Journal of Sports Sciences
ISSN: 0264-0414 (Print) 1466-447X (Online) Journal homepage: http://www.tandfonline.com/loi/rjsp20
Cardiorespiratory performance and physical activity in normal weight and overweight Finnish adolescents from 2003 to 2010 Sanna Palomäki, Pilvikki Heikinaro-Johansson & Pertti Huotari To cite this article: Sanna Palomäki, Pilvikki Heikinaro-Johansson & Pertti Huotari (2015) Cardiorespiratory performance and physical activity in normal weight and overweight Finnish adolescents from 2003 to 2010, Journal of Sports Sciences, 33:6, 588-596, DOI: 10.1080/02640414.2014.951874 To link to this article: http://dx.doi.org/10.1080/02640414.2014.951874
Published online: 03 Oct 2014.
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Full Terms & Conditions of access and use can be found at http://www.tandfonline.com/action/journalInformation?journalCode=rjsp20 Download by: [University of Florida]
Date: 12 December 2016, At: 22:05
Journal of Sports Sciences, 2015 Vol. 33, No. 6, 588–596, http://dx.doi.org/10.1080/02640414.2014.951874
Cardiorespiratory performance and physical activity in normal weight and overweight Finnish adolescents from 2003 to 2010
SANNA PALOMÄKI, PILVIKKI HEIKINARO-JOHANSSON & PERTTI HUOTARI Department of Sport Sciences, University of Jyväskylä, Jyväskylä, Finland (Accepted 2 August 2014)
Abstract We investigated changes in cardiorespiratory performance, BMI and leisure-time physical activity among Finnish adolescents from 2003 to 2010. In addition, we compared cardiorespiratory performance levels between normal weight and overweight adolescents, grouped according to their physical activity. Participants were a national representative samples of 15–16-year-old adolescents in their final (ninth) year of comprehensive school in 2003 (n = 2258) and in 2010 (n = 1301). They performed an endurance shuttle run test and reported their height and weight and leisure time physical activity on a questionnaire. Results showed no significant secular changes in cardiorespiratory performance from 2003 to 2010. The mean BMI increased in boys. Leisure-time physical activity increased among normal weight girls. Adolescents of normal weight had better cardiorespiratory performance than those classified as overweight at both assessment points. BMI-adjusted physical activity was a significant determinant for cardiorespiratory performance among overweight adolescents, and very active overweight adolescents had similar cardiorespiratory performance levels as moderately active adolescents of normal weight. The results of the present study support the idea that the physical activity has the great importance for the cardiorespiratory performance in adolescents. Overweight adolescents, in particular, benefit from higher levels of physical activity. Keywords: cardiorespiratory fitness, physical activity, overweight, adolescent
Introduction Physical fitness, body composition and physical activity are important for human functionality, health and well-being, with the importance of normal weight status and participation in high levels of physical activity to physical fitness and health being documented extensively (US Department of Health and Human Services, 2008). Meanwhile overweight and obesity have increased dramatically among children and adolescents in economically advanced countries and many of them do not meet the recommendations of daily physical activity (Currie et al., 2008; Vuorela, Saha, & Salo, 2009; Wang & Lobstein, 2006). In Finland, the prevalence of overweight and obesity in early adolescence increased 1.8 fold in boys and 1.5 fold in girls from 1986 to 2006 (Vuorela et al., 2009) and only 17% of 15–16-year old boys and 10% of girls meet the current physical activity guidelines of at least 60 min of moderate- to vigorous-intensity daily physical activity (Currie et al., 2012). Additionally, previous studies have shown a declining trend in cardiorespiratory fitness in adolescents in Finland
(Huotari, Nupponen, Laakso, & Kujala, 2010) and some other countries (Albon, Hamlin, & Ross, 2010; Andersen et al., 2010; Dyrstad, Berg, & Tjelta, 2012). These studies also suggest that the decline is greater among those children and adolescents that are least physically fit (Albon et al., 2010; Andersen et al., 2010; Huotari et al., 2010). In general, minimal amounts of physical activity and large amounts of sedentary behaviour along with a high energy intake contribute to the development of overweight, obesity and poor cardiorespiratory fitness (Patrick et al., 2004). Being overweight and having low levels of physical activity are both associated with lower physical fitness performances (Albon et al., 2010; Fogelholm, Stigman, Huisman, & Metsämuuronen, 2008). Overweight youths may have had poorer scores on weight-bearing tasks, such as cardiorespiratory fitness performance (Aires et al., 2010), but not necessarily perform poorly on all fitness components (Deforche et al., 2003; Fogelholm et al., 2008). Regular physical activity is essential to both weight management (Wareham, Van Sluijs, & Ekelund, 2005) and cardiorespiratory fitness (Aires et al.,
