Cardiorespiratory Fitness in Childhood and Adolescence Affects Future Cardiovascular Risk Factors: A Systematic Review of Longitudinal Studies Body mass index, fitness and physical activity from childhood through adolescence Improvements in fitness reduce the risk of becoming overweight across puberty. Effects of recreational soccer on physical fitness and health indices in sedentary healthy and unhealthy subjects A rationale and method for high-intensity progressive resistance training with children and adolescents. Two years of school-based intervention program could improve the physical fitness among Ecuadorian adolescents at health risk: subgroups analysis from a cluster-randomized trial Systematic review of effectiveness of universal self-regulation-based interventions and their effects on distal health and social outcomes in children and adolescents: review protocol Left ventricular structure and function in obese adolescents: relations to cardiovascular fitness, percent body fat, and visceral adiposity, and effects of physical training. Physical fitness and shapes of subcortical brain structures in children. Improving physical fitness and emotional well-being in adolescents of low socioeconomic status in Chile: results of a school-based controlled trial. Improving the fitness and physical activity levels of primary school children: results of the Fit-4-Fun group randomized controlled trial. Cross sectional analysis of the association between mode of school transportation and physical fitness in children and adolescents [Improving physical fitness in adolescents through a school-based intervention: the EDUFIT study]. Weight status, physical activity, and fitness among third-grade rural children. Rationale and study protocol for the 'eCoFit' randomized controlled trial: Integrating smartphone technology, social support and the outdoor physical environment to improve health-related fitness among adults at risk of, or diagnosed with, Type 2 Diabetes. Why do kids eat healthful food? Perceived benefits of and barriers to healthful eating and physical activity among children and adolescents. The association of physical activity and physical fitness with pre-adolescent obesity: an observational study in Metromanila, Philippines. Low physical fitness in childhood is associated with the development of asthma in young adulthood: the Odense schoolchild study. The Outcomes of a 12-Week Internet Intervention Aimed at Improving Fitness and Health-Related Quality of Life in Overweight Adolescents: The Young & Active Controlled Trial Mediating effects of resistance training skill competency on health-related fitness and physical activity: the ATLAS cluster randomised controlled trial Benefits of Strength and Skill-based Training During Primary School Physical Education The Effects of Physical Activity on Health and Quality of Life in Adolescent Cancer Survivors: A Systematic Review Get Fit with the Grizzlies: a community-school-home initiative to fight childhood obesity. Physical and psychological effects of aerobic exercise in delinquent adolescent males. Dance for health: improving fitness in African American and Hispanic adolescents. Suspected Motor Problems and Low Preference for Active Play in Childhood Are Associated with Physical Inactivity and Low Fitness in Adolescence Physical activity and obesity mediate the association between childhood motor function and adolescents’ academic achievement Long-term effects of physically active academic lessons on physical fitness and executive functions in primary school children. Correlates of cardiorespiratory and muscular fitness among Brazilian adolescents. Get fit with the Grizzlies: a community-school-home initiative to fight childhood obesity led by a professional sports organization. Influence of a lifestyle intervention in preschool children on physiological and psychological parameters (Ballabeina): study design of a cluster randomized controlled trial Effectiveness of parent‐centred interventions for the prevention and treatment of childhood overweight and obesity in community settings: a systematic review Muscle Strengthening in Children and Adolescents With Spastic Cerebral Palsy: Considerations for Future Resistance Training Protocols A school-based physical activity program to improve health and fitness in children aged 6–13 years ("Kinder-Sportstudie KISS"): study design of a randomized controlled trial [ISRCTN15360785]
Background Although cardiorespiratory fitness ( CRF ) in childhood and adolescence may be linked to future cardiovascular health , there is currently limited evidence for a longitudinal association . Objectives To provide a systematic review on the prospect i ve association between CRF in childhood and adolescence and cardiovascular disease ( CVD ) risk factors at least 2 years later . Methods Using a systematic search of Medline , Embase , and SPORTD iscus , relevant articles were identified by the following criteria : generally healthy children and adolescents between 3 and 18 years of age with CRF assessed at baseline , and a follow-up period of ≥ 2 years . The outcome measures were CVD risk factors . We appraised quality of the included articles with STROBE and QUIPS checklists . Results After screening 7524 titles and abstract s , we included 38 articles , assessing 44,169 children and adolescents followed up for a median of 6 years . Eleven articles were of high quality . There was considerable heterogeneity in methodology , measurement of CRF , and outcomes , which hampered meta- analysis . In approximately half of the included articles higher CRF in childhood and adolescence was associated with lower body mass index ( BMI ) , waist circumference , body fatness and lower prevalence of metabolic syndrome in later life . No associations between CRF in childhood and adolescence and future waist-to-hip ratio , blood pressure , lipid profile , and glucose homeostasis were observed . Conclusion Although about half of the included articles reported inverse associations between CRF in childhood and adolescence and future BMI , body fatness , and metabolic syndrome , evidence for other CVD risk factors was unconvincing . Many articles did not account for important confounding factors such as adiposity . Recommendations for future research include st and ardizing the measurement of CRF , i.e. by reporting VO2max , using st and ardized outcome assessment s , and performing individual patient data meta-analyses Background Obesity , sedentary lifestyle and poor cardiorespiratory fitness in childhood may increase the risk of health problems later in life . Purpose The authors studied the association of early childhood weight status with cardiorespiratory fitness and leisure-time physical activity ( LTPA ) in adolescence . The stability and associations of LTPA and fitness from childhood through adolescence were also studied . Methods  Body mass index ( BMI ) was assessed annually since birth in a prospect i ve , longitudinal study . The mean BMI between ages 2 and 7 years indicated weight status at preschool age . Fitness was studied with a shuttle run test at age 9 and with a maximal cycle ergometer test at age 17 . The same question naire was used to assess LTPA at age 9 , 13 and 17 . Complete data on preschool BMI , LTPA at ages 13 and 17 and fitness at age 17 years was provided by 351 children , while fitness and LTPA data were available for 74 children at ages 9 and 17 . Results Preschool BMI was inversely associated with fitness in adolescence independently of adolescent LTPA ( p=0.0001 ) . Children who had a high preschool BMI but whose weight status was reduced in adolescence had similar fitness in adolescence as the children with a persistently low BMI . Regardless of the fitness level in childhood , the children whose LTPA increased between age 9 and 17 had a similar adolescent fitness level as persistently active subjects . Conclusions It is important to maintain a healthy body weight and a physically active lifestyle from very childhood through adolescence to improve fitness during adolescence PURPOSE Information about factors related to overweight development in early stages of life is needed for design ing useful strategies to prevent overweight and related diseases . Longitudinal studies can contribute to this goal . The present study aim ed to identify factors in childhood that determine the development of overweight/obesity in adolescence . METHODS A prospect i ve study in 598 normal-weight Estonian and Swedish children age 9.5 ± 0.4 yr from the European Youth Heart Study , who were followed during 6 yr , was conducted . Weight and height were measured at baseline and follow-up , and weight status was ascertained according to the international criteria for body mass index . Cardiorespiratory fitness  ( expressed as  VO(2max ) ( mL·kg(-1)·min(-1 ) ) ) was assessed by a maximal