Open Access
Assessing basic motor competences, physical fitness, and executive function in 4-5-year-old children: a longitudinal study in a primary care setting
(BMC, 2024) Legarra Gorgoñón, Gaizka; García Alonso, Yesenia; Ramírez Vélez, Robinson; Alonso Martínez, Loreto; Izquierdo Redín, Mikel; Alonso Martínez, Alicia; Ciencias de la Salud; Osasun Zientziak
Background: To evaluate the progression of physical fitness (PF), basic motor competence (BMC), and executive function (EF) over one year in children aged 4-5 years at a health center. Methods: In this longitudinal analysis, children's BMC was evaluated using the MOBAK KG test for object and self-movement. The PREFIT Battery gauged PF through handgrip strength, standing long jump, and other fitness measures, while the Early Years Toolbox appraised EF. Results: Adjustments for confounding factors showed notable improvements in BMC, particularly in object movement (OM; mean difference 0.789, p=0.044) and self-movement (SM; mean difference 0.842, p=0.037), with overall MOBAK scores also increasing (mean difference 1.632, p=0.018). Enhancements in the standing long jump (mean difference 9.036 cm, p=0.014) and EF tasks "Mr. Ant" (mean difference 0.669, p<0.001) and "Go/No-Go" (mean difference 0.120, p<0.001) were evident, signifying substantial BMC gains and some progress in PF and EF. Conclusion: This research underscores the positive impact of regular training on BMC and PF in young children. Significant BMC development and associated improvements in PF and EF over the study period highlight the importance of structured activities in early childhood. These findings advocate for standardized training programs to enhance childhood health and encourage active lifestyles.
Open Access
Factors associated with meeting the WHO physical activity recommendations in pregnant colombian women
(Springer Nature, 2022) López Gil, José Francisco; Izquierdo Redín, Mikel; García Hermoso, Antonio; Alonso Martínez, Alicia; Rincón Pabón, David; Morales Osorio, Marco Antonio; Ramírez Vélez, Robinson; Ciencias de la Salud; Osasun Zientziak
In the absence of medical contraindications, physical activity (PA) can offer health maternal and fetal health outcomes during pregnancy. However, most pregnant women may not consider PA to be feasible, suitable and safe. Hence, it is essential to determine the prevalence of pregnant women who meet the PA recommendations and the possible factors associated with that meeting, since it might be important from the perspective of pregnant women's health. The aim of the present study was to establish the prevalence of meeting the World Health Organization PA recommendations for Colombian pregnant women, as well as possible factors that may be associated with meeting that recommendations. A cross-sectional study including representative data from the National Nutritional Situation Survey (2015) in Colombia was performed. Data were collected in 2015–2016. From an initial sample of 1140 Colombian pregnant women, 702 participants with complete data were included in the final analysis. PA was assessed by self-reported information through the long version of the International Physical Activity Questionnaire. Several potential factors were analysed according to four levels of the socioecological model: the individual, interpersonal, organizational and community levels. The prevalence of Colombian pregnant women who met with the PA recommendations was 7.5%. Indigenous and Mestizo pregnant women showed lower probabilities of meeting the PA recommendations [Indigenous: OR 0.05, 95% CI (0.01–0.18); Mestizo: OR 0.12, 95% CI (0.06–0.22)] than Afro-Colombian participants. Additionally, participants who lived near green and safe spaces for PA were more likely to meet the PA recommendations [OR 2.30, 95% CI (1.06–4.79)] than those who did not live near green areas. In conclusion, a low percentage of Colombian pregnant women met the new PA recommendations. The associations found according to race/ethnicity and living near green and safe areas underline the presence of fundamental disparities associated with meeting PA recommendations.