Correspondence: Sanna Palomäki, University of Jyväskylä, Jyväskylä, Finland. E-mail: sanna.h.palomaki@jyu.fi © 2014 Taylor & Francis
Cardiorespiratory performance and physical activity 2010; Duncan, 2010). Despite a person’s genetic tendency to be overweight or obese, physical activity seems to be important for fitness because it helps to reduce the influence of genetic effects on body mass index and waist circumference (Mustelin, Silventoinen, Pietiläinen, Rissanen, & Kaprio, 2009). Although changes in cardiorespiratory fitness are determined in part by genetic and environmental factors, even small increase in physical activity may provide health benefits and improve cardiorespiratory fitness particular in adults, especially, overweight and obese people would benefit most from the increased energy expenditure from physical activity (Duncan, 2010; Mustelin et al., 2009). However, it has to be taken into consideration that although physical exercise training will enhance cardiorespiratory fitness performance, relationship between young people’s physical activity and cardiorespiratory fitness performance is not clear (Armstrong, Tomkinson, & Ekelund, 2011). The association among physical activity, BMI and cardiorespiratory performance in adolescents is a current and relevant topic. Prospective studies are necessary for investing the potential changes in relationships over time. The purpose of this paper was to investigate changes in cardiorespiratory performance, BMI and leisure-time physical activity among Finnish adolescents from 2003 to 2010. In addition, we compared the level of cardiorespiratory performance between normal weight and overweight adolescents grouped according to their physical activity.
Methods Study design and participants This study is based on data collected during the national evaluation of learning outcomes of physical education students in their final (ninth) year of comprehensive school during 2003 and 2010. The Finnish National Board of Education, an official governmental authority, is authorised to conduct these evaluations and data collection procedures were similar both years. The samples were three-phased stratified randomsamples drawn from schools representing different provinces, types of municipalities (cities, urban and rural) and official languages (Finnish and Swedish). In the first phase, the municipalities were selected from different geographical areas of Finland. In the second phase, the random sample of the schools matched for size was taken from the selected municipalities. In third phase, the students were selected systemically from the alphabetical list. All students in selected small schools (≤30 students at ninth grade) were included in the study, but in larger schools
589
(more than 30 students at ninth grade) the sample size was limited from 30 to 50 students by random exclusion. In 2003, the data were collected from 100 Finnish-speaking and 11 Swedish-speaking comprehensive schools and after the sampling procedure a questionnaire and 20 m shuttle run was completed by 2390 students (1207 boys and 1183 girls). In 2010, the data were collected from 47 Finnish speaking and 4 Swedish-speaking comprehensive schools and after sampling the questionnaire and 20 m shuttle run was completed by 1346 students (683 boys and 663 girls). ICC (Intra class correlation) coefficients of 20 m shuttle run were under 0.20 for both boys and girls in both samples. Both samples were nationally representative, although fewer schools were included in 2010 because national evaluations of other school subjects were being conducted at the same time. All data were obtained in the schools by trained physical education teachers. Students could opt out from participating in the 20 m shuttle run test because of illness or injury. The analysis of nonparticipants regarding 20 m shuttle run test in 2010 showed that non-participants’ (16.9%, n = 273) BMI and leisure-time physical activity did not differ significantly from the values of the participants. The final sample includes all 15 to 16 year old students, who participated in the endurance shuttle run test and reported their height and weight and leisure time physical activity on a questionnaire. Overall, 97% of eligible students reported their body weight and height. The final number of participants in 2003 was 2258 adolescents: 1116 boys (mean age 15.2 years ± 0.4) and 1142 girls (mean age 15.1 years ± 0.3). In 2010, there were data for 1301 students: 661 boys (mean age 15.3 ± 0.4) and 640 girls (mean age 15.2 ± 0.4).