bike test . Parents reported their weight , height , and educational level . RESULTS Being male ( vs female ) and Estonian ( vs Swedish ) was related to higher risk for incident overweight/obesity . Change in fitness was a stronger predictor of incident overweight/obesity than childhood fitness , parental overweight , or parental education . The risk of developing overweight/obesity was reduced 10 % every 1 mL·kg(-1)·min(-1 ) of VO(2max ) increase ( odds ratio = 0.90 and 95 % confidence interval = 0.84 - 0.95 ) after adjustment for a set of confounders including baseline body mass index and without differences by gender . CONCLUSIONS Our results suggest that improvements in fitness from childhood to adolescence are associated with a lower risk of becoming overweight/obese in adolescence . The current findings highlight the importance of promoting fitness through physical exercise from early stages in life , as a promising strategy to fight against overweight and obesity . Gender and country differences observed in this study require social and political attention Recreational soccer ( RS ) is becoming a popular alternative to the classical continuous exercise mode used for the improvement of cardiovascular and metabolic fitness in untrained people . The objective of this paper was to conduct a detailed systematic review of the literature , identifying the physiological responses to RS and the training effects of RS on aerobic fitness and health in untrained healthy individuals and clinical patients . PubMed , Google Scholar and ScienceDirect data bases were search ed using terms related to recreational soccer . Inclusion criteria were r and omized controlled trials ( RCT ) that assessed acute physiological responses to RS or the training effects of RS on physical fitness and health in sedentary , untrained subjects of any age or health status . All studies were assessed for method ological quality using the PEDro scale . Thirty-five articles met the inclusion criteria ; seven examined the acute response to RS , and 28 assessed training effects . Clear evidence was found that RS had positive effects on many health-related indices and variables , including VO2max ( gains of 7 - 16 % ) , blood pressure ( reductions of 6 - 13 mmHg ) , body composition ( decreased fat mass and improved indices of bone health ) , and metabolic and cardiac function . These positive effects were observed in both healthy individuals and clinical patients , irrespective of age or sex . Although this review provides clear evidence of the positive effects of RS on health , most studies had limitations of methodology ( an average PEDro score < 6 ) . Furthermore , many of the training studies were from a small number of research groups . Future studies should be extended to other countries and institutions to ensure generality of the results . Regular RS training leads to significant cardiovascular and muscular adaptations and gains of health both in sedentary individuals and clinical patients at all ages , suggesting that RS is a potentially highly motivational method to enhance population health BACKGROUND The rising prevalence of obesity in children and adolescents is implicated in the metabolic abnormalities that track into adulthood . The associated increased incidence of insulin resistance , metabolic syndrome and type 2 diabetes being identified in younger cohorts has given rise to a critical global health issue . Muscular strength is a vital component of metabolic fitness that provides protection from insulin resistance in adults , and we have recently shown this to be true in children as well . Targeting muscular strength deficiencies at an early age may be an effective preventative strategy for metabolic syndrome and type 2 diabetes . PURPOSE There is limited evidence -based best practice for progressive resistance training ( PRT ) , adiposity and metabolic fitness in children and adolescents . The purpose of this paper is to describe the methodology we utilized for implementing a PRT program to avoid publication bias , enable replication of the study and share a novel program that we have found safe and suitable for use with youth . METHODS We conducted the first r and omized controlled trial ( RCT ) prescribing high-intensity PRT to children and adolescents ( 10 - 15 years ) as a community-based primary prevention program to address adiposity and metabolic health . Participants were instructed to complete 2 sets of 8 repetitions of 11 exercises targeting all the major muscle groups twice a week at an RPE of 15 - 18 for 8 weeks . RESULTS Primary outcome was waist circumference ; secondary outcomes included insulin resistance , lipid levels , muscle strength , cardiorespiratory fitness , body composition , self-efficacy , self-concept , habitual physical activity , nutritional and sedentary behavior patterns . CONCLUSION The supervised PRT program that we used with children and adolescents has been described in detail . The efficacy of this modality of exercise for metabolic fitness and other health outcomes is now under investigation Background Adolescents with overweight and poor physical fitness have an increased likelihood of developing cardiovascular diseases during adulthood . In Ecuador , a health promotion program improved the muscular strength and speed-agility , and reduced the decline of the moderate-to-vigorous physical activity of adolescents after 28 months . We performed a sub-group analysis to assess the differential effect of this intervention in overweight and low-fit adolescents . Methods We performed a cluster-r and omized pair matched trial in schools located in Cuenca – Ecuador . In total 20 schools ( clusters ) were pair matched , and 1440 adolescents of grade 8 and 9 ( mean age of 12.3 and 13.3 years respectively ) participated in the trial . For the purpose s of the subgroup analysis , the adolescents were classified into groups according to their weight status ( body mass index ) and aerobic capacity ( scores in the 20 m shuttle run and FITNESSGRAM st and ards ) at baseline . Primary outcomes included physical fitness ( vertical jump , speed shuttle run ) and physical activity ( proportion of students achieving over 60 min of moderate – to-vigorous physical activity/day ) . For these primary outcomes , we stratified analysis by weight ( underweight , normal BMI and overweight/obese ) and fitness ( fit and low fitness ) groups . Mixed linear regression models were used to assess the intervention effect . Results The prevalence of overweight/obesity , underweight and poor  physical  fitness  was 20.3 % , 5.8 % and 84.8 % respectively . A higher intervention effect was observed for speed shuttle run in overweight ( β = −1.85 s , P = 0.04 ) adolescents compared to underweight ( β = −1.66 s , P = 0.5 ) or normal weight ( β = −0.35 s , P = 0.6 ) peers . The intervention effect on vertical jump was higher in adolescents with poor physical fitness ( β = 3.71 cm , P = 0.005 ) compared to their fit peers ( β = 1.28 cm , P = 0.4 ) . The proportion of students achieving over 60 min of moderate-to-vigorous physical activity/day was not significantly different according to weight or fitness status . Conclusion Comprehensive school-based interventions that aim to improve diet and physical activity could improve speed and strength aspects of physical fitness in low-fit and overweight/obese adolescents . Trial registration Clinical trials.gov identifier NCT01004367 . Registered October 28 , 2009 Background Growing evidence suggests that childhood and adolescence self-regulation contributes to multiple health , educational and social outcomes . Considering the potential impact of self-regulation skills on improved life chances in conjunction with evidence suggesting that self-regulation can be modified by interventions , there is a need to identify interventions which are most effective in improving childhood and adolescence self-regulation . The present systematic review was design ed to determine the effectiveness of universal interventions focused on enhancing the  self-regulation of children and adolescents . As secondary outcomes , we will also examine the effectiveness of such interventions on distal health and social outcomes . Methods Eligible studies include r and omised controlled trials ( including cluster r and omised trials ) reporting on universal interventions design ed to improve self-regulation in childhood and adolescence ( age 0–19 years ) . The following data bases will be search ed for peer- review ed publications using an iterative search strategy : Medline , PsycINFO , EMBASE , ERIC , CINAHL Plus , British Education Index , Child Development & Adolescent Studies and CENTRAL without applying language or date filters . Additionally , reference lists and citations of included studies will be search ed for eligible studies . A 10 % proportion of