Revista Adolescência e Saúde

Revista Oficial do Núcleo de Estudos da Saúde do Adolescente / UERJ

NESA Publicação oficial
ISSN: 2177-5281 (Online)

Vol. 14 nº 4 - Oct/Dec - 2017

Original Article Imprimir 

Páginas 48 a 57

Impact of obesity on physical fitness related to health and sport of male school adolescent

Impacto de la obesidad sobre la aptitud física relacionada a la salud y al deporte de escolares adolescentes del sexo masculino

Impacto da obesidade sobre a aptidão física relacionada à saúde e ao esporte de escolares adolescentes do sexo masculino

Autores: Leslie Andrews Portes1; Natália Cristina de Oliveira2

1. Doctor in Health Sciences. Master in Health Sciences from the Federal University of São Paulo (UNIFESP). São Paulo, SP, Brazil. Professor of the Professional Master's Degree in Health Promotion and Undergraduate Courses in Physical Education, Nursing, Physical Therapy and Nutrition. Researcher of the Research Group on Physical Exercise, Lifestyle and Health Promotion (GEFEV) and Coordinator of the Laboratory of Exercise Physiology (LAFEX) of the Adventist University Center of São Paulo (UNASP). São Paulo, SP, Brazil
2. Doctor in Medical Sciences. Professor of the Professional Master's Degree in Health Promotion and Undergraduate Courses in Physical Education, Nursing and Nutrition. Researcher of the Research Group on Physical Exercise, Lifestyle and Health Promotion (GEFEV) and Laboratory of Exercise Physiology (LAFEX) of the Adventist University Center of São Paulo (UNASP). São Paulo, SP, Brazil

Leslie Andrews Portes
Centro Universitário Adventista de São Paulo, Laboratório de Fisiologia do Exercício (LAFEX)
Estrada de Itapecerica, 5859, Jardim IAE
São Paulo, SP, Brasil. CEP: 05858-005

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Keywords: Adolescent, growth and development, obesity, physical fitness.
Palabra Clave: Adolescente, crecimiento y desarrollo, obesidad, aptitud física.
Descritores: Adolescente, crescimento e desenvolvimento, obesidade, aptidão física.

OBJECTIVE: Assess the burden of overweight and obesity in some physical fitness tests.
METHODS: Anthropometry measures involved height, weight and triceps and subscapular skinfolds. Body mass index (BMI) was calculated, as well as percent body fat (%F) and fat free mass (FFM). Growth, development, BMI and adiposity were evaluated. Physical fitness was determined by cardiorespiratory endurance (12-minutes walking/jogging), strength and local muscle resistance (repetitions in bar and abdominal crunches), agility (shuttle-run) and muscle power (vertical jump) tests. Prevalences were analyzed through chi-square test and comparisons among different groups regarding BMI and %F were drawn through "one way ANOVA", followed by Tukey's test (P < 0.05).
RESULTS: Although more than 94% of adolescents exhibit appropriate height and weight for their ages, and over 70% have reached results considered suitable or above the expected in physical fitness tests (>50% in maximal VO2), prevalence of overweight and obesity, respectively, as assessed by BMI (12 and 5%) and %F (12% and 17%) have negatively affected the test results, where %F had the highest impact.
CONCLUSION: Overweight and obesity had a weak to moderate negative impact on adolescents physical fitness, suggesting that other lifestyle aspects may exert influence and must be identified.

OBJETÍVO: Evaluar el impacto del sobrepeso y de la obesidad en algunos test de aptitud física.
MÉTODOS: La antropometría comprendió estatura, peso y pliegues cutáneos tricipital y subescapular. Se calculó el índice de masa corporal (IMC), el porcentaje de grasa corporal (%G), la masa libre de grasa (MM) e se evaluó el crecimiento, desarrollo, el IMC y la adiposidad corporal. La aptitud física fue determinada por los test de resistencia cardiorrespiratoria (caminada/corrida en 12 minutos), fuerza y resistencia muscular localizada (repeticiones en la barra y abdominales), agilidad (shuttle-run) y potencia muscular (impulso vertical). Las prevalencias fueron analizadas por el test del Chi-cuadrado y las comparaciones entre diferentes grupos en relación al IMC y al %G por la "ANOVA one way" seguida del test de Tukey (P < 0,05).
RESULTADOS: Si bien más del 94% de los adolescentes exhiben estatura y peso adecuados a la edad, y  más del 70% alcanzaron resultados adecuados o arriba de lo esperado en los test de aptitud física (>50% en el VO2 máximo), las prevalencias de sobrepeso y obesidad, respectivamente, por el IMC (12% y 5%) y por el %G (12% y 17%) afectaron negativamente los resultados de los test, siendo que el %G ejerció el mayor impacto.
CONCLUSIÓN: El sobrepeso y la obesidad ejercieron débil a moderado impacto negativo sobre a aptitud física de los adolescentes, sugiriendo que otros aspectos de estilo de vida ejerzan influencia y deban ser identificados.

