Revista Española de Cardiología is an international scientific journal committed to the publication of research articles on cardiovascular medicine. The journal, published because 1947, is the official publication that the Spanish society of Cardiology and also founder of the REC Publications newspaper family. Articles are published in both English and also Spanish in its electronic edition.


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Physical task in adult is associated with a reduced risk the obesity, cardiovascular disease, high blood pressure, diabetes, cancer, and also premature death. There is substantial evidence the cardiovascular condition has its origins in childhood and also adolescence. Lipid and lipoprotein profiles, blood pressure, and also adiposity in young human being tend to persist over their lifetimes (tracking).1 over there is likewise evidence that behavioral patterns of physical activity in childhood are maintained throughout adulthood.2 Childhood and also adolescence room therefore vital to the primary prevention that cardiovascular an illness and other conditions linked with a sedentary lifestyle. This is particularly true as soon as we take right into account the an obstacle involved in editing adult lifestyles.

Although the is commonly assumed that much more active youngsters will have greater levels of physics fitness, and that the partnership is causal, the presumption may no longer be valid in the light of current knowledge. Only a tiny amount that the variation in various measures of physical fitness in children and teens can be attributed to physics activity. Actions of physical task and physical fitness additionally show great variability. In order to research the relationship between these 2 concepts in much more detail, it is perhaps best to start by specifying them.

The state "physical activity," "physical exercise," and also "physical fitness" are often confused. Although castle are closely related, they need to not be treated together synonyms. "Physical activity" ad to any bodily movement created by skeleton muscle i m sorry requires intake of energy. "Physical exercise," ~ above the various other hand, is characterized as any kind of planned, structured, and systematic physical activity designed to boost or maintain one or an ext components of physics fitness. "Physical fitness" in turn deserve to be interpreted as a measure up of the volume to carry out physical activity and/or physical practice that integrates the bulk of the bodily attributes (skeletomuscular, cardio-respiratory, hematocirculatory, endocrine-metabolic, and psycho-neurological) connected in bodily movement. Physical fitness has historically to be conceptualized as consisting of 3 components: cardio-respiratory volume (CRC), strength, and also agility. End time, the focus has change from strength and agility to aspects which are much more directly regarded health, and also has caused the coining that the term "health-related physics fitness." although the tests offered to identify health-related physics fitness are rather heterogeneous, they incorporate cardio-respiratory capacity, strength and also muscle resistance, flexibility, and body composition (particularly adiposity). In children, they also include speed and also agility.

back a large part of the variability in physical fitness is genetically determined, environmental factors, and specifically physical exercise, likewise influence physical fitness. In children, the relationship in between physical task and physical fitness is much less clear. It has actually been said that physical task in children and younger adolescents is i can not qualify to modify physical fitness due to the fact that it is mostly unpredictable and non-systematic, and occurs in relatively short bursts. The absence of agreement between studies which have actually examined the relationship in between physical activity and physical fitness in youngsters and adolescents could be as result of the range of methods used to measure both physical fitness and also physical activity. Once trying to evaluate the results of physical activity, it is necessary to take right into account the difficulty of obtaining precious and specific measurements.

results from the europe Youth heart Study published in the current worry of Revista Española de Cardiología through Ortega et al3 assistance the theory that adolescents who can be considered active, ie, those that perform at least 60 min of center to extreme physical task daily, have higher cardiovascular capacity. It is a meticulous and also rigorous short article which tackles a topic i beg your pardon is of certain relevance at a time once sedentary behavior and poor physics fitness are increasingly prevalent among teenagers in the majority of developed countries. This tendencies are paralleled by increases in the frequency the overweight and obesity to alarming proportions in some Mediterranean countries. The study's main contribution is to indicate that, although over there is a well-established association between physical activity and CRC, the is not clear that compliance with current recommendations top top the quantity and intensity the physical activity in adolescents will be adequate to accomplish a healthy CRC. In bespeak to investigate this element further, they supplied accelerometers to measure up the frequency and intensity that physical activity and VO2máx with a cycloergometer to measure CRC. Castle conclude that teenagers who do at least 60 min of moderate to extreme physical activity daily are much more likely to have a healthy and balanced CRC, individually of the level of sexual maturity and adiposity.

