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Cardiorespiratory fitness and body mass index of 9–11-year-old English children: a serial cross-sectional study from 1998 to 2004

International Journal of Obesity volume 31, pages 1172–1178 (2007)Cite this article

Abstract

Objective:

To examine the changes over time in cardiorespiratory fitness and body mass index (BMI) of children.

Design:

Serial cross-sectional, population-based study.

Setting:

Primary schools in Liverpool, UK.

Participants:

A total of 15 621 children (50% boys), representing 74% of eligible 9–11-year olds in the annual school cohorts between 1998/9 and 2003/4, who took part in a 20m multi-stage shuttle run test (20mMST).

Main outcome measures:

Weight, height, BMI (kg/m2) and obesity using the International Obesity Taskforce definition.

Results:

Median (95% confidence interval) 20mMST score (number of runs) fell in boys from 48.9 (47.9–49.9) in 1998/9 to 38.1 (36.8–39.4) in 2003/4, and in girls from 35.8 (35.0–36.6) to 28.1 (27.2–29.1) over the same period. Fitness scores fell across all strata of BMI (P<0.001). Moreover, BMI increased over the same 6-year period even among children in fittest third of 20mMST.

Conclusion:

In a series of uniform cross-sectional assessments of school-aged children, BMI increased whereas cardiorespiratory fitness levels decreased within a 6-year period. Even among lean children, fitness scores decreased. Public health measures to reduce obesity, such as increasing physical activity, may help raise fitness levels among all children – not just the overweight or obese.

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References

  1. World Health Organization. Obesity: Preventing and Managing the Global Epidemic. World Health Organization: Geneva, 2000.

  2. Prentice AM, Jebb SA . Obesity in Britain: gluttony or sloth? BMJ 1995; 311/7002: 437–439.

    Article  Google Scholar 

  3. Bundred P, Kitchiner D, Buchan I . Prevalence of overweight and obese children between 1989 and 1998: population based series of cross sectional studies. BMJ 2001; 322/7282: 326–328.

    Article  Google Scholar 

  4. Reilly JJ, Dorosty AR . Epidemic of obesity in UK children. Lancet 1999; 354/9193: 1874–1875.

    Article  Google Scholar 

  5. Troiano RP, Briefel RR, Carroll MD, Bialostosky K . Energy and fat intakes of children and adolescents in the United States: data from the national health and nutrition examination surveys. Am J Clin Nutr 2000; 72/5 (Suppl): 1343S–1353S.

    Article  Google Scholar 

  6. Schlicker SA, Borra ST, Regan C . The weight and fitness status of United States children. Nutr Rev 1994; 52/1: 11–17.

    Google Scholar 

  7. Johnson MS, Figueroa-Colon R, Herd SL, Fields DA, Sun M, Hunter GR et al. Aerobic fitness, not energy expenditure, influences subsequent increase in adiposity in black and white children. Pediatrics 2000; 106/4: E50.

    Article  Google Scholar 

  8. Dencker M, Thorsson O, Karlsson MK, Linden C, Eiberg S, Wollmer P et al. Daily physical activity related to body fat in children aged 8–11 years. J Pediatr 2006; 149/1: 38–42.

    Article  Google Scholar 

  9. Grund A, Dilba B, Forberger K, Krause H, Siewers M, Rieckert H et al. Relationships between physical activity, physical fitness, muscle strength and nutritional state in 5- to 11-year-old children. Eur J Appl Physiol 2000; 82/5–6: 425–438.

    Article  Google Scholar 

  10. Wedderkopp N, Froberg K, Hansen HS, Andersen LB . Secular trends in physical fitness and obesity in Danish 9-year-old girls and boys: Odense School Child Study and Danish substudy of the European Youth Heart Study. Scand J Med Sci Sports 2004; 14/3: 150–155.

    Article  Google Scholar 

  11. Dencker M, Thorsson O, Karlsson MK, Linden C, Svensson J, Wollmer P et al. Daily physical activity and its relation to aerobic fitness in children aged 8–11 years. Eur J Appl Physiol 2006; 96/5: 587–592.