Open Access
Effects of exercise intervention on health-related physical fitness and blood pressure in preschool children: a systematic review and meta-analysis of randomized controlled trials
(Springer, 2020) García Hermoso, Antonio; Alonso Martínez, Alicia; Ramírez Vélez, Robinson; Izquierdo Redín, Mikel; Ciencias de la Salud; Osasun Zientziak
Background: No previous systematic review has quantitatively examined the effect of physical exercise interventions on health-related physical fitness and blood pressure in children younger than 6 years old. Objective: To evaluate the effects of exercise interventions on health-related physical fitness (i.e., physical fitness components and body composition) and blood pressure in preschoolers. Methods: We searched four databases. Only randomized controlled trials (RCTs), evaluating the effectiveness of exercise intervention on weight-related outcomes, blood pressure, and physical fitness components in preschoolers (1–5.99 years old) were included. The effect sizes were reported as Hedges’ g using random-effects models. Results: A total of 19 RCTs were included. Exercise interventions favored reductions in body mass index (g = − 0.17; 95% confidence interval [CI], − 0.31 to − 0.03), waist circumference (g = − 0.25; 95% CI − 0.47 to − 0.03), and body fat percentage (g = − 0.31; 95% CI − 0.60 to − 0.23); as well as improvement in cardiorespiratory fitness (g = 0.25; 95% CI 0.08–0.42), muscular strength (g = 0.25; 95% CI 0.09–0.40), and speed–agility (g = − 0.51; 95% CI − 0.78 to − 0.24). Blood pressure was not reduced. The subgroup analysis revealed that physical exercise alone favored larger reductions in body mass index and waist circumference compared with physical exercise combined with another intervention. Also, changes in cardiorespiratory fitness, lower-body muscular strength and speed–agility were associated with larger decreases in body composition. Conclusion: Physical exercise whether combined or not with additional intervention has a small effect on both body weight and physical fitness in preschoolers. Also, it seems that interventions to prevent obesity should be directed towards improving physical fitness of preschoolers.
Open Access
Physical activity, sedentary behavior, sleep and self-regulation in Spanish preschoolers during the COVID-19 lockdown
(MDPI, 2021) Alonso Martínez, Alicia; Ramírez Vélez, Robinson; García Alonso, Yesenia; Izquierdo Redín, Mikel; García Hermoso, Antonio; Ciencias de la Salud; Osasun Zientziak; Gobierno de Navarra / Nafarroako Gobernua, CENEDUCA1/2019
Background: A better understanding of the effects of the lockdown on lifestyle behaviors may help to guide the public health response to COVID-19 at a national level and to update the global strategy to respond COVID-19 pandemic. The aim of the study was to examine the effects of the COVID-19 lockdown on device-measured physical activity (PA), sedentary time, sleep and self-regulation; and to determine whether PA and sleep are related to self-regulation problems during the lockdown. Methods: PA, sedentary time and sleep were assessed using accelerometry in the week in which the Spanish national state of alarm was declared (n = 21). Parents reported preschooler’s self-regulation difficulties (internalizing and externalizing) before (n = 268) and during the lockdown (n = 157) by a validated questionnaire. Results: Preschoolers showed a decrease in total PA (mean difference [MD] = -43.3 min per day, 95% CI -68.1 to -18.5), sleep efficiency (MD = -2.09%, 95% CI -4.12 to -0.05), an increase in sedentary time (MD = 50.2 min per day, 95% CI 17.1 to 83.3) internalizing (MD = 0.17, 95% CI 0.06 to 0.28) and externalizing (MD = 0.33, 95% CI 0.23 to 0.44) problems. Preschoolers who met the World Health Organization recommendations for PA had lower internalizing scores than non-active peers (MD = -1.28, 95% CI -2.53 to -0.03). Conclusions: Our findings highlight the importance of meeting PA recommendations to reduce psychosocial difficulties during a lockdown situation.
Open Access
Prevalence of meeting all three 24-h movement guidelines and its correlates among preschool-aged children
(Wiley, 2023) Ramírez Vélez, Robinson; Izquierdo Redín, Mikel; López Gil, José Francisco; Rincón Pabón, David; Martínez-Jamioy, Edwar Nicolas; Rivera-Ruiz, Rosemberg; Castellanos-Montaña, Sebastián; Atencio Osorio, Miguel Alejandro; Carrillo Arango, Hugo Alejandro; Alonso Martínez, Alicia; García Hermoso, Antonio; Ciencias de la Salud; Osasun Zientziak; Universidad Pública de Navarra / Nafarroako Unibertsitate Publikoa
The aim of the present study was twofold: first, to determine the meeting all three 24-h movement guidelines in Colombian preschool-aged children, and second, to explore the associations between different socio-ecological correlates and the meeting of these guidelines. This was a cross-sectional study with data from the Encuesta Nacional de Situación Nutricional (ENSIN-2015) in Colombia, 2015–2016. The sample comprised 3002 low-income preschoolers (3–4 years old, 50.7% boys). Data on physical activity, screen time, and sleep time were collected using the Cuestionario para la Medición de Actividad Física y Comportamiento Sedentario, reported by their parents. In total, 18 potential correlates (individual, interpersonal, organizational, and community level) were analyzed. Backward binary logistic regression analysis was performed with the potential correlates as independent variables and meeting all three 24-h movement guidelines as dependent variables. The prevalence of preschoolers meeting all three 24-h movement guidelines or none was 4.8% and 16.6%, respectively. In the final model, boys (odds ratio [OR] = 1.87, 95% confidence interval [CI] 1.00–3.50) and those who do not have television in their bedroom (OR = 2.09, 95%CI 1.05–4.14) were more likely to meet all three 24-h movement guidelines compared to with girls and those who have television, respectively. In conclusion, strategies to promote adherence to all 24-h movement guidelines among low-income preschoolers are warranted, and should focus on actions considering the importance of sex and home environment changes to support these movement behaviors.