As the study's contributions room of good practical importance, the is worth examining specific aspects the the relationship in between physical task and physics fitness in much more detail, also the connection of these v health.

Relationship in between Physical activity and physical Fitness in Children and Adolescents

It is usually assumed that physical task is concerned physical fitness and also that physically energetic children will therefore be in far better physical condition. For some authors, return they might not make it explicit, this connection is additionally causal, and it is often alleged that the evidence indicates that just high soot physical task (over 6 MET) boosts physical fitness. To date, although the data indigenous the study in concern seem to point in the direction, together affirmations have actually no solid scientific basis, as we will watch below. In the first place, it have to be stated that the relationship in between physical task and physics fitness is only weak or moderate and also in some research studies it is no significant. Furthermore, daily physical activity explains only a reasonably small relationship of aerobic capacity.4

number of reasons have actually been placed forward to describe this weak association, consisting of the fact that actions of physical task and physics fitness vary substantially in terms of their validity and reliability, the moderate-high intensity physical task in children and young people is not maintained over prolonged periods, and that the relationship in between physical fitness and physical activity in youngsters and teens can be masking at least in component by the heterogeneity that the samples in researches of children and adolescents.5

It is true the the measure of physical task in children and also young people is subject to numerous conditioning determinants which threaten validity and also reliability. The constraints of measure up physical task using scales and questionnaires have actually been faced in excellent reviews so it is not necessary to go into information on that element here.6 that is worth pointing out, however, the although the measure of physical task using accelerometers is certainly the many objective method, it is not exempt from serious constraints which also threaten its validity and also reliability. In the an initial place, accelerometers are poor at recording details movements which involve minimal upright displacements, such as pedaling. These form a significant proportion that children and also adolescents' leisure-time physical activities in some European countries, including Sweden, whereby data for the present study to be collected. In the 2nd place, the cut-points used to categorize the intensity of physical activity were defined under laboratory conditions and are not really representative of the movements children and teenagers make under natural conditions. Finally, whilst over there is a stringent need to administer data top top non-response once studies use questionnaires to measure up physical activity, and it may even be vital to analysis differences between responders and non-responders, this is not the instance when accelerometers are supplied to measure physical activity. The ratio of measurements which are discounted because they perform not meet inclusion criteria (at least 3 days through a minimum that 10 h of documents per job in the Ortega et al study) is regularly not reported. Our experience in measuring physical activity in kids and adolescents using accelerometers leads us to suspect that there might be differences in between those who satisfy inclusion criteria and those who do not in regards to patterns of physics activity.

Physical activity and physics Fitness. The duty of Obesity and Genetic Determinants

number of studies have presented that adult people who regularly carry out physical activity are less likely to build health problems. Likewise, over there is evidence of an inverse relationship in between physical fitness and also the threat of ending up being ill and also of dying. It has been reported the physical fitness far better predicts wellness outcomes in adults than physical activity.7 In children, data indigenous cross-sectional8 and prospective9 studies have actually been supplied to indicate increasing physical task is insufficient, together future cardiovascular hazard is more dependent on physical fitness 보다 on the quantity of physical task performed. Nevertheless, some arguments might lead us to question this affirmation.

Firstly, the relationship in between physical activity and physics fitness, and also the relationship between the latter and also several cardiovascular risk determinants cannot it is in analyzed there is no taking right into account numerous confounding factors, specifically adiposity and genetic determinants. The results of an treatment study10 show that only high soot physical exercise has any type of effect top top CRC in obese adolescents, and that both moderate and also high strongness physical practice modifies adiposity. ~ above the various other hand, a more recent cross-sectional study11 verified that both the complete amount the physical activity and extreme physical activity were linked with a far better CRC, although just intense physical task reduced adiposity. Our opinion is that, provided that both physical fitness and adiposity have actually a marked hereditary component, teens who space genetically predisposed to bad physical problem or obesity are much less likely to get involved in intense physical activity. To more complicate the situation, genetic inheritance deserve to also influence the relationship between CRC and cardiovascular risk. This has actually been displayed to be the instance in research studies which have linked polymorphisms of the angiotensin converting enzyme and also CRC on the one hand, and also others which have displayed an association in between low birth load (which is in component genetically determined) v a low CRC in childhood and also adolescence.

