Open Access
What is the role of adherence to 24-hour movement guidelines in relation to physical fitness components among adolescents?
(Wiley, 2023) Tapia-Serrano, Miguel Ángel; López Gil, José Francisco; Sevil-Serrano, Javier; García Hermoso, Antonio; Sánchez-Miguel, Pedro Antonio; Ciencias de la Salud; Osasun Zientziak; Universidad Pública de Navarra / Nafarroako Unibertsitate Publikoa–1225/2022
Background: Physical inactivity, excessive sedentary time, and lack of sleep time have been independently associated with lower health-related physical fitness. However, little is known about the combined association between 24-h movement guidelines (i.e., physical activity, recreational screen time, and sleep duration) and components of physical fitness. Objective: The main aim was to examine the likelihood of having high/very high levels on different components of physical fitness based on meeting with 24-h movement guidelines. Methods: In this cross-sectional study, 1276 Spanish youths (13.07±0.86; 55.88% boys), aged 11–16 years, completed self-reported questionnaires on physical activity, recreational screen time, and sleep duration. Physical fitness components were assessed by 20-m shuttle-run test, standing long jump test, handgrip strength test, and 4×10-m shuttle-run test. Meeting 24-h movement guidelines was defined as: 9–11h/day (children aged 5–13) or 8–10h/day (adolescents aged 14–17) of sleep, ≤2h/day of recreational screen time and at least 60min/day of moderateto-vigorous physical activity. The probability of having a high/very high score for each physical fitness components (i.e., ≥60th centile according to the normative cut-off points for European adolescents) in relation to adherence to 24-h movement guidelines was analyzed using a series of binary logistic regressions. Results: Participants who met the three 24-h movement guidelines were more likely to have high/very high for cardiorespiratory fitness (OR=3.31; 95% CI: 1.79, 6.14; p<0.001), standing long jump (OR=1.91; 95% CI: 1.06, 3.45; p=0.031), muscular fitness (OR=2.05; 95% CI: 1.09, 3.86; p=0.048) and physical fitness (OR=1.99; 95% CI: 1.08, 3.66; p=0.012), but not for handgrip strength (OR=1.15; 95% CI: 0.64, 2.01; p=0.636) and speed/agility (OR=1.65; 95% CI: 0.92, 2.96; p=0.093), compared to those who did not meet all three recommendations. Conclusion: Since meeting the three 24-h movement guidelines increased the likelihood of having higher levels in most physical fitness components, it seems necessary to promote these movement behaviors early in life, as they could serve as a gateway for improving health-related fitness in future generations.
Embargo
Physical fitness and sleep-related problems among adolescents: findings from the EHDLA study
(Wiley, 2025-03-19) Muñoz Pardeza, Jacinto; Ezzatvar, Yasmin; Gutiérrez Espinoza, Héctor; Páez-Herrera, Jacqueline; Olivares-Arancibia, Jorge; Yáñez-Sepúlveda, Rodrigo; García Hermoso, Antonio; López Gil, José Francisco; Ciencias de la Salud; Osasun Zientziak
Physical fitness, particularly cardiorespiratory fitness, has been shown to positively impact sleep quality. However, the relation-ship between overall physical fitness and sleep-related problems in adolescents remains underexplored. Therefore, the aim ofthis study was to analyze the association between overall physical fitness and sleep-related problems in adolescents. This cross-sectional study included 812 adolescents (median age: 14 years [interquartile range = 12–17]; 54.9% girls) from the Eating Healthyand Daily Life Activities (EHDLA) data. Physical fitness was measured objectively using the Assessing the Levels of PHysicalActivity and fitness (ALPHA-Fit) battery for children and adolescents and a flexibility test, while sleep-related problems wereevaluated using the BEARS sleep screening tool (B = Bedtime problems, E = Excessive daytime sleepiness, A = Awakenings dur-ing the night, R = Regularity and duration of sleep, S = Snoring). Generalized linear models were used to examine the associationof overall physical fitness with the different components of sleep-related problems. The odds of experiencing sleep-related prob-lems decreased significantly with each kilogram increase in handgrip strength (odds ratio [OR] = 0.97, 95% confidence interval[CI] 0.94–0.99), and with each standard deviation increase in overall physical fitness (OR = 0.76, 95% CI 0.59–0.99). In contrast,despite not statistically significant, an increase in long jump appeared to reduce the sleep-related problems (OR = 0.91; 95% CI0.82–1.02), while a longer time in the 4×10-m shuttle run test might increase sleep problems (OR = 1.12; 95% CI 0.98–1.28). Inconclusion, greater levels of physical fitness, particularly muscular strength, may be key for reducing sleep-related problems,emphasizing the importance of personalized training programs.
