Abstract
BackgroundFitness and physical activity are important for cardiovascular and mental health but activity and fitness levels are declining especially in adolescents and among girls. This study examines clustering of factors associated with low fitness in adolescents in order to best target public health interventions for young people.Methods1147 children were assessed for fitness, had blood samples, anthropometric measures and all data were linked with routine electronic data to examine educational achievement, deprivation and health service usage. Factors associated with fitness were examined using logistic regression, conditional trees and data mining cluster analysis. Focus groups were conducted with children in a deprived school to examine barriers and facilitators to activity for children in a deprived community.ResultsUnfit adolescents are more likely to be deprived, female, have obesity in the family and not achieve in education. There were 3 main clusters for risk of future heart disease/diabetes (high cholesterol/insulin); children at low risk (not obese, fit, achieving in education), children ‘visibly at risk’ (overweight, unfit, many hospital/GP visits) and ‘invisibly at risk’ (unfit but not overweight, failing in academic achievement). Qualitative findings show barriers to physical activity include cost, poor access to activity, lack of core physical literacy skills and limited family support.ConclusionsLow fitness in the non-obese child can reveal a hidden group who have high risk factors for heart disease and diabetes but may not be identified as they are normal weight. In deprived communities low fitness is associated with non-achievement in education but in non-deprived communities low fitness is associated with female gender. Interventions need to target deprived families and schools in deprived areas with community wide campaigns.
Highlights
Fitness and physical activity are important for cardiovascular and mental health but activity and fitness levels are declining especially in adolescents and among girls
The aim of this paper is to examine clustering of risk factors in order to highlight where public health interventions might be most effective and to explore the barriers to activity among teenagers from a deprived background so that public health intervention can be targeted to address these barriers
The detailed demographic details of the children participating in the health survey have previously been published [7]
Summary
Fitness and physical activity are important for cardiovascular and mental health but activity and fitness levels are declining especially in adolescents and among girls. This study examines clustering of factors associated with low fitness in adolescents in order to best target public health interventions for young people. Fitness and physical activity are important for health, growth and development during childhood and adolescence [1,2]. Given strong evidence of fitness as a critical marker of adolescent and adult health [17], it is desirable to formulate effective and timely preventive strategies starting early in life. The aim of this paper is to examine clustering of risk factors in order to highlight where public health interventions might be most effective and to explore the barriers to activity among teenagers from a deprived background so that public health intervention can be targeted to address these barriers
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