    Article  Google Scholar 

  12. Brage S, Wedderkopp N, Ekelund U, Franks PW, Wareham NJ, Andersen LB et al. Features of the metabolic syndrome are associated with objectively measured physical activity and fitness in Danish children: the European Youth Heart Study (EYHS). Diabetes Care 2004; 27/9: 2141–2148.

    Article  Google Scholar 

  13. Ferreira I, Twisk JW, van MW, Kemper HC, Stehouwer CD . Development of fatness, fitness, and lifestyle from adolescence to the age of 36 years: determinants of the metabolic syndrome in young adults: the Amsterdam growth and health longitudinal study. Arch Intern Med 2005; 165/1: 42–48.

    Article  Google Scholar 

  14. LaMonte MJ, Barlow CE, Jurca R, Kampert JB, Church TS, Blair SN . Cardiorespiratory fitness is inversely associated with the incidence of metabolic syndrome: a prospective study of men and women. Circulation 2005; 112/4: 505–512.

    Article  Google Scholar 

  15. Eisenmann JC, Wickel EE, Welk GJ, Blair SN . Relationship between adolescent fitness and fatness and cardiovascular disease risk factors in adulthood: the Aerobics Center Longitudinal Study (ACLS). Am Heart J 2005; 149/1: 46–53.

    Article  Google Scholar 

  16. Andersen LB, Wedderkopp N, Hansen HS, Cooper AR, Froberg K . Biological cardiovascular risk factors cluster in Danish children and adolescents: the European Youth Heart Study. Prev Med 2003; 37/4: 363–367.

    Article  Google Scholar 

  17. Blair SN, Kampert JB, Kohl III HW, Barlow CE, Macera CA, Paffenbarger Jr RS et al. Influences of cardiorespiratory fitness and other precursors on cardiovascular disease and all-cause mortality in men and women. JAMA 1996; 276/3: 205–210.

    Article  Google Scholar 

  18. Taylor S, Hackett A, Stratton G, Lamb L . SportsLinx: improving the health and fitness of Liverpool's youth. Educ Health 2004; 22: 3–7.

    Google Scholar 

  19. Dummer TJ, Gibbon MA, Hackett AF, Stratton G, Taylor SR . Is overweight and obesity in 9–10-year-old children in Liverpool related to deprivation and/or electoral ward when based on school attended? Public Health Nutr 2005; 8/6: 636–641.

    Google Scholar 

  20. EUROFIT. European Test of Physical Fitness. Committee for the Development of Sport, Council of Europe: Rome, 1998.

  21. Baquet G, Twisk JW, Kemper HC, Van PE, Berthoin S . Longitudinal follow-up of fitness during childhood: interaction with physical activity. Am J Hum Biol 2006; 18/1: 51–58.

    Article  Google Scholar 

  22. van Mechelen W, Hlobil H, Kemper HC . Validation of two running tests as estimates of maximal aerobic power in children. Eur J Appl Physiol Occup Physiol 1986; 55/5: 503–506.

    Article  Google Scholar 

  23. Leger LA, Mercier D, Gadoury C, Lambert J . The multistage 20 metre shuttle run test for aerobic fitness. J Sports Sci 1988; 6/2: 93–101.

    Article  Google Scholar 

  24. Office of the Deputy Prime Minister. The English Indices of Deprivation in 2004 (revised). The Stationary Office Limited: London, 2004.

  25. Cole TJ, Bellizzi MC, Flegal KM, Dietz WH . Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ 2000; 320/7244: 1240–1243.

    Article  Google Scholar 

  26. Brage S, Wedderkopp N, Ekelund U, Franks PW, Wareham NJ, Andersen LB, et al. Features of the metabolic syndrome are associated with objectively measured physical activity and fitness in Danish children: the European Youth Heart Study (EYHS). Diabetes Care 2004; 27/9: 2141–2148.

    Article  Google Scholar 

  27. LaMonte MJ, Barlow CE, Jurca R, Kampert JB, Church TS, Blair SN . Cardiorespiratory fitness is inversely associated with the incidence of metabolic syndrome: a prospective study of men and women. Circulation 2005; 112/4: 505–512.

