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The aim of the this study was to establish age- and gender-specific physical fitness normative values and to compare percentiles and Z scores values in a large, nationwide sample of Greek children aged 6-18 years. From March 2014 to May 2014, a total of 424,328 boys and girls aged 6-18 years who attended school in Greece were enrolled. The studied sample was representative, in terms of age-sex distribution and geographical region. Physical fitness tests (i.e. 20 m shuttle run test (SRT), standing long jump, sit and reach, sit-ups, and 10 × 5 m SRT) were performed and used to calculate normative values, using the percentiles of the empirical distributions and the lambda, mu, and sigma statistical method. Normative values were presented as tabulated percentiles for five health-related fitness tests based on a large data set comprising 424,328 test performances. Boys typically scored higher than girls on cardiovascular endurance, muscular strength, muscular endurance, and speed/agility, but lower on flexibility (all p values <0.001). Older boys and girls had better performances than younger ones (p < 0.001). Physical fitness tests' performances tended to peak at around the age of 15 years in both sexes. The presented population-based data are the most up-to-date sex- and age-values for the health-related fitness of children and adolescents in Greece and can be used as standard values for fitness screening and surveillance systems and for comparisons among the same health-related fitness scores of children from other countries similar to Greece. Schools need to make efforts to improve the fitness level of the schoolchildren through the physical education curriculum to prevent cardiovascular risk.

Objective: To examine the influence of cardiorespiratory fitness on total and truncal fatness in children. It was hypothesised that high cardiorespiratory fitness would result in lower total and central obesity. Design: Observational cohort study. Setting: Primary and secondary schools in Athens, Greece. Subjects: A total of 1362 healthy children aged 6-13 y (742 boys and 620 girls). Methods: Anthropometric data (height, body mass, four skinfolds thickness) were collected and per cent body fat was calculated. Body mass index (BMI) sex-and age-specific cutoff points were used for overweight and obesity definition and children were placed in two groups: overweight/obese and nonoverweight. Cardiorespiratory fitness (CRF) was assessed with the endurance shuttle-run test. Participants were grouped into high (upper two quintiles) and low (lower two quintiles) CRF based on age and sex distributions. T-test and Mann-Whitney test were used for comparisons between fit and unfit children within each BMI category. Results: Sum of skinfolds, subscapular and truncal skinfold thickness, BMI and per cent body fat were lower in overweight and obese youths with high CRF in comparison with youths at the same BMI category with low CRF (Po0.01). The beneficial effect of high CRF was also presented in nonoverweight children (Po0.01). The influence of CRF on body composition remained even after correcting body fatness for BMI. Conclusions: Central and total obesity were lower in overweight and obese children with high CRF. This is the first study to show that a high CRF may reduce the hazards of obesity in children. Sponsorship: None.

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Objective: We examined secular trends in physical fitness and BMI status in 8- to 9-year-old Greek children during an 11-year period (1997–2007). Methods: Population data derived from a yearly health survey performed in over 85% of Greek schools. Anthropometric measurements and physical fitness tests from 651,582 children were analyzed. The gender- and age-specific BMI cut-off points by the International Obesity Task Force were used to define overweight/obesity. Results: Aerobic performance decreased by 4.9% (p < 0.001) for boys and 4.4% (p < 0.001) for girls between 1997 and 2007 while obesity increased by approximately 50% in both genders (p < 0.001). Time-series analyses revealed that the increasing trends in obesity were independent of the reduction in fitness levels. An increase from 21% in 1997 to 48.2% in 2007 was observed in the prevalence of the low quartile of aerobic performance for girls (p < 0.001) and from 25.7% in 1997 to 38.7% in 2007 (p < 0.001) for boys. Approximately 80% and 85% of obese boys and girls, respectively, failed to pass the low quartile of all aerobic tests in 2007. Conclusions: Inverse but independent trends in obesity and fitness levels were observed among Greek children during an 11-year period (1997–2007), a fact that predisposes our children to serious health risks as they grow older.