Cited by 512Physical Activity and HealthObesity, Physical Activity, DietChildren's Physical and Motor Development

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Is Muscular Fitness Associated with Future Health Benefits in Children and Adolescents? A Systematic Review and Meta-Analysis of Longitudinal Studies

García-Hermoso, Antonio, Ramírez-Campillo, Rodrigo, Izquierdo, Mikel·2019·Sports Medicine

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Abstract

Background No previous systematic review has quantitatively examined the association between muscular fitness during childhood and adolescence and health parameters later in life.Objective The aim was to systematically review and meta-analyze the current evidence for a prospective association between muscular fitness in childhood and adolescence and future health status.Methods Two authors systematically searched MEDLINE, EMBASE and SPORTDiscus electronic databases and conducted manual searching of reference lists of selected articles. Relevant articles were identified by the following criteria: apparently healthy children and adolescents aged 3-18 years with muscular fitness assessed at baseline (e.g., handgrip, standing long jump, sit-ups, among others), and a follow-up period of ≥ 1 year. The outcome measures were anthropometric and adiposity measurements and cardiometabolic, bone and musculoskeletal health parameters. Two authors independently extracted data.Results Thirty studies were included in the meta-analysis, yielding a total of 21,686 participants. The meta-analysis found a significant, moderate-large (p < 0.05) effect size between muscular fitness at baseline and body mass index (r = - 0.14; 95% confidence interval (CI) - 0.21 to - 0.07), skinfold thickness (r = - 0.32; 95% CI - 0.40 to - 0.23), homeostasis model assessment estimated insulin resistance (r = - 0.10; 95% CI - 0.16 to - 0.05), triglycerides (r = - 0.22; 95% CI - 0.30 to - 0.13), cardiovascular disease risk score (r = - 0.29; 95% CI - 0.39 to - 0.18), and bone mineral density (r = 0.166; 95% CI 0.086 to 0.243) at follow-up.Conclusion A prospective negative association was observed between muscular fitness in childhood/adolescence and adiposity and cardiometabolic parameters in later life, together with a positive association for bone health. There is inconclusive evidence for low back pain benefits.