the total titles and abstract s will be r and omly selected and screened independently by two review ers ( AP and DH ) . Results will be compared to ensure less than 5 % discrepancy , followed by screening of all results by one review er ( AP ) . Full-text review and data collection will be independently performed by two review ers . Any discrepancies will be solved by mutual discussion , and if unresolved , a third review er ( RV ) will be consulted . Meta- analysis will be conducted to quantify trial effects , if the data is sufficiently homogenous to allow quantitative synthesis . Otherwise , results will be described narratively . Discussion The evidence derived from the systematic review will strengthen the evidence base to inform planning of effective interventions targeting self-regulation skills in childhood and adolescence . This will benefit policy makers , academicians , research ers , health professionals , and also , young people who will benefit from policy and interventions informed by this review . Systematic review registration CRD42016047661 OBJECTIVE Little is known about the relations of fitness and fatness to left ventricular structure and function in obese adolescents . This project had 2 purpose s : 1 ) to determine the correlations of cardiovascular fitness and adiposity to left ventricular parameters in obese adolescents ; and 2 ) to see the effect of 8 months of physical training ( PT ) at low and high intensities . DESIGN Obese 13- to 16-year-olds ( N = 81 ) were tested at baseline and then r and omly assigned to lifestyle education ( LSE ) alone , LSE plus moderate-intensity PT , or LSE plus high-intensity PT . Follow-up testing was conducted 8 months later . Because no significant differences were found between moderate-intensity and high-intensity PT , the groups were combined to form a LSE + PT group . INTERVENTION Eight months of PT , offered 5 days per week with the target energy expenditure for all PT participants being 250 kcal/session , and LSE every 2 weeks . Outcome Measures . Left ventricular mass divided by height to the 2.7th power ( LVM/Ht(2.7 ) ) , midwall fractional shortening ( MFS ) , and relative wall thickness ( RWT ) were measured using M-mode echocardiography . Cardiovascular fitness was measured by a maximal multistage treadmill test ; percent body fat ( % BF ) with dual-energy radiograph absorptiometry ; and visceral adipose tissue ( VAT ) with magnetic resonance imaging . RESULTS At baseline , high levels of VAT were associated with higher RWT ( r = 0.30 ) and lesser MFS ( r = -0.29 ) . Compared with the LSE-alone group , the LSE + PT group significantly improved in cardiovascular fitness and decreased in % BF and VAT . However , there were no significant differences between groups on changes in LVM/Ht(2.7 ) , MFS , or RWT . Individual changes in cardiovascular fitness , % BF , and VAT did not correlate significantly with interindividual changes in left ventricular structure and function . CONCLUSIONS High levels of VAT were associated with unfavorable left ventricular structure and function . However , no evidence was provided that an 8-month PT program , which improved cardiovascular fitness and reduced general and visceral adiposity , improved left ventricular structure and function . Future studies consisting of longer training programs and /or greater weight reductions are needed to see whether the adverse left ventricular effects of obesity can be ameliorated by exercise training A few studies have recently reported that higher cardiorespiratory fitness is associated with higher volumes of subcortical brain structures in children . It is , however , unknown how different fitness measures relate to shapes of subcortical brain nuclei . We aim ed to examine the association of the main health-related physical fitness components with shapes of subcortical brain structures in a sample of forty-four Spanish children aged 9·7 ( sd 0·2 ) years from the NUtraceuticals for a HEALthier life project . Cardiorespiratory fitness , muscular strength and speed agility were assessed using valid and reliable tests ( ALPHA-fitness test battery ) . Shape of the subcortical brain structures was assessed by MRI , and its relationship with fitness was examined after controlling for a set of potential confounders using a partial correlation permutation approach . Our results showed that all physical fitness components studied were significantly related to the shapes of subcortical brain nuclei . These associations were both positive and negative , indicating that a higher level of fitness in childhood is related to both expansions and contractions in certain regions of the accumbens , amygdala , cau date , hippocampus , pallidum , putamen and thalamus . Cardiorespiratory fitness was mainly associated with expansions , whereas h and grip was mostly associated with contractions in the structures studied . Future r and omised-controlled trials will confirm or contrast our findings , demonstrating whether changes in fitness modify the shapes of brain structures and the extent to which those changes influence cognitive function Regular physical activity is associated with a reduced risk of all-cause mortality , and mortality due to cardiovascular disease and cancer . Among adolescents , physical activity is associated with benefits in the prevention and control of emotional distress , and improvement of self-esteem . Countries in transitional epidemiological scenarios , such as Chile , need to develop effective strategies to improve physical activity as a way to face the epidemic of chronic diseases . The objective of this study was to evaluate the effects of a school-based physical activity program on physical fitness and mental health status of adolescents living in a low socioeconomic status area in Santiago , Chile . A quasi-experimental design was used to evaluate the effects of the program over one academic year . The study included 198 students aged 15 years old . Two ninth grade classes were r and omly selected as the  intervention group , with two classes of the same grade as controls . A social planning approach was used to develop the intervention . The program was design ed and implemented based on student preferences , teachers ' expertise and local re sources . Changes in physiological and mental health status were assessed . After the intervention , maximum oxygen capacity achieved a significant increase of 8.5 % in the intervention versus 1.8 % in the control group ( p < 0.0001 ) . Speed and jump performance scores improved significantly more in the intervention versus the control group ( p > 0.01 ) . Anxiety score decreased 13.7 % in the intervention group versus 2.8 % in the control group ( p < 0.01 ) , and self-esteem score increased 2.3 % in the intervention group and decreased 0.1 % in the control group after the end of the program ( p < 0.0001 ) . No significant change was observed in the depressive score . Student participation and compliance with the program was > 80 % . To conclude , a school-based program to improve physical activity in adolescents of low socioeconomic status , obtained a high level of participation and achieved significant benefits in terms of physical fitness and mental health status OBJECTIVE To evaluate the impact of a multi-component school-based physical activity intervention ( Fit-4-Fun ) on health-related fitness and objective ly measured physical activity in primary school children . METHODS Four Hunter primary schools were recruited in April , 2011 and r and omized by school into treatment or control conditions . Participants included 213 children ( mean age = 10.72 years ± 0.6 ; 52.2 % female ) with the treatment group ( n = 118 ) completing the 8-week Fit-4-Fun Program . Participants were assessed at baseline and 6-month follow-up , with a 91 % retention rate . Cardio-respiratory fitness ( CRF ) ( 20 m shuttle run ) was the primary outcome , and secondary outcomes included body composition ( BMI , BMI ( Z ) ) , muscular fitness ( 7-stage sit-up test , push-up test , basketball throw test , St and ing Jump ) , flexibility ( sit and reach ) and physical activity ( 7 days pedometry ) . RESULTS After 6-months , significant treatment effects were found for CRF ( adjusted mean difference , 1.14 levels , p < 0.001 ) , body composition ( BMI mean , -0.96 kg/m(2 ) , p < 0.001 and BMI z-score mean -0.47 z-scores , p < 0.001 ) , flexibility ( sit and reach mean , 1.52 cm , p = 0.0013 ) , muscular fitness ( sit-ups ) ( mean 0.62 stages , p = 0.003 ) and physical activity ( mean , 3253 steps/day , p < 0.001 ) . There were no group by time effects for the other muscular fitness measures . CONCLUSIONS A primary school-based intervention focusing on fitness education significantly improved health-related fitness and physical activity levels in children Objective To investigate the