Embargo
Twenty-four-hour movement guidelines and depressive symptoms: association, temporal trends and moderators over a ten-year period among 45,297 US adolescents
(Springer, 2025-02-24) López Gil, José Francisco; Solmi, Marco; García Hermoso, Antonio; Vancampfort, Davy; Fabiano, Nicholas; Schuch, Felipe; Stubss, Brendon; Smith, Lee; Torous, John; Firth, Joseph; Ciencias de la Salud; Osasun Zientziak
The aims of the present study were: (1) to examine the association between meeting the 24-h movement guidelines and depressive symptoms among U.S. adolescents; (2) to analyze the temporal trends of this association; and (3) to test whether sex, age, or race/ethnicity moderate these associations. This is a cross-sectional study using repeated data collection from the high school Youth Risk Behavior Surveys (YRBS), involving 45,297 adolescents in the US (49.7% females). Data were collected bi-annually between 2011 and 2021. These surveys represent cross-sectional snapshots rather than a longitudinal study, capturing data at distinct points in time across multiple years. The three 24-h movement guidelines, including guidelines for physical activity, screen time, and sleep duration were assessed by self-reported questions. Depressive symptoms were assessed by the question “During the past 12 months, did you ever feel so sad or hopeless almost every day for two weeks or more in a row that you stopped doing your usual activities?” with yes/no answer options. A generalized linear mixed model (GLMM) was employed to gauge the association between adherence to the 24-h movement guidelines (exposure) and the likelihood of having depressive symptoms (outcome). The year of data collection was included as a random intercept in the mixed-effects model to account for potential variations in depressive symptoms across different time points. The model was further adjusted for covariates, including sex, age, race/ethnicity, alcohol and tobacco consumption, school bullying, cyberbullying, and excess weight. Adolescents meeting all three 24-h movement guidelines (physical activity, screen time, and sleep) had the lowest probability of depressive symptoms (21.3%, 95% CI 17.3–25.3%) compared to those meeting none (37.6%, 95% CI 33.4–41.8%). Significant protective effects were observed across all adherence levels (p < 0.05). Over the 2011–2021 period, adherence remained consistently associated with reduced depressive symptoms, with the strongest effects seen in 2019 and 2021. Younger adolescents, males, and White individuals showed the greatest benefits, while females, older adolescents, Black, Hispanic/Latino, and individuals from other racial/ethnic groups exhibited weaker protective effects despite adherence. Findings from the present study highlight the importance of encouraging adherence to 24-h movement guidelines as a potential strategy to reduce depressive symptoms in adolescents. Notably, the protective effects of adherence varied across sociodemographic groups, with younger adolescents, females, and White individuals experiencing the greatest benefits.
