Mediation role of cardiorespiratory fitness on association of physical activity and physical literacy among 8-12 years old children: the PAK-IPPL cross-sectional study.

Background: The effect of cardiorespiratory fitness (CRF) on the relationship of physical activity (PA), and physical literacy (PL) in 8-12 Pakistani children are largely unknown. Therefore, this study aims to examine the mediating role of CRF in the relationship between PA and PL in this demographic. Methods: This cross-sectional study involved 1,360 children aged 8-12 (mean age = 10.00, SD = 1.41 years) from 85 higher secondary schools in South Punjab, Pakistan. Data were collected during the 2020-2021 academic year using the Canadian Assessment of Physical Literacy-2 (CAPL-2) protocol to assess physical activity (PA), Body Mass Index (BMI), and PL levels. CRF was measured using the PACER (Progressive Aerobic Cardiovascular Endurance Run) test. Descriptive statistics, independent samples t-tests, Chi-squared tests, and Generalized Additive Models for Location, Scale, and Shape (GAMLSS) were used for age and sex-specific CAPL-2 scoring. Associations among components were evaluated through Pearson's correlation, multivariate logistic regression, and mediation analyses. Results: The study revealed that boys had significantly higher scores in CRF, PA, and PL across all age groups compared to girls (p < 0.001), with boys' scores being 20%, 10%, and 14% higher, respectively, than those of girls. Conversely, overweight children showed significantly reduced PA and PL levels (p < 0.001). An inverse correlation was found between BMI and CRF (r 2 linear = 0.022; quadratic = 0.028). CRF scores had significant negative correlations BMI (r = -0.143) and positive associations with MVPA, PA, DB, and PL (r ranging from 0.241 to 0.624). CRF was observed to partially mediate the association between MVPA and PL. The direct impact of PA on PL was significant and meaningful (ß = 0.002, p < .001). Additionally, the indirect effect of PA on PL through CRF was also significant (ß = 0.001, p < .001), indicating that CRF serves as an important mediator in this relationship. The combined total effect of PA on PL, which includes both direct and mediated pathways, was robust and highly significant (ß = 0.003, p < .001). Conclusion: The study revealed a strong positive correlation between CRF, PA, and PL, but a negative one with BMI in South Punjab children aged 8-12. Notably, CRF and PA emerged as significant predictors of PL levels in this population. Consequently, interventions that are both systematic and targeted towards improving these factors should be implemented as strategies to enhance children's PL levels and promote physically active behaviors.

Establishing age- and sex-specific anthropometric growth references standards for South Punjab adolescents utilizing the LMS method: findings from the Pakistani population.

Background: The physical health of adolescents is crucial for the prosperity and sustainable development of a nation. Developing specific growth standards is essential for prioritizing the wellbeing of the youth of Pakistan. This study aimed to establish normative standards for height, weight, and body mass index (BMI) among 12- to 16-year-olds in South Punjab, facilitating accurate health assessments and tailored interventions. Method: This study utilized a cross-sectional design and stratified random sampling to select 2,970 adolescents (49.73% boys and 50.26% girls) aged 12-16 years from South Punjab, Pakistan. Anthropometric measurements, including height, weight, and BMI, were collected. The data were stratified by age and sex, and smoothed percentile curves were computed using the LMS method, which incorporates the L (γ-lambda), M (µ-mu), and S (δ-sigma) parameters. The results were compared to international references to provide a comprehensive analysis. Results: The results highlight sex-specific trends in anthropometric indicators among adolescents. Boys exhibited higher mean values in height (160.50 ± 11.50 cm), weight (45.02 ± 9.78 kg), and BMI (17.30 ± 2.41) than girls (158.57 ± 9.34 cm, 41.00 ± 7.89 kg, and 16.29 ± 2.82, respectively). Growth patterns indicate boys grow faster in height and weight between ages 12 and 14, whereas girls show slower annual increases. Comparative analysis with international standards reveals that boys' height and weight were generally lower than international medians (P50th), whereas girls' height was comparable or higher. BMI values for both sexes were lower than international norms, reflecting unique regional growth patterns. Conclusion: This research establishes updated age- and sex-specific normative reference standards for adolescents in South Punjab, Pakistan. The study revealed that Pakistani adolescent boys exhibit higher mean values in height, weight, and BMI than girls, with faster growth rates between ages 12 and 14. Compared to international standards, Pakistani adolescents show lower BMI values, highlighting unique regional growth patterns. These standards have practical applications in screening, monitoring, and health strategy planning, contributing to efforts to promote a healthier future for the population. Future studies are recommended to utilize these local growth references for health surveillance and treatment in the local population.

Assessment of physical literacy in 8- to 12-year-old Pakistani school children: reliability and cross-validation of the Canadian assessment of physical literacy-2 (CAPL-2) in South Punjab, Pakistan.

