Fitness Measures and
Health Outcomes in Youth
Committee on Fitness Measures and Health Outcomes in Youth
Russell Pate, Maria Oria, and Laura Pillsbury, Editors
Food and Nutrition Board
INSTITUTE OF MEDICINE
OF THE NATIONAL ACADEMIES
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NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance.
This study was supported by Grant No. 61747 between the National Academy of Sciences and the Robert Wood Johnson Foundation. Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the view of the organizations or agencies that provided support for this project.
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Suggested citation: IOM (Institute of Medicine). 2012. Fitness measures and health outcomes in youth. Washington, DC: The National Academies Press.
“Knowing is not enough; we must apply.
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INSTITUTE OF MEDICINE
OF THE NATIONAL ACADEMIES
Advising the Nation. Improving Health.
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COMMITTEE ON FITNESS MEASURES AND HEALTH OUTCOMES IN YOUTH
RUSSELL R. PATE (Chair), Professor, Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia
CAMERON BLIMKIE, Professor, Department of Kinesiology, McMaster University, Hamilton, Ontario
DARLA CASTELLI, Associate Professor, Department of Kinesiology and Health Education, University of Texas, Austin
CHARLES B. CORBIN, Professor Emeritus, Department of Exercise and Wellness, Arizona State University, Phoenix
STEPHEN R. DANIELS, Professor and Chair, Department of Pediatrics, University of Colorado School of Medicine, and Pediatrician-in-Chief, Children’s Hospital Colorado, Aurora
HAROLD W. KOHL III, Professor, School of Public Health and Michael & Susan Dell Center for Healthy Living, University of Texas Health Science Center-Houston, and Department of Kinesiology and Health Education, University of Texas, Austin
ROBERT M. MALINA, Professor Emeritus, Department of Kinesiology and Health Education, University of Texas, Austin and Research Professor, Department of Kinesiology, Tarleton State University, Stephenville, Texas
JENNIFER SACHECK, Associate Professor, John Hancock Research Center on Physical Activity, Nutrition, and Obesity Prevention, Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts
DAVID STODDEN, Associate Professor, Department of Health, Exercise, and Sport Sciences, Texas Tech University, Lubbock
MELICIA WHITT-GLOVER, President and CEO, Gramercy Research Group, LLC, Winston-Salem, North Carolina
WEIMO ZHU, Professor, Department of Kinesiology and Community Health, College of Applied Health Sciences, University of Illinois at Urbana-Champaign
MARIA ORIA, Study Director
LAURA PILLSBURY, Program Officer
ALLISON BERGER, Senior Program Assistant
ALICE VOROSMARTI, Research Associate
ANTON L. BANDY, Financial Officer
GERALDINE KENNEDO, Administrative Assistant
LINDA D. MEYERS, Director, Food and Nutrition Board
MICHAEL W. BEETS, University of South Carolina, Columbia
RONA BRIERE, Briere Associates, Inc., Arlington, Virginia
WILLIAM H. DIETZ, Centers for Disease Control and Prevention, Atlanta, Georgia (retired)
JOAN M. DORN, Centers for Disease Control and Prevention, Atlanta, Georgia
JANET E. FULTON, Centers for Disease Control and Prevention, Atlanta, Georgia
SARAH M. LEE, Centers for Disease Control and Prevention, Atlanta, Georgia
MELINDA MILLARD-STAFFORD, Georgia Institute of Technology, Atlanta
JANE WARGO, President’s Council on Fitness, Sports, and Nutrition, Rockville, Maryland
This report has been reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise, in accordance with procedures approved by the National Research Council’s Report Review Committee. The purpose of this independent review is to provide candid and critical comments that will assist the institution in making its published report as sound as possible and to ensure that the report meets institutional standards for objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the deliberative process. We wish to thank the following individuals for their review of this report:
Virginia Rall Chomitz, Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, Massachusetts
Wm. Cameron Chumlea, Lifespan Health Research Center, Boonshoft School of Medicine, Wright State University, Dayton, Ohio
Angela Diaz, Department of Pediatrics and Department of Preventative Medicine, Mount Sinai School of Medicine, New York, New York
Avery Faigenbaum, Department of Health and Exercise Science, The College of New Jersey, Ewing
B. Don Franks, Department of Kinesiology, School of Public health, University of Maryland, College Park
Maxine Hayes, State of Washington Department of Health, Tumwater
Steven Heymsfield, Pennington Biomedical Research Center, Baton Rouge, Louisiana
Duane Knudson, Department of Health & Human Performance, Texas State University, San Marcos
Matthew Mahar, Department of Kinesiology, The College of Health & Human Performance, East Carolina University, Greenville, North Carolina
J. Michael McGinnis, Institute of Medicine, Washington, DC
Thomas McKenzie, School of Exercise and Nutritional Sciences, San Diego State University, California
Mark Tremblay, Department of Pediatrics, University of Ottawa, Canada
Although the reviewers listed above provided many constructive comments and suggestions, they were not asked to endorse the report’s conclusions or recommendations, nor did they see the final draft of the report before its release. The review of this report was overseen by Diane Birt, Professor, Department of Food Science and Human Nutrition, Iowa State University, and Elena O. Nightingale, Scholar-in-Residence, Institute of Medicine. Appointed by the Institute of Medicine, both were responsible for making certain that an independent examination of this report was carried out in accordance with institutional procedures and that all review comments were carefully considered. Responsibility for the final content of this report rests entirely with the authoring committee and the institution.