    Article  Google Scholar 

  28. Andersen LB, Wedderkopp N, Hansen HS, Cooper AR, Froberg K . Biological cardiovascular risk factors cluster in Danish children and adolescents: the European Youth Heart Study. Prev Med 2003; 37/4: 363–367.

    Article  Google Scholar 

  29. Blair SN, Kampert JB, Kohl III HW, Barlow CE, Macera CA, Paffenbarger Jr RS et al. Influences of cardiorespiratory fitness and other precursors on cardiovascular disease and all-cause mortality in men and women. JAMA 1996; 276/3: 205–210.

    Article  Google Scholar 

  30. Wedderkopp N, Froberg K, Hansen HS, Andersen LB . Secular trends in physical fitness and obesity in Danish 9-year-old girls and boys: Odense School Child Study and Danish substudy of the European Youth Heart Study. Scand J Med Sci Sports 2004; 14/3: 150–155.

    Article  Google Scholar 

  31. Tomkinson GR, Leger LA, Olds TS, Cazorla G . Secular trends in the performance of children and adolescents (1980–2000): an analysis of 55 studies of the 20 m shuttle run test in 11 countries. Sports Med 2003; 33/4: 285–300.

    Article  Google Scholar 

  32. Dencker M, Thorsson O, Karlsson MK, Linden C, Eiberg S, Wollmer P et al. Daily physical activity related to body fat in children aged 8–11 years. J Pediatr 2006; 149/1: 38–42.

    Article  Google Scholar 

  33. Grund A, Dilba B, Forberger K, Krause H, Siewers M, Rieckert H et al. Relationships between physical activity, physical fitness, muscle strength and nutritional state in 5- to 11-year-old children. Eur J Appl Physiol 2000; 82/5–6: 425–438.

    Article  Google Scholar 

  34. Wedderkopp N, Froberg K, Hansen HS, Andersen LB . Secular trends in physical fitness and obesity in Danish 9-year-old girls and boys: Odense School Child Study and Danish substudy of the European Youth Heart Study. Scand J Med Sci Sports 2004; 14/3: 150–155.

    Article  Google Scholar 

  35. Deforche B, Lefevre J, De I B, Hills AP, Duquet W, Bouckaert J . Physical fitness and physical activity in obese and nonobese Flemish youth. Obes Res 2003; 11/3: 434–441.

    Article  Google Scholar 

  36. Dencker M, Thorsson O, Karlsson MK, Linden C, Svensson J, Wollmer P et al. Daily physical activity and its relation to aerobic fitness in children aged 8–11 years. Eur J Appl Physiol 2006; 96/5: 587–592.

    Article  Google Scholar 

  37. Durnin JVGA . Physical activity levels – past and present. In: Norgan NG (ed) Physical Activity and Health. Cambridge University Press: Cambridge, 1992. pp 20–27.

    Chapter  Google Scholar 

  38. Prentice AM, Jebb SA . Obesity in Britain: gluttony or sloth? BMJ 1995; 311/7002: 437–439.

    Article  Google Scholar 

  39. Dencker M, Thorsson O, Karlsson MK, Linden C, Eiberg S, Wollmer P et al. Daily physical activity related to body fat in children aged 8–11 years. J Pediatr 2006; 149/1: 38–42.

    Article  Google Scholar 

  40. Dencker M, Thorsson O, Karlsson MK, Linden C, Svensson J, Wollmer P et al. Daily physical activity and its relation to aerobic fitness in children aged 8–11 years. Eur J Appl Physiol 2006; 96/5: 587–592.

    Article  Google Scholar 

  41. Caspersen CJ, Powell KE, Christenson GM . Physical activity, exercise, and physical fitness: definitions and distinctions for health-related research. Public Health Rep 1985; 100/2: 126–131.

    Google Scholar 

  42. American College of Sports Medicine Position Stand. The recommended quantity and quality of exercise for developing and maintaining cardiorespiratory and muscular fitness, and flexibility in healthy adults. Med Sci Sports Exerc 1998; 30/6: 975–991.

