Health-Related Physical Fitness is Associated with Total and Central Body Fat in Children Aged 6 to 10 Years
DOI:
https://doi.org/10.17309/tmfv.2022.3s.16Keywords:
cardiorespiratory fitness, muscular strength, motor fitness, children, obesityAbstract
Study purpose. This study purpose was to investigate whether health-related physical fitness is associated with total and central body fat in school children aged 6–10 years.
Materials and methods. A total of 2197 Macedonian children aged 6–10 years (1096 boys and 1101 girls) participated in the study. Health-related physical fitness was measured by the modified EUROFIT test battery: the 20 m shuttle run test (cardiorespiratory fitness); the handgrip strength test, the standing long jump and the 30 s sit-ups tests (muscular strength); the 4×10 m shuttle run test (motor fitness) and the sit and reach test (flexibility). Body mass index, body fat percentage and waist circumference were used as markers of total and central body fat, respectively.
Results. The standing long jump, the 30 s sit-ups, the 4×10 m shuttle run and the 20 m shuttle run tests were negatively associated with all markers of total and central body fat in boys and girls after controlling for age (p<0.01). The handgrip strength test was positively associated with all markers of total and central body fat (p<0.01). No statistically significant correlation was established between the markers of total and central body fat and the sit and reach test.
Conclusions. The present study broadens previous findings in children and adolescents which demonstrate correlations between the health-related physical fitness components, chiefly the muscle strength, the agility and cardiorespiratory fitness and total central adiposity. Fitness assessment should be introduced in future epidemiological and intervention studies in school children because it seems to be an important factor determining health.
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References
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Myers, J., Prakash, M., Froelicher, V., Do, D., Partington, S., & Atwood, J. E. (2002). Exercise capacity and mortality among men referred for exercise testing. New England journal of medicine, 346(11), 793-801. https://doi.org/10.1056/NEJMoa011858
Ortega, F. B., Ruiz, J. R., Castillo, M. J., & Sjöström, M. (2008). Physical fitness in childhood and adolescence: a powerful marker of health. International journal of obesity, 32(1), 1-11. https://doi.org/10.1038/sj.ijo.0803774
Ortega, F. B., Ruiz, J. R., Hurtig-Wennlöf, A., & Sjöström, M. (2008). Physically active adolescents are more likely to have a healthier cardiovascular fitness level independently of their adiposity status. The European youth heart study. Revista Española de Cardiología (English Edition), 61(2), 123-129. https://doi.org/10.1016/S1885-5857(08)60087-0
Haerens, L., Deforche, B., Maes, L., Cardon, G., & De Bourdeaudhuij, I. (2007). Physical activity and endurance in normal weight versus overweight boys and girls. Journal of Sports Medicine and Physical Fitness, 47(3), 344. PMID: 17641603
Brunet, M., Chaput, J. P., & Tremblay, A. (2007). The association between low physical fitness and high body mass index or waist circumference is increasing with age in children: the ‘Quebec en Forme’Project. International journal of obesity, 31(4), 637-643. https://doi.org/10.1038/sj.ijo.0803448
Casajús, J. A., Leiva, M. T., Villarroya, A., Legaz, A., & Moreno, L. A. (2007). Physical performance and school physical education in overweight Spanish children. Annals of Nutrition and Metabolism, 51(3), 288-296. https://doi.org/10.1159/000105459
Martinez‐Tellez, B., Sanchez‐Delgado, G., Cadenas‐Sanchez, C., Mora‐Gonzalez, J., Martín‐Matillas, M., Löf, M., ... & Ruiz, J. R. (2016). Health‐related physical fitness is associated with total and central body fat in preschool children aged 3 to 5 years. Pediatric obesity, 11(6), 468-474. https://doi.org/10.1111/ijpo.12088
Fogelholm, M., Stigman, S., Huisman, T., & Metsämuuronen, J. (2008). Physical fitness in adolescents with normal weight and overweight. Scandinavian journal of medicine & science in sports, 18(2), 162-170. https://doi.org/10.1111/j.1600-0838.2007.00685.x
Gontarev, S., & Ruzdija, K. (2014). The relationship between overweight, obesity and physical fitness among eleven and twelve-year-old Macedonian adolescents. Journal of Physical Education and Sport, 14(2), 178. https://doi.org/10.7752/jpes.2014.02028
Gontarev, S., Kalac, R., Velickovska, L., Stojmanovska, D., Misovski, A., & Milenkovski, J. (2018). Health-related physical fitness of normal, stunted and overweight children aged 6-14 years in Macedonia. Nutrición Hospitalaria. http://dx.doi.org/10.20960/nh.1843
Xu, Y., Mei, M., Wang, H., Yan, Q., & He, G. (2020). Association between weight status and physical fitness in Chinese Mainland children and adolescents: a cross-sectional study. International journal of environmental research and public health, 17(7), 2468. https://doi.org/10.3390/ijerph17072468
Heyward, V.H., & Gibson, A. (2014). Advanced fitness assessment and exercise prescription. 7th ed. Champaign, IL: Human Kinetics.
