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

Abstract

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 lifestylerelated 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 healthrelated fitness tests for possible use in future health information systems.

Reliability of health-related physical fitness tests in European adolescents. The HELENA Study

“…10,35 When the search was extended to healthy or unhealthy people of any age, only eight additional studies using the Bland-Altman approach were found. [36][37][38][39][40][41][42][43] Given that physical fitness can already be considered a marker of health in this period of life, 3,6,44 information about the reliability of health-related physical fitness tests in young people is of interest. In addition, the review also shows that both cardiorespiratory fitness and muscular strength were the most studied physical fitness qualities (in 41 and 50%, respectively, of the reviewed studies), whereas data about speed-agility, coordination and flexibility in young people are lacking (used in 4-14% of the reviewed studies).…”

“…The scientific rationale for the selection of all of these tests has been published earlier. 6 (1) Back-saver sit and reach test (flexibility assessment): a standard box with a small bar, which has to be pushed by the participant, was used to perform the test. The adolescent bends his/her trunk and reaches forward as far as possible from a seated position, with one leg straight and the other bent at the knee.…”

“…For this purpose, a set of standardized tests has been chosen, and the scientific rationale for their selection has been published elsewhere. 6 Reliability can be defined as the consistency of measurements. Terms that have been used interchangeably with reliability in the literature are 'repeatability', 'reproducibility', 'consistency', 'agreement', 'concordance' and 'stability'.…”

“…[7][8][9] In this paper, we report the outcome of reliability testing, on a test-retest basis, of the set of health-related physical fitness tests used in the HELENA Study. 6 The outcome is discussed and compared with the outcome of an extensive overview of published data on reliability testing.…”

Physical fitness in childhood and adolescence: a powerful marker of health

“…In epidemiological studies involving young people, the most common test for assessing cardiorespiratory fitness has been the 20-m shuttle run test, or adaptations/modifications of this test. 15,16 The VO 2max can then be estimated from the score obtained in this test from equations. 17 Muscular fitness is the capacity to carry out work against a resistance.…”