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Additional file 1 of Motor performance and back pain in children and adolescents: a systematic review and meta-analysis protocol
Noll, M., Wedderkopp, N., Mendonça, C. R., & Kjaer, P. (2020) · Figshare · doi:10.6084/m9.figshare.12955270
Additional file 1 of Physical activity practiced at a young age is associated with a less severe subsequent clinical presentation in facioscapulohumeral muscular dystrophy
Bettio, C., Banchelli, F., Salsi, V., Vicini, R., Crisafulli, O., Ruggiero, L., Ricci, G., Bucci, E., Angelini, C. I., Berardinelli, A. L., et al. (2024) · Figshare · doi:10.6084/m9.figshare.26661302
Additional file 4 of Relationship between both cardiorespiratory and muscular fitness and health-related quality of life in children and adolescents: a systematic review and meta-analysis of observational studies
Bermejo‐Cantarero, A., Álvarez-Bueno, C., Martínez-Vizcaino, V., Redondo‐Tébar, A., Pozuelo‐Carrascosa, D. P., & Sánchez-López, M. (2021) · Figshare · doi:10.6084/m9.figshare.14462668
Additional file 4 of Assessments Related to the Physical, Affective and Cognitive Domains of Physical Literacy Amongst Children Aged 7–11.9 Years: A Systematic Review
Shearer, C., Goss, H. R., Boddy, L. M., Knowles, Z. R., Durden-Myers, E. J., & Foweather, L. (2021) · Figshare · doi:10.6084/m9.figshare.14691712
Additional file 2 of Relationship between both cardiorespiratory and muscular fitness and health-related quality of life in children and adolescents: a systematic review and meta-analysis of observational studies
Bermejo‐Cantarero, A., Álvarez-Bueno, C., Martínez-Vizcaino, V., Redondo‐Tébar, A., Pozuelo‐Carrascosa, D. P., & Sánchez-López, M. (2021) · Figshare · doi:10.6084/m9.figshare.14462662
Additional file 2 of Physical activity practiced at a young age is associated with a less severe subsequent clinical presentation in facioscapulohumeral muscular dystrophy
Bettio, C., Banchelli, F., Salsi, V., Vicini, R., Crisafulli, O., Ruggiero, L., Ricci, G., Bucci, E., Angelini, C. I., Berardinelli, A. L., et al. (2024) · Figshare · doi:10.6084/m9.figshare.26661305
Additional file 3 of Feasibility and content validity of the PERF-FIT test battery to assess movement skills, agility and power among children in low-resource settings
Smits-Engelsman, B. C. M., Bonney, E., Neto, J. L. C., & Jelsma, D. (2020) · Figshare · doi:10.6084/m9.figshare.12680149
Additional file 1 of Relationship between both cardiorespiratory and muscular fitness and health-related quality of life in children and adolescents: a systematic review and meta-analysis of observational studies
Bermejo‐Cantarero, A., Álvarez-Bueno, C., Martínez-Vizcaino, V., Redondo‐Tébar, A., Pozuelo‐Carrascosa, D. P., & Sánchez-López, M. (2021) · Figshare · doi:10.6084/m9.figshare.14462659
Additional file 3 of Physical activity practiced at a young age is associated with a less severe subsequent clinical presentation in facioscapulohumeral muscular dystrophy
Bettio, C., Banchelli, F., Salsi, V., Vicini, R., Crisafulli, O., Ruggiero, L., Ricci, G., Bucci, E., Angelini, C. I., Berardinelli, A. L., et al. (2024) · Figshare · doi:10.6084/m9.figshare.26661308
Additional file 2 of Motor performance and back pain in children and adolescents: a systematic review and meta-analysis protocol
Noll, M., Wedderkopp, N., Mendonça, C. R., & Kjaer, P. (2020) · Figshare · doi:10.6084/m9.figshare.12955273
Additional file 1 of Assessments Related to the Physical, Affective and Cognitive Domains of Physical Literacy Amongst Children Aged 7–11.9 Years: A Systematic Review
Shearer, C., Goss, H. R., Boddy, L. M., Knowles, Z. R., Durden-Myers, E. J., & Foweather, L. (2021) · Figshare · doi:10.6084/m9.figshare.14691700
Additional file 3 of Assessments Related to the Physical, Affective and Cognitive Domains of Physical Literacy Amongst Children Aged 7–11.9 Years: A Systematic Review
Shearer, C., Goss, H. R., Boddy, L. M., Knowles, Z. R., Durden-Myers, E. J., & Foweather, L. (2021) · Figshare · doi:10.6084/m9.figshare.14691709
La force musculaire dans l’enfance et l’adolescence est un indicateur de la santé tout au long de la vie
Vanhelst, J., & Oppert, J. (2025) · doi:10.64628/aak.ygkky59rs
Sex Differences in Resistance Training Participation and Beliefs Among Adolescent Athletes: An Exploratory Cross-Sectional Study
Rovzar, C., Howell, D. R., & Armento, A. M. (2026) · Sports · doi:10.3390/sports14010004
App-Guided Grip Strength Assessment: Feasibility and Validity of Self-administered Testing with a Smart DynamometerPreprint
Francis, G., DeTreux, K., Enright, M., George, L., Lambrides, Y., Varadarajan, K. M., & Tsui, W. (2026) · medRxiv · doi:10.64898/2026.01.29.26345154
The associations between speed performance and health outcomes in children and adolescents: A systematic review and meta-analysis
Yang, Y., Wu, J., He, J., Li, J., & Yu, J. J. (2026) · Journal of Exercise Science & Fitness · doi:10.1016/j.jesf.2026.200461
Temporal trends of physical fitness in northern Italian children (2014–2019): a repeated cross-sectional study
Gatti, A., Giuriato, M., Vandoni, M., Messina, G., Malavolta, R., Cavallo, C., Pirazzi, A., Pellino, V. C., Lovecchio, N., & Lazzer, S. (2026) · Journal of Public Health · doi:10.1093/pubmed/fdag020
The synergic relationship between muscular fitness and adiposity with cardiometabolic risk: a longitudinal mediation analysis