Open Access
Handgrip strength and its relationship with white blood cell count in U.S. adolescents
(MDPI, 2021) López Gil, José Francisco; Ramírez Vélez, Robinson; Izquierdo Redín, Mikel; García Hermoso, Antonio; Ciencias de la Salud; Osasun Zientziak; Universidad Pública de Navarra / Nafarroako Unibertsitate Publikoa, ID 420/2019
Background: The role of muscular fitness (as a protecting factor for an optimal immune system) and WBC count remains unclear. To the best of our knowledge, this is the first study to investigate the relationship between the total count of WBC and groups based on handgrip strength and body composition. The aim of this study was to elucidate the relationship between handgrip strength and WBC count in a nationally representative sample of adolescents from the U.S. Methods: We used data from the NHANES cross-sectional study (waves 2011 to 2014). The final analysis included 917 adolescents from 12–17 years old (51.0% boys). Normalized handgrip strength (kg) (NHS) was relativized by body composition parameters (body weight [NHSw], total body fat [NHSf], and trunk fat [NHSt]) assessed with dual energy X-ray absorptiometry. Results: An inverse association was found between total WBC count and all assessments of low NHS in both sexes (p < 0.05). Both boys and girls with low NHS had higher WBC counts in all estimations of NHS than those with high NHS (p < 0.05 for all). All estimations of low NHS showed significant differences with those with intermediate NHS (only in girls) (p < 0.05 for all). Girls with intermediate NHSt exhibited higher WBC count than those with high NHSt (p = 0.004). Conclusions: Our findings suggest that greater levels of NHS are linked to lower total WBC counts. From a public health perspective, our findings are clinically significant and emphasize the relevance of improving muscular fitness during adolescence since it may contribute to boosting the immune system among adolescents.
Open Access
Is higher adherence to the mediterranean diet associated with greater academic performance in children and adolescents? a systematic review and meta-analysis
(Elsevier, 2024-06-18) López Gil, José Francisco; Victoria-Montesinos, Desirée; García Hermoso, Antonio; Ciencias de la Salud; Osasun Zientziak
Objective: the aim of the present study was to synthesize the available evidence from the relationship between adherence to the Mediterranean diet (MedDiet) and academic performance in children and adolescents. Methods: a systematic review and meta-analysis was conducted, which adhered to the guidelines outlined in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Four electronic databases (PubMed, Scopus, Web of Science, and the Cochrane Library) were examined from inception to April 8th, 2024. Results: eighteen studies were included in the current systematic review and sixteen in the meta-analysis. The relationship between adherence to the MedDiet and academic performance among children and adolescents was statistically significant (Pearson's correlation coefficient [r] = 0.17, 95% confidence interval [CI]: 0.14 to 0.21, p < 0.001; inconsistency index [I2] = 56.7%). The influence analysis revealed that removing individual studies one at a time did not result in any changes to the overall results (p < 0.05 in all cases). Conclusions: a higher adherence to the MedDiet could play a relevant role in academic performance among children and adolescents.
Open Access
Cross-cultural adaptation, reliability, and validation of the Spanish perceived physical literacy instrument for adolescents (S-PPLI)
(Elsevier, 2023) López Gil, José Francisco; Martínez Vizcaíno, Vicente; Tárraga López, Pedro J.; García Hermoso, Antonio; Ciencias de la Salud; Osasun Zientziak
Objective: The aim of this study was to examine the reliability and validity of the Spanish Perceived Physical Literacy Instrument (S-PPLI) questionnaire in Spanish adolescents. Method: The participants of this study were 360 Spanish adolescents (aged 12-17 years) from three secondary schools in the Region of Murcia (Spain). A cultural adaptation process of the original version of the PPLI questionnaire was developed. Confirmatory factor analysis was applied to test the three-factor structure of physical literacy. Intraclass correlation coefficients were computed to estimate the test-retest concordance. Results: Using a confirmatory factor analysis, the factor loading of all items above the standard of 0.40 ranged from 0.53 to 0.77, suggesting that the observed variables sufficiently represented the latent variables. Analyses for convergent validity showed average variance extracted values that ranged from 0.40 to 0.52 and composite reliability values higher than 0.60. All the correlations were below the recommended cutoff point of 0.85, which indicated that the three physical literacy factors achieved adequate discriminant validity. Intraclass correlation coefficients ranged from 0.62 to 0.79 (p < 0.001 for all items), which indicated moderate/good reliability. Conclusions: Our results suggest that the S-PPLI is a valid and reliable measure of physical literacy among Spanish adolescents.