associations between body composition , cardiorespiratory and muscular fitness in relation to travel mode to school in children and adolescents . Method Children and adolescents from 40 elementary schools and 23 high schools representing all regions in Norway were invited to participate in the study . Anthropometry , cardiorespiratory and muscular fitness  were tested at the school location . Question naires were used in order to register mode of transport to school , age , gender and levels of leisure time physical activity . Results A total of 1694 ( i.e. 60 % of all invited participants ) children and adolescents at a mean age of 9.6 and 15.6 respectively ( SD = 0.4 for both groups ) were analyzed for associations with physical fitness variables . Males cycling to school had lower sum of skin folds than adolescents walking to school . Higher cardiorespiratory fitness in adolescents and male cyclists compared to walkers and passive commuters were observed . Among children , cycling and walking to school , higher isometric muscle endurance in the back extensors compared to passive commuters was observed . Conclusion Based on this national representative cross-sectional examination of r and omly selected children and adolescents there is evidence that active commuting , especially cycling , is associated with a favourable body composition and better cardiorespiratory and muscular fitness as compared to passive commuting INTRODUCTION AND OBJECTIVES Physical fitness level is a marker of cardiovascular health in young people . The aim of this study was to analyze the effects of a school-based intervention program , focused on increasing the volume and intensity of physical education ( PE ) sessions , on adolescents ' physical fitness . METHODS Sixty-seven adolescents ( 12 - 14 years old ) from three secondary school classes participated in a 16-week intervention . The classes were r and omly allocated to the control group , experimental group 1 ( EG1 ) or experimental group 2 ( EG2 ) . The control group received st and ard PE ( 2 sessions/week ) , the EG1 received 4 st and ard PE sessions/week and the EG2 received four high-intensity PE sessions/week . Aerobic fitness , muscle strength , speed-agility and flexibility were assessed using previously vali date d field-based tests before and after the intervention . RESULTS Doubling the number of PE sessions/week result ed in improvements in aerobic fitness and flexibility ( P=.008 and P=.04 , respectively ) . Further increases in the intensity of the sessions were related to improvements in speed-agility ( P<.001 ) . The maximal oxygen consumption increased by 3 and 5 mL/kg/min in the EG1 and EG2 , respectively . No differences were observed for muscle strength . CONCLUSIONS The results suggest that doubling the frequency of PE sessions is a sufficient stimulus to improve physical fitness , particularly aerobic fitness , which has been shown to be a powerful indicator of cardiovascular health in children and adolescents . Future studies involving larger sample sizes should confirm or refute these findings BACKGROUND Rural children are at a particular high risk for obesity . Given the importance of exercise in obesity and chronic disease prevention , this study evaluated the level and relationship between physical activity and fitness in a sample of rural third grade rs . The second purpose of the study was to determine potential differences in physical activity and fitness level by weight status in this sample . METHODS Twelve schools participating in a multidisciplinary research project were r and omly selected for the study . Body mass index-for-age percentile , the modified Self-administered Physical Activity Checklist  , and the FITNESSGRAM battery tests were utilized to determine children 's weight status , physical activity , and fitness level , respectively . RESULTS Thirty-eight percent of the 237 participating children ( 9.2 ± 0.4 years ) were overweight or obese . Nearly 15 % were extremely obese . Children spent 91.8 ± 83.8 and 32.2 ± 47.7 minutes in moderate- and vigorous-intensity activities . Obese children spent less time in moderate-intensity activity ( p < .01 ) and combined moderate- and vigorous-intensity activity more than other children ( p < .05 ) . Forty-three percent of all children failed to meet the fitness st and ard for muscular strength and 36 % failed to meet it for flexibility . CONCLUSIONS Rural children in this sample had higher rates of obesity compared to the national average ; they had poor fitness and 30 % failed to meet the minimum physical activity recommendations on the previous day . Future interventions should focus on increasing physical activity , especially of moderate-intensity , and improving physical fitness in order to reduce obesity and decrease the risk of future chronic diseases in this high-risk population INTRODUCTION The prevalence and risk of Type 2 Diabetes ( T2D ) has dramatically increased over the past decade . Physical activity ( PA ) has significant benefits for the treatment and prevention of T2D . The aim of this study is to develop , implement and evaluate a community-based PA intervention to improve aerobic and muscular fitness among adults at risk of , or diagnosed with T2D . RESEARCH DESIGN AND METHODS The eCoFit pilot intervention will be evaluated using a r and omized controlled trial ( RCT ) design . The 20-week ( Phases 1 and 2 ) multi-component intervention was guided by Social Cognitive Theory , Health Action Process Approach Model , and Cognitive Behavior Therapy strategies . Phase 1 ( Weeks 1 - 10 ) includes : i ) 5 group face-to-face sessions consisting of outdoor training and cognitive mentoring ; and ii ) the use of the eCoFit smartphone application with a description of where and how to use the outdoor environment to be more physically active . Phase 2 ( Weeks 11 - 20 ) includes the use of the eCoFit smartphone application only . Assessment s are to be conducted at baseline , 10-weeks ( primary end-point ) and 20-weeks ( secondary end-point ) post-baseline . Primary outcomes are cardio-respiratory fitness and muscular fitness ( lower body ) . Secondary outcomes include physical , behavioral , mental health and quality of life , and social-cognitive outcomes . DISCUSSION eCoFit is an innovative , multi-component intervention , which integrates smartphone technology , social support and the outdoor physical environment to promote aerobic and resistance training PA among adults at risk of , or diagnosed with T2D . The findings will be used to guide future interventions and to develop and implement effective community-based prevention programs . TRIAL REGISTRATION Australian New Zeal and Clinical Trials Registry No : ACTRN12615000990527 The goal was to have children and adolescents identify and rank the major perceived benefits of and barriers to healthful eating and physical activity and to suggest strategies for overcoming barriers . Semistructured , in-depth focus groups were undertaken using st and ardized questions and prompts . Students in grade s 2 through 11(ages 7 through 17 ; N=213 ) from 34 r and omly selected schools participated in 38 focus groups . Major benefits of healthful eating included improvements to cognitive and physical performance , fitness , endurance , psychological benefits , physical sensation ( feeling good physically ) , and production of energy . Barriers included convenience , taste , and social factors . Benefits of physical activity included social benefits , enhancement of psychological status , physical sensation , and sports performance . Barriers included a preference for indoor activities , lack of energy and motivation , time constraints , and social factors . Suggested strategies for overcoming barriers included support from parents and school staff , better planning , time management , self-motivation , education , restructuring the physical environment , and greater variety of physical activities BACKGROUND Childhood obesity has been inconsistently associated with decreased levels of physical activity and fitness . Moreover , little is known about this relationship among Filipino preteens . METHODS This cross sectional study reports the association between childhood obesity , measures of physical activity , and fitness .  Children aged 11 to 12 from r and omly selected schools from San Juan , Metromanila were included . Outcome measures were body mass index , Filipino modified Physical Activity Question naire for Older children ( F_PAQ-C ) ,  st and ing broad jump , 50 m sprint  and  20 m multistage shuttle run .  