Ruiz, J. R., Castro-Piñero, J., España-Romero, V., Artero, E. G., Ortega, F. B., Cuenca, M. M., ... & Castillo, M. J. (2011). Field-based fitness assessment in young people: the ALPHA health-related fitness test battery for children and adolescents. British journal of sports medicine, 45(6), 518-524. http://dx.doi.org/10.1136/bjsm.2010.075341
Artero, E. G., España‐Romero, V., Ortega, F. B., Jiménez‐Pavón, D., Ruiz, J. R., Vicente‐Rodríguez, G., ... & Castillo, M. J. (2010). Health‐related fitness in adolescents: underweight, and not only overweight, as an influencing factor. The AVENA study. Scandinavian journal of medicine & science in sports, 20(3), 418-427. https://doi.org/10.1111/j.1600-0838.2009.00959.x
Gutin, B., Yin, Z., Humphries, M. C., Hoffman, W. H., Gower, B., & Barbeau, P. (2004). Relations of fatness and fitness to fasting insulin in black and white adolescents. The Journal of pediatrics, 145(6), 737-743. https://doi.org/10.1016/j.jpeds.2004.07.016
Okely, A. D., Booth, M. L., & Chey, T. (2004). Relationships between body composition and fundamental movement skills among children and adolescents. Research quarterly for exercise and sport, 75(3), 238-247. https://doi.org/10.1080/02701367.2004.10609157
Ara, I., Vicente-Rodriguez, G., Jimenez-Ramirez, J., Dorado, C., Serrano-Sanchez, J. A., & Calbet, J. A. L. (2004). Regular participation in sports is associated with enhanced physical fitness and lower fat mass in prepubertal boys. International journal of obesity, 28(12), 1585-1593. https://doi.org/10.1038/sj.ijo.0802754
Deforche, B., Lefevre, J., De Bourdeaudhuij, I., Hills, A. P., Duquet, W., & Bouckaert, J. (2003). Physical fitness and physical activity in obese and nonobese Flemish youth. Obesity research, 11(3), 434-441. https://doi.org/10.1038/oby.2003.59
Malina, R. M., Beunen, G. P., Claessens, A. L., Lefevre, J., Eynde, B. V., Renson, R., ... & Simons, J. (1995). Fatness and physical fitness of girls 7 to 17 years. Obesity Research, 3(3), 221-231. https://doi.org/10.1002/j.1550-8528.1995.tb00142.x
Prista, A., Maia, J. A. R., Damasceno, A., & Beunen, G. (2003). Anthropometric indicators of nutritional status: implications for fitness, activity, and health in school-age children and adolescents from Maputo, Mozambique. The American journal of clinical nutrition, 77(4), 952-959. https://doi.org/10.1093/ajcn/77.4.952
Forbes, G. B. (1964). Lean body mass and fat in obese children. Pediatrics, 34(3), 308-314. https://doi.org/10.1542/peds.34.3.308
Elezi, A., Elezi, G., Gontarev, S., & Georgiev, G. (2021). Gender Differences in Absolute and Relative Values of Hand Dynamometer Test with 9 and 10-Year Old Children From the Skopje Region in RN Macedonia. Physical Education Theory and Methodology, 21(2), 113-12. https://doi.org/10.17309/tmfv.2021.2.03
Pollock, M. L., Franklin, B. A., Balady, G. J., Chaitman, B. L., Fleg, J. L., Fletcher, B., ... & Bazzarre, T. (2000). Resistance exercise in individuals with and without cardiovascular disease: benefits, rationale, safety, and prescription an advisory from the committee on exercise, rehabilitation, and prevention, council on clinical cardiology, American Heart Association. Circulation, 101(7), 828-833. https://doi.org/10.1161/01
Kell, R. T., Bell, G., & Quinney, A. (2001). Musculoskeletal fitness, health outcomes and quality of life. Sports Medicine, 31(12), 863-873. https://doi.org/10.2165/00007256-200131120-00003
Stump, C. S., Henriksen, E. J., Wei, Y., & Sowers, J. R. (2006). The metabolic syndrome: role of skeletal muscle metabolism. Annals of medicine, 38(6), 389-402. https://doi.org/10.1080/07853890600888413