Silveira, J. F. D. C., Andersen, L. B., Pfeiffer, K. A., Burns, R. D., Lima, R. A., Renner, J. D. P., Reuter, É. M., Sehn, A. P., Gaya, A. R., & Reuter, C. P. (2026) · Sport Sciences for Health · doi:10.1007/s11332-026-01699-5
“Another possible mechanism relates to the longitudinal relationship between muscular fitness and insulin sensitivity responses [61, 63], which is believed to be a key driver of clustering of cardiometabolic risk factors as it serves as a common mechanism influencing blood pressure, lipids, and…”
Are health- and skill-related truly separate components of physical fitness in youth?
Silveira, J. F. D. C., Bandeira, P. F. R., Mello, J. B., Faigenbaum, A. D., Pfeiffer, K. A., Reuter, C. P., & Gaya, A. R. (2026) · Sport Sciences for Health · doi:10.1007/s11332-026-01706-9
“…directly linked to overall health and disease prevention beginning early in life [4, 14], since they also show beneficial associations with obesity-related outcomes [40–45], cardiometabolic risk factors [40–45], mental health [43, 44, 46], cognitive [11], and bone health indicators [41, 43, 45].”
Association of Physical Fitness With Overweight and Obesity Among Chinese Children and Adolescents: A Multiprovincial Follow-Up Survey From 2019 to 2020
Cai, S. L., Dang, J., Liu, Y. F., Zhong, P., Shi, D., Chen, Z., Zhang, Y., Dong, Y., Ma, J. X., & Song, Y. (2026) · Journal of Physical Activity and Health · doi:10.1123/jpah.2025-0074
Reliability and validity of the 90° push-up test in children and adolescents: A systematic review and meta-analysis
Carballo-Afonso, R., Blanco-Martínez, N., Varela, S., Diz-Gómez, J. C., & Ayán, C. (2026) · International Journal of Sports Science & Coaching · doi:10.1177/17479541261443480
Optimizing the start of the second half: A meta-analysis of re-warm-up effects in team sports players
Wu, J., Yan, Z., Du, J., Wang, Y., & Zhang, L. (2026) · International Journal of Sports Science & Coaching · doi:10.1177/17479541261437807
Trends in physical fitness before and after the COVID-19 pandemic in Austrian children
Drenowatz, C. J., Greier, K., & Hinterkörner, F. (2026) · Discover Public Health · doi:10.1186/s12982-026-01996-x
Association between physical fitness and anthropometric indicators according to area of residence in Chilean adolescents: a cross-sectional study
Yáñez-Sepúlveda, R., Clemente‐Suárez, V. J., Matsudo, S. M., Cortés-Roco, G., de Souza-Lima, J., Zavala-Crichton, J. P., Hinojosa-Torres, C., Páez‐Herrera, J., Almonacid, J. G. H., Reyes-Amigo, T., et al. (2026) · BMJ Open · doi:10.1136/bmjopen-2025-103822
“8 Likewise, higher levels of cardiorespiratory fitness during adolescence are linked to better health parameters across the lifespan.”
Relationship Between Standing Long Jump Performance and Health-Related Indicators and Lifestyle Factors in Chilean Adolescents: A Cross-Sectional Study
Montalva-Valenzuela, F., Guzmán-Muñoz, E., Castillo-Paredes, A., Gatica, C. T., Ruiz, N. E., Concha‐Cisternas, Y., Valdés-Badilla, P. A., Farfán-Díaz, Á., & García-Carrillo, E. (2026) · Healthcare · doi:10.3390/healthcare14121744
Are children and adolescents with ADHD less physically fit? Findings from a systematic review and meta-analysis
Blanco-Martínez, N., Diz-Gómez, J. C., Outeda-Monteagudo, B., Carballo-Afonso, R., & Ayán, C. (2026) · Archives de Pédiatrie · doi:10.1016/j.arcped.2026.105583
Agreement Between Self-Administered and Supervised Grip Strength Testing Using a Smart Digital Dynamometer
Francis, G., DeTreux, K., Enright, M., George, L., Lambrides, Y., Varadarajan, K. M., & Tsui, W. (2026) · Archives of Rehabilitation Research and Clinical Translation · doi:10.1016/j.arrct.2026.100693
Associations of handgrip strength and standing long jump performance with hypertension among children and adolescents in China
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Dose-response association between different screen time behaviors and cardiorespiratory fitness among elementary and junior high school students: A population-based cross-sectional study in a Japanese city
Abe, T., Kitayuguchi, J., Kamada, M., Okada, S., Fukushima, N., Kidokoro, T., & Tanaka, C. (2026) · Journal of Exercise Science & Fitness · doi:10.1016/j.jesf.2026.200510
Temporal trends in standing long jump performance of 6,233,940 Chinese children and adolescents between 2000 and 2025
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Updated Age- and Sex-Specific Reference Values and Anthropometric Correlates of Maximum Handgrip Strength in Preschool Children from the Araucanía Region, Chile
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“Muscular strength is increasingly recognized as a fundamental component of health-related physical fitness during childhood and adolescence, contributing to motor performance and functional capacity and showing associations with cardiometabolic, skeletal, and overall health outcomes [1–4].”
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“Similarly, meta-analyses of correlation coefficients (r) indicated small to moderate effect sizes for prospective associations of adolescents’ muscular fitness with insulin resistance ( r = − 0.1), triglyceride ( r = − 0.22), and composite cardio-metabolic risk score ( r = − 0.29) 27 .”
Influential
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Rakhimova, L. S. (2026) · ITECX Journal International Academic Journal · doi:10.68209/mescwd5