RESULTS 380 children participated in the study . Obese children had significantly lower median scores in the F_PAQ-C compared with overweight children . Overweight children had lower scores in the st and ing broad jump , 50 m sprints and predicted VO2max as compared with children with normal BMI . There were modest associations between the 50 m sprint , predicted VO2max , and F_PAQ-C. CONCLUSION Our study has showed that physical activity and fitness scores were strongly correlated with childhood obesity . If childhood physical fitness is a predictor of physical fitness in adulthood which is a risk factor in cardiovascular diseases , there is a strong possibility that the prevalence of cardiovascular disease in the Philippines will increase dramatically in the future Intense physical activity in  children may either improve fitness and protect against asthma , or may trigger symptoms . The aim of this study was to determine whether physical fitness in childhood has an impact on the development of asthma . In this prospect i ve , community-based study , 757 ( 84 % ) asymptomatic children with an average age at inclusion of 9.7 yrs were followed for 10.5 yrs . In both surveys a maximal progressive exercise test on a bicycle ergometer was used to measure physical fitness ( maximal workload ) and to induce airway narrowing . A methacholine provocation test was performed in the subjects at follow-up . During the 10-yr study period , 51 ( 6.7 % ) of the previously asymptomatic children developed  asthma . These subjects had a lower mean physical fitness in 1985 than their peers : ( 3.63 versus 3.89 W x kg(-1 ) ; p=0.02 ) in boys and ( 3.17 versus 3.33 W x kg(-1 ) ; p=0.02 ) in girls . A weak correlation was found between physical fitness in childhood and airway responsiveness to methacholine at follow-up when adjusted for body mass index , age and sex ( r=0.11 ; p<0.01 ) . In a multiple regression analysis , physical fitness was inversely related to the development of physician diagnosed asthma , odds ratio=0.93 ( 0.87 - 0.99 ) . Thus , the risk for the development of asthma during adolescence is reduced 7 % by increasing the maximal workload 1 W x kg(-1 ) . In conclusion , this study showed that physical fitness in childhood is weakly correlated with the development of asthma during adolescence and that high physical fitness seems to be associated with a reduced risk for the development of asthma Background Overweight and obesity among adolescents may have consequences , with potentially lasting effects on health and health-related quality of life ( HRQoL ) . Excess weight is also associated with decreases in physical activity and cardiorespiratory fitness . The aim of the current study was to investigate the short-term effects of a 12-week Internet intervention in a primary care setting intended to increase cardiorespiratory fitness and HRQoL among overweight and obese adolescents . Methods In this controlled trial , participants ( 13–15 years ) were non-r and omly allocated to an intervention- or a control group . The intervention group received 12-weeks access to an online program providing tailored physical activity counseling based on principles from Self-determination Theory and Motivational Interviewing . The control group received st and ard follow-up by the school nurses . The primary outcome measure of cardiorespiratory fitness was determined using a shuttle run test . The secondary outcomes : HRQoL , leisure time exercise , body image and self-determined motivation for physical activity and exercise , were assessed by self-report measures . Age- and gender-adjusted body mass index ( BMI ) was calculated based on measurements of height and weight . To compare pre-to post intervention differences within groups , a paired sample s t-test was used while crude differences between groups were analyzed with an independent sample s t-test . Results Of the 120 participants , 108 completed the study , 75 in the intervention group and 33 in the control group . Exposure to the intervention had a small effect on cardiorespiratory fitness ( 0.14 ; 95 % CI [ 0.01;0.28 ] ; P = 0.04 ) , and a moderate effect on HRQoL ( 5.22 ; 95 % CI [ 0.90 ; 9.53 ] ; P = 0.02 ) . Moreover , the control group increased significantly in BMI , yielding a moderate preventive effect on BMI ( −0.39 ; 95 % CI [ −0.74;−0.03 ] ; P = 0.03 ) for the intervention group . Conclusion The results suggest that the Internet intervention with tailored physical activity counseling can have beneficial short-term effect on cardiorespiratory fitness , HRQoL and BMI among adolescents with overweight and obesity . Trial Registration Clinical Trials.gov Abstract The purpose of this study was to examine the mediating effect of resistance training skill competency on percentage of body fat , muscular fitness and physical activity among a sample of adolescent boys participating in a school-based obesity prevention intervention . Participants were 361 adolescent boys taking part in the Active Teen Leaders Avoiding Screen-time ( ATLAS ) cluster r and omised controlled trial : a school-based program targeting the health behaviours of economically disadvantaged adolescent males considered “ at-risk ” of obesity .  Body fat percentage ( bioelectrical impedance ) , muscular fitness ( h and grip dynamometry and push-ups ) , physical activity ( accelerometry ) and resistance training skill competency  were assessed at baseline and post-intervention ( i.e. , 8 months ) . Three separate multi-level mediation models were analysed to investigate the potential mediating effects of resistance training skill competency on each of the study outcomes using a product-of-coefficients test . Analyses followed the intention-to-treat principle . The intervention had a significant impact on the resistance training skill competency of the boys , and improvements in skill competency significantly mediated the effect of the intervention on percentage of body fat and the combined muscular fitness score . No significant mediated effects were found for physical activity . Improving resistance training skill competency may be an effective strategy for achieving improvements in body composition and muscular fitness in adolescent boys Abstract Faigenbaum , AD , Bush , JA , McLoone , RP , Kreckel , MC , Farrell , A , Ratamess , NA , and Kang , J. Benefits of strength and skill-based training during primary school physical education . J Strength Cond Res 29(5 ) : 1255–1262 , 2015—Physical education ( PE ) programs are evolving from a traditional skill-centered model to a health-centered model that focuses on time engaged in moderate to vigorous physical activity ( MVPA ) . However , improvements in muscular fitness and fundamental movement skills are prerequisites for continuous participation in MVPA . The purpose of this study was to examine the effects of integrative strength and skill-based training on measures of physical fitness in children during primary school PE . Children from two fourth grade PE classes were cluster r and omized into either a fundamental integrative training ( FIT ) group ( n = 20 ) or a control ( CON ) group ( n = 21 ) . The 8-week FIT program was performed twice per week during the first ∼15 minutes of each PE class and consisted of a circuit of strength and skill-based exercises . All participants were assessed for health- and skill-related fitness before and after the intervention . The outcome variables were analyzed via 2 × 2 repeated measures analysis of variance with post hoc analysis . A significant ( p ⩽ 0.05 ) interaction of group by time was observed in FIT participants with improvements in aerobic capacity , push-ups , sit and reach flexibility , and single-leg hop . There were no groups by time effects for the sit-up and long jump tests . No injuries were reported . These findings highlight the potential benefits of integrating both health- and skill-related fitness components into primary school PE as evidence d by improvements in measures of aerobic capacity and muscular fitness in children Background There are numerous published controlled trials assessing the safety and the benefits of physical activity ( PA ) for child and adult cancer survivors . However , trials exclusively comprised of adolescent cancer survivors aged 13 - 19 years , who may experience different health and quality of life ( QOL ) effects as a function of their developmental status , are lacking . Rather , some trials have included both adolescent and child cancer survivors together . Objective The aim of this systematic review was to synthesize the findings from r and omized controlled trails ( RCTs ) and controlled clinical trials ( CCTs ) investigating the effects of PA on health and QOL outcomes in sample s comprised of > 50 % adolescent cancer survivors to summarize the current state of evidence , identify knowledge gaps , and highlight areas in need of additional research within this population . Methods Using a search strategy developed for this review , 10 electronic data bases were search ed for RCTs and CCTs that reported on the effects of PA on at least 1 health and /or QOL outcome in sample s comprised of > 50 % adolescent cancer survivors . Results From the 2249 articles identified , 2 CCTs met the predetermined eligibility criteria and were included in this review . Combined , 28 adolescents ( of 41 participants ) who were receiving active treatment participated in the 2 studies review ed . A total of 4 health and QOL outcomes ( ie , bone mass , fatigue , grip strength , QOL ) were assessed pre- and post-PA intervention . Conclusions On the basis of the 2 studies review ed , PA appears to be safe and feasible .  