Wolfe, R. R. (2006). The underappreciated role of muscle in health and disease. The American journal of clinical nutrition, 84(3), 475-482. https://doi.org/10.1093/ajcn/84.3.475
Ruiz, J. R., Castro-Piñero, J., Artero, E. G., Ortega, F. B., Sjöström, M., Suni, J., & Castillo, M. J. (2009). Predictive validity of health-related fitness in youth: a systematic review. British journal of sports medicine, 43(12), 909-923. http://dx.doi.org/10.1136/bjsm.2008.056499
Lee, S. J., & Arslanian, S. A. (2007). Cardiorespiratory fitness and abdominal adiposity in youth. European journal of clinical nutrition, 61(4), 561-565. https://doi.org/10.1038/sj.ejcn.1602541
Ortega, F. B., Ruiz, J. R., & Sjöström, M. (2007). Physical activity, overweight and central adiposity in Swedish children and adolescents: the European Youth Heart Study. International Journal of Behavioral Nutrition and Physical Activity, 4(1), 1-10. https://doi.org/10.1186/1479-5868-4-61
Ortega, F. B., Tresaco, B., Ruiz, J. R., Moreno, L. A., Martin‐Matillas, M., Mesa, J. L., ... & AVENA Study Group. (2007). Cardiorespiratory fitness and sedentary activities are associated with adiposity in adolescents. Obesity, 15(6), 1589-1599. https://doi.org/10.1038/oby.2007.188
Ruiz, J. R., Rizzo, N. S., Hurtig-Wennlöf, A., Ortega, F. B., W àrnberg, J., & Sjöström, M. (2006). Relations of total physical activity and intensity to fitness and fatness in children: the European Youth Heart Study. The American journal of clinical nutrition, 84(2), 299-303. https://doi.org/10.1093/ajcn/84.2.299
Ortega, F. B., Labayen, I., Ruiz, J. R., Kurvinen, E., Loit, H. M., Harro, J., ... & Sjöström, M. (2011). Improvements in fitness reduce the risk of becoming overweight across puberty. Medicine and science in sports and exercise, 43(10), 1891-1897. https://doi.org/10.1249/mss.0b013e3182190d71
Yamborisut, U., Sakamoto, N., Wimonpeerapattana, W., & Tontisirin, K. (2010). Waist circumference and body fat distribution indexes as screening tools for the overweight and obesity in Thai preschool children. Obesity Research & Clinical Practice, 4(4), e307-e314. https://doi.org/10.1016/j.orcp.2010.08.001
Ceschia, A., Giacomini, S., Santarossa, S., Rugo, M., Salvadego, D., Da Ponte, A., ... & Lazzer, S. (2016). Deleterious effects of obesity on physical fitness in pre-pubertal children. European Journal of Sport Science, 16(2), 271-278. https://doi.org/10.1080/17461391.2015.1030454
Sacchetti, R., Ceciliani, A., Garulli, A., Masotti, A., Poletti, G., Beltrami, P., & Leoni, E. (2012). Physical fitness of primary school children in relation to overweight prevalence and physical activity habits. Journal of sports sciences, 30(7), 633-640. https://doi.org/10.1080/02640414.2012.661070
Tokmakidis, S. P., Kasambalis, A., & Christodoulos, A. D. (2006). Fitness levels of Greek primary schoolchildren in relationship to overweight and obesity. European journal of pediatrics, 165(12), 867-874. https://doi.org/10.1007/s00431-006-0176-2
Dumith, S. C., Ramires, V. V., Souza, M. A., Moraes, D. S., Petry, F. G., Oliveira, E. S., ... & Hallal, P. C. (2010). Overweight/obesity and physical fitness among children and adolescents. Journal of Physical Activity and Health, 7(5), 641-648. https://doi.org/10.1123/jpah.7.5.641
Malina, R. M., Reyes, M. E., Tan, S. K., & Little, B. B. (2011). Physical fitness of normal, stunted and overweight children 6–13 years in Oaxaca, Mexico. European journal of clinical nutrition, 65(7), 826-834. https://doi.org/10.1038/ejcn.2011.44
