Enric Conesa-Milian

This study aimed to assess the effect of exercise on high‐sensitivity cardiac troponin T (hs‐cTnT) concentrations in children and adolescents and to examine whether sex, maturational status, anthropometric characteristics, cardiorespiratory fitness, and physical activity influence the hs‐cTnT response. In this trial 733 participants completed the 20‐m shuttle run test. Venous blood samples were collected at rest and 3 h postexercise to determine hs‐cTnT concentrations. We included 296 girls and 437 boys (12.2 ± 1.7 years; 40% girls). At baseline, 61% of participants had hs‐cTnT values below the limit of detection (LoD), and 2.5% exceeded the upper reference limit (URL). Postexercise, 36% remained below LoD, while 7.5% exceeded the URL. Overall, hs‐cTnT increased from baseline to 3 h postexercise in 56.2% of participants. Linear mixed‐effects models showed a significant main effect of time (β = −0.42, 95% CI 0.35–0.49; p < 0.01) and no main effect of sex ( p = 0.85), although a small but significant time × sex interaction was observed (β = −0.11, 95% CI −0.20 to −0.02; p = 0.021), indicating a slightly greater exercise‐induced increase in girls. Additional significant time × covariate interactions were identified for maturational, anthropometric, and fitness‐related variables. However, these factors together explained only a small proportion of the overall variability in hs‐cTnT response. Consequently, the 20‐m shuttle run test induces a significant increase in hs‐cTnT concentrations in children and adolescents. Exercise‐induced hs‐cTnT release is common but highly heterogeneous, and is only partly explained by sex, maturational, anthropometric, and fitness‐related factors, suggesting an important contribution of individual‐specific determinants not captured by conventional variables.

Objectives: High‐sensitivity cardiac troponin T (hs‐cTnT) is widely used in adult cardiology, yet pediatric reference values remain scarce. This study aimed to establish reference values for hs‐cTnT in healthy sport‐participating youth aged 8–16 years from Spain; to examine differences by age, sex, and pubertal stage; and to explore associations with anthropometry and physical activity. Methods: This cross‐sectional study used baseline data from the Cor‐School cohort, including 733 organized sport participants aged 8–16 years from northeastern Spain. Anthropometry, pubertal status, biological maturity, and PHV timing were assessed alongside hs‐cTnT and habitual physical activity. Percentiles were calculated from detectable hs‐cTnT concentrations below the 99.75th percentile. Group comparisons, correlations, and regression models examined developmental patterns. Results: Among 733 youth, 39% had detectable hs‐cTnT and 4.7% exceeded 14 ng/L. The 97.5th and 99th percentiles were 15.2 ng/L (90% CI: 12.4–16.9) and 19.1 ng/L (90% CI: 15.2–21.3), peaking in early adolescence (11–13 years) and around PHV. Tanner Stage 4 showed the highest 99th percentile (20.4 ng/L), while Tanner 5 had lower values. Boys presented greater detectability (42% vs. 33%) and higher percentiles (99th: 19.1 vs. 15.6 ng/L). hs‐cTnT correlated weakly with maturity offset ( ρ = 0.183, p = 0.002) and inversely with body fat ( ρ = −0.170, p = 0.040), but no independent predictors remained in multivariable models ( R ² adj = 0.033). Conclusions: hs‐cTnT increases physiologically during adolescence, reflecting biological maturation. Pediatric‐specific reference values by age and developmental stage are recommended to avoid misclassification. As all participants were regularly engaged in organized sport, the reference values obtained likely represent the upper end of physiological hs‐cTnT concentrations in physically active youth.

Organized sports are assumed to boost overall physical activity, but evidence suggests structured training does not always increase general activity outside formal sessions. This study explores the link between physical activity levels and weekly training hours in adolescent athletes across sports and competition levels. A total of 10,196 participants aged 11 to 19 were included in the analyses. Participants were classified into seven groups: inactive, somewhat active, non-competitive athletes, and athletes competing at the local, regional, national, or international level. They completed the Spanish version of the Physical Activity Questionnaire and answered questions regarding their performance level, training volume, and socioeconomic status. Girls exhibited lower physical activity levels than boys, even at higher competition levels where both sexes had comparable training hours. Competitive athletes reported the highest physical activity levels. In competitive athletes, physical activity levels decreased with age despite a substantial increase in weekly training hours. They were similar across athletes competing in different sports and at different levels, despite significant differences in training hours. Many athletes, including those at the national and international levels, displayed low physical activity levels, and no clear relationship was found between physical activity level and weekly training hours. The current study provides valuable insights into adolescent physical activity patterns by sex, age, sport, and competition level. Girls showed lower physical activity than boys, even with similar training hours. Physical activity levels declined with age despite increasing training volumes, and no strong association was observed between physical activity and weekly training hours. These results reveal a discrepancy between structured training and overall activity levels, challenging assumptions about the impact of sports participation on daily physical activity.

