The Development of Fast, Fit, and Fatigue Resistant Youth Field and Court Sport Athletes: A Narrative Review.

Humans are fascinated by the bipedal locomotor capacities at both ends of the athletic spectrum-sprinting speed and endurance. Some of the more popular field (eg, soccer, rugby, and lacrosse) and court (eg, basketball, tennis, and netball) sports utilize mixed energy systems requiring an interplay of both maximal sprinting speed (MSS) and maximal aerobic speed (MAS) to meet the high-intensity running demands of varying frequency, duration, intensity, and recovery. Recently, these locomotor capacities have been considered in combination to produce what is called the anaerobic speed reserve (ASR) as part of the locomotor profile concept (MSS, MAS, and ASR). The purpose of this narrative review is to (1) provide an overview of the locomotor profile concept; (2) review the assessment methods for estimating MSS, MAS, and ASR; (3) examine the age-, sex-, and maturity-associated variations in MSS, MAS, and ASR; (4) examine the trainability of MSS, MAS, and ASR in youth athletes; and (5) conclude with the practical applications using principles of long-term athlete development for training the locomotor profile in youth field and court sport athletes. Based on the available data in young male athletes, MSS, MAS, and ASR generally increase with age and across maturity groups and are trainable. Overall, decisions on training need to consider the sport demands, current fitness and maturity status, and targeted training adaptation sought.

Motor Competence, Physical Fitness, Psychosocial, and Physical Activity Characteristics in 9- to 14-Year-Olds: Sex Differences and Age and Maturity Considerations.

Sex, chronological age, and maturity potentially impact multidimensional health-related characteristics (i.e. motor competence, physical fitness, psychosocial, physical activity), which adds to the challenges of reversing current youth health-related concerns. Previous research fails to optimally assess such characteristics and consider sex, age, and maturity among youth. Therefore, the aims were to 1) present the multidimensional health-related characteristics of 9-14-year-olds from the UK, 2) examine sex differences, and 3) account for the effect of age and maturity on such characteristics. Eighty-one girls (mean age = 12.8 ± 1.2 years) and 136 boys (mean age = 13.1 ± 1.2 years) were purposively sampled and assessed across each of the four health-related domains. Multiple ANCOVA analyses examined sex differences among characteristics while accounting for chronological age. Pearson's correlations were used to evaluate the associations between maturity and multidimensional health-related characteristics. Multidimensional health-related characteristics were lower than similar populations and highly variable. Boys outperformed girls on most physical measures (ES = -0.76 to 0.76), elicited greater self-determined motivation (ES = 0.36), greater perceived competence (ES = 0.54), and engaged in more vigorous physical activity (ES = 0.78). Small age effects were present across some characteristics (e.g. isometric mid-thigh pull). Associations between maturity and multidimensional health-related characteristics were different for boys and girls (e.g. maturity offset positively associated with motor competence scores in girls only). Results suggest that multidimensional health-related characteristics of 9- to 14-year-olds are a concern, and are impacted by sex, age, and maturity. Identifying methods to improve multidimensional health-related characteristics which considers sex, age, and maturity are required. Assessing multidimensional health-related characteristics across youth is recommended to inform and measure interventions.

Associations Between Motor Competence and Physical Activity, Physical Fitness and Psychosocial Characteristics in Adolescents: A Systematic Review and Meta-analysis.

