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Lovro Štefan,1 Mario Kasović,1,2 Martin Zvonar2,3 1Faculty of Kinesiology, Department of General and Applied Kinesiology, University of Zagreb, Zagreb, Croatia; 2Faculty of Sports Studies, Department of Sports Motorics, Masaryk University, Brno, Czech Republic; 3RECETOX, Faculty of Science, Masaryk University, Brno, Czech RepublicCorrespondence: Lovro ŠtefanFaculty of Kinesiology, Department of General and Applied Kinesiology, University of Zagreb, Horvaćanski Zavoj 15, Zagreb, CroatiaTel +385-98-9177-060Email lovro.stefan1510@gmail.comPurpose: The main purpose of the study was to establish a gait speed cut-off value to predict foot pain and the risk of falls among community-dwelling older adults.Patients and Methods: In this cross-sectional study, one-hundred and twenty White older women speaking Croatian (mean ± SD age 71.02 ± 6.78 years, height 161.77 ± 6.23 cm, weight 70.29 ± 12.97 kg, body mass index 26.79 ± 4.42 kg/m2) were recruited. The prevalence of foot pain was assessed by a single-item question and the risk of falls by the Downtown Fall Risk Index with a proposed cut-off value of “low risk” (< 3 points) vs “high risk” (≥ 3 points) of falls. Self-selected gait speed (the independent variable) was estimated with a pressure platform (Zebris Company, Munich, Germany).Results: Mean gait speed was 0.95 m/s. Of the total sample, 53.30% and 33.30% reported foot pain and had higher risk of falls. For foot pain and the risk of falls, gait speed cut-off values were 0.88 m/s and 0.85 m/s (area under the curve = 0.80 and 0.83, standard error = 0.043 and 0.043, p < 0.001). Sensitivity for foot pain and the risk of falls was 66.20% and 85.90% and specificity was 84.80% and 69.00%. Slower gait speed was associated with higher prevalence of foot pain (OR = 10.92, 95% CI 4.28 to 27.89, p < 0.001) and higher risk of falls (OR = 13.59, 95% CI 5.45 to 33.87, p < 0.001).Conclusion: Proposed gait speed values of 0.88 m/s and 0.85 m/s may be used in clinical settings to predict foot pain and the risk of falls among community-dwelling older women.Keywords: velocity, discomfort, elderly, risk, falls

Mario Kasović,1,2 Lovro Štefan,1 Martin Zvonar2 1Faculty of Kinesiology, Department of General and Applied Kinesiology, University of Zagreb, Zagreb, Croatia; 2Faculty of Sports Studies, Department of Kinesiology, Masaryk University, Brno, Czech RepublicCorrespondence: Lovro ŠtefanFaculty of Kinesiology, University of Zagreb, Horvaćanski Zavoj 15, Zagreb, CroatiaTel +385 98-9177-060Email lovro.stefan1510@gmail.comPurpose: The main purpose of the study was to determine the level of correlation between self-reported and measured physical fitness.Patients and Methods: In this cross-sectional study, we recruited 120 older women aged ≥ 60 years. Self-reported physical fitness was assessed on a scale from 1 to 10, where higher score indicated better physical fitness perception. Objective measure included seven physical fitness tests: 1) waist circumference, 2) chair stand in 30 sec, 3) arm curl in 30 sec, 4) 2-min step test, 5) chair sit-and-reach test, 6) back scratch test and 7) 8-feet up-and-go test. Correlation between the two measures was analyzed by using Spearman coefficient (p≤ 0.05).Results: In the whole sample, self-reported physical fitness was associated with chair stand in 30 sec (r=0.39, p< 0.001), arm curl in 30 sec (r=0.54, p< 0.001), 2-min step test (r=0.43, p< 0.001), chair sit-and-reach test (r=0.39, p< 0.001), back scratch test (r=0.36, p< 0.001) and 8-feet up-and-go test (r=− 0.29, p< 0.001). No significant correlation between self-reported physical fitness and waist circumference was found (r=0.03, p=0.786). Overall physical fitness (sum of all physical fitness z-scores) was strongly correlated with self-reported physical fitness (r=0.63, p< 0.001).Conclusion: This study shows that self-reported measure of physical fitness is moderately correlated to objectively measured physical fitness in relatively healthy older women.Keywords: performance, aging, perception, correlation, variance