Measures Assessment of overweight and obesity. Participants reported their weight and height privately on a questionnaire in a classroom, and BMI was calculated later. Students were classified into normal weight and overweight (which included both overweight and obese students) groups based on age and sex, specific cut off points for body mass index (Cole, Bellizzi, Flegal, & Dietz, 2000). Leisure-time physical activity. Participants reported their leisure-time physical activity (LTPA) on the questionnaire, separately for organised and unorganised physical activity. There were two questions for both activity types: (1) frequency of LTPA bouts with a duration of at least 20 min and (2) duration
590
S. Palomäki et al.
Table I. Classification matrix for the level of leisure-time physical activity. Duration of vigorous LTPA (sweating and breath taking h/week) Frequency of LTPA (at No sweating or 4 h or least 20 min at one time) breathing hard ½–1 h 2–3 h more Once in a month or less Once in a week 2–3 times weekly 4 times weekly or more
1 1 2 3
1 2 3 3
1 3 4 5
1 3 4 5
Note: Inactive (index ≤1.5), light active (index 1.51–2), moderate (index 2.1–3), active (index 3.1–4) and very active (index 4.1–5).
(in h) of vigorous LTPA, defined as activity leading to sweating and heavy breathing. Internal consistency of physical activity items was good (Cronbach’s α 0.80). As well, Nupponen, Laakso, Rimpelä, Pere, and Telama (2010) had used the questions previously in a 25-year study. They reported test-retest reliabilities of be good or moderate: correlation coefficients in the sub-samples (n = 1850) pooled over the years were 0.80 for frequency of organised LTPA and 0.66 for frequency of unorganised LTPA. On the questionnaire were seven response options for frequency of LTPA and six response options for duration of vigorous LTPA. Both items were rerecorded in four categories (Table I). The classification for LTPA was made by a combination of frequency of LTPA and duration of vigorous LTPA and participants got one value (1–5) for both organised and unorganised physical activity. Leisure-time physical activity indexes were computed as mean of these two values. Different levels of LTPA were named as follows: inactive (index ≤1.5), light active (index 1.51–2), moderate (index 2.1–3), active (index 3.1– 4) and very active (index 4.1–5). Cardiorespiratory performance. Cardiorespiratory performance was assessed using a maximal multistage 20-m shuttle running test (Léger, Mercier, Gadoury, & Lambert, 1988). The test has been widely used to assess the cardiorespiratory fitness of children, adolescents and adults and has been
shown to be a reliable and valid field test for estimating maximal oxygen uptake (Tomkinson, Léger, Olds, & Cazorla, 2003). Tests were carried out in school gyms in supervision of PE teachers. Students run back and forth across a 20-m space for as long as possible while pacing themselves to increasingly rapid auditory prompts. The frequency of the auditory signal initiated running speed at 8.5 km/h and increased it by 0.5 km/h each minute. The test was ended when the students could no longer maintain the pace and the results were scored as the number of completed 20-m shuttles. For the data analysis, the number of shuttles was transformed into meters completed. The distributions of the running test were positively skewed and the skewness values were similar over the time. Statistical analyses Mann-Whitney U-test was used to analyse the differences in participants’, height, weight, BMI, leisure-time physical activity index, and cardiorespiratory performance between years 2003 and 2010. Proportions of normal weight and overweight participants in years 2003 and 2010 were compared with Pearson Chi-square. Data for boys and girls were analysed separately. The associations of physical activity level, weight status (normal weight or overweight/obese) and their interaction with the cardiorespiratory performance were analysed by general linear model (GLM) and two-way analysis of variance (ANOVA) with Dunnett T3 post-hoc test. These analyses are based on combined data for years 2003 and 2010. All statistical tests were performed by SPSS statistical software, version 20.0. Results Results showed that there were no significant changes in the samples of 15–16-year-old Finnish boys’ and girls’ cardiorespiratory performance between 2003 and 2010 (Table II). Also, there were no significant changes in the proportions of overweight adolescents
Table II. Comparison of a national sample of 15–16-year-old Finnish boys and girls on body mass index (BMI), leisure-time physical activity (LTPA) and shuttle run (cardiorespiratory fitness) in 2003 and 2010. Girls
Boys
Year
2003 n = 1142
2010 n = 640
P-value
2003 n = 1116
2010 n = 661
P-value
BMI Shuttle run test (meters) LTPA index (max 5)
20.8 (2.9) 693 (323) 2.7 (1.0)
20.9 (3.1) 707 (328) 3.0 (1.1)
0.485 0.357
ISSN: 0264-0414 (Print) 1466-447X (Online) Journal homepage: http://www.tandfonline.com/loi/rjsp20
Cardiorespiratory performance and physical activity in normal weight and overweight Finnish adolescents from 2003 to 2010 Sanna Palomäki, Pilvikki Heikinaro-Johansson & Pertti Huotari To cite this article: Sanna Palomäki, Pilvikki Heikinaro-Johansson & Pertti Huotari (2015) Cardiorespiratory performance and physical activity in normal weight and overweight Finnish adolescents from 2003 to 2010, Journal of Sports Sciences, 33:6, 588-596, DOI: 10.1080/02640414.2014.951874 To link to this article: http://dx.doi.org/10.1080/02640414.2014.951874
Published online: 03 Oct 2014.
