Faculty of Kinesiology, University of Zagreb, Zagreb, Croatia.
Faculty of Medicine, Institute for Biostatistics and Medical Informatics, University of Ljubljana, Ljubljana, Slovenia.
BMC Public Health. 2024 Oct 23;24(1):2933. doi: 10.1186/s12889-024-20372-5.
Obesity in childhood has deleterious consequences for health while improving physical fitness can significantly reduce health risks related to high body mass index. We aimed to examine the evolution of disparities in physical fitness based on weight status among 7-15-year-olds in Slovenia between 1989 and 2019 and compare these trends across sex, age and socioeconomic status.
We used annual data collected within the SLOfit monitoring system in the period between 1989 and 2019, totalling 4,256,930 participants (about 137 000 per year). We examined cardiorespiratory fitness (600-m run test), muscular fitness (60-s sit-ups, bent arm hang, and standing broad jump test) and skill-related fitness (backwards obstacle course, 60-m dash, arm plate tapping). We grouped children according to the IOTF cut-offs for BMI to those living with normal weight or excess weight and estimated changes in physical fitness over time by fitting quantile regression models separately by sex and age group, and then using segmented regression to identify the patterns of trends over time.
Weight-based disparities in physical fitness were large in 1989 and have further increased by 2019. The increase in disparities was generally around 5 percentiles larger in boys, and 10-15-year-olds compared to younger children. It was particularly pronounced for body core strength and speed in boys (up to 15 and 19 percentiles, respectively) and upper body strength and speed among girls (up to 13 percentiles). Most of the increase in disparities in health-related fitness accumulated during the 2010s, when the fitness of children generally improved, but much less so in children living with excess weight.
Despite recent improvements in population fitness levels, children with excess weight seem to be left behind, which adds to existing health inequalities. Our results should encourage policymakers to redesign policies aimed at promoting physical activity and enhancing physical fitness to make them more equitable and ultimately lead to reducing inequalities in fitness.
儿童肥胖对健康有不良影响，而提高身体素质可以显著降低与高体重指数相关的健康风险。我们旨在研究 1989 年至 2019 年间，斯洛文尼亚 7 至 15 岁儿童的体重状况与身体素质之间的差异演变，并比较这些趋势在性别、年龄和社会经济地位方面的差异。
我们使用了 1989 年至 2019 年期间 SLOfit 监测系统收集的年度数据，共计 4256930 名参与者（每年约 137000 人）。我们检查了心肺功能（600 米跑测试）、肌肉力量（60 秒仰卧起坐、屈臂悬挂和立定跳远测试）和技能相关的体能（后向障碍跑、60 米冲刺、臂板敲击）。我们根据 IOTF 的 BMI 切点将儿童分为体重正常和超重的两组，并通过分别按性别和年龄组拟合分位数回归模型，然后使用分段回归来确定随时间变化的趋势模式，来估计身体素质随时间的变化。
1989 年，身体素质的体重差异很大，到 2019 年进一步增加。差异的增加通常在男孩中大 5 个百分点，在 10-15 岁儿童中比在年幼儿童中更大。男孩的身体核心力量和速度的差异尤其明显（分别增加了 15%和 19%），女孩的上肢力量和速度的差异也明显（增加了 13%）。健康相关身体素质差异的大部分增加发生在 2010 年代，当时儿童的身体素质普遍提高，但体重超重的儿童的提高幅度要小得多。
尽管人口身体素质水平最近有所提高，但超重的儿童似乎被抛在后面，这加剧了现有的健康不平等。我们的结果应该鼓励政策制定者重新设计旨在促进身体活动和增强身体素质的政策，使其更加公平，并最终减少身体素质方面的不平等。