OBJETIVO: Avaliar o impacto do sobrepeso e da obesidade em alguns testes de aptidão física.
MÉTODOS: A antropometria compreendeu estatura, peso e pregas cutâneas tricipital e subescapular. Calculou-se o índice de massa corporal (IMC), o percentual de gordura corporal (%G), a massa livre de gordura (MM) e avaliou-se o crescimento, desenvolvimento, o IMC e a adiposidade corporal. A aptidão física foi determinada pelos testes de resistência cardiorrespiratória (caminhada/ corrida em 12 minutos), força e resistência muscular localizada (repetições na barra e abdominais), agilidade (shuttle-run) e potência muscular (impulso vertical). As prevalências foram analisadas pelo teste do qui-quadrado e as comparações entre diferentes grupos em relação ao IMC e ao %G pela "ANOVA one way" seguida do teste de Tukey (P < 0,05).
RESULTADOS: Embora mais de 94% dos adolescentes exibam estatura e peso adequados à idade, e mais de 70% alcançaram resultados adequados ou acima do esperado nos testes de aptidão física (>50% no VO2 máximo), as prevalências de sobrepeso e obesidade, respectivamente, pelo IMC (12% e 5%) e pelo %G (12% e 17%) afetaram negativamente os resultados dos testes, sendo que o %G exerceu o maior impacto.
CONCLUSÃO: O sobrepeso e a obesidade exerceram fraco a moderado impacto negativo sobre a aptidão física dos adolescentes, sugerindo que outros aspectos de estilo de vida exerçam influência e devam ser identificados.


Overweight (PE) among Brazilian adults exceeded 55%, being overweight (OBO) and obesity (OBE) responsible for epidemic proportions of 46.6% and 13.9%, respectively1. In children and adolescents, PE approaches 30%1,2. As in other countries3, there are indications that PE has gradually increased by1.4, 6 in Brazil and among the main causes the lifestyle is highlighted: inadequate diet and sedentary lifestyle (low physical fitness)5.

PE is a risk factor for several diseases, such as arterial hypertension, arterial stiffness, coronary artery disease, hypercholesterolemia, diabetes, metabolic syndrome and sedentary lifestyle1,7,8. Evidence indicates that physical fitness levels areinversely related to the values of body mass index (BMI), percentage of body fat (% G), total cholesterol, triglycerides, blood pressure, insulin resistance and C-reactive protein5,8. Chen et al.7 observed, for example, that boys and girls with SOB and OBE between 6 and 18 years old presented worse results than their peers with normal BMI, sit-and-reach abdominal tests in 60 seconds, and cardiovascular index, as well as larger values of systolic and diastolic blood pressure in all age groups. Others found that the incidence of arterial hypertension was higher than 17% among patients with PE and low cardiorespiratory fitness7.

PE increases the prevalence of adolescents who do not meet the minimum criteria in health-related physical fitness tests5,9,10,11. Orsano et al.5, for example, reported reductions of 29% (abdominal in 60 seconds), 21% (lower limb muscle strength), 15% (flexibility) and 10% (agility) related to PE, and Burgos et al.12 found that among adolescents with SOB and OBE, more than 60% and 80%, respectively, had poor cardiorespiratory capacity. The association "low success rates in physical fitness tests" and "high prevalence of SOB and OBE" makes the issue of concern from the point of view of Public Health. It is interesting to note that few Brazilian studies have evaluated the impact of SOB and OBE on the physical fitness of adolescents5,6,12. Therefore, the objective of the present study was to determine the impact of SOB and OBE determined by BMI on performance in some physical fitness tests related to health and sport in Brazilian adolescents. In addition, since BMI is not the best indicator of body composition, we aimed to determine the impact of body fat (% G) on physical fitness. Our hypothesis was that SOB and OBE have a significant negative impact on physical fitness.



All boys aged between 14 and 18 years of high school (n = 698) were evaluated at the beginning of the school year of a private school in the south of the city of São Paulo. In the first two weeks they performed play and physical activities, 3 lessons / week, 50 minutes / lesson. Over the next four weeks, adolescents were submitted to anthropometry and health related physical fitness (AFRS) and sports related fitness tests (AFRE). The distribution of the tests and measures, described below, was made in such a way that there was alternation between the muscle groups, and that the neuromuscular tests were done first. All procedures were in accordance with the Declaration of Helsinki ( and Resolution 466/12 of the National Health Council (Brazil). The study was approved by the ethics committee of UNASP - Centro Universitário Adventista de São Paulo (protocol nº 14/2006).