  43. Haskell WL, Leon AS, Caspersen CJ, Froelicher VF, Hagberg JM, Harlan W et al. Cardiovascular benefits and assessment of physical activity and physical fitness in adults. Med Sci Sports Exerc 1992; 24/6 (Suppl): S201–S220.

    Google Scholar 

  44. Pate RR, Dowda M, Ross JG . Associations between physical activity and physical fitness in American children. Am J Dis Child 1990; 144/10: 1123–1129.

    Google Scholar 

  45. Ruiz JR, Rizzo NS, Hurtig-Wennlof A, Ortega FB, Warnberg J, Sjostrom M . Relations of total physical activity and intensity to fitness and fatness in children: the European Youth Heart Study. Am J Clin Nutr 2006; 84/2: 299–303.

    Article  Google Scholar 

  46. Ruiz JR, Rizzo NS, Hurtig-Wennlof A, Ortega FB, Warnberg J, Sjostrom M . Relations of total physical activity and intensity to fitness and fatness in children: the European Youth Heart Study. Am J Clin Nutr 2006; 84/2: 299–303.

    Article  Google Scholar 

  47. Goudas M, Biddle S, Fox K . Perceived locus of causality, goal orientations, and perceived competence in school physical education classes. Br J Educ Psychol 1994; 64 (Part 3): 453–463.

    Article  Google Scholar 

  48. Dummer TJ, Gibbon MA, Hackett AF, Stratton G, Taylor SR . Is overweight and obesity in 9–10-year-old children in Liverpool related to deprivation and/or electoral ward when based on school attended? Public Health Nutr 2005; 8/6: 636–641.

    Google Scholar 

  49. Eriksson J, Forsen T, Osmond C, Barker D . Obesity from cradle to grave. Int J Obes Relat Metab Disord 2003; 27/6: 722–727.

    Article  Google Scholar 

  50. Department of Health. Measuring Childhood Obesity: Guidance to Primary Care Trusts. Department of Health: London, 2006.

  51. Cole TJ, Bellizzi MC, Flegal KM, Dietz WH . Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ 2000; 320/7244: 1240–1243.

    Article  Google Scholar 

  52. Cole TJ, Bellizzi MC, Flegal KM, Dietz WH . Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ 2000; 320/7244: 1240–1243.

    Article  Google Scholar 

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Acknowledgements

We thank Liz Lamb for managing the programme and Glen Groves, Vicci Allan and Jenny for collecting the data. The SportsLinx project was funded by Liverpool City Council, Liverpool John Moores University, The Children's Fund and the Neighbourhood Renewal Fund.

Contributors: GS and AFH designed the Sportslinx project. GS noticed a downward trend in cardiorespiratory fitness and upward trend in BMI after the initial analysis and interpretation of the data and led the initial writing of the manuscript. SRT and LMB managed the data and contributed to the manuscript. IEB performed the statistical analysis, interpreted the findings and led the second draft of the manuscript. DC contributed to statistical analysis, interpretation and subsequent drafts of the manuscript. GS is the guarantor of the paper.

Ethics: Ethics approval has been given by Liverpool John Moores University ethics committee and the Royal Liverpool Children's Hospital Ethics Committee.

Author information

Authors and Affiliations

  1. Research into Activity and Children's Health Group, Research Institute for Sports and Exercise Sciences, Liverpool John Moores University, Liverpool, UK

    G Stratton, L M Boddy, S R Taylor & A F Hackett

  2. Medical School, The University of Manchester, Manchester, M13 9PT, UK

    D Canoy & I E Buchan

  3. North East Wales Institute of Higher Education, Plas Coch Campus, Wrexham, UK

    S R Taylor

  4. Centre for Tourism, Consumer and Food Studies, IM Marsh Campus, Liverpool, UK

    A F Hackett

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  1. G Stratton
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Correspondence to G Stratton.

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We declare that we have no conflict of interest.

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Stratton, G., Canoy, D., Boddy, L. et al. Cardiorespiratory fitness and body mass index of 9–11-year-old English children: a serial cross-sectional study from 1998 to 2004. Int J Obes 31, 1172–1178 (2007). https://doi.org/10.1038/sj.ijo.0803562

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