BACKGROUND: Motor competence is an integral component of the health and performance of youth. Numerous studies support the hypothesis that motor competence interacts with perceived motor competence and physical fitness during childhood to induce positive (e.g. healthy weight status) or negative (e.g. reduced physical activity engagement) trajectories. Yet, while adolescence is a key period of rapid growth and maturation, no systematic reviews and meta-analyses have examined the association between motor competence and physical activity, physical fitness and psychosocial characteristics solely within adolescents. OBJECTIVES: This study aimed to (1) analyse the scientific literature evaluating associations between motor competence and physical activity, physical fitness and/or psychosocial characteristics amongst adolescents; (2) evaluate the associations between motor competence and physical activity, physical fitness characteristics and/or psychosocial characteristics amongst adolescents; and (3) investigate the impact of moderator variables (i.e., age, sex, type of motor competence assessment) on the associations. METHODS: A systematic search of electronic databases was conducted, followed by a qualitative synthesis of study methods. Random-effects meta-analyses were performed to establish the magnitude and orientation of pooled correlation coefficients between motor competence and physical activity, physical fitness and psychosocial characteristics of adolescents, whilst considering potential moderators (i.e., age, sex, type of motor competence assessment). RESULTS: Sixty-one studies were included, totalling 22,256 adolescents. Twenty-seven different assessments of motor competence were used, with 31 studies utilising product-orientated (i.e. outcome) motor competence assessments. Meta-analyses of 43 studies showed that motor competence was positively associated with physical activity (r = 0.20 to 0.26), some physical fitness characteristics (e.g. muscular strength, cardiovascular endurance; r = 0.03 to 0.60) and psychosocial characteristics (r = 0.07 to 0.34), and inversely associated with weight status (r = - 0.36 to - 0.10), speed (r = - 0.31) and agility (r = - 0.37 to 0.41). Associations with flexibility were unclear. CONCLUSIONS: The results of this systematic review and meta-analysis support the hypothesised interactions of motor competence with physical activity (positive), physical fitness (positive except for weight status, speed and agility) and psychosocial characteristics (positive) in adolescence. However, methodological approaches vary considerably (e.g. variety of motor competence assessments utilised), with limitations of the current literature including an inadequate assessment of motor competence, a lack of longitudinal observations and a failure to account for biological maturation. Future research assessing associations between motor competence and physical activity, physical fitness and psychosocial characteristics of adolescents should include longitudinal observations of a combined motor competence assessment (i.e. process and product) and account for biological maturation. Improved evaluation using these recommendations could provide more accurate data, leading to more targeted interventions to improve adolescents' physical and psychosocial outcomes. CLINICAL TRIAL REGISTRATION: CRD42021233441 (PROSPERO ID).

Descriptive Epidemiology of Game-Related Youth Flag Football Injuries.

CONTEXT: Flag football is promoted as a safer alternative to tackle football. This may be 1 reason why participation rates have risen by 39% over the past 3 years. Despite rising participation, epidemiologic research on sport-specific injuries and associated relative risk is lacking. OBJECTIVE: To prospectively document the epidemiology of injuries in youth flag football. DESIGN: Descriptive epidemiology study. SETTING: Regional and national youth flag football tournaments. PATIENTS OR OTHER PARTICIPANTS: Athletes (N = 1939; 1744 boys and 195 girls), ages 6 to 12 years. An athletic trainer prospectively monitored the athletes for sport-related injury and exposures. MAIN OUTCOME MEASURE(S): Athlete risks of injury and injury rates were calculated overall and by sex. Injury characteristics were reported for the total population and by sex. RESULTS: Forty-seven injuries to unique individuals were recorded in 1939 athletes with a total of 9228 athlete-exposures (AEs). The overall risk of injury was 2.4% (95% CI = 1.79%, 3.21%), with an overall injury rate of 5.1 per 1000 AEs (95% CI = 3.75, 6.77). Of the 47 injuries, 36 occurred in boys (8365 AEs), and 11 occurred in girls (863 AEs). A higher risk in girls was evidenced by both the injury risk ratio (2.73; 95% CI = 1.41, 5.30) and injury rate ratio of 2.96 (95% CI = 1.51, 5.82). The most common injury sites were the head/face/neck (n = 15, 31.9%), followed by the ankle/foot (n = 9, 19.1%). The most frequent types of injury were contusion (55.3%), sprain/subluxation (14.9%), and general trauma (10.6%); 74.5% of all injuries resulted from direct impact. CONCLUSIONS: Although the competition injury rate for youth flag football was lower than the values from studies reporting comparable tackle football data, the frequencies by body part, type, and mechanism were similar. Given that most injuries were related to some form of impact and predominantly contusions, adopting minimal protective equipment or padding may reduce the numbers of these injuries.

Youth motor competence across stages of maturity: Perceptions of physical education teachers and strength and conditioning coaches.