The height of the adolescents was measured using a stadiometer with a precision of 0.1 cm and a digital scale (Filizola, São Paulo, Brazil) was used with a precision of 0.1 kg for the body mass, where the boys wore only shorts. The body mass index (BMI, kg/m2) was calculated using the equation: BMI = weight / height / height x 10,000. Body fatness was estimated using the anthropometric method using a 1.0 mm Lange plicometer. The skinfolds measured were triceps, subscapular, suprailiac, abdominal and thigh. Each skin fold was measured three times and the median value used for the calculations. Body composition was determined by the following variables: percentage of body fat (% G) and body fat free mass (MM). The% G was estimated using the equations of Slaughter et al.14 by summation (S2DC) of triceps (TR) and subscapular (SE) folds.

Growth and development were evaluated by height, weight and BMI for age15 and subjects divided into three categories of height and weight: percentile <3 (very low), between the 3 and 97 (appropriate) percentile and ≥ 97 (high). In relation to BMI, there were 4 categories: percentile <5 (low BMI), between the 5th and 85th (eutrophic) percentile, percentile> 85 and <95 (overweight), and finally, percentile ≥ 95 (obesity). Additionally, the Z scores of each student15 were calculated by subtracting the age-specific median value, and the result divided by the population standard deviation. Finally, the boys were divided into four categories according to the%G16: lean:%G <10%; Adequate adiposity:% G ≥ 10% <20%; excess fat:% G ≥ 20% and <25%; obesity:% G ≥ 25%.

Physical aptitude

Physical fitness was determined by the following tests (AFRS): elbow flexion and elbow extension (BA)13, abdominal repetitions in 60 seconds (ABDO)18 and exercise/walking in 12 minutes (12min)17. The sports-related physical fitness tests (AFRE) used were: shuttle-run: 4 x 9.14m (S-R)13 and vertical impulse test (IV)18. BA and ABDO tests served as indicators of localized muscle strength and endurance; the 12 minutes test for evaluation of cardiorespiratory fitness; S-R for agility assessment; and the IV test to assess the potency of the lower limbs. With the exception of the BA, ABDO and 12 minutes tests, the others were performed three times and the best result used for the analyzes. Additionally, from the results of the 12-minute test, it was possible to estimate the maximum oxygen consumption (VO2 maximum), expressed in relation to body mass17.

Statistical analysis

Data normality for all tests was tested by the D'Agostino-Pearson method. Initially, the adolescents were grouped by age groups (14, 15, 16, 17 and 18 years) for growth, development and physical fitness assessment (AFRS and AFRE). The prevalence of adolescents in the different categories of height and weight, BMI and body adiposity were determined. The impact of overweight (BMI) and body fat (% G) on physical fitness was evaluated by dividing school children into three success categories in physical fitness tests. The results below the 45th percentile were classified as being below the desirable; those who reached the 45th percentile and were below the 75th percentile were rated as having adequate physical fitness; and those who have reached or exceeded the 75th percentile as having higher than expected physical fitness.

The numerical data were compared using one-way ANOVA and, when necessary, using the Kruskal-Wallis method. The associations between numerical fitness variables and BMI or% G were established using the Pearson or Spearman correlation coefficient (r), when necessary. The determination coefficients (r2) were also calculated. The associations between the prevalences in the physical fitness tests according to the different categories of BMI and% G were analyzed using the Pearson chi-square test (X2 ). The results were considered statistically different when p < 0.05. All analyzes were done with the GraphPad Prism version 6.00 for Windows statistical package (GraphPad Software). All results were expressed as means ± standard deviations.


Table 1 summarizes the data on physical fitness variables, indicating a significant improvement (p < 0.05) in all tests from 14 to 17 years, stabilizing from 17 to 18 years.