This report, initiated at the request of the Robert Wood Johnson Foundation, belongs to a series that is part of a broad effort of the Institute of Medicine (IOM) on preventing childhood obesity. Past reports in the series have focused on areas in which preventive interventions could make a difference in the struggle against obesity. This report is the first to look directly at the role of youth physical fitness in health. The committee that conducted this study was charged with recommending the best health-related measures of various components of fitness for inclusion in a national youth fitness survey and, secondarily, recommending test items for administration in educational settings. As an aid in accomplishing this task, the committee was provided with a scientific literature search conducted and managed by the Centers for Disease Control and Prevention.
Physical fitness test batteries for youth have been designed and administered widely in the United States since the mid–20th century. While the components of fitness measured and the specific test items included in protocols have varied considerably across test batteries and over time, youth fitness testing has become a well-established institution in school physical education programs. In addition, national surveys of youth fitness were conducted periodically between the late 1950s and the mid-1980s; the period from the mid-1980s to the present, however, has seen a hiatus in such surveys, perhaps as the result of an increased emphasis on surveys of physical activity behavior as distinct from fitness. With the increased prevalence of overweight and obesity in American youth and expanded knowledge of the impact of fitness on health outcomes, interest in the fitness status of contemporary children and adolescents has grown. Accordingly, this report is intended to provide
guidance for the designers of a national survey of health-related fitness in American youth. Also, recognizing the importance of fitness testing in school physical education programs and in accordance with its statement of task, the committee recommends health-related fitness test items that are seen as both valid and feasible for administration in educational settings.
An important and sometimes vexing aspect of health surveys is the establishment of criteria for interpreting the survey findings. Accordingly, this report also includes guidelines for setting standards for performance on the various fitness test items included in the recommended battery. In doing its work, moreover, the committee encountered many gaps in the relevant scientific evidence; thus an important element of the report is a set of recommendations for future research on fitness testing in youth.
The committee comprised 11 experts with extensive knowledge in a range of areas related to fitness and physical activity, metabolic health, growth and maturation, body composition, and physical education, as well as the development of standards and validation of tests. In addition to its reviews of the literature and discussions in closed meetings, the committee benefited from rich discussions with other experts in fitness and youth during an open session. On behalf of the committee, I sincerely thank the participants and speakers who contributed to this open session, providing information critical to the completion of this report.
On behalf of the committee, I also would like to express my deep appreciation to the consultants who led the literature search, a main resource for the committee’s recommendations. Michael W. Beets, William H. Dietz, Joan Dorn, Janet E. Fulton, Sarah M. Lee, Melinda L. Stafford-Millard, and Jane Wargo not only conducted the main literature search but also facilitated the committee’s work by providing abstractions and summaries of the literature as requested. I would like to express my appreciation as well to Laura C. Leviton, senior adviser for evaluation at the Robert Wood Johnson Foundation, whose leadership has provided impetus for so many efforts on obesity prevention at the IOM, and to Tina J. Kauh, research and evaluation program officer at the Robert Wood Johnson Foundation.
I would also like to gratefully acknowledge the effort and skill the committee members brought to this study. Their backgrounds, experiences, and passion for the subject matter resulted in a report that will have a long life. Finally, I thank the project staff of the National Academies—Maria Oria, study director; Laura Pillsbury, program officer; and Allison Berger, senior program assistant—for their tireless dedication to the production of this report.
Robert R. Pate, Chair
Committee on Fitness Measures and Health
Outcomes in Youth