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Int J Sports Med 2023; 44(10): 728-735
DOI: 10.1055/a-1738-2072
Training & Testing

Temporal Trends in the Physical Fitness of Hong Kong Adolescents Between 1998 and 2015

Eric Tsz-Chun Poon
1   Department of Health and Physical Education, The Education University of Hong Kong, Shatin, Hong Kong
2   Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Shatin, Hong Kong
,
Grant R. Tomkinson
3   Department of Education, Health and Behavior Studies, University of North Dakota, Grand Forks, ND, USA
4   Alliance for Research in Exercise, Nutrition and Activity (ARENA), Allied Health and Human Performance, University of South Australia, Adelaide, SA, Australia
,
Wendy Yajun Huang
5   Centre for Health and Exercise Science Research, Department of Sport, Physical Education and Health, Hong Kong Baptist University, Hong Kong
,
Stephen Heung-Sang Wong
2   Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Shatin, Hong Kong
› Author Affiliations Funding The work described in this paper was partially supported by a fellowship award from the Research Grants Council of the Hong Kong Special Administrative Region, China (Project No. CUHK PDFS2021-4S11).
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Abstract

Low physical fitness in adolescence is linked with increased cardiometabolic risk and early all-cause mortality. This study aimed to estimate temporal trends in the physical fitness of Hong Kong adolescents aged 12–17 years between 1998 and 2015. Physical fitness (9-min run/walk, sit-ups, push-ups, and sit-and-reach) and body size data in a total of 28,059 adolescents tested across five population-representative surveys of Hong Kong secondary school pupils, were reported. Temporal trends in means were estimated at the gender-age level by best-fitting sample-weighted linear regression, with national trends estimated by a post-stratified population-weighting procedure. Overall, there were small declines in 9-min run/walk (effect size (ES)=−0.29 (95%CI: −0.32, −0.26)) and sit-ups performance (ES=−0.24 (95%CI: −0.27, −0.21)), with negligible changes in push-ups and sit-and-reach performance. There were small concurrent increases in both mean height and body mass, with a negligible increase in sum of skinfolds. Trends in mean physical fitness and body size/were not always uniform across the population distribution. The small declines in mean 9-min run/walk and sit-ups performance for Hong Kong adolescents are suggestive of corresponding declines in cardiorespiratory fitness and abdominal/core endurance, respectively. Increased national health promotion strategies are required to improve existing trends.

Key words

cardiorespiratory fitness - physical fitness - body size - adolescent - government - public health - cross-sectional studies

Supplementary Material



Publication History

Received: 19 October 2021

Accepted: 11 January 2022

Accepted Manuscript online:
12 January 2022

Article published online:
01 September 2023

© 2022. Thieme. All rights reserved.

Georg Thieme Verlag
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • References