The aim of the study was to determine the growth of explosive strength in both lower extremities in ice hockey players in the course of several years training cycles (later as RTC). Measurement was carried out at the beginning of the competitive season, and at the end of competitive and training season in years 2015-2017. To compare findings among age categories in each particular year. The level of explosive skills has been diagnosed by force plate Bertec in the laboratory of the Faculty of Sport Studies in Brno. The survey was carried out in groups of ice hockey players born in years 2000, 2001, 2002, 2003. In total 48 boys, aged 13 – 18 who play ice hockey on competitive level. All of them regularly train in Kometa Group Brno, divided according to age categories. Findings of the research indicate that statistically significant growth of an explosive strength of both lower extremities can be observed in players born in 2002 and 2003, or in other words on the verge of 14th and 15th year of age.

There is currently a strong scientific evidence about the negative health consequences of physical inactivity. One of the potential tools for promoting physical activity at the institutional level of the Ecological model is to create conditions and settings that would enable pupils, students and employees engage in some form of physical activity. However, physical activities as a subject are being eliminated from the study programs at Slovak universities. The purpose of the study was to find current evidence about the level of structured physical activity and health-related variables in university students in Košice.

Perfluorooctanoic acid (PFOA), a member of per- and polyfluoroalkyl substances (PFASs), has been widely used in manufacturing for decades. Currently, PFOA is strictly regulated, but due to its high stability and persistence, it is detected in both environmental as well as in human matrices. To elucidate mechanisms of PFOA toxicity in humans, we determined the genome-wide transcriptomic changes of peripheral blood mononuclear cells (PBMC) responding to PFOA exposure in a sex-stratified analysis. This work employed samples from 145 female and 143 male participants of the CELSPAC: YA study to characterize PFOA-associated transcripts in a broader context using computational analysis. PFOA-associated gene expression differed significantly between men and women, as only 2 % of mapped genes were expressed in both sexes. Disease-specific enrichment analysis revealed cancer and immune-related disease terms as those most enriched in male and female populations. Patterns of enriched terms within the gene set enrichment analysis indicated three main targets of PFOA toxicity: i) lipid metabolism for women; ii) cell cycle regulation for men; and iii) immune system response for both sexes. In summary, our genome-wide transcriptomics analysis described sex-specific differences in PFOA-associated gene expression and provided evidence about biological pathways underlying PFOA toxicity in humans., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Background: Per- and polyfluoroalkyl substances (PFASs) are emerging environmental contaminants with multiple hazardous properties including immunomodulation potency. Human exposure to PFASs has been associated with various immune-mediated diseases and outcomes. This study aimed to investigate the association between PFAS exposure and immune-mediated diseases such as allergies, eczemas, and autoimmune diseases in a population of adults in the Czech Republic., Methods: This study included 309 adults from the Central European Longitudinal Study of Parents and Children: Young Adults (CELSPAC: YA). 