Adherence to aerobic and muscle-strengthening activities guidelines: a systematic review and meta-analysis of 3.3 million participants across 32 countries.

OBJECTIVE: To estimate the global prevalence of meeting the WHO guidelines for both aerobic and muscle-strengthening activities (MSA) in populations aged ≥5 years, and whenever possible to explore this prevalence according to sociodemographic and lifestyle factors. DESIGN: A systematic review and meta-analysis. DATA SOURCES: Five databases were systematically searched for studies published from inception to September 2022. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Articles with representative samples aged ≥5 years reporting the prevalence of meeting both aerobic and MSA guidelines were included. RESULTS: Twenty-one studies comprising 3 390 001 individuals from 32 countries were included. Overall adherence to the aerobic and MSA guidelines was 17.12% (95% CI 15.42% to 18.88%) in adults ≥18 years (n=3 346 723). Among adolescents aged 12-17 years, adherence to both guidelines was 19.74% (95% CI 14.72% to 25.31%) (n=43 278). No studies reported data for children aged 5-11 years. Women, older age, low/medium education levels, underweight or obesity, and poor and moderate self-rated health were associated with lower adherence to the physical activity guidelines (p<0.001) among adults, although the prevalence remained very low in all cases. Subgroup analyses were not conducted with children and adolescents due to a lack of studies. CONCLUSIONS: Only one out of five adolescents and adults met the recommended combined aerobic and MSA guidelines. Large-scale public health interventions promoting both types of exercise are needed to reduce the associated burden of non-communicable diseases. PROSPERO REGISTRATION NUMBER: CRD42022338422.

A descriptive ranking of blood pressure and physical fitness of Latin-American ethnic schoolchildren.

BACKGROUND: There is a general lack of information about how insufficient physical activity impacts blood pressure and physical fitness in Latin-American ethnic minorities. AIMS: To describe the interactions between insufficient physical activity, blood pressure, and physical fitness outcomes in Latin-American schoolchildren of different ethnicity. METHODS: This was a prospective, international, multi-center, and cross-sectional study of three Latin-American countries involving schoolchildren from seven ethnic groups of Colombia (Tikuna, Nasa, Embera), Brazil (African, Mulato), and Chile (Mapuche), and also European schoolchildren from Brazil and Chile. Data were categorized based on whether participants were physically active (PA) or insufficient physical activity (iPA) using the WHO physical activity recommendations. The main outcomes were systolic (SBP), diastolic (DBP), and mean arterial (MAP) blood pressure, and scores for physical and cardiorespiratory fitness (CRF, by estimated V˙O2max), handgrip muscle strength (HGS), and standing long jump (SLJ). Secondary outcomes were anthropometric measures (weight, height, body mass index [BMI], waist circumference [WC], waist-to-height ratio), and body fat percentage (BF%, limited data by country). Primary and secondary outcomes were ranked. RESULTS: For both PA and iPA categories, significant interactions between ethnic groups were found concerning SBP/DBP (F(37.7), ES 0.08; F(51.5), ES 0.08), V˙O2max (F(37.7), ES 0.08; F(51.5), ES 0.08), HGS (F(33.8), ES 0.07; F(5.03), ES 0.04), and SLJ (F(64.3), ES 0.14; F(64.3), 0.14). In the iPA category, Mapuche schoolchildren were classified 1st (119.5; 81.5) with highest SBP/DBP and highest MAP (94.6 mmHg); Embera schoolchildren were classified 1st with lowest V˙O2max (33.7 mL/kg/min); and European schoolchildren were classified 1st (19.9 kg) with lowest HGS and SLJ (121.4 m) physical fitness. CONCLUSIONS: Under conditions of insufficient physical activity conditions, Mapuche schoolchildren had the most detrimental blood pressure, whereas Embera, Tikuna, and European schoolchildren had the lowest levels of physical fitness. These results serve to highlight the need for the early and appropriate promotion of physical activity based on ethnic differences in Latin-American schools.

Cardiorespiratory Fitness Normative Values in Latin-American Adolescents: Role of Fatness Parameters.

