European fitness landscape for children and adolescents: updated reference values, fitness maps and country rankings based on nearly 8 million test results from 34 countries gathered by the FitBack network

Abstract

Objectives(1) To develop reference values for health-related fitness in European children and adolescents aged 6–18 years that are the foundation for the web-based, open-access and multilanguage fitness platform (FitBack); (2) to provide comparisons across European countries.MethodsThis study builds on a previous large fitness reference study in European youth by (1) widening the age demographic, (2) identifying the most recent and representative country-level data and (3) including national data from existing fitness surveillance and monitoring systems. We used the Assessing Levels of PHysical Activity and fitness at population level (ALPHA) test battery as it comprises tests with the highest test–retest reliability, criterion/construct validity and health-related predictive validity: the 20 m shuttle run (cardiorespiratory fitness); handgrip strength and standing long jump (muscular strength); and body height, body mass, body mass index and waist circumference (anthropometry). Percentile values were obtained using the generalised additive models for location, scale and shape method.ResultsA total of 7 966 693 test results from 34 countries (106 datasets) were used to develop sex-specific and age-specific percentile values. In addition, country-level rankings based on mean percentiles are provided for each fitness test, as well as an overall fitness ranking. Finally, an interactive fitness platform, including individual and group reporting and European fitness maps, is provided and freely available online (www.fitbackeurope.eu).ConclusionThis study discusses the major implications of fitness assessment in youth from health, educational and sport perspectives, and how the FitBack reference values and interactive web-based platform contribute to it. Fitness testing can be conducted in school and/or sport settings, and the interpreted results be integrated in the healthcare systems across Europe.

Normative values of cardiorespiratory fitness in Croatian children and adolescents

“…Our findings showed that children and adolescents in a certain age group performed better, compared to international norms [ 17 ]. This has been confirmed in the most recent European study, which positions Croatia as having “intermediate” level of cardiorespiratory fitness (16 th place out of 34 countries studied) with percentile ranks of 58.1 and 52.5 for boys and girls, respectively [ 28 ]. However, a study by Tomkinson et al .…”

“…Although biological aspects explaining the differences between boys and girls in the cardiorespiratory fitness have been well-described [ 17 ], it is necessary to put into perspective our newly reference data for Croatia and compare them with international norms [ 17 , 28 ]. In a systematic review by Tomkinson et al .…”

“…[ 17 ] used the worldwide data from 50 countries and 9–17-year-olds, compared to Ortega et al . [ 28 ], who based reference data on 34 European countries. Nevertheless, our findings suggest that both boys and girls surpass the median value of the 20-m shuttle run test on European [ 28 ] and worldwide levels [ 17 ], pointing out that interventions should be directed towards enhancing or even maintaining cardiorespiratory fitness above the median value.…”

“…[ 28 ], who based reference data on 34 European countries. Nevertheless, our findings suggest that both boys and girls surpass the median value of the 20-m shuttle run test on European [ 28 ] and worldwide levels [ 17 ], pointing out that interventions should be directed towards enhancing or even maintaining cardiorespiratory fitness above the median value. Although we observed that boys and girls in this study had the VO 2 max values above the international norms [ 17 , 28 ], a most recent study has shown that Croatian youth is facing with the pandemic of being overweight and obesity, being 35.9% for children, placing Croatia at the top of ‘risk countries’ in Europe [ 38 ].…”

“…This would further imply the overall decline in cardiorespiratory fitness, being predominately observed in recent years. The latest study from 34 countries and nearly 8 million data results has presented Croatia as a country with intermediate cardiorespiratory fitness level, based on the mean centile of the 20-m shuttle run test [ 28 ]. However, the ranking was strictly based on a relatively small sample size ( N = 596) and narrow age range (15–18 years), while the data from primary school children have not been included.…”