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Marques - 2017 - Associations Between Self Reported Fitness and Self Rated Health

This study examined the associations between self-reported physical fitness and self-rated health, life satisfaction, and health-related quality of life among 3554 Portuguese adolescents. The study found that self-rated health, life satisfaction, and health-related quality of life were significantly and positively correlated with all components of physical fitness. Regression analyses showed that overall fitness and cardiorespiratory fitness were positively related to better self-rated health, higher life satisfaction, and improved health-related quality of life for both boys and girls. The findings suggest that higher perceived physical fitness is associated with enhanced psychosocial well-being in adolescents.

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0% found this document useful (0 votes)
23 views4 pages

Marques - 2017 - Associations Between Self Reported Fitness and Self Rated Health

This study examined the associations between self-reported physical fitness and self-rated health, life satisfaction, and health-related quality of life among 3554 Portuguese adolescents. The study found that self-rated health, life satisfaction, and health-related quality of life were significantly and positively correlated with all components of physical fitness. Regression analyses showed that overall fitness and cardiorespiratory fitness were positively related to better self-rated health, higher life satisfaction, and improved health-related quality of life for both boys and girls. The findings suggest that higher perceived physical fitness is associated with enhanced psychosocial well-being in adolescents.

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We take content rights seriously. If you suspect this is your content, claim it here.
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Journal of Exercise Science & Fitness 15 (2017) 8e11

Contents lists available at ScienceDirect

Journal of Exercise Science & Fitness


journal homepage: www.elsevier.com/locate/jesf

Associations between self-reported fitness and self-rated health, life-


satisfaction and health-related quality of life among adolescents
Adilson Marques a, b, *, Jorge Mota c, Ta
^nia Gaspar d, Margarida Gaspar de Matos e, f
a
Centro Interdisciplinar de Estudo da Performance Humana, Faculdade de Motricidade Humana, Universidade de Lisboa, Lisboa, Portugal
b
Centro de Investigaça~o em Saúde Pública, Escola Nacional de Saúde Pública, Universidade Nova de Lisboa, Portugal
c
Centro de Investigaça~o em Atividade Física Saúde e Lazer (CIAFEL), Faculdade de Desporto, Universidade do Porto, Porto, Portugal
d
Universidade Lusíada, Lisboa, Portugal
e
Faculdade de Motricidade Humana, Universidade de Lisboa, Lisboa, Portugal
f
William James Center for Research, Instituto Superior de Psicologia Aplicada, Lisboa, Portugal

a r t i c l e i n f o a b s t r a c t

Article history: Background/objective: In recent years, there has been an increased interest in the associations between
Received 26 May 2016 physical fitness (PF) and psychosocial aspects of health. This study aimed to analyse the associations
Received in revised form between self-reported PF and self-rated health (SRH), life-satisfaction (LS), and quality of life (QoL).
23 February 2017
Methods: This is a cross-sectional study of 3554 adolescents (1652 boys), aged 13e18, from the HBSC
Accepted 2 March 2017
Available online 16 March 2017
Portuguese survey. PF, health, LS and OoL were self-rated.
Results: SRH, LS, and health-related OoL (HRQoL) were significantly and positively correlated with all PF
components. From regression model, overall fitness was significantly related with SRH (boys: b ¼ 0.18,
Keywords:
Fitness
p < 0.001; girls: b ¼ 0.16, p < 0.001), LS (boys: b ¼ 0.36, p < 0.001; girls: b ¼ 0.43, p < 0.001), and HRQoL
Cardiorespiratory fitness (boys: b ¼ 2.26, p < 0.001; girls: b ¼ 2.54, p < 0.001). Cardiorespiratory fitness was also positively and
Health perception significantly related with SRH (boys: b ¼ 0.17, p < 0.001; girls: b ¼ 0.11, p < 0.001), LS (boys: b ¼ 0.13,
Life satisfaction p < 0.05; girls: b ¼ 0.31, p < 0.001), and HRQoL (boys: b ¼ 1.74, p < 0.001; girls: b ¼ 1.57, p < 0.001).
Quality of life Conclusion: These findings suggest that perceived PF is associated with a better SRH, LS, and perceived
HRQoL. A few implications regarding public policies were highlighted.
© 2017 The Society of Chinese Scholars on Exercise Physiology and Fitness. Published by Elsevier
(Singapore) Pte Ltd. This is an open access article under the CC BY-NC-ND license (http://
creativecommons.org/licenses/by-nc-nd/4.0/).