Table 2 summarizes the prevalence of individuals in each category of growth, development and body composition. Adolescents were grouped by age group and the prevalence of SOB and OBE in relation to BMI, respectively, were as follows: 14 years: 13.2% and 10.5%, 15 years: 13.3% and 6.6% , 16 years: 12.3% and 2.9%, 17 years: 10.8% and 4.3% and 18 years: 0% and 3.1%. In relation to% G, the prevalence of excessive body fat and obesity, respectively, were as follows: 14 years: 10.5% and 21.1%, 15 years: 11.3% and 21.9%, 16 years: 15.8% and 17.5%, 17 years: 6.5% and 8.6% and 18 years: 15.6% and 3.1%. Table 2 also summarizes the anthropometric variables evaluated by age group and indicates that height, body mass and lean mass increased as a function of age, while body fat (% G) decreased, especially after 16 years. These changes were expected as a function of the second growth spurt. Z scores were also calculated, indicative of the distance that the individual values have from the population mean. Regarding height, there were no differences between ages, but 14  and 15 years old boys showed higher BMIs than 17 and 18 years old (p < 0.05). When grouped by body fat categories, obese adolescents showed the highest weight and BMI (p <0.05) scores: 1.58 ± 0.99 (weight) and 1.82 ± 1.01 (BMI).

Next, we sought to evaluate the association between age and success in physical fitness tests (Figure 1). In the 12-minute running / walking test, in relation to maximal VO2 , more than 70% of the boys reached adequate or higher values, and the success rate increased with age, resulting in a significant and positive association between age groups and the success rates (X2 = 44.07, p < 0.0001 and X2 = 29.97, p < 0.0002, respectively). In the muscle power test of lower limbs (IV) there was a positive and significant association between age groups and success rates (X2 = 16.26, p <0.039). Although more than 56% of boys had adequate muscle power, few achieved values above the 75th percentile. For agility (S-R), more than 75% achieved adequate or above success, and there was a positive and significant association between age groups and rates of success (X2 = 30.82, p <0.0002), especially in relation to the increase in the rate of adequate results. In relation to the ABDO test, less than 30% of the boys achieved below-desirable results, and although the association with age was not linear, it was significant and positive (X2 = 41.05, p <0.0001). Finally, in relation to the strength test (BA), more than 60% achieved adequate or above results, however, there was only a tendency of association between the results in the strength test (BA) and the age groups (X2 = 14, 91, p <0.061). In summary, more than 70% of the boys achieved adequate or above-expected results in the 12 min, S-R, ABDO and BA tests, while in the IV test and in relation to maximal VO2 , more than 50% of them achieved satisfactory results, indicating that most of these students exhibited adequate physical fitness.Another aspect that deserves to be highlighted is that success increased with increasing age in the tests evaluated, indicating that maturation played an important role in acquiring better physical fitness results.

Figure 1. Percentage success rates in physical fitness tests assessed by age group. There was a statistically significant association (p <0.05) between the ages and the prevalence of success in all tests except that of force (bars).

The association between physical fitness and BMI was also evaluated (Figure 2). Although statistically significant differences were only observed in the 12 min, S-R, BA and VO2 maximum tests (p <0.001), it was evident that the highest rates of failure were found in the SOB and OBE categories.

Figure 2. Percentage success rates in physical fitness tests as a function of BMI and in terms of body fat (% G). P < 0.05 : with the increase of the percentiles in the BMI categories, there was an increase in the prevalence of failure in the 12-min, S-R, BA and VO2 tests, and, with the increase in body fat (% G), there were increased prevalence of failure in all physical fitness tests.

Finally, we sought to evaluate the association between body adiposity (% G) and physical fitness tests (Figure 2). Similar to that observed in relation to BMI, the categories of adolescents with excessive body adiposity and obesity exhibited the lowest rates of success in the tests. The prevalence of adolescents with adequate success rates or above was higher than 72% in the categories of leanness and adequate adiposity. Statistically significant differences (p <0.03) were found in all tests.The mean scores ± standard deviations in the physical fitness tests verified in the different BMI and% G categories are described in Table 3.

The inverse and statistically significant relationships between the BMI and% G categories and the test performance were clear. The losses were 179% in the strength test (BA), 22% in the maximal VO2, 17% in the 12-min test performance, 14% in the localized muscular resistance (ABDO), 11% in the power of the (IV) and only 5% in the Agility (S-R) test. The correlation (r) and determination (r2 ) coefficients between age, BMI and% G and physical fitness scores showed that, as a function of age, r (12min: 0,33, VO2 max: 0, 33, IR: 0.34, S-R: -0.33, ABDO: 0.12 and BA: 0.27) indicated very weak and weak associations and r2 ranged between 0.02 and 0.12, suggesting that age would explain between 2% and 12% of variations in physical fitness tests. Regarding BMI, the results also indicated very weak and weak associations, showing that the BMI would explain between 1% and 12% of the variations observed in physical fitness tests (12min: -0.34, maximum VO2 : -0.34 , IR: -0.10, S-R: 0.20, ABDO: -0.14 and BA: -0.28). In relation to the% G, the r (12min: -0.46, VO2 maximum: -0.46, IV: -0.25, S-R: 0.43, ABDO: -0.28 and BA: -0, 47) were moderated for cardiorespiratory fitness, muscle strength and time in the agility test, but were weak in relation to localized muscular resistance and muscle power. The r2 ranged from 0.06 to 0.22, indicating that variations in the% G would explain from 6% to 22% of the variations in physical fitness. Logistic analyzes showed that% G was the variable that exerted the greatest influence on the test results (p <0.001).