Kotani, K., Nishida, M., Yamashita, S., Funahashi, T., Fujioka, S., Tokunaga, K., ... & Matsuzawa, Y. (1997). Two decades of annual medical examinations in Japanese obese children: do obese children grow into obese adults? International journal of obesity, 21(10), 912-921. https://doi.org/10.1038/sj.ijo.0800492
Kain, J., Uauy, R., Vio, F., & Albala, C. (2002). Trends in overweight and obesity prevalence in Chilean children: comparison of three definitions. European journal of clinical nutrition, 56(3), 200-204. https://doi.org/10.1038/sj.ejcn.1601301
Myers, J., Prakash, M., Froelicher, V., Do, D., Partington, S., & Atwood, J. E. (2002). Exercise capacity and mortality among men referred for exercise testing. New England journal of medicine, 346(11), 793-801. https://doi.org/10.1056/NEJMoa011858
Ortega, F. B., Ruiz, J. R., Castillo, M. J., & Sjöström, M. (2008). Physical fitness in childhood and adolescence: a powerful marker of health. International journal of obesity, 32(1), 1-11. https://doi.org/10.1038/sj.ijo.0803774
Ortega, F. B., Ruiz, J. R., Hurtig-Wennlöf, A., & Sjöström, M. (2008). Physically active adolescents are more likely to have a healthier cardiovascular fitness level independently of their adiposity status. The European youth heart study. Revista Española de Cardiología (English Edition), 61(2), 123-129. https://doi.org/10.1016/S1885-5857(08)60087-0
Haerens, L., Deforche, B., Maes, L., Cardon, G., & De Bourdeaudhuij, I. (2007). Physical activity and endurance in normal weight versus overweight boys and girls. Journal of Sports Medicine and Physical Fitness, 47(3), 344. PMID: 17641603
Brunet, M., Chaput, J. P., & Tremblay, A. (2007). The association between low physical fitness and high body mass index or waist circumference is increasing with age in children: the ‘Quebec en Forme’Project. International journal of obesity, 31(4), 637-643. https://doi.org/10.1038/sj.ijo.0803448
Casajús, J. A., Leiva, M. T., Villarroya, A., Legaz, A., & Moreno, L. A. (2007). Physical performance and school physical education in overweight Spanish children. Annals of Nutrition and Metabolism, 51(3), 288-296. https://doi.org/10.1159/000105459
Martinez‐Tellez, B., Sanchez‐Delgado, G., Cadenas‐Sanchez, C., Mora‐Gonzalez, J., Martín‐Matillas, M., Löf, M., ... & Ruiz, J. R. (2016). Health‐related physical fitness is associated with total and central body fat in preschool children aged 3 to 5 years. Pediatric obesity, 11(6), 468-474. https://doi.org/10.1111/ijpo.12088
Fogelholm, M., Stigman, S., Huisman, T., & Metsämuuronen, J. (2008). Physical fitness in adolescents with normal weight and overweight. Scandinavian journal of medicine & science in sports, 18(2), 162-170. https://doi.org/10.1111/j.1600-0838.2007.00685.x
Gontarev, S., & Ruzdija, K. (2014). The relationship between overweight, obesity and physical fitness among eleven and twelve-year-old Macedonian adolescents. Journal of Physical Education and Sport, 14(2), 178. https://doi.org/10.7752/jpes.2014.02028
Gontarev, S., Kalac, R., Velickovska, L., Stojmanovska, D., Misovski, A., & Milenkovski, J. (2018). Health-related physical fitness of normal, stunted and overweight children aged 6-14 years in Macedonia. Nutrición Hospitalaria. http://dx.doi.org/10.20960/nh.1843
Xu, Y., Mei, M., Wang, H., Yan, Q., & He, G. (2020). Association between weight status and physical fitness in Chinese Mainland children and adolescents: a cross-sectional study. International journal of environmental research and public health, 17(7), 2468. https://doi.org/10.3390/ijerph17072468
Heyward, V.H., & Gibson, A. (2014). Advanced fitness assessment and exercise prescription. 7th ed. Champaign, IL: Human Kinetics.