1. Introduction regarding lifestyle behaviour, such as physical activity and nutri-


tion.5 For instance, self-rated health (SRH) was suggested as a
Physical fitness (PF) is associated with health benefits in young health indicator among adolescents7 since SRH appears to be a
people1 and it is considered an important health status marker that function of adolescents' overall sense of functioning8 and adoles-
predicts cardiovascular disease and mortality.2e4 However, aside cent's health-related QoL (HRQoL).9
from the effects on biological parameters, the consideration of as- Previously, it was suggested that an accurate self-reported
sociations with psychosocial aspects of health has gained interest in measure of fitness could be used to identify low-fit adolescents
recent years. Constructs such as health perception, life satisfaction for targeted physical activity and obesity prevention in-
(LS), and quality of life (QoL) are included in a broader domain as terventions.10 However, to the best of our knowledge there is no
they pertain to positive health.5,6 study addressing the use of self-reported measures of PF with
Beyond the objective measures, perceptions that one can have positive health variables such as SRH, LS and QoL. We hypothesized
about their own health and life may add value to further decisions that those who reported higher PF are those who not only
perceived better health, but also reported better LS as well as QL.
Therefore this study aimed to analyse the associations between
self-reported fitness and SRH, LS, and HRQoL among a represen-
* Corresponding author. Faculdade de Motricidade Humana, Universidade de tative sample of Portuguese adolescents of both sexes.
Lisboa, Estrada da Costa, 1499-002, Cruz Quebrada, Portugal.
E-mail address: [email protected] (A. Marques).

http://dx.doi.org/10.1016/j.jesf.2017.03.001
1728-869X/© 2017 The Society of Chinese Scholars on Exercise Physiology and Fitness. Published by Elsevier (Singapore) Pte Ltd. This is an open access article under the CC
BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
A. Marques et al. / Journal of Exercise Science & Fitness 15 (2017) 8e11 9