12 PFASs were measured in participants' serum by HPLC-MS/MS, 3 PFASs were removed from the subsequent analyses due to low detection frequency. The associations of 9 PFASs with 9 immune-mediated diseases were assessed by logistic regression. Furthermore, Bayesian kernel machine regression (BKMR) was used to estimate the effect of the PFAS mixture on immune-mediated diseases. All analyses were adjusted for sex, age, BMI, smoking, education, and family history of immune-mediated diseases. In cases of a statistically significant interaction of PFASs and sex, stratified analyses were performed for men and women., Results: Perfluorooctanoate (PFOA) and perfluorooctane sulfonate (PFOS) were negatively associated with both atopic eczema (OR per IQR increase 0.58 (95% CI 0.37-0.90) for PFOA and 0.56 (0.32-0.95) for PFOS) and contact dermatitis (0.37 (0.16-0.85) for PFOA and 0.33 (0.11-0.94) for PFOS). Perfluoroundecanoate (PFUnDA) was negatively associated with pollen, dust, and mite allergy (0.62 (0.43-0.89)). BKMR modelling showed a negative tendency in the overall effect of PFAS mixture on immune-health outcomes. Based on the stratified analysis, sex was suggested to be an effect modifier in the association of PFOS and atopic eczema., Conclusion: Our results contribute to the body of literature that observes the immunosuppressive effect of PFAS exposure during eczemas and allergies, both for PFASs individually and as a mixture., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Phthalates are mainly used as plasticizers for polyvinyl chloride (PVC). Exposure to several phthalates is associated with different adverse effects most prominently on the development of reproductive functions. The HBM4EU Aligned Studies (2014-2021) have investigated current European exposure to ten phthalates (DEP, BBzP, DiBP, DnBP, DCHP, DnPeP, DEHP, DiNP, DiDP, DnOP) and the substitute DINCH to answer the open policy relevant questions which were defined by HBM4EU partner countries and EU institutions as the starting point of the programme. The exposure dataset includes ∼5,600 children (6-11 years) and adolescents (12-18 years) from up to 12 countries per age group and covering the North, East, South and West European regions. Study data from participating studies were harmonised with respect to sample size and selection of participants, selection of biomarkers, and quality and comparability of analytical results to provide a comparable perspective of European exposure. Phthalate and DINCH exposure were deduced from urinary excretions of metabolites, where concentrations were expressed as their key descriptor geometric mean (GM) and 95th percentile (P95). This study aims at reporting current exposure levels and differences in these between European studies and regions, as well as comparisons to human biomonitoring guidance values (HBM-GVs). GMs for children were highest for ∑DEHP metabolites (33.6 μg/L), MiBP (26.6 μg/L), and MEP (24.4 μg/L) and lowest for∑DiDP metabolites (1.91 μg/L) and ∑DINCH metabolites (3.57 μg/L). In adolescents highest GMs were found for MEP (43.3 μg/L), ∑DEHP metabolites (28.8 μg/L), and MiBP (25.6 μg/L) and lowest for ∑DiDP metabolites (= 2.02 μg/L) and ∑DINCH metabolites (2.51 μg/L). In addition, GMs and P95 stratified by European region, sex, household education level, and degree of urbanization are presented. Differences in average biomarker concentrations between sampling sites (data collections) ranged from factor 2 to 9. Compared to the European average, children in the sampling sites OCC (Denmark), InAirQ (Hungary), and SPECIMEn (The Netherlands) had the lowest concentrations across all metabolites and ESTEBAN (France), NAC II (Italy), and CROME (Greece) the highest. For adolescents, comparably higher metabolite concentrations were found in NEB II (Norway), PCB cohort (Slovakia), and ESTEBAN (France), and lower concentrations in POLAES (Poland), FLEHS IV (Belgium), and GerES V-sub (Germany). Multivariate analyses (Survey Generalized Linear Models) indicate compound-specific differences in average metabolite concentrations between the four European regions. Comparison of individual levels with HBM-GVs revealed highest rates of exceedances for DnBP and DiBP, with up to 3 and 5%, respectively, in children and adolescents. No exceedances were observed for DEP and DINCH. With our results we provide current, detailed, and comparable data on exposure to phthalates in children and - for the first time - in adolescents, and - for the first time - on DINCH in children and adolescents of all four regions of Europe which are particularly suited to inform exposure and risk assessment and answer open policy relevant questions., Competing Interests: Declaration of competing interest The authors declare no conflict of interest related to this work., (Copyright © 2023 The Authors. Published by Elsevier GmbH.. All rights reserved.)

