Age- and sex-specific physical fitness reference and association with body mass index in Hong Kong Chinese schoolchildren

Yip, K.-M. et al. (2022) Age- and sex-specific physical fitness reference and association with body mass index in Hong Kong Chinese schoolchildren. International Journal of Environmental Research and Public Health, 19(22), 15346. (doi: 10.3390/ijerph192215346) (PMID:36430065) (PMCID:PMC9690690)

Abstract

There is lacking a population-based study on the fitness level of Hong Kong schoolchildren, and it seems that increasing childhood obesity prevalence has shifted the classification of healthy fitness, with ‘underfit’ as normal. This cross-sectional territory study aimed to develop an age- and sex-specific physical fitness reference using a representative sample of children aged 6–17 and to determine the associations with body mass index in schoolchildren. The study analyzed Hong Kong School Physical Fitness Award Scheme data covering grade 1 to grade 12 students’ physical fitness and anthropometric measurements from 2017 to 2018. This reference was established without the impact due to COVID-19. Four aspects of physical fitness tests were measured using a standardized protocol, including (i) upper limb muscle strength, (ii) one-minute sit-up, (iii) sit-and-reach, and (iv) endurance run tests. The generalized additive model for location, scale, and shape was used to construct the reference charts. A Mann–Whitney U test was used to compare the mean differences in age, weight, and height, and a Pearson’s chi-square test was used to examine the distributions of sex groups. A Kruskal–Wallis test was used to compare the group differences in BMI status, followed by the Dunn test for pairwise comparisons. A 5% level of significance was regarded as statistically significant. Data of 119,693 students before the COVID-19 pandemic were included in the analysis. The association between physical fitness level and BMI status varied depending on the test used, and there were significant differences in fitness test scores among BMI groups. The mean test scores of the obese group were lower in most of the tests for both boys and girls, except for handgrip strength. The underweight group outperformed the obese group in push-ups, one-minute sit-ups, and endurance run tests, but not in handgrip strength. In conclusion, a sex- and age-specific physical fitness reference value for Hong Kong Chinese children aged 6 to 17 years old is established, and this study demonstrated a nonlinear relationship between BMI status and physical fitness. The reference will help to identify children with poor physical fitness to offer support and guidance on exercise training. It also serves as a baseline for assessing the impact of the COVID-19 pandemic on Hong Kong students’ physical fitness.

• Item Type: Articles
• Keywords: COVID-19 - epidemiology, pandemics, body mass index, Hong Kong, BMI, female, adolescent, child, physical fitness, reference values, physical Fitness - physiology, pediatric obesity, male, hand strength, Chinese children, Hong Kong - epidemiology, exercise, cross-sectional studies.
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Ho, Dr Frederick

Creator Roles

Ho, F. K.: Writing – review and editing

• Authors: Yip, K.-M., Wong, S. W.S., Chua, G. T., So, H.-K., Ho, F. K., Wong, R. S., Tung, K. T.S., Chan, E. Y.N., Tso, W. W.Y., Chow, B.-C., Fung, G. P.G., Wong, W. H.S., and Ip, P.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Public Health
• Journal Name: International Journal of Environmental Research and Public Health
• Publisher: MDPI
• ISSN: 1661-7827
• ISSN (Online): 1660-4601
• Published Online: 20 November 2022
• Copyright Holders: Copyright © 2022 The Authors
• First Published: First published in International Journal of Environmental Research and Public Health 19(22): 15346
• Publisher Policy: Reproduced under a Creative Commons License