Ángel Gutiérrez

Field-based fitness assessment in young people: the ALPHA health-related fitness test battery for children and adolescents

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.

Harmonization of Anthropometric Measurements for a Multicenter Nutrition Survey in Spanish Adolescents

OBJECTIVE Although the need for accurate anthropometric measurement has been repeatedly stressed, reports on growth and physical measurements in human populations rarely include estimates of measurement error. We describe the standardization process and reliability of anthropometric measurements carried out in a pilot study. METHODS For the intraobserver assessment of anthropometric measurements, we studied 101 adolescents (58 boys and 43 girls) from five cities. For interobserver assessment, we studied 10 adolescents from the same class in Zaragoza and different from those in the intraobserver sample. RESULTS For skinfold thickness, intraobserver technical errors of measurement (TEMs) in general were smaller than 1 mm; for circumferences, TEMs in general were smaller than 1 cm. Intraobserver reliability for skinfold thickness was greater than 95% for almost all cases; for circumferences, intraobserver reliability generally was greater than 95%. Interobserver TEMs ranged from 1 to 2 mm for the six skinfold thicknesses measured; for circumferences, TEMs were smaller than 1 cm for the arm, biceps, and waist and between 1 and 2 cm for the hip and thigh. Interobserver reliabilities for skinfold thickness and circumference were always greater than 90%, except for biceps skinfold. CONCLUSIONS Our results are in agreement with those recommended in the literature. Therefore, these anthropometric measures seem to be adequate to assess body composition in a multicenter survey in adolescents.

Low Level of Physical Fitness in Spanish Adolescents. Relevance for Future Cardiovascular Health (AVENA Study)

INTRODUCTION AND OBJECTIVES 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. SUBJECTS AND METHOD 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. RESULTS 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. CONCLUSIONS 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.

Cardiorespiratory Fitness and Sedentary Activities Are Associated with Adiposity in Adolescents

Objective: To determine whether physical activity, sedentary activities, and/or cardiorespiratory fitness are related to waist circumference in adolescents, as previously reported in adults.

Muscular and cardiorespiratory fitness are independently associated with metabolic risk in adolescents: the HELENA study

Artero EG, Ruiz JR, Ortega FB, España‐Romero V, Vicente‐Rodríguez G, Molnar D, Gottrand F, González‐Gross M, Breidenassel C, Moreno LA, Gutiérrez A; on behalf of the HELENA Study Group. Muscular and cardiorespiratory fitness are independently associated with metabolic risk in adolescents: the HELENA study.

Health-related fitness assessment in childhood and adolescence: a European approach based on the AVENA, EYHS and HELENA studies

Results from cross-sectional and longitudinal studies such as Alimentación y Valoración del Estado Nutricional en Adolescentes: Food and Assessment of the Nutritional Status of Spanish Adolescents (AVENA) and the European Youth Heart Study (EYHS) respectively, highlight physical fitness as a key health marker in childhood and adolescence. Moderate and vigourous levels of physical activity stimulate functional adaptation of all tissues and organs in the body (i.e. improve fitness), thereby also making them less vulnerable to lifestyle-related degenerative and chronic diseases. To identify children and adolescents at risk for these major public health diseases and to be able to evaluate the effects of alternative intervention strategies in European countries and internationally, comparable testing methodology across Europe has to be developed, tested, agreed upon and included in the health monitoring systems currently under development by the European Commission (EC): the Directorate General for Health and Consumer Affairs (DG SANCO); the Statistical Office of the European Communities (EUROSTAT), etc. The Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) study group plans, among other things, to describe the health-related fitness of adolescents in a number of European countries. Experiences from AVENA and EYHS will be taken advantage of. This review summarises results and experiences from the developmental work so far and suggests a set of health-related fitness tests for possible use in future health information systems.

El perfil lipídico-metabólico en los adolescentes está más influido por la condición física que por la actividad física (estudio AVENA)*

Introduction and objectives. 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. Methods. From a total of 2859 Spanish adolescents (age 13.0-18.5 years) taking part in the Diet and Appraisal of Nutrition State in Adolescents 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 flexed arm. A lipidmetabolic cardiovascular risk index was derived from the levels of triglycerides, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and glucose. Results. 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.