  • 1 Ortega FB, Ruiz JR, Castillo MJ. et al. Physical fitness in childhood and adolescence: a powerful marker of health. Int J Obesity 2008; 32: 1-11
    CrossrefPubMedSearch in Google Scholar
  • 2 ACSM. American College of Sports Medicine’s guidelines for exercise testing and prescription. 11th ed. Wolters Kluwer; 2021
    Search in Google Scholar
  • 3 Kodama S, Saito K, Tanaka S. et al. Cardiorespiratory Fitness as a Quantitative Predictor of All-Cause Mortality and Cardiovascular Events in Healthy Men and Women A Meta-analysis. Jama-J Am Med Assoc 2009; 301: 2024-2035
    CrossrefPubMedSearch in Google Scholar
  • 4 Soysal P, Hurst C, Demurtas J. et al. Handgrip strength and health outcomes: Umbrella review of systematic reviews with meta-analyses of observational studies. Journal of Sport and Health Science 2021; 10: 290-295
    CrossrefPubMedSearch in Google Scholar
  • 5 Garcia-Hermoso A, Ramirez-Campillo R, Izquierdo M. Is Muscular Fitness Associated with Future Health Benefits in Children and Adolescents? A Systematic Review and Meta-Analysis of Longitudinal Studies. Sports Medicine 2019; 49: 1079-1094
    CrossrefPubMedSearch in Google Scholar
  • 6 Smith JJ, Eather N, Morgan PJ. et al. The Health Benefits of Muscular Fitness for Children and Adolescents: A Systematic Review and Meta-Analysis. Sports Medicine 2014; 44: 1209-1223
    CrossrefPubMedSearch in Google Scholar
  • 7 Hogstrom G, Ohlsson H, Crump C. et al. Aerobic fitness in late adolescence and the risk of cancer and cancer-associated mortality in adulthood: A prospective nationwide study of 1.2 million Swedish men. Cancer Epidemiol 2019; 59: 58-63
    CrossrefPubMedSearch in Google Scholar
  • 8 Ortega FB, Silventoinen K, Tynelius P. et al. Muscular strength in male adolescents and premature death: cohort study of one million participants. Bmj-Brit Med J 2012; 345
    CrossrefPubMedSearch in Google Scholar
  • 9 IOM. In: Pate R, Oria M, Pillsbury L, Hrsg. Fitness Measures and Health Outcomes in Youth. Washington (DC): 2012.
    CrossrefSearch in Google Scholar
  • 10 Ruiz JR, Castro-Pinero J, Artero EG. et al. Predictive validity of health-related fitness in youth: a systematic review. Br J Sports Med 2009; 43: 909-923
    CrossrefPubMedSearch in Google Scholar
  • 11 Lang JJ, Tomkinson GR, Janssen I. et al. Making a Case for Cardiorespiratory Fitness Surveillance Among Children and Youth. Exerc Sport Sci Rev 2018; 46: 66-75
    CrossrefPubMedSearch in Google Scholar
  • 12 Lang JJ, Smith J, Tomkinson GR. Global surveillance of cardiorespiratory and musculoskeletal fitness. In: Brusseau TA, Fairclough S, Lubans DR, Hrsg. The Routledge handbook of youth physical activity. New York: Routledge; 2020: 47-68
    Search in Google Scholar
  • 13 Huang WY, Wong SH, Wong MC. et al. Results From Hong Kong’s 2016 Report Card on Physical Activity for Children and Youth. J Phys Act Health 2016; 13: S169-S175
    CrossrefPubMedSearch in Google Scholar
  • 14 Huang WY, Wong SHS, Sit CHP. et al. Results from the Hong Kong’s 2018 report card on physical activity for children and youth. Journal of Exercise Science & Fitness 2019; 17: 14-19
    CrossrefPubMedSearch in Google Scholar
  • 15 So HK, Nelson EA, Li AM. et al. Secular changes in height, weight and body mass index in Hong Kong Children. Bmc Public Health 2008; 8: 320
    CrossrefPubMedSearch in Google Scholar
  • 16 Kwok MK, Leung GM, Chung TWH. et al. Divergent secular trends in blood pressure and body mass index in children and adolescents in Hong Kong. Sci Rep 2017; 7: 4763
    CrossrefPubMedSearch in Google Scholar
  • 17 Tomkinson GR, Kaster T, Dooley FL. et al. Temporal Trends in the Standing Broad Jump Performance of 10,940,801 Children and Adolescents Between 1960 and 2017. Sports Medicine 2021; 51: 531-548
    CrossrefPubMedSearch in Google Scholar
  • 18 Kaster T, Dooley FL, Fitzgerald JS. et al. Temporal trends in the sit-ups performance of 9,939,289 children and adolescents between 1964 and 2017. J Sport Sci 2020; 38: 1913-1923
    CrossrefPubMedSearch in Google Scholar
  • 19 Tomkinson GR, Lang JJ, Tremblay MS. Temporal trends in the cardiorespiratory fitness of children and adolescents representing 19 high-income and upper middle-income countries between 1981 and 2014. Brit J Sport Med 2019; 53: 478-+
    CrossrefPubMedSearch in Google Scholar
  • 20 Dooley FL, Kaster T, Fitzgerald JS. et al. A Systematic Analysis of Temporal Trends in the Handgrip Strength of 2,216,320 Children and Adolescents Between 1967 and 2017. Sports Medicine 2020; 50: 1129-1144
    CrossrefPubMedSearch in Google Scholar