Background: Health-related quality of life is a key indicator of well-being that integrates physical, emotional, and social dimensions. Identifying its determinants during childhood and adolescence is essential to guide effective health promotion strategies. Objective: To analyze the association between health-related quality of life and demographic, anthropometric, biochemical, lifestyle, and environmental variables in school-aged children and adolescents. Methods: A cross-sectional study was conducted during the 2023–2024 academic year in northeastern Spain. A total of 571 children and adolescents participated in the study (mean age = 11.64 ± 1.64 years), of whom 254 were girls (44.48%). Health-related quality of life was assessed using the Revised Children’s Quality of Life Questionnaire (KINDL-R), a validated instrument for assessing perceived well-being in pediatric populations. Independent variables included waist-to-height ratio, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, adherence to the Mediterranean diet, weekly physical activity, sleep quality, and residential context (i.e., large urban areas, small urban areas, and municipalities). Multiple linear regression analysis was performed to explore the associations. Results: Older age was associated with lower health-related quality of life (β = −1.07; 95% CI: −1.61 to −0.53; p < 0.001). In contrast, better adherence to the Mediterranean diet (β = 0.72; 95% CI: 0.09 to 1.37; p = 0.023), better sleep quality (b = −2.48; p < 0.001), and participants living in cities and large urban areas reported compared to those in municipalities were associated with higher HRQoL (p < 0.05), with moderate effect sizes. No significant associations were found for sex, waist-to-height ratio, cholesterol levels, or physical activity. Conclusions: This study highlights the importance of adopting a multidimensional approach to promote health-related quality of life in young populations, addressing dietary habits, sleep quality, and environmental factors within health promotion strategies.

Background: The increasing prevalence of overweight and obesity among young people poses a significant public health challenge. Childhood and adolescence are critical periods for establishing long-term health habits. Diet plays a central role in maintaining a healthy weight, and adherence to the Mediterranean diet has been consistently linked to numerous health benefits, including improved weight management and overall well-being. Understanding the factors that influence Mediterranean diet adherence in adolescents can help design effective interventions to promote healthier eating behaviors. Objectives: This study sought to explore the association between following the Mediterranean diet and key physiological factors, including age, sex, body mass index, and pubertal status. Additionally, it explored how Mediterranean diet adherence relates to lifestyle behaviors such as sleep quality and physical activity levels, using data from a sample of 668 Spanish adolescents. Method: Participants completed validated questionnaires assessing dietary habits, physical activity, sleep quality, and pubertal status (Tanner scale). Results: The findings revealed significant associations between Mediterranean diet adherence and body mass index, pubertal status, and physical activity level, while sex, age, and sleep quality showed no significant influence. Adolescents with lower body mass index tended to adhere more to the Mediterranean diet, reinforcing its role in weight management. Additionally, greater adherence was observed in later pubertal stages, suggesting increased nutritional awareness. Conclusions: Healthy eating patterns are associated with a strong promotion of physical activity, highlighting the link between an active lifestyle and adherence to the Mediterranean diet. This positive multifactorial synergy requires further research to better understand its mechanisms and to design effective strategies for promoting healthy habits among adolescents.