Ruiz, J. R., Castro-Piñero, J., España-Romero, V., Artero, E. G., Ortega, F. B., Cuenca, M. M., ... & Castillo, M. J. (2011). Field-based fitness assessment in young people: the ALPHA health-related fitness test battery for children and adolescents. British journal of sports medicine, 45(6), 518-524. http://dx.doi.org/10.1136/bjsm.2010.075341
Artero, E. G., España‐Romero, V., Ortega, F. B., Jiménez‐Pavón, D., Ruiz, J. R., Vicente‐Rodríguez, G., ... & Castillo, M. J. (2010). Health‐related fitness in adolescents: underweight, and not only overweight, as an influencing factor. The AVENA study. Scandinavian journal of medicine & science in sports, 20(3), 418-427. https://doi.org/10.1111/j.1600-0838.2009.00959.x
Gutin, B., Yin, Z., Humphries, M. C., Hoffman, W. H., Gower, B., & Barbeau, P. (2004). Relations of fatness and fitness to fasting insulin in black and white adolescents. The Journal of pediatrics, 145(6), 737-743. https://doi.org/10.1016/j.jpeds.2004.07.016
Okely, A. D., Booth, M. L., & Chey, T. (2004). Relationships between body composition and fundamental movement skills among children and adolescents. Research quarterly for exercise and sport, 75(3), 238-247. https://doi.org/10.1080/02701367.2004.10609157
Ara, I., Vicente-Rodriguez, G., Jimenez-Ramirez, J., Dorado, C., Serrano-Sanchez, J. A., & Calbet, J. A. L. (2004). Regular participation in sports is associated with enhanced physical fitness and lower fat mass in prepubertal boys. International journal of obesity, 28(12), 1585-1593. https://doi.org/10.1038/sj.ijo.0802754
Deforche, B., Lefevre, J., De Bourdeaudhuij, I., Hills, A. P., Duquet, W., & Bouckaert, J. (2003). Physical fitness and physical activity in obese and nonobese Flemish youth. Obesity research, 11(3), 434-441. https://doi.org/10.1038/oby.2003.59
Malina, R. M., Beunen, G. P., Claessens, A. L., Lefevre, J., Eynde, B. V., Renson, R., ... & Simons, J. (1995). Fatness and physical fitness of girls 7 to 17 years. Obesity Research, 3(3), 221-231. https://doi.org/10.1002/j.1550-8528.1995.tb00142.x
Prista, A., Maia, J. A. R., Damasceno, A., & Beunen, G. (2003). Anthropometric indicators of nutritional status: implications for fitness, activity, and health in school-age children and adolescents from Maputo, Mozambique. The American journal of clinical nutrition, 77(4), 952-959. https://doi.org/10.1093/ajcn/77.4.952
Forbes, G. B. (1964). Lean body mass and fat in obese children. Pediatrics, 34(3), 308-314. https://doi.org/10.1542/peds.34.3.308
Elezi, A., Elezi, G., Gontarev, S., & Georgiev, G. (2021). Gender Differences in Absolute and Relative Values of Hand Dynamometer Test with 9 and 10-Year Old Children From the Skopje Region in RN Macedonia. Physical Education Theory and Methodology, 21(2), 113-12. https://doi.org/10.17309/tmfv.2021.2.03
Pollock, M. L., Franklin, B. A., Balady, G. J., Chaitman, B. L., Fleg, J. L., Fletcher, B., ... & Bazzarre, T. (2000). Resistance exercise in individuals with and without cardiovascular disease: benefits, rationale, safety, and prescription an advisory from the committee on exercise, rehabilitation, and prevention, council on clinical cardiology, American Heart Association. Circulation, 101(7), 828-833. https://doi.org/10.1161/01
Kell, R. T., Bell, G., & Quinney, A. (2001). Musculoskeletal fitness, health outcomes and quality of life. Sports Medicine, 31(12), 863-873. https://doi.org/10.2165/00007256-200131120-00003
Stump, C. S., Henriksen, E. J., Wei, Y., & Sowers, J. R. (2006). The metabolic syndrome: role of skeletal muscle metabolism. Annals of medicine, 38(6), 389-402. https://doi.org/10.1080/07853890600888413
Wolfe, R. R. (2006). The underappreciated role of muscle in health and disease. The American journal of clinical nutrition, 84(3), 475-482. https://doi.org/10.1093/ajcn/84.3.475