  • 21 Macfarlane DJ, Tomkinson GR. Evolution and variability in fitness test performance of Asian children and adolescents. Med Sport Sci 2007; 50: 143-167
    CrossrefPubMedSearch in Google Scholar
  • 22 Tomkinson GR, Macfarlane D, Noi S. et al. Temporal Changes in Long-Distance Running Performance of Asian Children between 1964 and 2009. Sports Medicine 2012; 42: 267-279
    CrossrefPubMedSearch in Google Scholar
  • 23 Henriksson H, Henriksson P, Tynelius P. et al. Muscular weakness in adolescence is associated with disability 30 years later: a population-based cohort study of 1.2 million men. Brit J Sport Med 2019; 53: 1221-+
    CrossrefPubMedSearch in Google Scholar
  • 24 Fraser BJ, Blizzard L, Schmidt MD. et al. Childhood cardiorespiratory fitness, muscular fitness and adult measures of glucose homeostasis. Journal of Science and Medicine in Sport 2018; 21: 935-940
    CrossrefPubMedSearch in Google Scholar
  • 25 Albon HM, Hamlin MJ, Ross JJ. Secular trends and distributional changes in health and fitness performance variables of 10-14-year-old children in New Zealand between 1991 and 2003. Br J Sports Med 2010; 44: 263-269
    CrossrefPubMedSearch in Google Scholar
  • 26 HKSAR Report. Surveys on ‘Physical Fitness Status of Hong Kong School Pupils’. In. Hong Kong: Education Bureau, The Government of the Hong Kong Special Administrative Region; 2016
    Search in Google Scholar
  • 27 HKCHF. School Physical Fitness Award Scheme – Teacher’s Handbook. In. Hong Kong: Hong Kong Childhealth Foundaton; 2005
    Search in Google Scholar
  • 28 Cohen J. Statistical power analysis for the behavioral sciences. In. 2nd ed. Aufl Mahwah, NJ: Lawrence Erlbaum; 1988
    Search in Google Scholar
  • 29 Nations U. World population prospects 2019: data booklet (ST/ESA/SER.A/424). In. New York: 2019
    Search in Google Scholar
  • 30 Cleveland WS, Devlin SJ. Locally Weighted Regression – an Approach to Regression-Analysis by Local Fitting. J Am Stat Assoc 1988; 83: 596-610
    CrossrefPubMedSearch in Google Scholar
  • 31 Tomkinson GRT. M. , Liu Y Temporal trends in step test performance for Chinese adults between 2000 and 2014. Journal of Exercise Science & Fitness 2021; 19: 216-222
    CrossrefPubMedSearch in Google Scholar
  • 32 Fraser BJ, Rollo S, Sampson M. et al. Health-Related Criterion-Referenced Cut-Points for Musculoskeletal Fitness Among Youth: A Systematic Review. Sports Med 2021; 51: 2629-2646
    CrossrefPubMedSearch in Google Scholar
  • 33 Rollo S, Fraser BJ, Seguin N. et al. Health-Related Criterion-Referenced Cut-Points for Cardiorespiratory Fitness Among Youth: A Systematic Review. Sports Med 2021; doi:10.1007/s40279-021-01537-3
    CrossrefPubMedSearch in Google Scholar
  • 34 Tomkinson GR, Lang JJ, Tremblay MS. et al. International normative 20 m shuttle run values from 1 142 026 children and youth representing 50 countries. Brit J Sport Med 2017; 51: 1545-+
    CrossrefPubMedSearch in Google Scholar
  • 35 Lang JJ, Tremblay MS, Leger L. et al. International variability in 20 m shuttle run performance in children and youth: who are the fittest from a 50-country comparison? A systematic literature review with pooling of aggregate results. Br J Sports Med 2018; 52: 276
    CrossrefPubMedSearch in Google Scholar
  • 36 Mayorga-Vega D, Bocanegra-Parrilla R, Ornelas M. et al. Criterion-Related Validity of the Distance- and Time-Based Walk/Run Field Tests for Estimating Cardiorespiratory Fitness: A Systematic Review and Meta-Analysis. Plos One 2016; 11
    CrossrefPubMedSearch in Google Scholar
  • 37 Batista MB, Romanzini CLP, Castro-Pinero J. et al. Validity of Field Tests to Estimate Cardiorespiratory Fitness in Children and Adolescents: A Systematic Review. Rev Paul Pediatr 2017; 35: 222-233
    CrossrefPubMedSearch in Google Scholar
  • 38 Tomkinson GR, Olds TS. Secular changes in pediatric aerobic fitness test performance: the global picture. Med Sport Sci 2007; 50: 46-66
    CrossrefPubMedSearch in Google Scholar
  • 39 Sandercock GR, Ogunleye A, Voss C. Six-year changes in body mass index and cardiorespiratory fitness of English schoolchildren from an affluent area. Int J Obes (Lond) 2015; 39: 1504-1507
    CrossrefPubMedSearch in Google Scholar
  • 40 Morrow JR, Tucker JS, Jackson AW. et al. Meeting physical activity guidelines and health-related fitness in youth. Am J Prev Med 2013; 44: 439-444
    CrossrefPubMedSearch in Google Scholar
  • 41 Williams S, Netto K, Kennedy R. et al. Biomechanical correlates of running performance in active children. Journal of Science and Medicine in Sport 2019; 22: 65-69