As one of the core elements of the European Human Biomonitoring Initiative (HBM4EU) a human biomonitoring (HBM) survey was conducted in 23 countries to generate EU-wide comparable HBM data. This survey has built on existing HBM capacity in Europe by aligning national or regional HBM studies, referred to as the HBM4EU Aligned Studies. The HBM4EU Aligned Studies included a total of 10,795 participants of three age groups: (i) 3,576 children aged 6-12 years, (ii) 3,117 teenagers aged 12-18 years and (iii) 4,102 young adults aged 20-39 years. The participants were recruited between 2014 and 2021 in 11-12 countries per age group, geographically distributed across Europe. Depending on the age group, internal exposure to phthalates and the substitute DINCH, halogenated and organophosphorus flame retardants, per- and polyfluoroalkyl substances (PFASs), cadmium, bisphenols, polycyclic aromatic hydrocarbons (PAHs), arsenic species, acrylamide, mycotoxins (deoxynivalenol (total DON)), benzophenones and selected pesticides was assessed by measuring substance specific biomarkers subjected to stringent quality control programs for chemical analysis. For substance groups analyzed in different age groups higher average exposure levels were observed in the youngest age group, i.e., phthalates/DINCH in children versus teenagers, acrylamide and pesticides in children versus adults, benzophenones in teenagers versus adults. Many biomarkers in teenagers and adults varied significantly according to educational attainment, with higher exposure levels of bisphenols, phthalates, benzophenones, PAHs and acrylamide in participants (from households) with lower educational attainment, while teenagers from households with higher educational attainment have higher exposure levels for PFASs and arsenic. In children, a social gradient was only observed for the non-specific pyrethroid metabolite 3-PBA and di-isodecyl phthalate (DiDP), with higher levels in children from households with higher educational attainment. Geographical variations were seen for all exposure biomarkers. For 15 biomarkers, the available health-based HBM guidance values were exceeded with highest exceedance rates for toxicologically relevant arsenic in teenagers (40%), 3-PBA in children (36%), and between 11 and 14% for total DON, Σ (PFOA + PFNA + PFHxS + PFOS), bisphenol S and cadmium. The infrastructure and harmonized approach succeeded in obtaining comparable European wide internal exposure data for a prioritized set of 11 chemical groups. These data serve as a reference for comparison at the global level, provide a baseline to compare the efficacy of the European Commission's chemical strategy for sustainability and will give leverage to national policy makers for the implementation of targeted measures., Competing Interests: Declarations of competing interest The authors declare no conflict of interest. José V. Tarazona is employed by the European Food Safety Authority (EFSA). The views expressed in this publication are those of the authors and should not be interpreted as representing the official position of EFSA., (Copyright © 2023 The Authors. Published by Elsevier GmbH.. All rights reserved.)

Background: Although evidence suggests that obesity track well from childhood to adolescence, most of the research has been done in Western and high-income countries. Moreover, most of the studies have tracked body-mass index, as a proxy of nutritional status, while tracking characteristics of circumferences and skinfold thicknesses have been less studies. Therefore, the main purpose of the study was to explore tracking characteristics of complete anthropometric data from childhood to adolescence., Methods: This sub-study was part of the Czech ELSPAC study. In the present 8-year longitudinal study, we collected information from pediatrician's medical records at the ages of 8 y (n = 888), 11 y (n = 1065), 13 y (n = 811) and 15 y (n = 974), including circumferences (head, chest, waist, hips, and arm), indices (body-mass index, waist-to-hip ratio and waist-to-height ratio) and skinfold thicknesses (biceps, triceps, subscapula, suprailiaca, thigh and the sum of 5 skinfolds). Participants were recruited from the two selected regions of the Czech Republic (Brno and Znojmo). Linear generalized estimating equations were conducted to analyze tracking patterns over an 8-year follow-up period for all anthropometric measurements., Results: Tracking coefficients were moderate to strong, ranging from 0.40 to 0.62 for circumferences, 0.41 to 0.74 for indices and 0.72 to 0.86 for skinfolds. According to body-mass index and waist circumference standards, overweight/obese children and children with abdominal obesity at the age of 8 y were 11.31 (95% CI = 8.41 to 15.22, p < 0.001) and 10.73 (95% CI = 7.93 to 14.52, p < 0.001) more likely to remain overweight/obese and to have abdominal obesity at the age of 15 y., Conclusions: Findings show moderate to strong tracking of anthropometric characteristics, i.e. circumferences track moderately well, while strong tracking for indices and skinfold thicknesses is observed. Moreover, strong tracking of general overweight/obesity and abdominal obesity between ages 8 y and 15 y indicates that the detection of these risk factors at the beginning of primary school should be advocated., (© 2022. The Author(s).)

