Predictive validity of health-related fitness in youth: a systematic review

J R Ruiz, J Castro-Pinero, E G Artero, F B Ortega, M Sjostrom, J Suni, M J Castillo
2009 British Journal of Sports Medicine  
The objective of the present systematic review was to investigate whether physical fitness in childhood and adolescence is a predictor for cardiovascular disease risk factors, events and syndromes, quality of life and low back pain later in life. Physical fitness-related components were: cardiorespiratory fitness, musculoskeletal fitness, motor fitness and body composition. Adiposity was considered as both exposure and outcome. The results of 42 studies reporting the predictive validity of
more » ... ve validity of health-related physical fitness for cardiovascular disease risk factors, events and syndromes as well as the results of 5 studies reporting the predictive validity of physical fitness for low back pain in children and adolescents were summarised. We found strong evidence indicating that: higher levels of cardiorespiratory fitness at childhood and adolescence are associated with healthier cardiovascular profile later in life. Muscular strength improvements from childhood to adolescence are negatively associated with changes in overall adiposity. A healthier body composition at childhood and adolescence is associated with a healthier cardiovascular profile later in life, and with a lower risk of death. The evidence was moderate for the association between changes in cardiorespiratory fitness and cardiovascular disease risk factors, and between cardiorespiratory fitness and the risk of developing metabolic syndrome and arterial stiffness. We also found moderate evidence on the lack of relationship between body composition and low back pain. Due to a limited number of studies, we found inconclusive evidence for a relationship between muscular strength or motor fitness and cardiovascular disease risk factors, and between flexibility and low back pain. Downloaded from syndrome, and cardiovascular events later in life. We also examined if there is evidence that physical fitness in childhood and adolescence is a predictor for quality of life and low back pain later in life. on 21 January 2009 bjsm.bmj.com Downloaded from METHODS The present systematic review is produced as a part of the ALPHA (instruments for Assessing Levels of PHysical Activity and fitness) study. The ALPHA study aims to provide a set of instruments for assessing levels of physical activity as well as healthrelated physical fitness in a comparable way within the European Union. Selected health outcomes Based on the recent knowledge on the major health problems and their risk factors, several health outcomes were selected to seek evidence for associations between physical fitness and health status in children and adolescents. The main question was: "does low/high fitness in youth predicts future disease/better health status? We selected longitudinal cohort studies examining the association between physical fitness in children and adolescents and future: 1) Cardiovascular disease risk factors: blood lipids, blood pressure, insulin sensitivity, inflammatory markers, and overall and central adiposity. 2) Cardiovascular disease/syndromes: obesity, hypertension, dyslipidemia, diabetes, and metabolic syndrome. 3) Low back pain. 4) Quality of life and well-being, also called positive health outcomes: school performance, self-esteem, mood-status, socialization, resilience (i.e., the positive capacity of people to cope with stress), and risk avoidance behaviour. The health-related fitness components and factors/traits are depicted in Figure 1. 14
doi:10.1136/bjsm.2008.056499 pmid:19158130 fatcat:mbhun2pcwfa2vdcig2nqefeyfu