    CrossrefPubMedSearch in Google Scholar
  • 42 Olds TS, Ridley K, Tomkinson GR. Declines in aerobic fitness: are they only due to increasing fatness?. Med Sport Sci 2007; 50: 226-240
    CrossrefPubMedSearch in Google Scholar
  • 43 Center for Health Protection. Statistics on Youth Health-related Behaviour – Physical Activity. In. Hong Kong: Department of Health, The Government of the Hong Kong Special Administrative Region; 2021
    Search in Google Scholar
  • 44 Timpka S, Petersson IF, Zhou C. et al. Muscle strength in adolescent men and risk of cardiovascular disease events and mortality in middle age: a prospective cohort study. Bmc Med 2014; 12: 62
    CrossrefPubMedSearch in Google Scholar
  • 45 Katzmarzyk PT, Craig CL. Musculoskeletal fitness and risk of mortality. Med Sci Sports Exerc 2002; 34: 740-744
    CrossrefPubMedSearch in Google Scholar
  • 46 Oliver GD, Adams-Blair HR. Improving Core Strength to Prevent Injury. J Phys Educ Recreat 2010; 81: 15-19
    CrossrefPubMedSearch in Google Scholar
  • 47 Bliven KCH, Anderson BE. Core Stability Training for Injury Prevention. Sports Health-a Multidisciplinary Approach 2013; 5: 514-522
    CrossrefPubMedSearch in Google Scholar
  • 48 Myer GD, Faigenbaum AD, Chu DA. et al. Integrative Training for Children and Adolescents: Techniques and Practices for Reducing Sports-Related Injuries and Enhancing Athletic Performance. Physician and Sportsmedicine 2011; 39: 74-84
    CrossrefPubMedSearch in Google Scholar
  • 49 Mitchell UH, Johnson AW, Adamson B. Relationship between Functional Movement Screen Scores, Core Strength, Posture, and Body Mass Index in School Children in Moldova. Journal of Strength and Conditioning Research 2015; 29: 1172-1179
    CrossrefPubMedSearch in Google Scholar
  • 50 Sandercock GRH, Cohen DD. Temporal trends in muscular fitness of English 10-year-olds 1998-2014: An allometric approach. Journal of Science and Medicine in Sport 2019; 22: 201-205
    CrossrefPubMedSearch in Google Scholar
  • 51 Venckunas T, Emeljanovas A, Mieziene B. et al. Secular trends in physical fitness and body size in Lithuanian children and adolescents between 1992 and 2012. J Epidemiol Commun H 2017; 71: 181-187
    CrossrefPubMedSearch in Google Scholar
  • 52 Huotari PRT, Nupponen H, Laakso L. et al. Secular trends in muscular fitness among Finnish adolescents. Scand J Public Healt 2010; 38: 739-747
    CrossrefPubMedSearch in Google Scholar
  • 53 Dollman J, Olds T, Norton K. et al. The evolution of fitness and fatness in 10-11-year-old Australian schoolchildren: Changes in distributional characteristics between 1985 and 1997. Pediatr Exerc Sci 1999; 11: 108-121
    CrossrefPubMedSearch in Google Scholar
  • 54 Hidayat K, Du X, Shi BM. Body fatness at a young age and risks of eight types of cancer: systematic review and meta-analysis of observational studies. Obes Rev 2018; 19: 1385-1394
    CrossrefPubMedSearch in Google Scholar
  • 55 Baker JL, Olsen LW, Sorensen TIA. Childhood body-mass index and the risk of coronary heart disease in adulthood. New Engl J Med 2007; 357: 2329-2337
    CrossrefPubMedSearch in Google Scholar
  • 56 Twig G, Yaniv G, Levine H. et al. Body-Mass Index in 2.3 Million Adolescents and Cardiovascular Death in Adulthood. New Engl J Med 2016; 374: 2430-2440
    CrossrefPubMedSearch in Google Scholar
  • 57 Tung JYL, Ho FKW, Tung KTS. et al. Does obesity persist from childhood to adolescence? A 4-year prospective cohort study of chinese students in Hong Kong. Bmc Pediatr 2021; 21
    CrossrefPubMedSearch in Google Scholar
  • 58 Hui SS, Zhang R, Suzuki K. et al. Physical activity and health-related fitness in Asian adolescents: The Asia-fit study. J Sports Sci 2020; 38: 273-279
    CrossrefPubMedSearch in Google Scholar
  • 59 Department of Health. Physical Activity Guide for Children in Hong Kong. In. Hong Kong: Department of Health, The Government of the Hong Kong Special Administrative Region; 2021
    PubMed
  • 60 Huen KF, Leung SS, Lau JT. et al. Secular trend in the sexual maturation of southern Chinese girls. Acta Paediatr 1997; 86: 1121-1124
    CrossrefPubMedSearch in Google Scholar
  • 61 Wong GW, Leung SS, Law WY. et al. Secular trend in the sexual maturation of southern Chinese boys. Acta Paediatr 1996; 85: 620-621
    CrossrefPubMedSearch in Google Scholar
  • 62 Eckert-Lind C, Busch AS, Petersen JH. et al. Worldwide Secular Trends in Age at Pubertal Onset Assessed by Breast Development Among Girls A Systematic Review and Meta-analysis. Jama Pediatrics 2020; 174
    CrossrefPubMedSearch in Google Scholar