2. Methods adolescents,10 and for the present data the reliability was good,
with an alpha of 0.86.
2.1. Participants and procedures
2.3. Statistical analyses
This study is based on data from Health Behaviour in School-
Aged Children (HBSC) Portuguese survey.11 HBSC Portugal is one Descriptive statistics (means, standard deviation and percent-
of 43 countries and regions that make up the HBSC Network.12 The ages) were calculated for the entire sample, and according to sex.
HBSC is a school-based survey of adolescents' health behaviours, Ordinal variables were treated as continuous.19 All variables were
carried out every 4 years. Collected data is used for policy and by tested for normality prior to any analyses. The normality of the
decision makers to gain new insight into young people's health variables were tested by Kolmogorov-Smirnov test, and homoge-
and well-being, to understand the social and psychological de- neity of variance were tested by Levene's test. Chi square and
terminants of health, and to incorporate policies to improve young Student t-test were used to assess the differences between sexes in
people's lives. The Portuguese HBSC 2014 survey included a BMI, SRH, LS, HRQoL, and PF components. Pearson product-
representative sample of 6026 students (2872 boys) from 125 moment correlation coefficient was used to examine the relation-
public schools, with weighted distributions reflecting the distri- ship between SRH, LS and HRQoL with the different components of
bution of Portuguese students in grades 6, 8, and 10. For the PF. To analyse the effect of the PF components on SRH, LS, and
present study only students from grades 8 and 10 were selected, HRQoL several linear regression analyses were conducted. As-
because they had better awareness of their physical fitness. Stu- sumptions of linearity were verified and multicollinearity was
dents from grade 6 were excluded (n ¼ 2157). In addition, 71 checked using the variance inflation factor (VIF). VIF values were
students did not report weight and/or height, 95 did not report less than 5 in all analysis, indicating that there was no multi-
their health perception, 149 did not self-report their fitness, and collinearity. All analyses were adjusted for age and BMI zscore, and
were removed from the sample. The result was a final sample size were run separately for boys and girls because it was observed that
of 3554 adolescents (1652 boys, 1902 girls), aged 13-18 years there were significant differences between sexes on all variables
(14.75 ± 1.18). under study. All statistical analyses were performed using IBM SPSS
The administration of the surveys was conducted according to Statistics 22.0. The level of significance was set at 0.05.
standard guidelines from the HBSC survey protocol13; the survey
was carried out online with the assistance of trained teachers 3. Results
(experts in informatics) during class time. Questionnaires were
administered between January and February in 2014. Participation Table 1 shows the sample characteristics, and results of BMI
was voluntary and questionnaires were answered anonymously. zscore, BMI category, SRH, LS, HRQoL, as well as PF components.
The questionnaire application took approximately 60 minute. The proportion of overweight and obese boys was significantly
Research was in accordance with the Ethical Committee of OPorto higher in boys than girls (c2(2) ¼ 8.542, p ¼ 0.014). Moreover, boys
Medical School, and the National Data Protection System, and had presented a significantly higher value in SRH (t (3552) ¼ 13.653,
the approval of the Ministry of Education. All school administrators p < 0.001), LS (t (3552) ¼ 7.167, p < 0.001), and HRQoL (t
gave their consent, legal guardians gave written informed consent, (3552) ¼ 13.310, p < 0.001). Likewise, boys reported better overall
and students provided assent. PF (t (3552) ¼ 16.897, p < 0.001), CRF (t (3552 ¼ 18.473, p < 0.001),
muscular fitness (t (3552) ¼ 20.289, p < 0.001), speed-agility (t
2.2. Measures (3552) ¼ 20.271, p < 0.001), and flexibility (t (3552) ¼ 7.167,
p < 0.001) than girls did.
Actual weight (to the nearest 0.5 kg) and height (to the nearest The correlation between SRH, LS, HRQoL, with PF is shown in
0.5 cm) were also self-reported. Body mass index (BMI) was then Table 2. The data showed that all variables were significant and
calculated based on mass (kilograms) divided by height (square positively correlated with PF components, although some sex dif-
metres). Adolescents were classified into normal weight, over- ferences were seen. For boys, the strongest correlations were be-
weight, and obese categories according to age- and sex-specific cut- tween overall fitness and SRH (r ¼ 0.43, p < 0.001), as well as
off points proposed by the International Obesity Task Force.14 between CRF and SRH (r ¼ 0.42, p < 0.001). For girls the data
The perception of adolescents about their health was collected showed that the strongest correlations were found between overall
through the question, “You would say your health is … ?” Answers fitness and HRQoL (r ¼ 0.43, p < 0.001), as well as SRH (r ¼ 0.34,
were given, through selection, on a 4-point scale (poor, fair, good, p < 0.001).
and excellent).15 Results of the multivariate linear regression for the relationship
To identify the opinions about LS, the Cantril Self-Anchoring between physical fitness components and SRH, LS, and HRQoL are
Striving Scale16 was used. Adolescents indicated where they stood shown in Table 3. For boys and girls, overall fitness was significantly
on a 10-point ladder, with zero being the ‘worst possible life’ and related to SRH (boys: b ¼ 0.18, p < 0.001; girls: b ¼ 0.16, p < 0.001),
ten being the ‘best possible life’. LS (boys: b ¼ 0.36, p < 0.001; girls: b ¼ 0.43, p < 0.001), and HRQoL
HRQoL was assessed by KIDSCREEN-10. It contains 10 items (boys: b ¼ 2.26, p < 0.001; girls: b ¼ 2.54, p < 0.001). CRF was also
regarding family life, peers, and school life. The items result in one positively and significantly related to SRH (boys: b ¼ 0.17, p < 0.001;
global score. This one-dimensional measure represents a global girls: b ¼ 0.11, p < 0.001), LS (boys: b ¼ 0.13, p < 0.05; girls: b ¼ 0.31,
score adequate for use in large (epidemiological) surveys, as p < 0.001), and HRQoL (boys: b ¼ 1.74, p < 0.001; girls: b ¼ 1.57,
described elsewhere.17,18 p < 0.001). Is it clear that the strongest relationships were between
PF was measured using the international fitness scale (IFIS), overall fitness, CRF, and HRQoL.
which is a self-administered scale to assess PF. The IFIS is composed
of 5 questions about the perceived adolescents' overall fitness, 4. Discussion
cardiorespiratory fitness (CRF), muscular fitness, speed and agility,
and flexibility in comparison with their friends' PF. Each response Based on a representative sample of Portuguese adolescents,
was given on a 5-point scale (very poor, poor, average, good and this study aimed to examine the associations between PF percep-
very good). It has been shown that the IFIS is reliable in tions (self-reported) and SRH, LS, and HQoL. To the best of our
10 A. Marques et al. / Journal of Exercise Science & Fitness 15 (2017) 8e11

Table 1
Sample characteristics.

Total (n ¼ 3554) Boys (n ¼ 1652) Girls (n ¼ 1902) p

n (%) or M±SD n (%) or M±SD n (%) or M±SD

Age 14.75 ± 1.18 14.73 ± 1.17 14.77 ± 1.18 0.349


School grade 0.002
Grade 8 2130 (59.93) 1036 (62.71) 1094 (57.52)
Grade 10 1424 (40.07) 616 (37.29) 808 (42.48)
BMI zscore 0.00 ± 0.98 0.00 ± 0.97 0.01 ± 0.98 0.650
BMI category 0.014
Normal weight 2954 (83.12) 1350 (81.72) 1604 (84.33)
Overweight 505 (14.21) 245 (14.83) 260 (13.67)
Obese 95 (2.67) 57 (3.45) 38 (2.00)
Self-rated health 3.18 ± 0.69 3.34 ± 0.67 3.03 ± 0.68 <0.001
Life satisfaction 7.17 ± 1.89 7.41 ± 1.82 6.96 ± 1.93 <0.001
HRQoL 50.00 ± 10.00 52.34 ± 958 47.97 ± 9.91 <0.001
Self-reported fitness
Overall fitness 3.68 ± 0.90 3.95 ± 0.88 3.45 ± 0.85
Cardiorespiratory fitness 3.56 ± 0.98 3.87 ± 0.93 3.29 ± 0.93 <0.001
Muscular fitness 3.63 ± 0.89 3.94 ± 0.86 3.36 ± 0.83 <0.001
Speedeagility 3.63 ± 0.93 3.95 ± 0.88 3.35 ± 0.89 <0.001
Flexibility 3.45 ± 0.98 3.52 ± 0.99 3.39 ± 0.97 <0.001

BMI, body mass index.


