Fitness, Food, and Biomarkers: Characterizing Body Composition in 19,634 Early Adolescents

A Rodriguez, K Korzeniowska, K Szarejko, H Borowski, M Brzezinski, M Mysliwiec, L Czupryniak, Per-Olof Berggren, M Radziwiłł, P Soszynski

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Adolescent obesity persists as a major concern, especially in Central and Eastern Europe, yet evidence gaps exist regarding the pivotal early adolescent years. Our objective was to provide a comprehensive picture using a holistic approach of measured anthropometry in early adolescence, including body composition, cardiorespiratory fitness (CRF), and reported lifestyle characteristics. We aimed to elucidate potential sex/gender differences throughout and associations to biomarkers of disease risk for obese adolescents. Methods: Trained nurses measured 19,634 early adolescents (12–14-year-olds), we collected parental reports, and, for obese adolescents, fasting blood samples in four major Polish cities using a cross-sectional developmental design. Results: 24.7% boys and 18.6% girls were overweight/obese, and 2886 had BMI ≥ 90th percentile. With increasing age, there was greater risk of obesity among boys (p for trend = 0.001) and a decreasing risk of thinness for girls (p for trend = 0.01). Contrary to debate, we found BMI (continuous) was a useful indicator of measured fat mass (FM). There were 38.6% with CRF in the range of poor/very poor and was accounted for primarily by FM in boys, rather than BMI, and systolic blood pressure in girls. Boys, in comparison to girls, engaged more in sports (t = 127.26, p < 0.0001) and consumed more fast food (t = 188.57, p < 0.0001) and sugar-sweetened beverages (167.46, p < 0.0001). Uric acid, a potential marker for prediabetes, was strongly related to BMI in the obese subsample for both boys and girls. Obese girls showed signs of undernutrition. Conclusion: these findings show that overweight/obesity is by far a larger public health problem than thinness in early adolescence and is characterized differentially by sex/gender. Moreover, poor CRF in this age, which may contribute to life course obesity and disease, highlights the need for integrated and personalized intervention strategies taking sex/gender into account.

Original languageEnglish
Article number1369
Issue number7
Publication statusPublished (in print/issue) - 1 Apr 2022

Bibliographical note

Funding Information:
Funding: This research was funded by Jochnick Family Foundation to M.R. and by Medicover Foundation to M.R. and P.S.

Publisher Copyright:
© 2022 by the authors. Licensee MDPI, Basel, Switzerland.


  • adiposity
  • adolescents
  • anthropometry
  • body mass index
  • fat mass
  • lifestyle
  • junk food
  • obesity
  • sex differences
  • PoZdro!
  • undernutrition
  • Central and Eastern Europe


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