The main purpose of the study was to examine longitudinal associations between sport participation and fat mass with body posture in children. We used data from children recruited in the Czech European Longitudinal Study of Pregnancy and Childhood (CELSPAC) at the ages of 11 y (n = 1065), 13 y (n = 811) and 15 y (n = 974). Information on body posture, practicing sport in a club and at a competitive level, and skinfold thicknesses (biceps, triceps, subscapula, suprailiaca and thigh) from pediatrician's medical records were collected. Body posture was inspected by a pediatrician. The sum of 5 skinfolds was used as a proxy of fat mass. The 85th and 95th percentiles defined 'overfat' and 'obese'children. Practicing sport in a club and at a competitive level were included as 'yes/no' answers. General linear mixed models with risk ratios (RR) and 95% confidence intervals (95% CI) were calculated. Overall, 35.6% of children and adolescents had impaired body posture; the prevalence of 'incorrect' body posture increased by age (from 41.0% to 28.0%, p<0.001). Practicing sport in a club and at a competitive level decreased by follow-up (p<0.001), while the level of 'overfat' and 'obese' children increased (p<0.01). In separate models, 'incorrect' body posture was associated with non-practicing sport in clubs (RR = 1.68; 95% CI 1.43-1.97, p<0.001) or at competitive level (RR = 1.61; 95% CI 1.37-1.88, p<0.001) and with being 'overfat' (RR = 2.05; 95% CI 1.52-2.75, p<0.001) and 'obese' (RR = 2.15; 95% CI 1.68-2.75, p<0.001). When all variables were put simultaneously into the model additionally adjusted for sex, self-rated health and baseline body posture, similar associations remained. This study shows, that not participating in sport and being overfat/obese are longitudinally associated with 'incorrect' body posture. Therefore, the detection of these risk factors in childhood, through the development of school- and community-based interventions, should be advocated., Competing Interests: The authors have declared that no competing interests exist.

Objective: Our aim was to analyze dose-response associations between maternal pre-pregnancy body mass index and physical activity levels with childhood sports injury rates., Methods: Participants included pre-pregnant mothers ( n = 4811) and their children at the age of 7 years ( n = 3311). Maternal anthropometry (height, weight, and body mass index), time spent in physical activity, and education level were recorded. All sports injuries were defined as injuries reported in the past year by the children at the age of 7 years., Results: Children whose mothers were overweight/obese in the pre-pregnancy period were 2.04 (OR = 2.04, 95% CI = 1.12-3.71) times more likely to report a sports injury at the age of 7 years. Underweight mothers exhibited a 74% decrease in the odds of their children reporting a sports injury at follow-up (OR = 0.26, 95% CI = 0.10-0.68). Finally, an increase in maternal physical activity across the last three quartiles was associated with a lower odds of sports injuries., Conclusions: The risk of reporting a sports injury was greater for children whose mothers were overweight/obese in the pre-pregnancy period. However, there was a lower risk with both maternal underweight status and increasing minutes of physical activity.

(1) Background: The objective of this study was to assess the prevalence of Developmental Dysplasia of the Hip (DDH) as a primary or secondary diagnosis during physiotherapy practice. No other studies have investigated the prevalence and associations of DDH within the practice of pediatric rehabilitation. (2) Methods: This retrospective review was performed on 12,225 physiotherapy referrals to the King Abdullah Specialized Children's Hospital (KASCH), Riyadh, Kingdom of Saudi Arabia, from May 2016 to October 2021. Only DDH referrals for conservative treatment were included in the study. The plan for brace treatment was carried out by the pediatric orthopedics clinic in KASCH. The diagnostic methods were either a pelvic radiograph or ultrasound, depending on the participant's age. DDH is considered one of the most common secondary complications for children with other medical diagnoses. (3) Results: The most common indication for referral was neurological diagnosis (44%), followed by orthopedic (28%), genetic (19%), cardiac (5%), ophthalmologic (3%), dermatologic (1%) and rheumatologic (0.5%) diagnoses. (4) Conclusion: The prevalence of DDH among all referrals in this study was 6%. In physiotherapy practice, neurologic, genetic, and orthopedic primary or secondary diagnoses were the most prevalent when DDH referrals were investigated. A relatively high prevalence of DDH in the pediatric rehabilitation clinic at KASCH in Riyadh was reported in this study.

