolescents (P = 0.001). However, after adjusting for both sexual maturation status and BF%, the difference disappeared in males, while it remained significant in females (P = 0.001). CVF was negatively associated with sexual maturation status in males (P = 0.001). However, after adjusting for BF%, the association disappeared in males, while it was significant in females (P = 0.05). These results suggest that for CVF comparisons and interpretation in adolescent populations, sexual maturation status and BF%, as well as the way to express the CVF, should be taken into account.
American Journal of Human Biology 19(6):801-8. · 2.27 Impact Factor
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ABSTRACT: Introducción y objetivos. En diversos estudios se ha mostrado la relación entre el nivel de forma física durante la infancia-adolescencia y el riesgo cardiovascular en la edad adulta. Dado que no se dispone de datos relativos al nivel de condición física de los adolescentes españoles, los objetivos de este estudio son: a) determinar el nivel de condición física de los adolescentes españoles y establecer valores de referencia que puedan ser utilizados en el medio sanitario y educativo como indicadores de salud cardiovascular, y b) conocer la proporción de adolescentes españoles que no alcanza valores de capacidad aeróbica indicativos de salud cardiovascular futura. Sujetos y método. Se ha utilizado la batería EUROFIT modificada para evaluar la condición física de una muestra representativa de adolescentes españoles (n = 2.859; 1.357 varones y 1.502 mujeres) procedente del estudio AVENA (Alimentación y Valoración del Estado Nutricional de los Adolescentes). Resultados. Se han obtenido los valores normativos de condición física de la población adolescente española. El rango del percentil 5 respecto a la capacidad aeróbica máxima (test de Course Navette) es de 2,0-3,3 y 1,4-1,9 paliers para varones y mujeres, respectivamente. Casi 1 de cada 5 adolescentes presenta riesgo cardiovascular futuro sobre la base de su capacidad aeróbica. Este subgrupo de adolescentes mostró también una peor forma física que el resto de adolescentes en todas las pruebas físicas realizadas. Conclusiones. Los resultados obtenidos en el presente estudio permiten evaluar e interpretar correctamente el nivel de forma física de cualquier adolescente. Los resultados obtenidos indican la necesidad de mejorar el nivel de condición física de los adolescentes españoles.
Revista española de cardiología, ISSN 0300-8932, Vol. 58, Nº. 8, 2005, pags. 898-909.