PA also shows promise to mitigate reductions in bone mass and might be a viable strategy to improve fatigue , grip strength , and QOL . High- quality controlled trials with larger sample s exclusively comprised of adolescent cancer survivors that assess a wide range of outcomes are needed to determine the effects of PA on health and QOL outcomes in this population BACKGROUND Professional sport organizations in the United States have notable celebrity status , and several teams have used this " star power " to collaborate with local school districts toward the goal of affecting children 's health . Program effectiveness is unknown due to the absence of comprehensive evaluations for these initiatives . The Memphis Grizzlies , the city 's National Basketball Association franchise , launched " Get Fit with the Grizzlies , " a 6-week , curricular addition focusing on nutrition and physical activity for the fourth and fifth grade s in Memphis City Schools ( MCS ) . The health-infused mini-unit was delivered by physical education teachers during their classes . The purpose of this study was to evaluate the " Get Fit " program effectiveness . METHODS Survey research was employed which measured health knowledge acquisition and health behavior change using a matched pre/posttest design in r and omly chosen schools ( n = 11 ) from all elementary schools in the MCS system ( N = 110 ) . The total number of matched pre/posttests ( n = 888 ) equaled approximately 5 % of the total fourth-/fifth- grade population . McNemar 's test for significance ( p < .05 ) was applied . Odds ratios were calculated for each question . RESULTS Analyses confirmed that there was significant health knowledge acquisition ( 7 of 8 questions ) with odds ratios confirming moderate to strong associations . Seven out of 10 health behavior change questions significantly improved after intervention , whereas odds ratios indicated a low level of association after intervention . CONCLUSIONS This community-school-home initiative using a professional team 's celebrity platform within a certain locale is largely overlooked by school districts and should be considered as a positive strategy to confront childhood obesity Aerobic exercise has been associated with improved psychological status and physical fitness in adults , but its effects in adolescents have been less clear . This study evaluated the effects of aerobic exercise on the self-concept , depression level , and physical fitness of juvenile delinquents . Ninety-eight incarcerated youths who volunteered to participate were assigned in a blind fashion to one of two exercise programs lasting three months . Sixty-nine completed all phases of the study and are the subjects of this report . One exercise program ( 32 subjects ) emphasized aerobic exercise ; the other ( 37 subjects ) , limited exertion . Before and after participating , each subject underwent measurement of self-concept , mood , and physical fitness . While the aerobic and comparison groups were initially similar , the data demonstrated an association between participation in the aerobic exercise program and improved self-concept , mood , and fitness . Improvement in psychological variables was not dependent on improved physical fitness and was not related to preintervention measures Cardiovascular disease begins early in life but might be prevented or delayed by primary prevention programs design ed for children and adolescents .  Regular physical activity is an important part of primary prevention programs , and school physical education programs have potential for the promotion of regular physical activity . Cardiovascular disease is the major cause of death among Hispanics and African Americans in the United States . Low levels of fitness and increased body mass index are common in African American and Hispanic adolescents . Increased physical activity and the adoption of healthy eating habits would increase fitness and reduce body mass index among these adolescents . The purpose of the study was to undertake a small-scale controlled trial to determine if Dance for Health , an intervention program design ed to provide an enjoyable aerobic program for African American and Hispanic adolescents , has a significant effect on improving aerobic capacity , helping students maintain or decrease weight , and on improving attitudes toward physical activity and physical fitness . In the first year of the program ( 1990 - 91 ) , approximately 110 boys and girls ages 10 - 13 years participated in an aerobic dance pilot program three times per week for 12 weeks . Dance for Health was revised and continued in the 1992 - 93 school year with seventh grade students and an added culturally sensitive health curriculum . Forty-three students were r and omized to Dance for  Health and 38 to  usual physical activity . Those in the intervention class received a health education curriculum twice a week and a dance oriented physical education class three times a week . The usual physical activity consisted mostly of playground activities . Students in the intervention had a significantly greater lowering in body mass index and resting heart rate than students in regular physical activity Background This prospect i ve longitudinal study investigates whether suspected motor problems and low preference for active play in childhood are associated with  physical inactivity and low cardiorespiratory fitness in adolescence . Methodology /Principal Findings The study sample consisted of the Northern Finl and Birth Cohort 1986 ( NFBC 1986 ) composed of 5,767 children whose parents responded to a postal inquiry concerning their children 's motor skills at age 8 years and who themselves reported their physical activity at age 16 years .  Cardiorespiratory fitness  was measured with a  cycle ergometer test at age 16 years . Odds ratios ( OR ) and their 95 % confidence intervals ( 95 % CI ) for the level of physical activity and fitness were obtained from multinomial logistic regression and adjusted for socio-economic position and body mass index . Low preference for active play in childhood was associated with physical inactivity ( boys : OR 3.31 , 95 % CI 2.42–4.53 ; girls : OR 1.79 , 95 % CI 1.36–2.36 ) and low cardiorespiratory fitness ( boys : OR 1.87 , 95 % CI 1.27–2.74 ; girls : OR 1.52 , 95 % CI 1.09–2.11 ) in adolescence . Suspected gross ( OR 2.16 , 95 % CI 1.33–3.49 ) and fine ( OR 1.88 , 95 % CI 1.35–2.60 ) motor problems were associated with physical inactivity among boys . Children with suspected motor problems and low preference for active play  tended to have an even higher risk of physical inactivity in adolescence . Conclusions / Significance Low preference for active play in childhood was associated with physical inactivity and low cardiorespiratory fitness in adolescence . Furthermore , children with suspected motor problems and low preference for active play tended to have an even higher risk of physical inactivity in adolescence . Identification of children who do not prefer active play and who have motor problems may allow targeted interventions to support their motor learning and participation in active play and thereby promote their physical activity and fitness in later life The global epidemic of obesity and physical inactivity may have detrimental implication s for young people ’s  cognitive function and academic achievement . This prospect i ve study investigated whether childhood motor function predicts later academic achievement via physical activity , fitness , and obesity . The study sample included 8,061 children from the Northern Finl and Birth Cohort 1986 , which contains data about parent-reported motor function at age 8 y and self-reported physical activity , predicted cardiorespiratory fitness ( cycle ergometer test ) , obesity ( body weight and height ) , and academic achievement ( grade s ) at age 16 y.  