Ruiz, J. R., Castro-Piñero, J., Artero, E. G., Ortega, F. B., Sjöström, M., Suni, J., & Castillo, M. J. (2009). Predictive validity of health-related fitness in youth: a systematic review. British journal of sports medicine, 43(12), 909-923. http://dx.doi.org/10.1136/bjsm.2008.056499
Lee, S. J., & Arslanian, S. A. (2007). Cardiorespiratory fitness and abdominal adiposity in youth. European journal of clinical nutrition, 61(4), 561-565. https://doi.org/10.1038/sj.ejcn.1602541
Ortega, F. B., Ruiz, J. R., & Sjöström, M. (2007). Physical activity, overweight and central adiposity in Swedish children and adolescents: the European Youth Heart Study. International Journal of Behavioral Nutrition and Physical Activity, 4(1), 1-10. https://doi.org/10.1186/1479-5868-4-61
Ortega, F. B., Tresaco, B., Ruiz, J. R., Moreno, L. A., Martin‐Matillas, M., Mesa, J. L., ... & AVENA Study Group. (2007). Cardiorespiratory fitness and sedentary activities are associated with adiposity in adolescents. Obesity, 15(6), 1589-1599. https://doi.org/10.1038/oby.2007.188
Ruiz, J. R., Rizzo, N. S., Hurtig-Wennlöf, A., Ortega, F. B., W àrnberg, J., & Sjöström, M. (2006). Relations of total physical activity and intensity to fitness and fatness in children: the European Youth Heart Study. The American journal of clinical nutrition, 84(2), 299-303. https://doi.org/10.1093/ajcn/84.2.299
Ortega, F. B., Labayen, I., Ruiz, J. R., Kurvinen, E., Loit, H. M., Harro, J., ... & Sjöström, M. (2011). Improvements in fitness reduce the risk of becoming overweight across puberty. Medicine and science in sports and exercise, 43(10), 1891-1897. https://doi.org/10.1249/mss.0b013e3182190d71
Yamborisut, U., Sakamoto, N., Wimonpeerapattana, W., & Tontisirin, K. (2010). Waist circumference and body fat distribution indexes as screening tools for the overweight and obesity in Thai preschool children. Obesity Research & Clinical Practice, 4(4), e307-e314. https://doi.org/10.1016/j.orcp.2010.08.001
Ceschia, A., Giacomini, S., Santarossa, S., Rugo, M., Salvadego, D., Da Ponte, A., ... & Lazzer, S. (2016). Deleterious effects of obesity on physical fitness in pre-pubertal children. European Journal of Sport Science, 16(2), 271-278. https://doi.org/10.1080/17461391.2015.1030454
Sacchetti, R., Ceciliani, A., Garulli, A., Masotti, A., Poletti, G., Beltrami, P., & Leoni, E. (2012). Physical fitness of primary school children in relation to overweight prevalence and physical activity habits. Journal of sports sciences, 30(7), 633-640. https://doi.org/10.1080/02640414.2012.661070
Tokmakidis, S. P., Kasambalis, A., & Christodoulos, A. D. (2006). Fitness levels of Greek primary schoolchildren in relationship to overweight and obesity. European journal of pediatrics, 165(12), 867-874. https://doi.org/10.1007/s00431-006-0176-2
Dumith, S. C., Ramires, V. V., Souza, M. A., Moraes, D. S., Petry, F. G., Oliveira, E. S., ... & Hallal, P. C. (2010). Overweight/obesity and physical fitness among children and adolescents. Journal of Physical Activity and Health, 7(5), 641-648. https://doi.org/10.1123/jpah.7.5.641
Malina, R. M., Reyes, M. E., Tan, S. K., & Little, B. B. (2011). Physical fitness of normal, stunted and overweight children 6–13 years in Oaxaca, Mexico. European journal of clinical nutrition, 65(7), 826-834. https://doi.org/10.1038/ejcn.2011.44
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2022-11-30
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Gjonbalaj, M., Morina, B., Gontarev, S., & Georgiev, G. (2022). Health-Related Physical Fitness is Associated with Total and Central Body Fat in Children Aged 6 to 10 Years. Physical Education Theory and Methodology, 22(3s), S117-S123. https://doi.org/10.17309/tmfv.2022.3s.16
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