Physical education (PE) teachers and strength and conditioning (S&C) coaches are well placed to develop motor competence within youth populations. However, both groups' perceptions of important motor competencies are relatively unknown, especially when considering stage of maturity. Therefore, this study aimed to 1) present PE teachers and S&C coaches' perceptions of motor competence importance according to stage of maturity; 2) compare perceptions of motor competence between stages of maturity, and between PE teachers and S&C coaches; and 3) explore factors that influence PE teachers and S&C coaches' perceptions of motor competence importance. Via a mixed-method questionnaire, 47 PE teachers (professional experience = 10.3±6.6 years) and 48 S&C coaches (professional experience = 8.6±4.8 years) rated the importance of developing 21 motor competencies across four stages of maturity (childhood, pre-peak height velocity [PHV], circa-PHV, and post-PHV) using a Likert-scale (1 = not important, 5 = very important). Participants also provided open-ended explanations for their perceptions. Frequency analysis indicated that participants rated a broad range of competencies important, with S&C coaches rating more competencies important than PE teachers across all stages of maturity. Mixed-model analysis highlighted several differences in motor competence importance when comparing perceptions between participant groups, and between stages of maturity for PE teachers and S&C coaches. For example, S&C coaches rated strength-based motor competencies less important during childhood (d = -1.83 to -0.43), while PE teachers rated them less important during childhood (d = -2.22 to -0.42) and pre-PHV (d = -1.70 to -0.51) compared to other stages of maturity. Codebook thematic analysis showed several factors that influenced participant's perceptions of motor competence importance (e.g., participants understanding of themselves). The findings suggest that multiple environments may be required to adequately facilitate motor competence development amongst youth. Coach education should target misunderstandings around the risks of strength-based activity during early stages of maturity and the benefits of developing strength-based motor competencies across youth populations.

Optimising long-term athletic development: An investigation of practitioners' knowledge, adherence, practices and challenges.

Long-term athletic development practices have been recommended for the past two decades. However, limited research exists exploring the knowledge and skills required by practitioners to optimise long-term athletic development. Therefore, this study aimed to evaluate the knowledge, adherence, practices, and challenges of practitioners responsible for delivering long-term athletic development. A mixed methods survey was completed by 236 practitioners (e.g., sport coaches, physical education teachers) consisting of four parts; 1) demographics, 2) knowledge, 3) adherence, and 4) practices and challenges. Quantitative and qualitative data were analysed by Friedman's analysis of variance and thematic analyses, respectively. Quantitative findings showed practitioners 1) recognised their responsibility for delivering long-term athletic development, 2) have a familiarity with existing developmental models, and 3) had high adherence, focused upon health and wellbeing, to delivering long-term athletic development. However, practices associated with growth and maturity, monitoring and assessment, and the systematic progression and individualisation of training had lower adherence. Qualitative analysis indicated that practitioner's perceived definitions of athleticism and long-term athletic development were inconsistent, especially according to the psychological components (i.e., confidence). Practitioners' descriptions of their long-term athletic development practices identified two higher order themes; 1) goals, in which long-term athletic development "is for life" and the importance of "an individual centered journey" highlighted as sub-themes; and 2) realities of delivering long-term athletic development, whereby variety in programme delivery, monitoring development and practical challenges were noted as key priorities. Eight practical challenges were identified including governance and priorities, resources, education, early specialization, high training volumes, staff communication, parents and youth motivation. This mixed method survey highlighted a multitude of knowledge, adherence, practices and challenges towards long-term athletic development. These novel findings can help inform policy to optimise long-term athletic development and to support the complex problem of developing a healthier, fitter and more physically active youth population.

Developing motor competency in youths: Perceptions and practices of strength and conditioning coaches.

Motor competency is integral to the long-term athletic development of youths. Strength and conditioning (S&C) coaches are recommended to deliver motor competency interventions, yet no studies have investigated their perceptions and practices for developing motor competency in youths. Sixty-seven male, and 4 female S&C coaches completed an initial and follow up questionnaire using a 5-point Likert scale, rating 1] the importance of developing competence, and 2] how frequently they developed competence across 90 motor competencies. Over 55% of S&C coaches reported a broad range of "important" (69/90) and "frequently developed" (48/90) motor competencies. The most important motor competency was "deceleration" (4.9 ± 0.3), whilst "hip hinge (bilateral)" was the most practised (4.4 ± 0.5). S&C coaches targeted upper body pushing and pulling competencies more than their perceived importance, whilst agility (e.g., turning) competencies were targeted less than their importance. Further analysis showed S&C coaches who delivered 3-4 sessions per week targeted 15-18% more competencies compared to ≤ 2 sessions per week. Overall, these findings have strong implications for youth motor competency development including the reflection of important vs. practised competencies, coach education programmes, and consideration for how S&C coaches should seek to optimise motor competency development within youths.