Structural equation models with unst and ardized ( B ) and st and ardized ( β ) coefficients were used to test whether , and to what extent , physical activity , cardiorespiratory fitness , and obesity at age 16 mediated the association between childhood motor function and adolescents ’ academic achievement . Physical activity was associated with a higher grade -point average , and obesity was associated with a lower grade -point average in adolescence . Furthermore , compromised motor function in childhood had a negative indirect effect on adolescents ’ academic achievement via physical inactivity ( B = –0.023 , 95 % confidence interval = –0.031 , –0.015 ) and obesity ( B = –0.025 , 95 % confidence interval = –0.039 , –0.011 ) , but not via cardiorespiratory fitness . These results suggest that physical activity and obesity may mediate the association between childhood motor function and adolescents ’ academic achievement . Compromised motor function in childhood may represent an important factor driving the effects of obesity and physical inactivity on academic underachievement Integrating physical activity into the curriculum has potential health and cognitive benefits in primary school children . The aim of this study was to investigate the effects of physically active academic lessons on cardiovascular fitness , muscular fitness and executive functions . In the current r and omized controlled trial , 499 second and third grade rs within 12 primary schools ( mean age = 8.1 ± 0.7 ) were r and omized to the intervention  ( n = 249 ) or control condition  ( n = 250 ) . The physically active academic lessons were given for 2 consecutive school years , 22 weeks per year , three times a week , with a duration of 20 - 30 min per lesson . Multiple tests were administered before , between and after the intervention period , measuring cardiovascular fitness , muscular fitness and executive functions . Multilevel analysis accounted for the nested structure of the children within classes and schools . Results showed a larger improvement in speed-coordination ( B = -0.70,P = 0.002 ) and a lower improvement in static strength ( B = -0.92,P < : 0.001 ) for the intervention group compared with the control group . The current lessons did not result in a significant change in executive functions OBJECTIVE To analyze socioeconomic indicators , physical activity ( PA ) opportunities , and behavioral correlates of cardiorespiratory and muscular fitness among Brazilian boys and girls . METHODS A sample of 1555 adolescents was r and omly selected . Age- and sex-specific st and ard scores were calculated for each fitness component . RESULTS Among boys , head of household 's schooling , involvement in organized PA , meeting the PA recommendations , and computer/games use were associated with cardiorespiratory fitness . Involvement in organized PA and active time in Physical Education ( PE ) classes were predictors of muscular fitness . Among girls , active time in PE classes and TV watching were predictors of cardiorespiratory fitness . Meeting the PA recommendations was associated with muscular fitness . CONCLUSION PA variables and sedentary behaviors should be independently considered for physical fitness promotion in youth BACKGROUND Professional sports organizations in the United States have notable celebrity status , and several teams have used this " star power " to collaborate with local schools toward the goal of affecting childhood obesity ( e.g. , NFL Play 60 ) . Program effectiveness is unknown owing to the absence of comprehensive evaluations for any of these initiatives . In 2006 , the Memphis Grizzlies , the city 's National Basketball Association ( NBA ) franchise , launched  " Get Fit with the Grizzlies  , " a 6-week , curricular addition focusing on nutrition and physical activity for the 4th and 5th grade s in Memphis City Schools . The health-infused mini-unit was delivered by the physical education teachers during their classes . National and local sponsors whose business objectives matched the " Get Fit " objectives were solicited to fund the program . Here we highlight the program evaluation results from the first year of " Get Fit " and the Journal of School Health article . However , the " Get Fit " program has now taken place in Memphis area schools for 5 years . During the 2010 - 11 school-year , " Get Fit " evolved into a new program called " Healthy Home Court " with Kellogg 's as the primary sponsor . " Healthy Home Court " included the original fitness part of the program and added a breakfast component at high schools where data indicated great need . Kellogg 's sponsored special " carts " with healthy breakfast options ( i.e. , fruit , protein bars ) for students to grab and eat . This program matched their existing program " Food Away from Home . " Research supports the objectives of these programs and has shown that breakfast consumption can have a positive impact on academic achievement , behavior in school , and overall health status . METHOD Survey research employed over the first 4 years measured health knowledge acquisition and health behavior change using a matched pre/post test design ( n=2210 ) in r and omly chosen schools ( n=18 ) from all elementary schools in the Memphis area .  McNemar 's test for significance ( < 05 ) was applied to measure correct answers pre and post . Also , breakfast attendance numbers were observed for intervention high schools and compared with breakfast attendance numbers from control high schools . RESULTS Analyses confirmed that , from the first year through this past one ( 2010 - 11 ) , there was significant health knowledge acquisition and health behavior improvement at post-intervention . Breakfast numbers matched these findings . Also , exit polling that took place at one intervention high school indicated the students attending the breakfast assembly gained knowledge and positively changed attitudes regarding the academic and health benefits of eating a healthy breakfast . CONCLUSIONS This community-school-home initiative using a professional team 's celebrity platform is largely overlooked by school districts and should be considered as an effective way to confront childhood obesity Background Childhood obesity and physical inactivity are increasing dramatically worldwide . Children of low socioeconomic status and /or children of migrant background are especially at risk . In general , the overall effectiveness of school-based programs on health-related outcomes has been disappointing . A special gap exists for younger children and in high risk groups . Methods / Design This paper describes the rationale , design , curriculum , and evaluation of a multicenter preschool r and omized intervention study conducted in areas with a high migrant population in two out of 26 Swiss cantons . Twenty preschool classes in the German ( canton St. Gallen ) and another 20 in the French ( canton Vaud ) part of Switzerl and were separately selected and r and omized to an intervention and a control arm by the use of opaque envelopes . The multidisciplinary lifestyle intervention aim ed to increase physical activity and sleep duration , to reinforce healthy nutrition and eating behaviour , and to reduce media use . According to the ecological model , it included children , their parents and the teachers . The regular teachers performed the majority of the intervention and were supported by a local health promoter . The intervention included physical activity lessons , adaptation of the built infrastructure ; promotion of regional extracurricular physical activity ; playful lessons about nutrition , media use and sleep , funny homework cards and information material s for teachers and parents . It lasted one school year . Baseline and post-intervention evaluations were performed in both arms . Primary outcome measures included BMI and aerobic fitness ( 20 m shuttle run test ) . Secondary outcomes included total ( skinfolds , bioelectrical impedance ) and central ( waist circumference ) body fat , motor abilities ( obstacle course , static and dynamic balance ) , physical activity and sleep duration ( accelerometry and question naires ) , nutritional behaviour and food intake , media use , quality of life and signs of hyperactivity ( question naires ) , attention and spatial working memory ability ( two vali date d tests ) . Research ers were blinded to group allocation . Discussion The purpose of this paper is to outline the design of a school-based multicenter cluster r and omized , controlled trial aim ing to reduce body mass index and to increase aerobic fitness in preschool children in culturally different parts of Switzerl and with a high migrant population .Trial Registration Trial Registration : clinical trials.gov Background Worldwide in 2000 , 10 % of children aged five to 17 years were reported as being overweight with an additional 2‐3 % being obese . Overweight and obesity in childhood can adversely impact on both physical and psychological health . The rise in the prevalence of childhood obesity is a complex issue but widely recognised contributors include increased energy intake , decreased levels of physical activity and greater time spent in sedentary pursuits . A large number of environmental and cultural factors have also been identified as contributing