Physical fitness among children with diverse weight status during and after the COVID-19 pandemic: a population-wide, cohort study based on the Slovenian physical fitness surveillance system (SLOfit)

Martinko, Antonio; Sorić, Maroje; Jurak, Gregor; Starc, Gregor

doi:10.1016/j.lanepe.2023.100748

Cited by 6 publications

(2 citation statements)

References 60 publications

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“…Therefore, this study ignores trends after 2019 although presently those results could be of particular importance. Still, as this was a period of abrupt changes in fitness that would distort segmental analysis, we reported these trends in a recent analysis 83 and felt it would be inappropriate to include it here. Finally, in terms of comparability of our results with other studies, it is important to note that differences in trends between children included in studies conducted in Slovenia and those from other studies might be related to the specifics of the tests used, which varied between countries and were not always consistent between boys and girls.…”

Section: Discussionmentioning

confidence: 99%

Temporal trends in weight-based disparities in physical fitness of children: 30-years of continuous surveillance through Slovenian national system

Martinko,

Blagus,

Jurak

et al. 2024

Preprint

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Background Obesity in childhood has deleterious consequences for health while improving physical fitness can significantly reduce health risks related to high body mass index. This study leverages near-census data collected by the national fitness surveillance system in Slovenia to investigate the evolution of weight-based disparities in the physical fitness of 7–15-year-olds between 1989 and 2019. Methods We used annual data collected within the SLOfit monitoring system in the period between 1989–2019, totalling 4,256,930 participants (about 137 000 per year). We examined cardiorespiratory fitness (600-m run test), muscular fitness (60-s sit-ups, bent arm hang, and standing broad jump test) and skill-related fitness (backwards obstacle course, 60-m dash, arm plate tapping). We grouped children according to the IOTF cut-offs for BMI to those living with normal weight or excess weight and estimated changes in physical fitness over time by fitting quantile regression models separately by sex and age group, and then using segmented regression to identify the structure of trends over time. Results Weight-based disparities in physical fitness were large in 1989 and have further increased from 1989 to 2019 for all fitness components and across all age and sex groups. The increase in disparities was generally larger in boys than in girls, and 10–15-year-olds compared to younger children. Most of the increase in disparities in health-related fitness accumulated during the 2010s, when the fitness of children generally improved, but much less so in children living with excess weight. Conclusions Despite recent improvements in population fitness levels, children with excess weight seem to be left behind, which adds to existing health inequalities. Our results should encourage policymakers to redesign policies aimed at promoting physical activity and enhancing physical fitness to make them more equitable and ultimately lead to reducing inequalities in fitness.

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Section: Discussionmentioning

confidence: 99%

Temporal trends in weight-based disparities in physical fitness of children: 30-years of continuous surveillance through Slovenian national system

Martinko,

Blagus,

Jurak

et al. 2024

Preprint

Self Cite

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“…The assessment of the physical fitness of children and young people has been considered as an indicator of the health status of adolescents and is therefore important from the point of view of public health [25], while the assessment of physical fitness has become increasingly relevant, precisely because of the global decline in physical fitness and PA among children and adolescents [24]. Children's fitness testing has been used in several special-level, cross-sectional, longitudinal, and long-term trend studies [26].…”

Section: Assessment Of Physical Fitnessmentioning

confidence: 99%

The Influence of Kindergarten Environment on the Development of Preschool Children’s Physical Fitness