Exploring the relationship between adolescent biological maturation, physical activity, and sedentary behaviour: a systematic review and narrative synthesis.

CONTEXT: Across adolescence, there is a notable decline in physical activity in boys and girls. Maturational timing may be a risk factor for disengagement from physical activity and increased sedentary behaviours during adolescence. OBJECTIVE: This systematic review aimed to summarise literature that examined the relationship between maturational timing, physical activity and sedentary behaviour in adolescents. METHODS: Six electronic databases were searched for articles that assessed biological maturation and physical activity (including sports participation and active transportation) or sedentary behaviours in adolescents. Two reviewers conducted title, abstract, and full-text screening, reference and forward citation searches. Included articles were evaluated for quality using a standardised tool. A narrative synthesis was used to analyse the findings due to the heterogeneity of the studies. RESULTS: Searches yielded 78 articles (64 unique studies) that met the inclusion criteria, representing 242,316 participants (153,179 unique). Studies ranged from 30.0% (low) to 91.7% (high) in quality. An inverse relationship between maturational timing and physical activity (in 50 and 60% of studies in boys and girls, respectively) and a positive relationship between maturational timing and sedentary behaviour (in 100% and 53% of studies in boys and girls, respectively) was most commonly reported. Evidence supporting an association between maturational timing, sports participation, and active transportation was inconsistent. CONCLUSIONS: While this review demonstrates some evidence for early maturational timing as a risk factor for disengagement from physical activity and increase in sedentary behaviours, the reviewed literature also demonstrates that this relationship is complex. Future research that tracks maturity-related variations in physical activity and sedentary behaviours over adolescence is warranted.

Relationship Between Trajectories of Trunk Fat Development in Emerging Adulthood and Cardiometabolic Risk at 36 Years of Age.

OBJECTIVE: This study examined trajectories of trunk fat mass (FM) accrual during emerging adulthood of individuals categorized, at 36 years of age, as having higher compared with lower scores of (1) metabolic risk and (2) blood pressure risk. METHODS: Fifty-five individuals from the Saskatchewan Pediatric Bone Mineral Accrual Study (1991-2017) were assessed from adolescence (mean [SD], 11.5 [1.8] years) through emerging adulthood (26.2 [2.2] years) and into early adulthood (35.6 [2.2] years) (median 11 visits per individual). Sex-specific median splits of continuous standardized risk scores at 36 years of age were created. Dual-energy x-ray absorptiometry-assessed trunk FM trajectories were analyzed using multilevel random effects models. RESULTS: Higher risk scores of blood pressure risk and metabolic risk had significantly steeper trajectories of fat development (0.45 [0.11] and 0.44 [0.11] log g, respectively) than the lower risk scores. Dietary fat was not related (P > 0.05). Physical activity was negatively related (-0.04 [0.02] physical activity score) to trunk FM development during emerging adulthood. CONCLUSIONS: Young adults with higher metabolic risk at 36 years of age had greater trunk FM development during both adolescence and emerging adulthood, supporting the need for intervention at both these critical periods of fat accrual.

Physical Activity, BMI, and Blood Pressure in US Youth: NHANES 2003-2006.

PURPOSE: The objective of this study was to examine the independent and combined association of physical activity and body mass index (BMI) with blood pressure in youth. METHODS: Youth aged 8-18 years from the 2003-2006 National Health and Nutrition Examination Survey (NHANES) with BMI, blood pressure, and physical activity (accelerometer) were included in the analyses. A total of 2585 subjects (1303 males; 47% of all 8- to 18-year-olds) met these criteria. RESULTS: Obese youth had a systolic blood pressure that was 8 mm Hg higher than normal weight youth. A significant interaction between BMI and physical activity on blood pressure was found (P < .001), and group differences among the BMI/activity groups showed that the 3 obese groups and the overweight/least active group had significantly higher systolic blood pressure than the normal weight/active group across all analyses. The overweight/least active and normal weight/least active groups had significantly higher diastolic blood pressure than the normal weight/active group as well. CONCLUSIONS: This study showed a significant independent and combined association of BMI and physical activity with blood pressure in youth. Interventions need to focus on the reduction of fatness/BMI as a way to reduce the cardiovascular risk in youth.

