Physical fitness reference standards in European children: the IDEFICS study.
OBJECTIVE
A low fitness status during childhood and adolescence is associated with important health-related outcomes, such as increased future risk for obesity and cardiovascular diseases, impaired skeletal health, reduced quality of life and poor mental health. Fitness reference values for adolescents from different countries have been published, but there is a scarcity of reference values for pre-pubertal children in Europe, using harmonised measures of fitness in the literature. The IDEFICS study offers a good opportunity to establish normative values of a large set of fitness components from eight European countries using common and well-standardised methods in a large sample of children. Therefore, the aim of this study is to report sex- and age-specific fitness reference standards in European children.


METHODS
Children (10,302) aged 6-10.9 years (50.7% girls) were examined. The test battery included: the flamingo balance test, back-saver sit-and-reach test (flexibility), handgrip strength test, standing long jump test (lower-limb explosive strength) and 40-m sprint test (speed). Moreover, cardiorespiratory fitness was assessed by a 20-m shuttle run test. Percentile curves for the 1st, 3rd, 10th, 25th, 50th, 75th, 90th, 97th and 99th percentiles were calculated using the General Additive Model for Location Scale and Shape (GAMLSS).


RESULTS
Our results show that boys performed better than girls in speed, lower- and upper-limb strength and cardiorespiratory fitness, and girls performed better in balance and flexibility. Older children performed better than younger children, except for cardiorespiratory fitness in boys and flexibility in girls.


CONCLUSIONS
Our results provide for the first time sex- and age-specific physical fitness reference standards in European children aged 6-10.9 years.
1] GENUD (Growth, Exercise, NUtrition and Development) Research Group, Universidad de Zaragoza, Zaragoza, Spain [2] Department of Psychiatry and Nursing, Faculty of Health Sciences, University of Zaragoza, Zaragoza, Spain [3] Department of Paediatrics, Faculty of Medicine, Universidad de Zaragoza, Zaragoza, Spain.
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De Miguel-Etayo
1] GENUD (Growth, Exercise, NUtrition and Development) Research Group, Universidad de Zaragoza, Zaragoza, Spain [2] CHERC (Children's Health and Exercise Research Centre), College of Life and Environmental Sciences, Sport and Health Sciences, University of Exeter, Exeter, UK.
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Gracia-Marco
1] PROFITH (PROmoting FITness and Health through physical activity) Research Group, School of Sports Science, University of Granada, Granada, Spain [2] Department of Biosciences and Nutrition, Karolinska Institutet, Stockholm, Sweden.
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Ortega
Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany.
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Intemann
Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany.
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Foraita
Department of Public Health and Community Medicine, University of Gothenburg, Gothenburg, Sweden.
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Lissner
National Institute for Health Development, Tallinn, Estonia.
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Oja
Epidemiology and Population Genetics, Institute of Food Science, National Research Council, Avellino, Italy.
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Barba
Department of Public Health, Ghent University, Ghent, Belgium.
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Michels
Research and Education Institute for Child Health, Strovolos, Cyprus.
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Tornaritis
Department of Pediatrics, University of Pécs Medical School, Pécs, Hungary.
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Molnár
Centre for Sport and Exercise Science and Medicine (SESAME), University of Brighton, Eastbourne, UK.
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Pitsiladis
1] Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany [2] Institute of Statistics, Faculty of Mathematics and Computer Science, University of Bremen, Bremen, Germany.
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Ahrens
1] GENUD (Growth, Exercise, NUtrition and Development) Research Group, Universidad de Zaragoza, Zaragoza, Spain [2] Department of Psychiatry and Nursing, Faculty of Health Sciences, University of Zaragoza, Zaragoza, Spain.
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Moreno
D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000517:prevention & control; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D004032:Diet; D005060:Europe / Q000453:epidemiology; D005080:Exercise Test / Q000379:methods*; D005260:Female; D018737:Hand Strength; D006306:Health Surveys; D006801:Humans; D008019:Life Style; D008297:Male; D053580:Muscle Strength; D009765:Obesity / Q000517:prevention & control; D010809:Physical Fitness; D004856:Postural Balance; D011446:Prospective Studies; D011788:Quality of Life; D012015:Reference Standards; D012737:Sex Factors; D044465:White People