The abovementioned studies additionally raise questions around the directionality the the association in between physical activity and physical fitness. Because that example, after 23 year of follow-up, researcher from the Amsterdam Growth and Health Longitudinal examine concluded the there is a far-reaching though weak association between physical task and aerobic capacity throughout adolescence, although the direction the the connection was no clear. They additionally concluded that physical activity in adolescence was not connected with aerobic volume in adulthood, which says that hereditary factors might be more important than environmental components in identify the relationship in between physical activity and aerobic capacity.12 few of our team's newly published data13 indigenous the review of a routine to promote leisure-time physical activity in school-age kids showed a palliation in adiposity and an advancement in lipid profiles there is no substantial change in physics fitness. The regimen was handle to children aged 9-10 years from 20 institutions in the Cuenca province (Spain). Physical activity was quantified by comparing counts every minute videotaped by accelerometer during each that 3 weekly 90 min sessions matches those job on i m sorry there was no conference (available at: www.movidavida.org).

one more noteworthy element of the examine by Ortega et al space the differences in the strength of the association between physical activity and physics fitness when gender is taken into account. The authors indicate that this results can stem indigenous the socio-cultural differences in between boys and girls. Although we acknowledge that over there is part difficultly in explaining this finding, us believe, as pointed out earlier, the genetic factors should be thought about as a possible explanation because that a substantial amount that the variability in physics fitness. This might be because of the way genetics influence fat distribution and aerobic capacity, as well as their effect on the levels of testosterone and other hormones connected with strength and flexibility. Together the authors indicate, future researches in this area need to attempt to clarify the causes of differences in physical activity and CRC between boys and girls.

In summary, the examine by Ortega et al is notable for that is rigor and precision in measuring physical activity and physical fitness, and the reality that it gives data ~ above the relationship in between recommendations because that physical task and physical fitness, and also on the prominence of sex in the relationship. The results of this study indicate hypotheses about the duty of gender, genetics, and, possibly, other environmental components in the relationship in between physical task and CRC. It additionally highlights the much reduced prevalence of short CRC amongst adolescent boys in Sweden contrasted to Spain (9% vs 19%, respectively). The numbers are comparable in females (20% and 17%, respectively).

The best Preventive Strategy in Adolescents: provide Opportunities for Physical Activity

Nonetheless, back we indeed need to further explore the relationship between physical task and physics fitness, we should not shed sight the the horizon. Physical activity is a behavior and physical fitness, a state. The is in ~ our way to promote active behaviors i m sorry can assist modify the level of physics fitness. Physics fitness is a an outcome not only of genetic conditioning but likewise of individual and also social determinants. As we are presently unable to modify hereditary determinants, we need to focus on editing and enhancing individual and also social determinants of physics activity. In spite of some authors' doubts that physical exercise listed below recommended levels will influence physical fitness, exercise at this levels may nevertheless still lead to renovations in self-esteem, scholastic performance, or bone density.

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there is, then, an urgent need to provide more opportunities for physical task in adolescents. These might include the supplication of "cycle lanes" to access educational and recreation centers, easy accessibility to sporting activities facilities, parks through "fun" jogging circuits, pedestrian-safe cities, physical activity during free-time in education centers, and also the promo of out-of-school, non-competitive physical practice programs, and games. At the exact same time, we need to ensure the the act of physical exercise is something to it is in valued and appreciated in the adolescents' environment. To execute that we need to increase awareness among families, educators, and other social agents that fostering competitive and, particularly, non-competitive physical practice is the best way to ensure a healthy future for the young world of today.

See articles on pages 123-9

Correspondence: Dr. V. Martínez-Vizcaíno. Centro de Estudios Socio-Sanitarios. Universidad de Castilla-La Mancha. Santa Teresa Jornet, s/n. Edificio Melchor Cano. 16071 Cuenca. España. E-mail: Vicente.Martinez