Calculating a Continuous Metabolic Syndrome Score Using Nationally Representative Reference Values.

OBJECTIVE: The prevalence of metabolic syndrome in youth varies on the basis of the classification system used, prompting implementation of continuous scores; however, the use of these scores is limited to the sample from which they were derived. We sought to describe the derivation of the continuous metabolic syndrome score using nationally representative reference values in a sample of obese adolescents and a national sample obtained from National Health and Nutrition Examination Survey (NHANES) 2011-2012. METHODS: Clinical data were collected from 50 adolescents seeking obesity treatment at a stage 3 weight management center. A second analysis relied on data from adolescents included in NHANES 2011-2012, performed for illustrative purposes. The continuous metabolic syndrome score was calculated by regressing individual values onto nationally representative age- and sex-specific standards (NHANES III). Resultant z scores were summed to create a total score. RESULTS: The final sample included 42 obese adolescents (15 male and 35 female subjects; mean age, 14.8 ± 1.9 years) and an additional 445 participants from NHANES 2011-2012. Among the clinical sample, the mean continuous metabolic syndrome score was 4.16 ± 4.30, while the NHANES sample mean was quite a bit lower, at -0.24 ± 2.8. CONCLUSIONS: We provide a method to calculate the continuous metabolic syndrome by comparing individual risk factor values to age- and sex-specific percentiles from a nationally representative sample.

Premier League academy soccer players' experiences of competing in a tournament bio-banded for biological maturation.

Individual differences in the growth and maturation have been shown to impact player performance and development in youth soccer. This study investigated Premier League academy players' experiences of participating in a tournament bio-banded for biological maturation. Players (N = 66) from four professional soccer clubs aged 11 and 14 years and between 85-90% of adult stature participated in a tournament. Players competed in three 11 vs 11 games on a full size pitch with 25-min halves. Sixteen players participated in four 15-min focus groups and were asked to describe their experiences of participating in the bio-banded tournament in comparison to age group competition. All players described their experience as positive and recommended the Premier League integrate bio-banding into the existing games programme. In comparison to age-group competitions, early maturing players described the bio-banded games more physically challenging, and found that they had to adapt their style of play placing a greater emphasis on technique and tactics. Late maturing players considered the games to be less physically challenging, yet appreciated the having more opportunity to use, develop and demonstrate their technical, physical, and psychological competencies. Bio-banding strategies appear to contribute positively towards the holistic development of young soccer players.

Association between the Family Nutrition and Physical Activity Screening Tool and obesity severity in youth referred to weight management.

BACKGROUND: The Family Nutrition and Physical Activity Screening Tool (FNPA) evaluates family behavioural and environmental factors associated with pediatric obesity, but it is unknown if FNPA scores differ among youth across obesity severities. Our aim was to determine the association between the FNPA and obesity severity in youth referred to weight management. METHODS: Upon initiating treatment, height, weight, and the FNPA were collected according to standard procedures. Cut-points for overweight/obesity, severe obesity (SO) class 2, and SO class 3 were calculated. FNPA scores were compared across weight status groups using analysis of covariance, and odds of SO across FNPA quartiles were evaluated with multiple logistic regression. RESULTS: Participants included 564 5-18year old who initiated treatment and completed the FNPA. After adjustment, FNPA scores differed by weight status with higher/healthier scores in youth with overweight/obesity (56.6±8.5) when compared to those with SO class 2 (55.0±7.1; p=0.015) or SO class 3 (53.6±9.0; p<0.001). Compared to those in the highest FNPA quartile, youth in the 2nd quartile had 1.8 (95% CI: 1.1, 2.9) times higher odds of SO, and those in the lowest FNPA quartile had 2.1 (95% CI: 1.3, 3.4) times higher odds of SO. Youth with SO had unhealthier subscale scores among 6 of 10 constructs, including nutritional, physical activity, sedentary, and sleep behaviours. CONCLUSIONS: Results suggest a consistent inverse relationship between the FNPA and adiposity among youth presenting for weight management. The FNPA is a useful metric for programs and clinicians targeting family behaviours and the home environment to combat obesity.

Reference Curves for Field Tests of Musculoskeletal Fitness in U.S. Children and Adolescents: The 2012 NHANES National Youth Fitness Survey.