Haav,

Oja,

Piksööt

2024

IJERPH

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The aim of this research is to find out to what extent the special qualifications of physical education teachers and the physical environment of kindergartens influence the physical development of preschoolers. Forty-four kindergartens across Estonia participated in the study, half of which had a physical education teacher (PEt), whereas the remaining 22 kindergartens were taught by non-qualified kindergarten teachers (NoPEt). Six Eurofit fitness tests were used to assess the physical development of children (n = 704; aged 6–7 years old, with an average age of 6.55 ± 0.5 years). An analysis of variance was used to compare the mean values of the fitness test results of the two groups. Linear regression analysis was applied to clarify the influence of individual and environmental factors on children’s fitness scores. In kindergartens where the position of a PEt had been created, the results of children’s physical fitness were statistically significantly better, more specifically in handgrip strength (m = 12.0, 95% CI = 11.8–12.3 vs. m = 11.5, 95% CI = 11.2–11.7) and in speed tests (m = 23.0, 95% CI = 22.8–23.2 vs. m = 23.6, 95% CI = 23.3–23.8). According to the teacher interviews, these kindergartens also had more rooms and areas specially created for physical exercises. The study revealed that the physical development of children is, when controlling for other individual and environmental factors, influenced by the professional qualification of the PE teacher (95% CI = 0.06–0.56) as well as children’s participation in sports training (95% CI = 0.29–0.83). These findings are important for preschool institutions and municipalities in designing the optimal physical environment for facilitating children’s physical fitness.

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Cardiorespiratory Fitness in Adolescence and Risk of Type 2 Diabetes in Late Adulthood: A Nationwide Sibling-Controlled Cohort Study

Ballin,

Ahlqvist,

Berglind

et al. 2024

Preprint

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Background The importance of adolescent cardiorespiratory fitness for long-term risk of type 2 diabetes (T2D) remains poorly investigated, and whether the association is influenced by unobserved familial confounding is unknown. Methods We conducted a sibling-controlled cohort study based on all Swedish men who participated in mandatory military conscription examinations from 1972 to 1995 around the age of 18, and who completed standardized cardiorespiratory fitness testing. The outcome was T2D, defined as a composite endpoint of diagnosis in inpatient or specialist outpatient care, or dispensation of antidiabetic medication, until 31 December 2023. Findings 1 124 049 men, of which 477 453 were full siblings, with a mean age of 18.3 years at baseline were included. During follow-up, 115 958 men (48 089 full siblings) experienced a first T2D event at a median age of 53.4 years. Compared to the first decile of fitness, higher fitness levels were associated with a progressively lower risk of T2D. In cohort analysis, the hazard ratio (HR) in the second decile was 0.83 (95% CI, 0.81 to 0.85), with a difference in the standardized cumulative incidence at age 65 of 4.3 (3.8 to 4.8) percentage points, dropping to a HR of 0.38 (0.36 to 0.39; incidence difference 17.8 [17.3 to 18.3] percentage points) in the tenth decile. When comparing full siblings, and thus controlling for all unobserved behavioral, environmental, and genetic confounders that they share, the association replicated, although with attenuation in magnitude. The HR in the second decile was 0.89 (0.85 to 0.94; incidence difference 2.3 [1.3 to 3.3] percentage points), and in the tenth decile it was 0.53 (0.50 to 0.57; incidence difference 10.9 [9.7 to 12.1] percentage points). Hypothetically shifting everyone in the first decile of fitness to the second decile was estimated to prevent 7.2% (6.4 to 8.0) of cases at age 65 in cohort vs. 4.6% (2.6 to 6.5) in full-sibling analysis. The association was similar in those with overweight as in those without. Interpretation Higher levels of adolescent cardiorespiratory fitness are associated with lower risk of T2D in late adulthood, with clinically relevant associations starting already from very low levels of fitness, and similarly in those with overweight compared to those without. The association replicates, but becomes weaker, after adjusting for unobserved familial confounders shared between full siblings. This suggests that adolescent cardiorespiratory fitness is a robust marker of long-term T2D risk, but that conventional observational analysis may yield biased estimates. Funding None.

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Physical fitness among children with diverse weight status during and after the COVID-19 pandemic: a population-wide, cohort study based on the Slovenian physical fitness surveillance system (SLOfit)

Cited by 6 publications

References 60 publications

Temporal trends in weight-based disparities in physical fitness of children: 30-years of continuous surveillance through Slovenian national system

Temporal trends in weight-based disparities in physical fitness of children: 30-years of continuous surveillance through Slovenian national system

The Influence of Kindergarten Environment on the Development of Preschool Children’s Physical Fitness

Cardiorespiratory Fitness in Adolescence and Risk of Type 2 Diabetes in Late Adulthood: A Nationwide Sibling-Controlled Cohort Study

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