Authors: García-Hermoso, A., Ramírez-Campillo, R., & Izquierdo, M.
ORCID: García-Hermoso, Antonio
Ramírez-Campillo, Rodrigo
Izquierdo, Mikel
Venue: Sports Medicine
Publisher: Springer Science and Business Media LLC
Published: 2019-04-05
Volume: 49
Issue: 7
Pages: 1079-1094
ISSN: 0112-1642 (ISSN-L)
1179-2035
DOI: 10.1007/s40279-019-01098-6
OpenAlex: W2935554824
Cited by: 512
References: 82
Citations by year: 2026: 45 · 2025: 56 · 2024: 81 · 2023: 75 · 2022: 90 · 2021: 93 · 2020: 57 · 2019: 14
FWCI: 7.46
Type: journal article
Language: en
Open access: closed
Licence: www.springer.com/tdm (tdm)
Locations: Sports Medicine (publishedVersion)
PubMed (publishedVersion)
Academica-e (Universidad Pública de Navarra) (acceptedVersion)
Topics: Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Physical Activity and Health
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
Social Sciences › Psychology › Developmental and Educational Psychology › Children's Physical and Motor Development
Keywords: muscular fitness, childhood, adolescence, body mass index, adiposity, cardiometabolic health, insulin resistance, triglycerides, cardiovascular risk, bone mineral density, musculoskeletal health, low back pain, grip strength, sit-ups, standing long jump, skinfold thickness
MeSH terms: Adolescent, Anthropometry, Child, Health Status, Humans, Physical Fitness, Bone Density, Body Mass Index, Adiposity, Muscle Strength

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Is Muscular Fitness Associated with Future Health Benefits in Children and Adolescents? A Systematic Review and Meta-Analysis of Longitudinal Studies

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