Purpose : Tracking of physical activity (PA) and sport participation (SP) during motherhood is poorly understood. The purpose of the study was to analyze the extent of tracking of maternal PA and SP. Methods : In this investigation, data were collected from the Czech ELSPAC study subsample of 4811 and 2609 women measured postnatally (1991-1992) and after 11 years of follow-up (2002-2003), respectively. The structured questionnaire was used to assess the participation and average weekly time spent in PA, and the frequency of engaging in different sports (running, cycling, strength training, racket sports, swimming, and team sports). Tracking was calculated using generalized estimating equations (GEE) with beta coefficients (β), odds ratios (ORs), and 95% confidence intervals (95% CI). Results : Moderately high tracking coefficients were observed for cycling (β = 0.69, 95% 0.67-0.72), strength training (β = 0.59, 95% 0.56-0.63), and weekly time spent in PA (β = 0.53, 95% 0.38-0.66); meanwhile, moderate tracking coefficients were generated for swimming (β = 0.48, 95% 0.44-0.52), team sports (β = 0.44, 95% 0.39-0.48), racket sports (β = 0.44, 95% 0.39-0.48), and running (β = 0.35, 95% 0.30-0.40). Mothers who did not participate in PA at baseline were 81% more likely not to participate in it at follow-up (OR = 1.81, 95% CI 1.53-2.13). Conclusion : Cycling- and strength-related activities and weekly PA were tracked moderately-to-moderately high during motherhood. Moreover, the strong tracking of physical inactivity indicates that the detection of this risk factor before pregnancy should be advocated.

Although previous evidence has shown that deviated foot structure and function are associated with falls, little is known of the association between foot rotations and falls in apparently healthy older adults. Therefore, the main purpose of the study was to determine the associations between foot rotation and falls. In this cross-sectional study, we recruited 120 older women (mean±SD; age 71.01±6.77 years; height 158.92±21.41 cm; weight 70.29±12.97 kg; body-mass index 26.79±4.42 kg/m2). Foot rotations were assessed by using pressure platform (Zebris manufacturer, Munich, Germany), while the risk of falls was assessed by using Downtown Fall Risk Index questionnaire. Correlations and multiple regression models were applied to calculate the associations. In unadjusted model, higher foot rotation was associated with higher risk of falls (β = 0.14, p<0.001 for both feet). In a model adjusted for age, body-mass index, foot pain and fitness index, higher foot rotation remained associated with higher risk of falls (β = 0.10, p<0.001 for both feet). Our study shows that older adults with higher foot rotation are at higher risk of falls. Special interventions aiming to correct for deviated foot function in older women are warranted., Competing Interests: The authors have declared that no competing interests exist.

Background: The main purpose of the study was to determine whether lower levels of physical activity were associated with higher plantar pressure generated under each foot., Methods: In this cross-sectional study, we recruited 641 children aged 6-14 years (age mean ± SD = 9.7  ± 2.4 years; height mean ± SD = 143.6  ± 15.3 cm, weight mean ± SD = 37.6  ± 13.4 kg; body-mass index mean ± SD = 17.6  ± 3.2 kg/m 2 ; 44.2% girls). We used EMED -XL pressure platform to measure force time integral, pressure-time integral, contact-time and contact area, peak plantar pressure and mean plantar pressure of the right and the left foot during the gait analysis. The level of physical activity was measured by using The Physical Activity Questionnaire for Older Children (PAQ-C). The associations were calculated by using generalized estimating equations with linear regression models., Results: Lower levels of physical activity were associated with higher force- and pressure-time integrals, longer contact time and higher peak and mean plantar pressures in both feet., Conclusion: Our study shows that the level of physical activity is strongly and inversely associated with plantar pressure in a sample of 6-14 year olds., Competing Interests: The authors declare there are no competing interests., (©2020 Stefan et al.)