Open Access
Consequences of low sleep duration in anthropometric and body composition parameters of Chilean preschoolers
(MDPI, 2021) Álvarez, Cristian; Paredes-Arévalo, Lorena; Obando, Isabel; Leal, Marlys; Ávila, Yennifer; Sadarangani, Kabir P.; Delgado Floody, Pedro; Alonso Martínez, Alicia; Izquierdo Redín, Mikel; Ciencias de la Salud; Osasun Zientziak
Reduced sleep duration in schoolchildren has been associated with poor health outcomes at the scholar level; however, there is little information on the effects of sleep loss on Chilean preschoolers. The aim of this study was to describe and compare cardiometabolic outcomes according with the sleep duration in Chilean preschoolers. A second aim was to identify potential risk outcomes (i.e., in odds ratios) for suffering anthropometric and body composition alterations related with participants' sleep duration. A total of 99 (n = 54 boys; n = 45 girls) preschoolers (mean age (95% CI) 3.1 (2.7, 3.4 years), mean weight 16.1 (15.5, 16.6 kg)) were included in this study. Sleep duration was assessed using standardized questionnaires with the parents. Socio-demographic parents’ information, as well as anthropometric, nutritional, and handgrip strength outcomes in preschoolers were distributed by tertiles (T1; < 10 h, T2; 10 to < 11 h, and T3; ≥ 11 h) of sleep time. Children in the lowest tertile of sleep duration had significantly higher body mass indices (p = 0.036), weight-for-height Z-scores (p < 0.0001), waist–hip ratios (p = 0.041), and body fat in percent (p = 0.035) and kg (p = 0.044) compared to those in the top tertile. Low sleep duration was associated with significantly greater risks of overweight/obesity (OR 1.3 (0.9, 1.8)), low height (OR 1.2 (0.8, 1.6)), and increased BMI (OR 1.5 (0.4, 1.4)), but not with reductions in grip strength. Chilean preschoolers with low sleep duration showed higher cardiometabolic markers (anthropometric/body composition) and were more likely to be classified as obese than youth with longer sleep duration.
Open Access
Effect of a gamified family-based exercise intervention on adherence to 24-hour movement behavior recommendations in preschool children: single-center pragmatic trial
(JMIR Publications, 2025-03-04) Legarra Gorgoñón, Gaizka; García Alonso, Yesenia; Ramírez Vélez, Robinson; Alonso Martínez, Loreto; Izquierdo Redín, Mikel; Alonso Martínez, Alicia; Ciencias de la Salud; Osasun Zientziak; Ciencias humanas y de la educación; Giza eta Hezkuntza Zientziak; Gobierno de Navarra / Nafarroako Gobernua
Background: Adherence to 24-hour movement behavior recommendations, including physical activity (PA), sedentary time, and sleep, is essential for the healthy development of preschool children. Gamified family-based interventions have shown the potential to improve adherence to these guidelines, but evidence of their effectiveness among children is limited. Objective: This study aimed to evaluate the effectiveness of a gamified family-based exercise intervention in promoting adherence to 24-hour movement behavior recommendations among preschool-aged children. Methods: This 12-week study is a single-center, pragmatic randomized controlled trial that included 80 preschool children (56% boys) and their families, who were randomly assigned to either the gamification group (n=40) or the control group (n=40). The “3, 2, 1 Move on Study” incorporates family-oriented physical activities and gamification techniques to increase PA domains, reduce sedentary behavior, and improve sleep patterns. The primary outcome was to increase moderate to vigorous PA (MVPA) by 5 minutes/day, as measured by accelerometer at follow-up. Accelerometer-determined daily time spent (PA domains, sedentary behavior, and sleep), physical fitness (cardiorespiratory, speed-agility, muscular, physical fitness z-score), basic motor competencies (self-movement and object movement), and executive function (memory, cognitive flexibility, and inhibitory control) were also included as secondary outcomes. Results: The 71 participants