The aim of this study was to provide percentile values for a cardiorespiratory fitness (CRF) field test for Latin-American adolescents (34,461 girls and 38,044 boys) aged 13 to 15 years. The role of fatness parameters on the CRF level across age groups was also examined, with a focus on non-obese (healthy) and obese groups. CRF was assessed using the 20-meter shuttle run test protocol. Anthropometric parameters were measured using body mass index z-score (body mass index (BMI) z-score), BMI, waist circumference (WC), and waist-to-height ratio (WHtR). Participants were categorized according to the BMI z-score, WC, and WHtR international cut-off points as healthy and obese. Age- and sex-specific reference tables for the 3rd, 10th, 25th, 50th, 75th, 90th, and 97th centile scores were calculated using Cole's lambda, mu, and sigma method. The prevalence of obesity according to the BMI z-score, WC, and WHtR was 9.6%, 11.2%, and 15.0%, respectively. Across all age and sex groups, a negative association was found between relative peak oxygen uptake ( V ˙ O2peak) and BMI, WC, and WHtR. In boys and girls there were higher levels of performance across all age groups, with most apparent gains between the ages of 13 and 14 years old. Overall, participants categorized in the healthy group had shown to have significantly higher V ˙ O2peak than their obese counterparts (p < 0.001; Cohen's d > 1.0). In conclusion, our study provides age- and sex-specific reference values for CRF ( V ˙ O2peak, mL·kg-1·min-1). The anthropometric parameters were inversely associated with CRF in all ages in both sexes. The obese group had worse CRF than their healthy counterparts independent of anthropometric parameters used to determine obesity.

Feasibility and Reliability of Physical Fitness Tests among Colombian Preschool Children.

The aim of the study was to assess the feasibility and reliability of physical fitness field tests used in the "Fuprecol kids" study among Colombian preschool children aged 3-5 years. A total of 90 preschoolers aged 3-5 years participated in the study. Weight, height, waist circumference, cardiorespiratory fitness (CRF), musculoskeletal fitness (handgrip strength and standing broad jump), speed-agility (4 × 10 m shuttle run), and flexibility (sit and reach test) components were tested twice (two weeks apart). The feasibility of the tests (preschoolers able to complete the test) ranged from 96% in the CRF test to 100% in the musculoskeletal fitness, speed-agility, and flexibility tests. Overall, the %TEMs were 0.625% for the weight, 0.378% for the height, 1.035% for the body mass index, and 0.547 % for the waist circumference. In addition, all tests were substantial reliable, for CRF (in stages and laps, concordance correlation coefficient = 0.944 and 0.941, respectively) in both sexes and flexibility (concordance correlation coefficient = 0.949) in girls. There were no significant differences in fitness test-retest mean differences in the boys (P > 0.05), except in CRF (laps P = 0.017). In girls, there were differences in CRF (stages (P = 0.017) and laps (P= 0.013)), and flexibility (P = 0.002) variables. The results from this study indicate that the "Fuprecol kids" battery of tests, administered by physical education teachers, was reliable and feasible for measuring components of physical fitness in preschoolers in a school setting in Colombia.

Cardiorespiratory Fitness Cut-Points are Related to Body Adiposity Parameters in Latin American Adolescents.

Background and Objectives: A deficiency exists in the criterion-referenced cut-points for field-based cardiorespiratory fitness (CRF) in Latin American youths. The aims of the present study were two-fold: (1) To identify the ability of CRF estimated by the 20-m shuttle-run test (20mSRT) to differentiate between "healthy" and "unhealthy" phenotypes (by adiposity) in adolescents; (2) to assess the association between obesity and relative peak oxygen uptake (VO2peak) in a large and diverse sample of Latin American youths. In total, 72,505 adolescents aged between 13 and 15 years were recruited from Chile and Colombia (47.5% girls). Materials and Methods: The waist circumference (WC) and waist-to-height ratio (WHtR) were used to identify body adiposity markers. CRF was measured using the 20mSRT (VO2peak). Receiver operating characteristic curves and logistic regression were used to determine the discriminatory ability of CRF to predict body adiposity parameters. Results: For boys and girls, VO2peak showed a significant predictive capacity to detect body fat (area under the curve [AUC] > 0.62). The sensitivity of VO2peak was medium (>63%) for all age- and sex-specific cut-points, with optimal cut-points in 13- to 15-year olds for obesity identified as 43.77 mL·kg-1·min-1 and 38.53 mL·kg-1·min-1 in boys and girls, respectively. Conclusions: According to these cut-points, adolescents with low CRF were more likely to be obese either by WC or WHtR. The CRF cut-points can be used as quantitative markers for a healthier body in Latin American adolescents.