BACKGROUND: The increasing prevalence of physical inactivity, declining fitness, and rising childhood obesity highlight the importance of physical literacy (PL), as a foundational component for fostering lifelong health and active lifestyle. This recognition necessitates the development of effective tools for PL assessment that are applicable across diverse cultural landscapes. AIM: This study aimed to translate the Canadian Assessment of Physical Literacy-2 (CAPL-2) into Urdu and adapt it for the Pakistani cultural context, to assess PL among children aged 8-12 years in Pakistan. METHOD: The Urdu version of CAPL-2 was administered among 1,360 children aged 8-12 from 87 higher secondary schools across three divisions in South Punjab province, Pakistan. Statistical analysis includes test-retest reliability and construct validity, employing confirmatory factor analysis to evaluate the tool's performance both overall and within specific subdomains. RESULTS: The Urdu version of CAPL-2 demonstrated strong content validity, with a Content Validity Ratio of 0.89. Confirmatory factor analysis supported the four-factor structure proposed by the original developers, evidenced by excellent model fit indices (GFI = 0.984, CFI = 0.979, TLI = 0.969, RMSEA = 0.041). High internal consistency was observed across all domains (α = 0.988 to 0.995), with significant correlations among most, excluding the Knowledge and Understanding domains. Notably, gender and age significantly influenced performance, with boys generally scoring higher than girls, with few exceptions. CONCLUSION: This study marks a significant step in the cross-cultural adaptation of PL assessment tools, successfully validating the CAPL-2 Urdu version for the Pakistani context for the first time. The findings affirm the tool's suitability for assessing PL among Pakistani children, evidencing its validity and reliability across the Pakistani population.

Establishment of health related physical fitness evaluation system for school adolescents aged 12-16 in Pakistan: a cross-sectional study.

Background: The decline in adolescent physical fitness is a significant global public health concern, and Pakistan is no exception. The country's absence of a health-related physical fitness (HRPF) evaluation system has compounded this issue. To bridge this gap, this study aims to develop a scientifically-based HRPF evaluation system for the adolescent population that meets international standards. The evaluation system identifies at-risk children and improves adolescent health outcomes, including obesity, cardiovascular and musculoskeletal disorders, chronic diseases, and psychological illnesses, through crucial physical fitness evaluation. This study specifically aims to establish an HRPF evaluation system for school adolescents aged 12-16 in Pakistan. Methods: A cross-sectional study was conducted among 2,970 school adolescents aged 12-16 years in the South Punjab, Pakistan. The study used a stratified sampling technique to select participants. The HRPF evaluation system included four components: cardiorespiratory endurance, core muscular endurance, muscular strength, and body composition. Data were collected through standardized tests and anthropometric measurements. Results: The study's results indicated that the HRPF evaluation scoring system was feasible and valid for evaluating the HRPF of school adolescents in the South Punjab region of Pakistan. The results of the evaluation system categorized participants into five groups based on their performance: excellent (6.2%), good (24.9%), medium (50.7%), poor (17%), and very poor (1.2%). Conclusion: The study establishes an HRPF evaluation system for Pakistani school adolescents. This system lays the foundation for implementing effective strategies to improve their physical health. The findings offer valuable insights to policymakers, health professionals, and educators, enabling them to promote fitness and devise impactful interventions for enhancing HRPF in this population.

Assessment of the Relationship between Body Weight Status and Physical Literacy in 8 to 12 Year Old Pakistani School Children: The PAK-IPPL Cross-Sectional Study.

(1) Background: Physical literacy (PL) is a multidimensional concept, since it fosters lifetime engagement in physical activities and reduces obesity; however, empirical evidence is lacking to support this association. This study first aimed to establish PL levels stratified by normal weight children and children with overweight and obesity. Furthermore, this study determined a correlation between PL domains and BMI by weight status among South Punjab school children. (2) Methods: This cross-sectional study involved 1360 (Boys: 675 and Girls: 685) children aged 8 to 12, and was conducted using CAPL-2. T-tests and chi-square were used to determine the difference between categorical variables, with MANOVA used to compare weight statuses. Spearman correlation was employed to determine the correlation between variables; p < 0.05 was considered significant. (3) Results: Normal weight children had significantly higher PL and domain scores, except for the knowledge domain. Most children with normal weights were at the achieving and excelling levels, while children with overweight and obesity were at the beginning and progressing levels. The correlation among PL domains in normal and overweight and obese children ranged from weak to strong (r = 0.001 to 0.737), and the knowledge domain was inversely correlated with the motivation domain (r = -0.023). PL and domain scores were inversely correlated to BMI, except for the knowledge domain. (4) Conclusions: Children with normal weight tend to have higher PL and domain scores, while those with overweight or obesity tend to have lower scores. There was a positive relationship between normal weight and higher PL and domain scores, and an inverse relationship was observed between BMI and higher PL scores.

Relationship between Moderate-to-Vigorous Physical Activity with Health-Related Physical Fitness Indicators among Pakistani School Adolescents: Yaali-Pak Study.

Background: The current study is the foremost study exploring the relationships between moderate-to-vigorous physical activity and health-related physical fitness indicators among 12-16-year-old adolescents of the South Punjab region of Pakistan. Methods: The researcher adopted the cross-sectional research design for the study. A total of 2970 participants (1477 boys and 1493 girls) aged adolescents from South Punjab, Pakistan, completed health-related physical fitness indicators measuring strength, endurance, and aerobic capacity through a hand-grip strength test, modified pull-up test, plank test, and 20-m shuttle run test, and physical activity were subjectively assessed by International Physical Activity Questionnaire Short Form (IPAQ-SF). Linear regression models were used to explore the between moderate-to-vigorous physical activity (MVPA) with health-related physical fitness indicators. Results: Positive associations were observed between hand-grip strength (p < 0.001), modified pull-up (p < 0.001), plank exercise (p < 0.001), and 20-m shuttle run test (p < 0.001), with MVPA. The gender-specific comparison also indicated a significant (p < 0.001) and positive relationship. The results revealed that as MVPA increases, body composition, muscular strength, core muscular endurance, and aerobic capacity could improve in both genders. Conclusions: MVPA appears to be an effective and reliable predictor of health-related physical fitness among school adolescents.