included in the per-protocol analyses (32 girls, 45%; 39 boys, 55%) had a mean (SD) age of 5.0 (0.5) years. Change in MVPA per day after the intervention (12 weeks) increased in both groups by +25.3 (SD 24.6) minutes/day in the gamification group and +10.0 (SD 31.4) minutes/day in the routine care group, but no significant between-group differences were observed (8.62, 95% CI –5.72 to 22.95 minutes/day, ηp2=.025; P=.23). The analysis of secondary outcomes showed significant between-group mean differences in the change in physical behaviors derived from the accelerometers from baseline to follow-up of 26.44 (95% CI 8.93 to 43.94) minutes/day in favor of light PA (ηp2=.138; P=.01) and 30.88 (95% CI 4.36 to 57.41) minutes/day in favor of total PA, which corresponds to a large effect size (ηp2=.087; P=.02). Likewise, the gamification group substantially increased their score in standing long jump and physical fitness z-score from baseline (P<.05). Conclusions: In the “3, 2, 1 Move on Study,” a gamified intervention showed a modest but relevant increase in MVPA and other domains of 24-hour movement behavior among preschool-aged children. Therefore, gamified family-based interventions may provide a viable alternative to improve adherence to 24-hour movement behavior recommendations.
Open Access
Association of physical education with improvement of health-related physical fitness outcomes and fundamental motor skills among youths: a systematic review and meta-analysis
(American Medical Association (AMA), 2020-08-31) García Hermoso, Antonio; Alonso Martínez, Alicia; Ramírez Vélez, Robinson; Pérez Sousa, Miguel A.; Ramírez Campillo, Rodrigo; Izquierdo Redín, Mikel; Ciencias de la Salud; Osasun Zientziak
This systematic review and meta-analysis of 55 studies that included 37 563 youths revealed that cardiorespiratory fitness levels and change over approximately 1 year during youth were associated with lower risk of developing obesity and cardiometabolic disease later in life. These early associations detected from baseline to follow-up dissipated over time. The study suggests that prevention strategies that target youth cardiorespiratory fitness may be associated with improved health parameters in later life.
Open Access
Association of cardiorespiratory fitness levels during youth with health risk later in life: a systematic review and meta-analysis.
(American Medical Association, 2020-08-31) García Hermoso, Antonio; Ramírez Vélez, Robinson; García Alonso, Yesenia; Alonso Martínez, Alicia; Izquierdo Redín, Mikel; Ciencias de la Salud; Osasun Zientziak; Gobierno de Navarra / Nafarroako Gobernua; Universidad Pública de Navarra / Nafarroako Unibertsitate Publikoa
Importance Although the associations between cardiorespiratory fitness (CRF) and health in adults are well understood, to date, no systematic review has quantitatively examined the association between CRF during youth and health parameters later in life. Objectives To examine the prospective association between CRF in childhood and adolescence and future health status and to assess whether changes in CRF are associated with future health status at least 1 year later. Data Sources For this systematic review and meta-analysis, MEDLINE, Embase, and SPORTDiscus electronic databases were searched for relevant articles published from database inception to January 30, 2020. Study Selection The following inclusion criteria were used: CRF measured using a validated test and assessed at baseline and/or its change from baseline to the end of follow-up, healthy population with a mean age of 3 to 18 years at baseline, and prospective cohort design with a follow-up period of at least 1 year. Data Extraction and Synthesis Data were processed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Random-effects models were used to estimate the pooled effect size. Main Outcomes and Measures Anthropometric and adiposity measurements and cardiometabolic health parameters. Results Fifty-five studies were included with a total of 37 563 youths (46% female). Weak-moderate associations were found between CRF at baseline and body mass index (r = –0.11; 95% CI, –0.18 to –0.04; I2 = 59.03), waist circumference (r = –0.29; 95% CI, –0.42 to –0.14; I2 = 69.42), skinfold thickness (r = –0.34; 95% CI, –0.41 to –0.26; I2 = 83.87), obesity (r = –0.15; 95% CI, –0.23 to –0.06; I2 = 86.75), total cholesterol level (r = –0.12; 95% CI, –0.19 to –0.05; I2 = 75.81), high-density lipoprotein cholesterol (HDL-C) level (r = 0.11; 95% CI, 0.05-0.18; I2 = 69.06), total cholesterol to HDL-C ratio (r = –0.19; 95% CI, –0.26 to –0.13; I2 = 67.07), triglyceride levels (r = –0.10; 95% CI, –0.18 to –0.02; I2 = 73.43), homeostasis model assessment for insulin resistance (r = –0.12; 95% CI, –0.18 to –0.06; I2 = 68.26), fasting insulin level (r = –0.07; 95% CI, –0.11 to –0.03; I2 = 0), and cardiometabolic risk (r = –0.18; 95% CI, –0.29 to –0.07; I2 = 90.61) at follow-up. Meta-regression analyses found that early associations in waist circumference (β = 0.014; 95% CI, 0.002-0.026), skinfold thickness (β = 0.006; 95% CI, 0.002-0.011), HDL-C level (β = −0.006; 95% CI, −0.011 to −0.001), triglyceride levels (β = 0.009; 95% CI, 0.004-0.014), and cardiometabolic risk (β = 0.007; 95% CI, 0.003-0.011) from baseline to follow-up dissipated over time. Weak-moderate associations were found between change in CRF and body mass index (r = –0.17; 95% CI, –0.24 to –0.11; I2 = 39.65), skinfold thickness (r = –0.36; 95% CI, –0.58 to –0.09; I2 = 96.84), obesity (r = –0.21; 95% CI, –0.35 to –0.06; I2 = 91.08), HDL-C level (r = 0.05; 95% CI, 0.02-0.08; I2 = 0), low-density lipoprotein cholesterol level (r = –0.06; 95% CI, –0.11 to –0.01; I2 = 58.94), and cardiometabolic risk (r = –0.08; 95% CI, –0.15 to –0.02; I2 = 69.53) later in life. Conclusions and Relevance This study suggests that early intervention and prevention strategies that target youth CRF may be associated with maintaining health parameters in later life.
Open Access
Twenty-four-hour movement guidelines during adolescence and its association with obesity at adulthood: results from a nationally representative study
(Springer, 2022) García Hermoso, Antonio; Ezzatvar, Yasmin; Alonso Martínez, Alicia; Ramírez Vélez, Robinson; Izquierdo Redín, Mikel; López Gil, José Francisco; Ciencias de la Salud; Osasun Zientziak; Universidad Pública de Navarra / Nafarroako Unibertsitate Publikoa
To determine the association between adherence to the 24-h movement guidelines during adolescence with obesity at adulthood 14 years later in a nationally representative cohort. We analyzed data from 6984 individuals who participated in Waves I (1994–1995) and IV (2008–2009) of the National Longitudinal Study of Adolescent Health (Add Health) in the USA. Obesity was defined by the International Obesity Task Force cut-off points at Wave I and adult cut-points at Wave IV (body mass index [BMI]≥30 kg/m2 and waist circumference [WC]≥102 cm in male and 88 cm in female). Physical activity, screen time and sleep duration were self-reported. Adolescents who met screen time recommendation alone (β = −1.62 cm, 95%CI −2.68 cm to −0.56), jointly with physical activity (β = −2.25 cm, 95%CI −3.75 cm to −0.75 cm), and those who met all three recommendations (β = −1.92 cm, 95%CI −3.81 cm to −0.02 cm) obtained lower WC at Wave IV than those who did not meet any of these recommendations. Our results also show that meeting with screen time recommendations (IRR [incidence rate ratio] = 0.84, 95%CI 0.76 to 0.92) separately and jointly with physical activity recommendations (IRR = 0.86, 95%CI 0.67 to 0.97) during adolescence is associated with lower risk of abdominal obesity at adulthood. In addition, adolescents who met all 24-h movement recommendations had lower risk of abdominal obesity later in life (IRR = 0.76, 95%CI 0.60 to 0.97). Conclusion: Promoting the adherence to the 24-h movement guidelines from adolescence, especially physical activity and screen time, seems to be related with lower risk of abdominal obesity later in life, but not for BMI.