British journal of sports medicine · 2025
Cardiorespiratory fitness and health in children and adolescents: an overview of systematic reviews with meta-analyses representing over 125 000 observations covering 33 health-related outcomes.
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Demchenko Iryna, Prince Stephanie A, Merucci Katherine, Cadenas-Sanchez Cristina, Chaput Jean-Philippe, Fraser Brooklyn J, Manyanga Taru, McGrath Ryan, Ortega Francisco B, Singh Ben, Tomkinson Grant R, Lang Justin J
Аннотация
OBJECTIVE: To synthesise data on the associations between cardiorespiratory fitness (CRF) and health in children and adolescents, evaluate the certainty of evidence and identify knowledge gaps.
DESIGN: An overview of systematic reviews with meta-analyses. Results were pooled using forest plots and certainty of evidence evaluated with GRADE.
DATA SOURCES: Medline, Embase, Scopus, CINAHL and SPORTDiscus were searched from January 2002 to March 2024.
ELIGIBILITY CRITERIA FOR SELECTED STUDIES: Systematic reviews with meta-analyses exploring CRF and health in children and adolescents aged <18 years.
RESULTS: From the 9062 records identified, 14 reviews were included. Meta-analysed data from 125 164 observations covering 33 health outcomes were compiled, showing favourable (n=26) or null (n=7) associations with CRF. Among general populations, the associations were weak-to-moderate, with favourable links between CRF and indicators of anthropometry and adiposity, cardiometabolic and vascular health, and mental health and well-being. Among clinical populations, CRF was lower in participants with a condition compared with healthy controls, with the largest difference for newly diagnosed cancer (mean difference=-19.6 mL/kg/min; 95%CI: -21.4,-17.8). Patients with cystic fibrosis had a greater risk for all-cause mortality when comparing low CRF vs. high (relative risk=4.9; 95%CI: 1.1, 22.1). The certainty of evidence ranged from very low to moderate.
CONCLUSION: CRF shows promising links to numerous health outcomes in paediatric populations, though the low certainty of evidence calls for further research. High-quality longitudinal evidence is warranted to confirm the findings and investigate a predictive role of childhood CRF for future health.
DESIGN: An overview of systematic reviews with meta-analyses. Results were pooled using forest plots and certainty of evidence evaluated with GRADE.
DATA SOURCES: Medline, Embase, Scopus, CINAHL and SPORTDiscus were searched from January 2002 to March 2024.
ELIGIBILITY CRITERIA FOR SELECTED STUDIES: Systematic reviews with meta-analyses exploring CRF and health in children and adolescents aged <18 years.
RESULTS: From the 9062 records identified, 14 reviews were included. Meta-analysed data from 125 164 observations covering 33 health outcomes were compiled, showing favourable (n=26) or null (n=7) associations with CRF. Among general populations, the associations were weak-to-moderate, with favourable links between CRF and indicators of anthropometry and adiposity, cardiometabolic and vascular health, and mental health and well-being. Among clinical populations, CRF was lower in participants with a condition compared with healthy controls, with the largest difference for newly diagnosed cancer (mean difference=-19.6 mL/kg/min; 95%CI: -21.4,-17.8). Patients with cystic fibrosis had a greater risk for all-cause mortality when comparing low CRF vs. high (relative risk=4.9; 95%CI: 1.1, 22.1). The certainty of evidence ranged from very low to moderate.
CONCLUSION: CRF shows promising links to numerous health outcomes in paediatric populations, though the low certainty of evidence calls for further research. High-quality longitudinal evidence is warranted to confirm the findings and investigate a predictive role of childhood CRF for future health.