Little evidence from observational studies has been provided regarding 'optimal' relative schoolbag load during primary education. Also, no study to date has provided reference-based standards for relative schoolbag weight. Therefore, the main purpose of the study was to establish normative values of relative schoolbag weight in a sample of children. In this cross-sectional study, we recruited 584 primary school students aged 6-14 (meanage±SD = 9.6±2.4 yrs, meanheight±SD = 1.4±0.2 m, meanweight±SD = 37.5±13.3 kg, meanbody-mass index±SD = 17.6±3.1 kg/m2, 44.4% girls) chosen from five schools in the city of Brno. Schoolbag weight and child's body weight were objectively measured by using digital scale. Relative schoolbag weight was calculated by dividing schoolbag weight with child's body weight and the result was expressed in percentage. Lambda, Mu and Sigma (LMS) method was used to create sex- and age-percentile curves. Boys carried slightly heavier schoolbag, compared with girls (mean difference 0.2 kg, p = 0.020). No significant differences between sexes in relative schoolbag weight were observed (p = 0.240). Median values (P50) for boys and girls were similar and the largest observed between ages 6-9 in boys (15-17%) and 6-8 in girls (16-18%). The percentage of children carrying relative schoolbag weight beyond 10% of their body weight was very high, especially between ages 6-10 in boys (85.1-100%) and 6-11 in girls (86.8-95.4%). This study provides first sex- and age- relative schoolbag weight normative values in primary school children. Future studies should use similar methods for generating comparable data., Competing Interests: The authors have declared that no competing interests exist.

Background . The main purpose of this study was to explore the body-mass index and waist circumference associated with physical fitness by gender. Methods. In this cross-sectional study, we included 1036 adolescents (55.4% girls) from eight randomly selected secondary schools within the city of Zagreb (Croatia). Body-mass index and waist circumference were objectively measured. Physical fitness included three tests: (1) 1 min sit-ups, (2) standing long jump and (3) a sit-and-reach test. Associations were calculated using linear regression models. Results. Boys had higher body-mass index and waist circumference values, compared to girls ( p < 0.001). They also performed better in 1 min sit-ups and the standing long jump tests ( p < 0.001), while girls obtained higher values in the sit-and-reach test ( p < 0.001). In boys, body-mass index and waist circumference were associated with 1 min sit-ups and the standing long jump. In girls, waist circumference was also associated with 1 min sit-ups and the standing long jump, while body-mass index was only associated with this standing long jump. Conclusions. Our study shows that anthropometric indices have non-linear associations with physical fitness tests in a large sample of Croatian adolescents. Screening for thinness and obesity to predict the level of physical fitness should be of a great interest.

Background : The main aim of the study was to explore the association between objectively measured physical fitness and the level of pain intensity. Methods : In this cross-sectional study, we included 1036 adolescents (m age ± SD = 16.3 ± 1.1 years; m height ± SD = 1.74 ± 0.1 m; m weight ± SD = 64.7 ± 12.4 kg; m body ± SD = 21.3 ± 3.0 kg/m -mass index ± SD = 21.3 ± 3.0 kg/m 2 ) from 11 secondary schools located in the city of Zagreb (Croatia). Physical fitness was determined by using waist circumference, sit-ups in 1 min, standing long jump and sit-and-reach tests. Overall physical fitness index was calculated by summing the z -score values of each physical fitness test. The level of pain intensity was assessed with the Numeric Pain Rating Scale, a one-dimensional measure of pain intensity. Associations were calculated with correlation analyses. Results : In boys, pain intensity was associated with sit-ups in 1 min ( r = -0.16, p < 0.001), standing long jump ( r = -0.14, p = 0.003) and overall physical fitness index ( r = -0.13, p = 0.004), while no significant associations with waist circumference ( r = 0.04, p = 0.438) and sit-and-reach test ( r = -0.01, p = 0.822) were observed. In girls, pain intensity was associated with standing long jump ( r = -0.17, p < 0.001) and overall physical fitness index ( r = -0.10, p = 0.018), while no significant associations with waist circumference ( r = 0.01, p = 0.735), sit-ups in 1 min ( r = -0.06, p = 0.126) and sit-and-reach test ( r = -0.05, p = 0.232) were observed. When we adjusted for self-rated health, sleep duration, smoking status, alcohol consumption, screen-time and psychological distress, similar associations remained. Conclusion s : Our study shows a weak association between physical fitness and pain intensity in a large sample of adolescents. Although a cross-sectional design, health-professionals should use physical fitness as a screening tool to assess the level of pain intensity., Competing Interests: The authors declare no conflict of interest.