Objective: This study analyzed the relationship between self-perceived physical fitness and anthropometric and biochemical variables in young athletes from extracurricular sports programs in northeastern Spain. Methods: A cross-sectional design was used with a sample of 673 young athletes. Data collection included self-reported physical fitness and objective anthropometric and biochemical measurements. The analysis explored associations between perceived fitness dimensions and physical/biochemical variables, with attention to sex differences. Results: Fat mass showed significant inverse associations with all perceived fitness dimensions: general fitness (OR = 0.62, 95% CI [0.41, 0.94]), cardiorespiratory fitness (OR = 0.56, 95% CI [0.37, 0.83]), muscular strength (OR = 0.61, 95% CI [0.41, 0.91]), speed/agility (OR = 0.59, 95% CI [0.39, 0.88]), and flexibility (OR = 0.57, 95% CI [0.39, 0.84]). Higher fat mass was consistently linked to lower perceived fitness. HDL levels were positively associated with general (OR = 1.40, 95% CI [1.13, 1.74]) and cardiorespiratory fitness (OR = 1.32, 95% CI [1.07, 1.62]), while LDL levels showed no significant effect (p > 0.05). Sex differences emerged for general fitness (OR = 0.52, 95% CI [0.33, 0.82]) and flexibility (OR = 0.51, 95% CI [0.33, 0.78]), favoring boys, but no differences were found for cardiorespiratory fitness, muscular strength, or speed/agility (p > 0.05). This suggests that shared athletic environments may reduce typical sex-based disparities. Conclusions: Our findings emphasize the importance of considering both anthropometric and biochemical variables when evaluating perceived fitness in youth athletes. Regular athletic engagement may buffer sex-based differences in fitness perception.

Background/Objectives: Cardiorespiratory fitness (CRF) is a key indicator of current and future health in children and adolescents, and is influenced by both physiological and behavioral factors. This study examined the associations between CRF, body composition, and health-related habits in 685 children and adolescents (aged 8–16 years) who regularly participated in extracurricular sports programs in northeastern Spain. Methods: Participants underwent anthropometric assessments, completed a 20 m shuttle run test to evaluate CRF, and filled out validated questionnaires on physical activity levels, sleep quality, and adherence to the Mediterranean diet. Results: Significant sex differences were observed, with boys achieving higher CRF performance (p < 0.001), primarily associated with greater muscle mass (p < 0.001) and lower body fat percentage (p < 0.001). Age positively correlated with improved CRF (p < 0.001), whereas higher body mass index (p = 0.003) and fat mass (p = 0.020) negatively impacted fitness outcomes. Conclusions: These findings underscore the critical role of physical activity and optimal body composition in promoting cardiorespiratory fitness among youth, emphasizing the importance of targeted interventions to foster healthy behaviors from early childhood. Future research should adopt longitudinal designs to better elucidate the dynamic interactions between lifestyle factors, body composition, and physical fitness throughout childhood and adolescence.

In an era where childhood health is increasingly at risk, understanding the role of physical activity in promoting well-being is critical. The COR-School project investigates the impact of physical activity on cardiometabolic health in over 700 Spanish children and adolescents aged 8 to 16 years. Over three years, the study will conduct three assessments (baseline and two follow-ups) to evaluate peak post-exercise levels of high-sensitivity cardiac troponin T (hs-cTnT), a biomarker for cardiac stress, following a submaximal 20 m shuttle run test. Secondary objectives include examining the influence of maturational status, physical activity, and cardiorespiratory fitness on hs-cTnT. Participants will complete fitness tests, questionnaires on health habits, sleep, and diet, as well as anthropometric and body composition measurements. Blood samples collected at baseline and three hours post-exercise will measure cardiac biomarkers and lipid profiles. Cardiovascular responses will be tracked using heart rate monitors. Normal ranges of hs-cTnT will be determined using data distribution (percentiles or mean ± SD), stratified by age, sex, and maturational stage. Statistical analyses, including repeated measures ANOVA and Pearson correlation, will explore trends across time, sex, developmental stages, and other health-related outcomes. Beyond providing clinical insights by establishing reference values for hs-cTnT in healthy youth after exercise, findings will inform educational policies to promote physical activity in schools, emphasizing its role in improving fitness, health behaviors, and overall development.

Cardiac troponin (cTn) is a recognized marker used to assess damage to the heart muscle. Actual research has indicated that the levels of cTn increase after doing exercise in individuals who are in good health, and this is believed to be a result of a normal cellular process rather than a pathological one. The main goal of this study was to investigate the evidence of a postexercise release of cTn in child and adolescent athletes (6–17.9 years old) of different ages, sex, and sports disciplines. The Web of Science, MEDLINE, and Scopus databases were used to conduct the research up to March 2023. Three hundred and twenty-eight records were identified from the databases, however, only twenty-three studies were included in the review after being screened and quality-assessed by two independent authors. The gender, age of the participants, maturational status, and training level of the participants, the timing of sample collection, the exercise modality, and the number of participants with values above the cut-off reference were the data analyzed. Males, older young people, and individual sports seemed to have higher levels of serum cTn after practice exercise. Different methodologies, analyzers, and cut-off reference values make it difficult to compare the data among studies.