Differences between sexes were tested by Chi-square and Independent Sample T Test.

Table 2
Correlations between self-rated health, life satisfaction, health-related quality of life, and self-reported fitness components.

Boys Boys Girls

Self-rated health Life satisfaction HRQoL Self-rated health Life satisfaction HRQoL

Overall fitness 0.43 0.23 0.39 0.34 0.25 0.35


Cardiorespiratory fitness 0.42 0.20 0.37 0.31 0.23 0.32
Muscular fitness 0.26 0.19 0.28 0.18 0.11 0.22
Speedeagility 0.34 0.15 0.32 0.26 0.15 0.27
Flexibility 0.26 0.13 0.23 0.20 0.13 0.18

Correlation tested by Pearson product-moment correlation coefficient.


All variables were significantly correlated at p < 0.001.

Table 3
Multivariate linear regression model predicting self-rated health, life satisfaction, and quality of life by physical fitness components.

Self-reported fitness Self-rated health Life satisfaction HRQoL

Boys Girls Boys Girls Boys Girls


b (95% CI) b (95% CI) b (95% CI) b (95% CI) b (95% CI) b (95% CI)
Overall fitness 0.18 (0.13 to 0.24)*** 0.16 (0.11 to 0.20)*** 0.36 (0.20 to 0.52)*** 0.43 (0.29 to 0.58)*** 2.26 (1.47 to 3.06)*** 2.54 (1.84 to 3.25)***
Cardiorespiratory fitness 0.17 (0.12 to 0.21)*** 0.11 (0.07 to 0.15)*** 0.13 (0.00 to 0.27)* 0.31 (0.19 to 0.43)*** 1.74 (1.07 to 2.40)*** 1.57 (0.98 to 2.16)***
Muscular fitness 0.00 (0.05 to 0.04) 0.01 (0.06 to 0.03) 0.11 (0.03 to 0.24) 0.10 (0.23 to 0.03) 0.31 (0.36 to 0.98) 0.30 (0.35 to 0.95)
Speedeagility 0.00 (0.06 to 0.05) 0.01 (0.04 to 0.06) 0.07 (0.22 to 0.09) 0.11 (0.25 to 0.03) 0.69 (0.06 to 1.44) 0.16 (0.52 to 0.84)
Flexibility 0.02 (0.01 to 0.06) 0.03 (0.01 to 0.06) 0.05 (0.06 to 0.16) 0.05 (0.06 to 0.15) 0.16 (0.37 to 0.68) 0.10 (0.60 to 0.40)

Analysis was adjusted for age and body mass index zscore.
*p < 0.05, ***p < 0.01, p < 0.001.

knowledge, this is the first study to examine these variables among health compared to their fit peers.22 The same authors also found
Portuguese adolescents. Although objective measures may give that CRF mediates the association between BMI and SRH. Thus,
deeper information regarding one's fitness status, perceptions of because of its association with a better metabolic profile and good
their PF condition are reliable to assess PF.10 Giving information SRH, CRF may improve psychological wellbeing, making it of great
related to overall quality of life, and positive or subjective well- value to public health, and an important objective for research. As
being, is central to healthy youth development (Forste and Moore, CRF is positively and strongly associated with physical activity
2012). (PA),23 intervention programs to enhance PA levels of the youth
The most important finding is that, regardless of sex, perception population may benefit their CRF and consequently improve their
of overall fitness and perceived CRF were significantly and posi- health perception and wellbeing.
tively associated with adolescents' perception of their health, LS, The relationship between self-reported PF and LS and HRQoL is
and HRQoL. less studied, which hampers further comparisons. Nonetheless,
Although the fitness measures utilized were self-reported, the overall PF and CRF were positively associated with LS,5,24 while it
findings are in line with other studies showing an association be- has been suggested that perceived fitness is a more important
tween PF and CRF with good SRH.20,21 In a similar population, it was mediator for perceived health than psychological state.25 Given the
found that unfit adolescents were more likely to self-rated negative fact that overall fitness and CFR were related to HRQoL, our data
A. Marques et al. / Journal of Exercise Science & Fitness 15 (2017) 8e11 11

emphasises the importance of perceived fitness; particularly the 2. Ortega FB, Ruiz JR, Castillo MJ, et al. Physical fitness in childhood and adoles-
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