Laurson, KR, Saint-Maurice, PF, Welk, GJ, and Eisenmann, JC. Reference curves for field tests of musculoskeletal fitness in U.S. children and adolescents: The 2012 NHANES National Youth Fitness Survey. J Strength Cond Res 31(8): 2075-2082, 2017-The purpose of the study was to describe current levels of musculoskeletal fitness (MSF) in U.S. youth by creating nationally representative age-specific and sex-specific growth curves for handgrip strength (including relative and allometrically scaled handgrip), modified pull-ups, and the plank test. Participants in the National Youth Fitness Survey (n = 1,453) were tested on MSF, aerobic capacity (via submaximal treadmill test), and body composition (body mass index [BMI], waist circumference, and skinfolds). Using LMS regression, age-specific and sex-specific smoothed percentile curves of MSF were created and existing percentiles were used to assign age-specific and sex-specific z-scores for aerobic capacity and body composition. Correlation matrices were created to assess the relationships between z-scores on MSF, aerobic capacity, and body composition. At younger ages (3-10 years), boys scored higher than girls for handgrip strength and modified pull-ups, but not for the plank. By ages 13-15, differences between the boys and girls curves were more pronounced, with boys scoring higher on all tests. Correlations between tests of MSF and aerobic capacity were positive and low-to-moderate in strength. Correlations between tests of MSF and body composition were negative, excluding absolute handgrip strength, which was inversely related to other MSF tests and aerobic capacity but positively associated with body composition. The growth curves herein can be used as normative reference values or a starting point for creating health-related criterion reference standards for these tests. Comparisons with prior national surveys of physical fitness indicate that some components of MSF have likely decreased in the United States over time.

The Association Between Measures of Fitness and Metabolic Health in Treatment-Seeking Youth with Obesity.

BACKGROUND: Both cardiorespiratory fitness (CRF) and measures of muscular fitness are associated with metabolic syndrome in adults. However, limited information exists about these relationships in youth with severe obesity who are at increased risk of metabolic dysfunction. The purpose of this study was to examine the relationship between fitness and metabolic health in treatment-seeking youth with obesity. METHODS: Data for this analysis were collected at the time of baseline visits at a stage 3 pediatric weight management center. Maximal voluntary contractions were obtained by using isometric hand-grip dynamometry, and CRF was obtained from a maximal treadmill test. Resting blood pressure and fasting measures of blood lipids, glucose, and insulin were used to calculate a continuous metabolic syndrome score (cMetS); homeostasis model assessment of insulin resistance (HOMA-IR) was calculated from fasting insulin and glucose. Relationships between measures of fitness and metabolic health were evaluated by using partial correlations adjusted for age. RESULTS: Sixty-nine participants (21 boys, 48 girls) were included in this analysis. Of these, 46% (n = 32) met the criteria for metabolic syndrome. No differences were found between boys and girls for any variable analyzed. Muscular strength was positively associated with cMetS (r = 0.35), though this association weakened after adjustment for body mass index percentile. CRF was inversely associated with homeostasis model assessment of insulin resistance (HOMA-IR) (r = -0.26) and fasting insulin (r = -0.27). Body fat percentage was positively associated with insulin (r = 0.36). No significant relationship was found between CRF and cMetS. CONCLUSION: Contrary to previous studies, CRF was not associated with metabolic syndrome in this group. Muscular strength, however, was associated with cMetS. Notably, CRF was associated with elevated HOMA-IR, which may be seen as a precursor to metabolic syndrome. These results suggest that CRF and muscular strength influence metabolic function independently.

The Stress-Metabolic Syndrome Relationship in Adolescents: An Examination of the Moderating Potential of Physical Activity.

BACKGROUND: The role of psychosocial stress in the development of obesity and metabolic syndrome is receiving increased attention and has led to examination of whether physical activity may moderate the stress-metabolic syndrome relationship. The current study examined relationships among physical activity, stress, and metabolic syndrome in adolescents. METHODS: Participants (N = 126; 57 girls, 69 boys) were assessed for anthropometry, psychosocial stress, physical activity, and metabolic syndrome variables; t tests were used to examine sex differences, and regression analysis was used to assess relationships among variables controlling for sex and maturity status. RESULTS: Mean body mass index approached the 75th percentile for both sexes. Typical sex differences were observed for systolic blood pressure, time spent in moderate and vigorous physical activity, and perceived stress. Although stress was not associated with MetS (ß = -.001, P = .82), a modest, positive relationship was observed with BMI (ß = .20, P = .04). CONCLUSIONS: Strong relationships between physical activity and stress with MetS or BMI were not found in this sample. Results may be partially explained by overall good physical health status of the participants. Additional research in groups exhibiting varying degrees of health is needed.