Health-related fitness in adolescents: underweight, and not only overweight, as an influencing factor. The AVENA study

This study investigated differences in health‐related fitness (20‐m shuttle run, handgrip, bent arm hang, standing long jump, shuttle run 4 × 10 m and sit and reach tests) in 2474 Spanish adolescents (1196 boys and 1278 girls; age 13–18.5 years) classed as underweight, normal weight, overweight or obese according to body mass index. Body fat and fat‐free mass were derived from skinfold thickness. The prevalence of underweight was higher than obesity in girls (4.8% vs 3.0%, respectively; P<0.05) and the opposite in boys (3.9% vs 5.8%, respectively; P<0.05). Underweight was associated with a higher performance in the bent arm hang test in girls (P<0.05) and a lower performance in handgrip in both genders (P<0.01) compared with normal weight. Overweight and obese adolescents presented a lower performance in 20‐m shuttle run, bent arm hang, standing long jump and shuttle run 4 × 10 m tests (P<0.001), but a higher performance in handgrip strength (P<0.001) compared with normal weight. In weight‐bearing tests, the association became non‐significant after adjusting for fat mass. In conclusion, not only overweight and obesity but also underweight seem to be determinants of health‐related fitness in adolescents. The associations could be related to differences in body composition.

Artificial neural network-based equation for estimating VO2max from the 20m shuttle run test in adolescents

OBJECTIVE To develop an artificial neural network (ANN)-equation to estimate maximal oxygen uptake (VO(2max)) from 20m shuttle run test (20 mSRT) performance (stage), sex, age, weight, and height in young persons. METHODS The 20 mSRT was performed by 193 (122 boys and 71 girls) adolescents aged 13-19 years. All the adolescents wore a portable gas analyzer to measure VO(2) and heart rate during the test. The equation was developed and cross-validated following the ANN mathematical model. The neural net performance was assessed through several error measures. Agreement between the measured VO(2max) and estimated VO(2max) from Légers and ANN equations were analysed following the Bland and Altman method. RESULTS The percentage error was 17.13 and 7.38 for Léger and ANN-equation (P<0.001), respectively, and the standard error of the estimate obtained with Légers equation was 4.27 ml/(kg min), while for the ANN-equation was 2.84 ml/(kg min). A Bland-Altman plot for the measured VO(2max) and Léger-VO(2max) showed a mean difference of 4.9 ml/(kg min) (P<0.001), while the Bland-Altman plot for the measured VO(2max) and ANN-VO(2max) showed a mean difference of 0.5 ml/(kg min) (P=0.654). In the validation sample, the percentage error was 21.08 and 8.68 for Léger and ANN-equation (P<0.001), respectively. CONCLUSIONS In this study, an ANN-based equation to estimate VO(2max) from 20 mSRT performance (stage), sex, age, weight, and height in adolescents was developed and cross-validated. The newly developed equation was shown to be more accurate than Légers. The proposed model has been coded in a user-friendly spreadsheet.

Hand span influences optimal grip span in boys and girls aged 6 to 12 years.

PURPOSE The first aim was to determine whether there is an optimal grip span for determining the maximum hand grip strength in boys and girls aged 6 to 12 years and whether the optimal grip span was related to hand span. If so, the second aim was to derive a mathematical equation relating hand span and optimal grip span. METHODS A total of 123 boys (9 y +/- 2) and 70 girls (8 y +/- 2) were evaluated. Each hand was randomly tested on 10 occasions using 5 different grip spans, allowing a 1-minute rest between attempts. The hand span was measured from the tip of the thumb to the tip of the little finger with the hand opened widely. RESULTS An optimal grip span to determine maximum hand grip strength was identified for both genders. Hand span and optimal grip span showed a significant linear association in the studied children. The equation relating grip span as a function of hand span in boys is formulated as y = x/4 + 0.44 and in girls as y = 0.3x - 0.52, where x is the hand span (maximal width between first and fifth fingers) and y is the optimal grip span. CONCLUSIONS The results suggest that there is an optimal grip span to which the dynamometer should be adjusted when measuring hand grip strength in children. The optimal grip span was influenced by hand span in both genders.