In a groundbreaking cross-sectional study detailed in the “Journal of Science and Medicine in Sport,” researchers set out to determine whether simple field-based tests like handgrip strength (HG) and the standing long jump (SLJ) could help identify European adolescents at risk of developing metabolic syndrome (MetS), a cluster of conditions that increase the risk of heart disease, stroke, and type 2 diabetes. The study, entitled “Muscle strength field-based tests to identify European adolescents at risk of metabolic syndrome: The HELENA study,” was published in August 2019 (DOI: 10.1016/j.jsams.2019.04.008). It involves 969 adolescents aged between 12.5 and 17.5 years from nine European countries.
The Prevalence and Risks of Metabolic Syndrome
Metabolic syndrome has become a considerable public health concern globally, with a prevalence of 3.1% reported among European adolescents. As the condition typically gives rise to complications like type 2 diabetes and cardiovascular diseases, timely intervention is crucial— especially during the teen years.
Assessing Muscle Strength as a Marker for MetS
Castro-Piñero José and colleagues leveraged the HELENA (Healthy Lifestyle in Europe by Nutrition in Adolescence) study to assess whether field-based muscle strength tests could serve as reliable indicators of MetS risk. Specifically, they examined the utility of handgrip strength (HG) and the standing long jump (SLJ) in detecting the syndrome’s presence.
The Study’s Design and Findings
The cross-sectional study involved participants performing absolute and relative HG and SLJ tests to evaluate upper and lower muscle strength. The team then analyzed this data alongside the adolescents’ MetS status, determined using age- and sex-specific cut points as proposed by Jolliffe and Janssen, and a continuous cardiometabolic risk index, factoring in waist circumference, mean arterial pressure, triglycerides/high-density lipoprotein cholesterol, and fasting insulin levels.
The most significant finding was that relative HG and absolute SLJ were the most effective tests for detecting the presence of MetS and elevated cardiometabolic risk index. The area under the receiver operating characteristic (AUC) for relative HG was 0.799 (95%CI:0.773-0.824), while for absolute SLJ, it was 0.695 (95%CI:0.665-0.724). Even more strikingly, for the elevated cardiometabolic risk index, the AUC for relative HG hit a remarkably high 0.873 (95%CI:0.838-0.902).
The strength of these associations held true even when adjusting for cardiorespiratory fitness, showcasing the robustness of muscle strength measures as indicators of MetS risk.
Implications of the HELENA Study’s Findings
The results from the HELENA study are significant, as they provide age- and sex-specific cut points for muscle strength among European adolescents. These cut points can help to identify the presence of MetS and elevated cardiometabolic risk index, providing an accessible and cost-effective method for early risk detection.
Importantly, the study not only offers substantial diagnostic statistics but also proposes health-related cut points that can initiate defining health-related levels of upper and lower muscle strength in adolescents. Such benchmarks can be used by adolescents themselves, parents, education systems, and healthcare professionals to understand and communicate what it means to meet or fail these fitness standards, with an eye on long-term metabolic health.
The Collaborative Effort
The study brought together researchers from a wide range of institutions across Europe, including the University of Cádiz in Spain, Illinois State University in the United States, the University of Almería in Spain, and many others. Their collective effort has helped shed light on straightforward ways to target and address the risks associated with MetS in a critical demographic group— adolescents.
Moving Forward: Recommendations for Practitioners and Parents
Based on the HELENA study’s findings, fitness professionals who work with adolescents should consider incorporating relative HG and SLJ tests into their health assessments. Furthermore, parents are encouraged to support opportunities for their children to engage in activities that promote muscle strength—not only for immediate fitness benefits but also for long-term metabolic health.
Conclusion
The HELENA study has paved the way for early identification of European adolescents at risk for metabolic syndrome through simple, field-based muscle strength tests. The significance of these findings lies not only in the implementation of these tests but also in the potential lifestyle interventions that can be empowered by them, with the ultimate goal of curbing the prevalence of MetS and enhancing the wellbeing of Europe’s young population.
References
1. Castro-Piñero José, Laurson Kelly R., Artero Enrique G., et al. (2019). Muscle strength field-based tests to identify European adolescents at risk of metabolic syndrome: The HELENA study. Journal of Science and Medicine in Sport. DOI: 10.1016/j.jsams.2019.04.008
2. Jolliffe and Janssen (2007). Development of age-specific adolescent metabolic syndrome criteria that are linked to the Adult Treatment Panel III and International Diabetes Federation criter. Diabetes Care.
3. Moreno Luis A., Gonzalez-Gross Marcela, Kersting Manfred, et al. (2008). Assessing, understanding and modifying nutritional status, eating habits and physical activity in European adolescents: The HELENA (Healthy Lifestyle in Europe by Nutrition in Adolescence) Study. Public Health Nutrition.
4. Ruiz Jonatan R., Ortega Francisco B., Gutierrez Ángel., et al. (2016). Health-related fitness assessment in childhood and adolescence: a European approach based on the AVENA, EYHS and HELENA studies. Journal of Public Health.
5. Widhalm Kurt, Koudouvo Keténya, Handjiev Svetoslav, et al. (2017). The effects of physical activity and physical fitness on children’s achievement and cognitive outcomes: a meta-analysis. Research Quarterly for Exercise and Sport.
Keywords
1. Metabolic syndrome in adolescents
2. Muscle strength field-based tests
3. HELENA study
4. Handgrip strength MetS assessment
5. Standing long jump metabolic health