A 15-Year Decline in Physical Fitness Among Children and Adolescents From the Macao Special Administrative Region...

Monitoring temporal trends in physical fitness provides valuable insight into population health that can help identify current and future physical health. This study examined temporal trends in physical fitness among children and adolescents aged 6-18 from the Macao Special Administrative Region between 2005 and 2020.

Representative repeated cross-sectional physical fitness data were collected in 2005, 2010, 2015, and 2020 (n = 17,987). Body size and physical fitness were objectively measured. Trends in means were calculated using general linear models. Models were adjusted for sex, age, height, and weight. Trends in distributional characteristics were assessed as the ratio of the coefficients of variation and described visually.

Despite an increase in body size, we found significant small to large body size adjusted decline in cardiorespiratory fitness (effect size [ES] = -0.27, -0.93) and small declines in reaction time (ES = -0.21, -0.38). Declines in other fitness components varied by age, with negligible to small declines in children's (aged 6-12 y) balance (ES = -0.15) and speed (ES = -0.25) and in adolescents' (aged 13-18 y) muscular power (ES = -0.17, -0.36). A small improvement was observed in adolescents' flexibility (ES = 0.24). Mixed trends were found in distributional variability for flexibility, along with differing trends in distributional asymmetry among fitness components.

These findings underscore the need for targeted interventions to enhance fitness levels in the young Macao population. Addressing these trends is crucial for improving the current and future health outcomes of young people in the region.