to the problem . Evidence to support an optimal approach to treating childhood obesity is limited with many studies showing only modest results at best in the long‐term . However , the importance of family‐based treatment that combines diet , physical activity and behavioral components has been acknowledged in a recent Cochrane Systematic Review . It has also been suggested that interventions offered in the community setting may help overcome barriers to participation , by making programs more accessible and allowing the targeting of specific sub‐groups of the population . Objectives The objective of this review was to identify the effectiveness of parent‐centred interventions implemented in the community setting in modifying eating and physical activity behaviors or weight‐related outcomes of children . Inclusion criteria Types of participants This review considered studies that included free‐living children of pre‐school , primary and secondary school age and /or their parents/guardians aged > 18 years . Types of intervention(s)/phenomena of interest Intervention programs were required to have a parental component , to target eating and /or exercise behaviors for the prevention or treatment of obesity , and child weight status reported . Types of studies All intervention studies were included in the review including : r and omized controlled trials ( RCTs ) ; non‐r and omized controlled trials , longitudinal studies , cohort ( both retrospective and prospect i ve ) , case control and time series studies which had been conducted in a community setting . Types of outcomes This review considered studies that included overweight/obesity related outcomes , eating behavior outcomes , physical activity behaviour outcomes , and sedentary behavior outcomes and constructs . Search strategy A literature search of community‐based parent‐centred intervention studies to promote nutrition and physical activity for the prevention and treatment and of childhood overweight and obesity was performed in eight electronic data bases dating from 1975 to April 2009 . Method ological quality Studies were critically appraised for method ological quality using st and ardized tools . Data collection Data was extracted by one review er using a st and ardized data extraction form developed by the research ers and checked for accuracy and consistency by a second review er . Data synthesis Data in relation to setting , methodology , intervention components and effect on weight , dietary intake and physical activity was extracted , and described in a narrative synthesis . Where possible a meta‐ analysis was undertaken . Results Of the home‐based interventions , five of nine studies reported statistically significant changes in anthropometric outcomes post intervention . Of the 10 studies in the before and after school care setting , seven reported a significant decrease in a weight‐related outcome post intervention , with only one reporting an increase . Conclusions Results from the review support the after‐school setting as the most promising for community intervention setting for targeting parents as agents of change within child obesity prevention and treatment programs . Implication s for practice At this stage , interventions to support parents should target the after‐school environment as opposed to being conducted in the home , summer camps , leisure centers or churches . Targeting a decrease in energy intake and sweetened beverages in parallel with increasing number of daily steps and decreasing screen time use . Implication s for research Future studies of high quality are needed across the full range of community setting s. Given that currently most of the higher quality RCTs and the studies showing positive impacts of weight change are in the after‐school setting , further studies in this area using similar method ologies to those already published will facilitate future meta‐analyses in this area Resistance training of the lower limbs is now commonly used in clinical practice in children and adolescents with spastic cerebral palsy ( CP ) . However , the effectiveness of this type of training is still disputed . The most recently published systematic review with meta- analysis included interventions such as electrical stimulation and resistance training and found insufficient evidence to support or refute the efficacy of these exercises in children with CP . Thus , the aim of this article is to evaluate the extent to which training protocol s from the most recent r and omized controlled trials are in keeping with the evidence for effective resistance  training in children who are developing typically , as reflected in the training guidelines of the National Strength and Conditioning Association . Recommendations for resistance training protocol s , based on this evidence and appropriate to children with CP , are provided to help guide both future research and clinical practice for resistance training in children with CP Background Childhood obesity is the result of a long lasting imbalance between energy intake and energy expenditure . A major contributing factor is physical inactivity which is closely linked to bone health , cardiovascular disease risk , fitness and psychological factors . The school seems to provide an excellent setting to enhance levels of  physical activity ( PA ) .  However , there is insufficient data from previous school-based intervention trials on how to enhance overall PA . It is also unknown whether an intervention aim ed at increasing PA is effective in improving the children 's health . The purpose of this paper is to outline the design of a school-based r and omized , controlled trial ( RCT ) aim ing to increase overall PA and to improve fitness and health in 6- to 13-year-old children . Methods / Design 15 schools were r and omized to the intervention ( n = 9 ) or the control ( n = 6 ) group , stratified by geographic region ( urban vs. rural ) and by age ( 1st and 5th grade ) . Participation was given for all children in the intervention group since in this group the intervention was part of the normal school curriculum . The intervention during one academic year consisted of : 1 . two additional physical education classes per week given by trained physical education teachers adding up to a total of five PA classes per week , 2 . short PA breaks ( 2–5 min each ) during academic lessons , 3 . PA home work , and 4 . adaptation of recreational areas around the school . All children underwent  anthropometric measurements , blood pressure assessment , fitness testing , measurement of PA  and they filled out question naires . At least 70 % of all children agreed to blood sampling and measurements of body composition and bone mineral measurements by dual energy x-ray absorptiometry . The primary endpoints of the study after one year were an increase in total PA by accelerometry , an increase in aerobic fitness measured by the 20 m shuttle run , a decrease in percent body fat derived from skinfold measurements and an increase in quality of life as assessed by the child health question naire in the intervention group compared to the control group . Secondary outcomes were overall fitness , differences in body composition including body fat distribution , cardiovascular risk factors , psychosocial health , bone mineral content and density of femur , lumbar spine and total body and food intake . Discussion Our preliminary data suggest that the children were representative of Swiss children with respect to sex , socio-demographic status , and body mass index . Short-term results can be expected by the beginning of 2007 . We hypothesized that our intervention will lead to an increase in PA , fitness and overall health . Based on our data , we aim to provide important information regarding the influence of such an intervention on these outcome measures in school-aged children and to provide nationwide guidelines to improve PA in children
Results Strong evidence was found for an inverse association between MF and total and central adiposity , and CVD and metabolic risk factors .
Strong evidence was also found for a positive association between MF and bone health and self-esteem .
Conclusion The findings of this review highlight the importance of developing MF in youth for a number of health-related benefits
Background Physical fitness during childhood and adolescence has been identified as an important determinant of current and future health status .
While research has traditionally focused on the association between cardio-respiratory fitness and health outcomes , the association between muscular fitness ( MF ) and health status has recently received increased attention .
Objective The aim of this systematic review and meta- analysis was to evaluate the potential physiological and psychological benefits associated with MF among children and adolescents .