Submit your article to this journal
Article views: 250
View related articles
View Crossmark data
Full Terms & Conditions of access and use can be found at http://www.tandfonline.com/action/journalInformation?journalCode=rjsp20 Download by: [University of Florida]
Date: 12 December 2016, At: 22:05
Journal of Sports Sciences, 2015 Vol. 33, No. 6, 588–596, http://dx.doi.org/10.1080/02640414.2014.951874
Cardiorespiratory performance and physical activity in normal weight and overweight Finnish adolescents from 2003 to 2010
SANNA PALOMÄKI, PILVIKKI HEIKINARO-JOHANSSON & PERTTI HUOTARI Department of Sport Sciences, University of Jyväskylä, Jyväskylä, Finland (Accepted 2 August 2014)
Abstract We investigated changes in cardiorespiratory performance, BMI and leisure-time physical activity among Finnish adolescents from 2003 to 2010. In addition, we compared cardiorespiratory performance levels between normal weight and overweight adolescents, grouped according to their physical activity. Participants were a national representative samples of 15–16-year-old adolescents in their final (ninth) year of comprehensive school in 2003 (n = 2258) and in 2010 (n = 1301). They performed an endurance shuttle run test and reported their height and weight and leisure time physical activity on a questionnaire. Results showed no significant secular changes in cardiorespiratory performance from 2003 to 2010. The mean BMI increased in boys. Leisure-time physical activity increased among normal weight girls. Adolescents of normal weight had better cardiorespiratory performance than those classified as overweight at both assessment points. BMI-adjusted physical activity was a significant determinant for cardiorespiratory performance among overweight adolescents, and very active overweight adolescents had similar cardiorespiratory performance levels as moderately active adolescents of normal weight. The results of the present study support the idea that the physical activity has the great importance for the cardiorespiratory performance in adolescents. Overweight adolescents, in particular, benefit from higher levels of physical activity. Keywords: cardiorespiratory fitness, physical activity, overweight, adolescent
Introduction Physical fitness, body composition and physical activity are important for human functionality, health and well-being, with the importance of normal weight status and participation in high levels of physical activity to physical fitness and health being documented extensively (US Department of Health and Human Services, 2008). Meanwhile overweight and obesity have increased dramatically among children and adolescents in economically advanced countries and many of them do not meet the recommendations of daily physical activity (Currie et al., 2008; Vuorela, Saha, & Salo, 2009; Wang & Lobstein, 2006). In Finland, the prevalence of overweight and obesity in early adolescence increased 1.8 fold in boys and 1.5 fold in girls from 1986 to 2006 (Vuorela et al., 2009) and only 17% of 15–16-year old boys and 10% of girls meet the current physical activity guidelines of at least 60 min of moderate- to vigorous-intensity daily physical activity (Currie et al., 2012). Additionally, previous studies have shown a declining trend in cardiorespiratory fitness in adolescents in Finland
(Huotari, Nupponen, Laakso, & Kujala, 2010) and some other countries (Albon, Hamlin, & Ross, 2010; Andersen et al., 2010; Dyrstad, Berg, & Tjelta, 2012). These studies also suggest that the decline is greater among those children and adolescents that are least physically fit (Albon et al., 2010; Andersen et al., 2010; Huotari et al., 2010). In general, minimal amounts of physical activity and large amounts of sedentary behaviour along with a high energy intake contribute to the development of overweight, obesity and poor cardiorespiratory fitness (Patrick et al., 2004). Being overweight and having low levels of physical activity are both associated with lower physical fitness performances (Albon et al., 2010; Fogelholm, Stigman, Huisman, & Metsämuuronen, 2008). Overweight youths may have had poorer scores on weight-bearing tasks, such as cardiorespiratory fitness performance (Aires et al., 2010), but not necessarily perform poorly on all fitness components (Deforche et al., 2003; Fogelholm et al., 2008). Regular physical activity is essential to both weight management (Wareham, Van Sluijs, & Ekelund, 2005) and cardiorespiratory fitness (Aires et al.,