In response to the objective of this study to assess the impact of SOB and OBE on performance in physical fitness tests of adolescents, excessive adiposity and obesity were found to result in significant impairment. Although this finding is not unprecedented5,6,12, it refers to at least three aspects: 1) the issue should receive greater attention from politicians, educators and health professionals, as the SOB and OBE, the high prevalence of sedentarism among adolescents and the high rates of unsatisfactory results in physical fitness tests, the risk of chronic-degenerative diseases in the population tends to increase; 2) there is clear disagreement between BMI and% G, quantitatively; 3) other aspects besides SOB and OBE are operating in relation to performance in physical fitness tests, since both BMI and% G explained a small part of the results.

Regarding the first aspect, researchers have drawn attention to the need for more effective public and educational policies in order to reverse this trend5. However, current indicators of overweight, sedentary lifestyle and low physical fitness indicate that these initiatives have not been sufficient. The result is that the time spent in sedentary activities is positively associated with high body adiposity and is inversely related to the time of physical activity practice5.

Regarding the second aspect, it is known that BMI and% G do not always agree when indicating the prevalence of obesity5. Therefore, the World Health Organization 19 suggested that, in addition to the use of the ≥ 85 percentile relative to BMI, triceps and subscapular skinfolds should be used (percentile ≥ 90). The association of the two indicators would maximize the specificity for the identification of adolescents with excess weight and excessive adiposity19. In the present study, it was verified that the BMI and body fat estimated by the% G agreed in relation to adolescents who exhibited SOB and excessive adiposity (prevalence of 12% in each indicator), but not in relation to OBE (BMI: 5% and% G: 17%). Additionally, when multiple logistic analyzes were performed in relation to age and BMI,% G was the one that had the greatest impact on the results of all physical fitness tests. Conte et al.6 also found that SOB resulted in impairment of physical fitness, but since its sample was not very representative, its results limit the conclusions. It is possible that the underestimation of the prevalences determined by BMI does not raise the attention of the authorities so much, so we emphasize the need to use% G.

Regarding the third aspect, in a study with adolescents from the North of Brazil5, it was observed that lifestyle was inversely associated with body adiposity. When studying urban and rural children and adolescents in the south of Brazil9 it was suggested that the lifestyle "contributed greatly to the fact that the rural ones obtained better performances in the battery of tests used". These data highlight the need to evaluate other aspects of lifestyle to better understand aspects of physical fitness. Certainly the low physical fitness has multifactorial causes, being the sedentarism and, consequently, the SOB and the OBE some of these components. However, very little has been investigated regarding the impact of dietary patterns, social relations, stress, spirituality / religiosity and other habits (smoking, alcoholism and drugs) on physical fitness.

Finally, we can not disregard the fact that most of the adolescents in the present study achieved adequate or above-expected results in the 12min, S-R, ABDO and BA tests, and in the IV test and in relation to the maximum VO2, more than 50 % of them achieved satisfactory results. These data suggest that, in general, they exhibited adequate physical fitness. However, when we associate the categories of body adiposity with the physical fitness tests, we verified clearly that the greater the adiposity, the higher the prevalence of fitness below the desirable one. Other authors have also found similar results5,6,20,21, even indicating that overweight and obese children (verified by BMI) have a reduced probability of 50% and 20%, respectively, of having success in the aptitude tests when compared to their eutrophic pairs. Data from Taiwanese adolescents21 indicate that the highest fitness scores occur in boys with BMI within the normal range. The mechanism that would link poor performance in physical fitness tests to overweight and excessive adiposity should be body overload and greater energy expenditure for the same task in relation to a eutrophic individual. However, this was not the case. The sedentary lifestyle may have operated with greater impact than the components of body composition, as already suggested by other authors9,20. We noticed this when correlations were established between age, BMI and adiposity, and the results of the physical fitness tests, considered to be very low to at most moderate (r = -0.55), which has also been observed by other5.


SOB and OBE had a negative impact on physical fitness related to adolescent health and sports, and body fatness responded by greater impact. Unsatisfactory results in fitness tests, allied to SOB, OBE, sedentary lifestyle and other lifestyle components seriously increase the risk of chronic-degenerative diseases in this population and in adulthood, impacting public health.


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