Open Access
Mediterranean diet-based interventions to improve anthropometric and obesity indicators in children and adolescents: a systematic review with meta-analysis of randomized controlled trials
(Elsevier, 2023) López Gil, José Francisco; García Hermoso, Antonio; Sotos-Prieto, Mercedes; Cavero-Redondo, Iván; Martínez Vizcaíno, Vicente; Kales, Stefanos N.; Ciencias de la Salud; Osasun Zientziak; Universidad Pública de Navarra / Nafarroako Unibertsitate Publikoa, 1225%2F2022
To our knowledge, no systematic review with meta-analysis has separately synthesized the effects of Mediterranean diet-based interventions in children and adolescents in relation to the effects on anthropometric measures. A better understanding of the effects of Mediterranean dietbased interventions on anthropometric variables could facilitate their implementation in efforts to prevent obesity in the young population. The aim of the present meta-analysis was to evaluate the effects of Mediterranean diet-based interventions on anthropometric and obesity indicators among children and adolescents. Four databases were systematically searched (PubMed, Scopus, Web of Science, and Cochrane Database of Systematic Reviews), including all studies up until 15 March, 2023. Eligible articles were randomized controlled trials measuring the effect of an intervention based on the promotion of the Mediterranean diet and obesity-associated parameters. The effect size of each study was estimated by Cohen’s d for continuous variables or risk difference for categorical variables. Compared to the control group, the Mediterranean diet-based interventions showed small and significant reductions in body mass index (d=- 0.14; 95% CI: 0.26, 0.01; I 2= 77.52%). Participants in the Mediterranean diet-based interventions had a significant reduction in the percentage of obesity (risk difference = 0.12; 95% CI: 0.01, 0.23; I 2= 84.56%) in comparison with the control group. Interventions had greater effects when aiming at participants with excess weight (that is, overweight or obesity), both for body mass index, waist circumference, waist-to-height ratio, percentage of obesity, and percentage of abdominal obesity. Mediterranean diet-based interventions have a significant effect on reducing the body mass index as well as reducing obesity in children and adolescents (aged 3–18 y). This trial was registered at PROSPERO as CRD42023386789.
Embargo
Is social jetlag associated with physical fitness among spanish adolescents?: insights from the EHDLA study
(Wiley, 2025-01-23) Miño, Camila; García Hermoso, Antonio; Gutiérrez Espinoza, Héctor; Olivares-Arancibia, Jorge; Yáñez-Sepúlveda, Rodrigo; Duclos-Bastías, Daniel; Smith, Lee; López Gil, José Francisco; Ciencias de la Salud; Osasun Zientziak
Background: The misalignment of sleeping times during weekdays/weekends (i.e., social jetlag) is particularly common amongadolescents and plausibly associated with their physical fitness. However, literature on this topic is scarce. Therefore, this studyaimed to investigate the association between social jetlag and physical fitness in Spanish adolescents. Methods: A secondary analysis was conducted on cross-sectional data from the Eating Healthy and Daily Life Activities(EHDLA) study among 812 adolescents (54.9% girls) aged 12–17 years from the Valle de Ricote (Region of Murcia, Spain). Socialjetlag was calculated from self-reported data on bedtimes and wake times for weekdays and weekends. Physical fitness was eval-uated with the Assessing the Levels of PHysical Activity and Fitness (ALPHA-FIT) for children and adolescents and includedcardiorespiratory fitness, muscular fitness, speed agility, and flexibility. Results: The analysis revealed significant negative associations between worse social jetlag and detrimental overall physical fit-ness (unstandardized beta coefficient [B] = −0.06, 95% confidence interval [CI]: −0.09, −0.02; p = 0.002), cardiorespiratory fitness(B = −1.28; 95% CI −2.22, −0.34; p = 0.008), and lower body muscular fitness (B = −2.01; 95% CI −3.90, −0.12; p = 0.038) after theadjustment for potential covariates (age, sex, socioeconomic status, physical activity level, sedentary behavior, nocturnal sleepduration, energy intake, and body mass index). In contrast with other fitness components, a significant positive association wasidentified between social jetlag and speed agility (B = 0.07; 95% CI 0.00, 0.14; p = 0.049). Conclusions: In adolescents, social jetlag is significantly linked to poorer physical fitness, especially for cardiorespiratory fit-ness and lower-body muscular fitness. Maintaining regular and well-synchronized sleep could be crucial for optimizing physicalhealth and preventing the decline of physical fitness during adolescence.