Correspondence: Sanna Palomäki, University of Jyväskylä, Jyväskylä, Finland. E-mail: sanna.h.palomaki@jyu.fi © 2014 Taylor & Francis
Cardiorespiratory performance and physical activity 2010; Duncan, 2010). Despite a person’s genetic tendency to be overweight or obese, physical activity seems to be important for fitness because it helps to reduce the influence of genetic effects on body mass index and waist circumference (Mustelin, Silventoinen, Pietiläinen, Rissanen, & Kaprio, 2009). Although changes in cardiorespiratory fitness are determined in part by genetic and environmental factors, even small increase in physical activity may provide health benefits and improve cardiorespiratory fitness particular in adults, especially, overweight and obese people would benefit most from the increased energy expenditure from physical activity (Duncan, 2010; Mustelin et al., 2009). However, it has to be taken into consideration that although physical exercise training will enhance cardiorespiratory fitness performance, relationship between young people’s physical activity and cardiorespiratory fitness performance is not clear (Armstrong, Tomkinson, & Ekelund, 2011). The association among physical activity, BMI and cardiorespiratory performance in adolescents is a current and relevant topic. Prospective studies are necessary for investing the potential changes in relationships over time. The purpose of this paper was to investigate changes in cardiorespiratory performance, BMI and leisure-time physical activity among Finnish adolescents from 2003 to 2010. In addition, we compared the level of cardiorespiratory performance between normal weight and overweight adolescents grouped according to their physical activity.
Methods Study design and participants This study is based on data collected during the national evaluation of learning outcomes of physical education students in their final (ninth) year of comprehensive school during 2003 and 2010. The Finnish National Board of Education, an official governmental authority, is authorised to conduct these evaluations and data collection procedures were similar both years. The samples were three-phased stratified randomsamples drawn from schools representing different provinces, types of municipalities (cities, urban and rural) and official languages (Finnish and Swedish). In the first phase, the municipalities were selected from different geographical areas of Finland. In the second phase, the random sample of the schools matched for size was taken from the selected municipalities. In third phase, the students were selected systemically from the alphabetical list. All students in selected small schools (≤30 students at ninth grade) were included in the study, but in larger schools
589
(more than 30 students at ninth grade) the sample size was limited from 30 to 50 students by random exclusion. In 2003, the data were collected from 100 Finnish-speaking and 11 Swedish-speaking comprehensive schools and after the sampling procedure a questionnaire and 20 m shuttle run was completed by 2390 students (1207 boys and 1183 girls). In 2010, the data were collected from 47 Finnish speaking and 4 Swedish-speaking comprehensive schools and after sampling the questionnaire and 20 m shuttle run was completed by 1346 students (683 boys and 663 girls). ICC (Intra class correlation) coefficients of 20 m shuttle run were under 0.20 for both boys and girls in both samples. Both samples were nationally representative, although fewer schools were included in 2010 because national evaluations of other school subjects were being conducted at the same time. All data were obtained in the schools by trained physical education teachers. Students could opt out from participating in the 20 m shuttle run test because of illness or injury. The analysis of nonparticipants regarding 20 m shuttle run test in 2010 showed that non-participants’ (16.9%, n = 273) BMI and leisure-time physical activity did not differ significantly from the values of the participants. The final sample includes all 15 to 16 year old students, who participated in the endurance shuttle run test and reported their height and weight and leisure time physical activity on a questionnaire. Overall, 97% of eligible students reported their body weight and height. The final number of participants in 2003 was 2258 adolescents: 1116 boys (mean age 15.2 years ± 0.4) and 1142 girls (mean age 15.1 years ± 0.3). In 2010, there were data for 1301 students: 661 boys (mean age 15.3 ± 0.4) and 640 girls (mean age 15.2 ± 0.4).
