Department of Kinesiology and Public Health Education, University of North Dakota, Grand Forks, North Dakota, USA.
Alliance for Research in Exercise, Nutrition and Activity (ARENA), School of Health Sciences & Sansom Institute for Health Research, University of South Australia, Adelaide, South Australia, Australia.
Br J Sports Med. 2019 Apr;53(8):478-486. doi: 10.1136/bjsports-2017-097982. Epub 2017 Oct 30.
To estimate international and national temporal trends in the cardiorespiratory fitness (CRF) of children and adolescents and to examine relationships between temporal trends in CRF and temporal trends in broad socioeconomic and health-related indicators across countries.
Data were obtained from a systematic search of studies that explicitly reported 20 m shuttle run test (a validated measure of CRF) descriptive data on apparently healthy individuals aged 9-17 years. Following the estimation of relative peak oxygen uptake (mL/kg/min) as a measure of CRF, sample-weighted temporal trends were estimated at the country-sex-age level using best-fitting linear or polynomial regression models relating the year of testing to mean CRF. Poststratified population-weighted mean changes in absolute and per cent CRF were estimated. Pearson's correlations were used to describe the association between linear temporal trends in CRF and linear temporal trends in broad socioeconomic and health-related indicators.
Temporal trends were estimated from 965 264 children and adolescents from 19 high-income and upper middle-income countries between 1981 and 2014, using data from 137 studies. Collectively, there was a moderate decline in CRF of 3.3 mL/kg/min (95% CI -3.5 to -3.1), equivalent to a decline of 7.3% (95% CI -7.8% to -6.7%) over the 33-year time period. This international decline diminished with each decade and stabilised near zero around 2000. The decline was larger for boys than girls and was similar for children and adolescents. Trends also differed in magnitude and direction between countries, with most showing declines. There was a strong negative association between country-specific trends in income inequality (Gini index) and trends in CRF across 18 countries; meaning, countries approaching income equality had more favourable trends in CRF.
There has been a substantial decline in CRF since 1981, which is suggestive of a meaningful decline in population health. However, the international trend in CRF has not followed the anticipated trajectory, diminishing and stabilising with negligible change since 2000. CRF data are needed from children in low-income and middle-income countries to more confidently determine true international trends and determine whether temporal trends are similar to those observed in high-income and upper middle-income countries.
评估儿童和青少年心肺功能（CRF）的国际和国家时间趋势，并研究 CRF 时间趋势与各国广泛的社会经济和健康相关指标时间趋势之间的关系。
从系统检索中获取数据，这些研究明确报告了 20 米穿梭跑测试（CRF 的一种经过验证的测量方法）关于年龄在 9-17 岁的明显健康个体的描述性数据。在估计相对最大摄氧量（mL/kg/min）作为 CRF 的衡量标准后，使用最佳拟合线性或多项式回归模型，将测试年份与平均 CRF 相关联，在国家-性别-年龄水平上估计样本加权时间趋势。估计绝对和百分比 CRF 的后分层人口加权平均变化。使用 Pearson 相关系数描述 CRF 的线性时间趋势与广泛的社会经济和健康相关指标的线性时间趋势之间的关联。
在 1981 年至 2014 年期间，使用来自 137 项研究的数据，从 19 个高收入和上中等收入国家的 965264 名儿童和青少年中估计了时间趋势。总体而言，CRF 适度下降了 3.3mL/kg/min（95%CI-3.5 至-3.1），相当于在 33 年的时间内下降了 7.3%（95%CI-7.8%至-6.7%）。这种国际下降趋势随着每个十年的推移而减弱，并在 2000 年左右稳定在接近零的水平。男孩的下降幅度大于女孩，儿童和青少年的下降幅度相似。趋势在国家之间的幅度和方向也有所不同，大多数国家都呈下降趋势。在 18 个国家中，国家特定的收入不平等（基尼指数）趋势与 CRF 趋势之间存在强烈的负相关关系；这意味着，收入趋于平等的国家的 CRF 趋势更为有利。
自 1981 年以来，CRF 大幅下降，这表明人口健康状况明显下降。然而，CRF 的国际趋势并没有遵循预期的轨迹，自 2000 年以来，下降趋势减弱并趋于稳定，变化微不足道。需要来自低收入和中等收入国家的儿童的 CRF 数据，以更有信心地确定真正的国际趋势，并确定时间趋势是否与高收入和上中等收入国家观察到的趋势相似。