Physical activity does not attenuate the relationship between daily cortisol and metabolic syndrome in obese youth.

OBJECTIVE: We examined the associations among daily cortisol, physical activity (MVPA) and continuous metabolic syndrome score (cMetS) in obese youth. METHODS: Fifty adolescents (mean age 14.8 ± 1.9 years) were recruited from medical clinics. Daily MVPA (min/day) was assessed by accelerometry. Saliva was sampled at prescribed times: immediately upon waking; 30 min after waking; and 3, 6 and 9 h after waking. Fasting lipids, glucose, waist circumference and blood pressure were used to calculate a continuous metabolic syndrome score (cMetS). Multiple linear regression analysis was used to examine associations among variables. RESULTS: The mean cMetS score was 4.16 ± 4.30 and did not differ by clinic or sex. No significant relationship was found between cortisol area under the curve (cAUC) and cMetS, nor did the interaction of MVPA with cAUC significantly predict cMetS. CONCLUSIONS: Physical activity, cortisol, and metabolic risk were not associated in this sample of obese adolescents. Future research should examine the role of insulin sensitivity in these relationships.

Association of the Family Nutrition and Physical Activity Screening Tool with Weight Status, Percent Body Fat, and Acanthosis Nigricans in Children from a Low Socioeconomic, Urban Community.

OBJECTIVE: To examine the association of the Family Nutrition and Physical Activity (FNPA) screening tool with weight status, percent body fat, and acanthosis nigricans (AN) in 6- to 13-year-old children from a low socioeconomic, urban community. METHODS: Children (n=415) from four elementary schools located around Flint, Michigan were assessed for body mass index, percent body fat, and AN. The FNPA screening tool was completed by parents. Mann-Whitney U tests were used to assess differences in FNPA score by sex and presence of AN. Logistic regression was used to evaluate the association of the FNPA (tertiles) with weight status and AN. RESULTS: Children with AN (13.7%) had a significantly lower FNPA score (56.3 + 7.1) compared with children without AN (61.0 + 7.1; P<.05). Children with FNPA scores in the lowest tertile (high-risk) had odds ratios of 1.74 (95% CI =1.05 - 2.91) and 2.77 (95% CI =1.22 - 6.27) compared with children with FNPA scores in the highest tertile (low-risk) for being overfat and having AN, respectively. CONCLUSION: Although the FNPA screening tool did not predict risk for being overweight or obese, it was significantly associated with an increased odds of children at risk for being overfat or having AN.

Graded Exercise Testing in a Pediatric Weight Management Center: The DeVos Protocol.

BACKGROUND: In this article, we describe a protocol used to test the functional capacity of the obese pediatric patient and describe the peak oxygen consumption (VO2peak) of patients seeking treatment at a pediatric weight management center. METHODS: One hundred eleven (mean age, 12.5 ± 3.0 years) patients performed a multistage exercise test on a treadmill, of which 90 (81%) met end-test criteria and provided valid VO2peak data. Peak VO2 was expressed: (1) in absolute terms (L·min(-1)); (2) as the ratio of the volume of oxygen consumed per minute relative to total body mass (mL·kg(-1)·min(-1)); and (3) as the ratio of the volume of oxygen consumed per minute relative to fat-free mass (mL·FFM·kg(-1)·min(-1)). RESULTS: Mean BMI z-score was 2.4 ± 0.3 and the mean percent body fat was 36.5 ± 9.7%. Absolute VO2peak (L·min(-1)) was significantly different between sexes; however, relative values were similar between sexes. Mean VO2peak was 25.7 ± 4.8 mL·kg(-1)·min(-1) with a range of 13.5-36.7 mL·kg(-1)·min(-1). CONCLUSIONS: Obese youth seeking treatment at a stage 3 pediatric weight management center exhibit low VO2peak. The protocol outlined here should serve as a model for similar programs interested in the submaximal and peak responses to exercise in obese pediatric patients.