Purpose: The main purpose of the present study was to establish percentile curves for body-mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR) and WHtR(exp) in adolescents., Methods: In this cross-sectional study, we recruited 1036 secondary-school students aged 15 to 18 years from eight randomly selected schools (55.3% girls). BMI, WC, WHtR and WHtR(exp) were calculated using standardized measuring protocol. The sex- and age-specific smoothed percentile curves with 5th, 10th, 25th, 50th, 75th, 90th, and 95th percentile for each anthropometric measure were constructed using Cole's LMS method., Results: In boys, both BMI and WC percentile curves increased by age, yet the 95th percentile curve for WHtR and WHtR(exp) decreased by age. In girls, the 95th percentile curve for BMI remained unchanged through the age of 15 to 18 years, yet the 90th and 95th percentile curves for WC and WHtR decreased by age., Conclusion: This is the first study in Croatia to establish combined BMI, WC, WHtR and WHtR(exp) percentile curves and add some new insight on anthropometric measures in 15- to 18-year-old adolescents.

Background: Physical development can be considered as an indicator of the overall health status of the youth population. Currently, it appears that the increasing trend of the prevalence of obesity among children and youths has stopped in a number of countries worldwide. Studies point to the fact that adolescence is a critical period for the development of obesity. Body mass index (BMI) seems to be an orientation parameter in the assessment of prevalence of obesity which is not sufficient for more accurate identification of at risk individuals. The purpose of this study was to evaluate association between BMI percentile zones as health-risk for being overweight and obese and body composition indicators in high-school students from the Prešov (Slovakia) region., Methods: A non-randomized cross-sectional study in high school students from the Prešov (Slovakia) region was conducted. The research sample consisted of 1014 participants (boys n = 466, girls n = 549). Body composition was measured using direct segmental multi-frequency bioelectrical impedance analysis (DSM-BIA). To examine the association between obesity and selected body composition indicators, Kruskal-Wallis ANOVA and Eta(2) were used. The relationship between selected body composition indicators and percentile BMI zones was determined using the Kendall tau correlation., Results: In groups with different BMI percentile zones (normal weight, overweight, obese), ANOVA showed significant differences for girls and boys (p ˂.05) with high effect size (η(2) ˂.26) in body weight, body fat mass index, body fat percentage, fat free mass index, fat-free mass percentage, visceral fat area, waist-to-hip ratio, waist circumference, protein mass and mineral mass. The highest degree of correlation among boys was between BMI values indicating overweight and obesity and fat free mass index and waist circumference, respectively (τ = .71, τ = .70, respectively). In girls, the highest correlation was found between classification of BMI percentile zones and waist circumference (t = .78)., Conclusion: The characteristics of body composition are very useful determinants of health and nutrition status. Our data revealed a direct association between BMI value and chosen body composition indicators. The most accurate indicator of overweight and obesity in our study appears to be waist circumference for both male and female population.

Purpose of the study was to examine relationship between distribution of healthy fitness zone standards of high school students and their type of housing or area of residence. Study sample consisted of 684 students (284 boys, 400 girls) from urban and rural areas of the region Presov in the eastern part of Slovakia. Physical fitness was assessed by four tests: back-saver sit and reach, shoulder stretch, curl-ups and 90° push-ups. Differences by place of residence and types of housing were examined by correspondence analysis of two-dimensional tables with computing Chi square value at significance level p < 0.05. Urban students performed higher level of flexibility, abdominal and upper strength and endurance than rural ones. Boys and girls living in a flat reached higher level of flexibility and abdominal strength/endurance however, they performed worse in upper strength and endurance than those living in a house. Slovak adolescents seem to have a healthier profile in abdominal muscular fitness and upper body flexibility than in lower body flexibility. The relationship between distribution of healthy fitness zone standards and residence area or housing type was revealed only in lower body flexibility, upper strength and endurance of urban and rural girls.