Measures Assessment of overweight and obesity. Participants reported their weight and height privately on a questionnaire in a classroom, and BMI was calculated later. Students were classified into normal weight and overweight (which included both overweight and obese students) groups based on age and sex, specific cut off points for body mass index (Cole, Bellizzi, Flegal, & Dietz, 2000). Leisure-time physical activity. Participants reported their leisure-time physical activity (LTPA) on the questionnaire, separately for organised and unorganised physical activity. There were two questions for both activity types: (1) frequency of LTPA bouts with a duration of at least 20 min and (2) duration
590
S. Palomäki et al.
Table I. Classification matrix for the level of leisure-time physical activity. Duration of vigorous LTPA (sweating and breath taking h/week) Frequency of LTPA (at No sweating or 4 h or least 20 min at one time) breathing hard ½–1 h 2–3 h more Once in a month or less Once in a week 2–3 times weekly 4 times weekly or more
1 1 2 3
1 2 3 3
1 3 4 5
1 3 4 5
Note: Inactive (index ≤1.5), light active (index 1.51–2), moderate (index 2.1–3), active (index 3.1–4) and very active (index 4.1–5).
(in h) of vigorous LTPA, defined as activity leading to sweating and heavy breathing. Internal consistency of physical activity items was good (Cronbach’s α 0.80). As well, Nupponen, Laakso, Rimpelä, Pere, and Telama (2010) had used the questions previously in a 25-year study. They reported test-retest reliabilities of be good or moderate: correlation coefficients in the sub-samples (n = 1850) pooled over the years were 0.80 for frequency of organised LTPA and 0.66 for frequency of unorganised LTPA. On the questionnaire were seven response options for frequency of LTPA and six response options for duration of vigorous LTPA. Both items were rerecorded in four categories (Table I). The classification for LTPA was made by a combination of frequency of LTPA and duration of vigorous LTPA and participants got one value (1–5) for both organised and unorganised physical activity. Leisure-time physical activity indexes were computed as mean of these two values. Different levels of LTPA were named as follows: inactive (index ≤1.5), light active (index 1.51–2), moderate (index 2.1–3), active (index 3.1– 4) and very active (index 4.1–5). Cardiorespiratory performance. Cardiorespiratory performance was assessed using a maximal multistage 20-m shuttle running test (Léger, Mercier, Gadoury, & Lambert, 1988). The test has been widely used to assess the cardiorespiratory fitness of children, adolescents and adults and has been
shown to be a reliable and valid field test for estimating maximal oxygen uptake (Tomkinson, Léger, Olds, & Cazorla, 2003). Tests were carried out in school gyms in supervision of PE teachers. Students run back and forth across a 20-m space for as long as possible while pacing themselves to increasingly rapid auditory prompts. The frequency of the auditory signal initiated running speed at 8.5 km/h and increased it by 0.5 km/h each minute. The test was ended when the students could no longer maintain the pace and the results were scored as the number of completed 20-m shuttles. For the data analysis, the number of shuttles was transformed into meters completed. The distributions of the running test were positively skewed and the skewness values were similar over the time. Statistical analyses Mann-Whitney U-test was used to analyse the differences in participants’, height, weight, BMI, leisure-time physical activity index, and cardiorespiratory performance between years 2003 and 2010. Proportions of normal weight and overweight participants in years 2003 and 2010 were compared with Pearson Chi-square. Data for boys and girls were analysed separately. The associations of physical activity level, weight status (normal weight or overweight/obese) and their interaction with the cardiorespiratory performance were analysed by general linear model (GLM) and two-way analysis of variance (ANOVA) with Dunnett T3 post-hoc test. These analyses are based on combined data for years 2003 and 2010. All statistical tests were performed by SPSS statistical software, version 20.0. Results Results showed that there were no significant changes in the samples of 15–16-year-old Finnish boys’ and girls’ cardiorespiratory performance between 2003 and 2010 (Table II). Also, there were no significant changes in the proportions of overweight adolescents
Table II. Comparison of a national sample of 15–16-year-old Finnish boys and girls on body mass index (BMI), leisure-time physical activity (LTPA) and shuttle run (cardiorespiratory fitness) in 2003 and 2010. Girls
Boys
Year
2003 n = 1142
2010 n = 640
P-value
2003 n = 1116
2010 n = 661
P-value
BMI Shuttle run test (meters) LTPA index (max 5)
20.8 (2.9) 693 (323) 2.7 (1.0)
20.9 (3.1) 707 (328) 3.0 (1.1)
0.485 0.357
