School-based physical activity and health-related fitness in Mediterranean students: findings from the DELICIOUS project

BackgroundPhysical inactivity among children is a growing public health concern, particularly in Mediterranean countries, where lifestyle changes have contributed to declining physical fitness levels. Structured school-based interventions have shown promise in improving children’s health-related phy...

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Main Authors: Mohamed Aly, Achraf Ammar, Khaled Trabelsi, Liwa Masmoudi, Noha El-Gyar, Amira M. Shalaby, Osama Abdelkarim
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-06-01
Series:Frontiers in Public Health
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Online Access:https://www.frontiersin.org/articles/10.3389/fpubh.2025.1603043/full
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author Mohamed Aly
Achraf Ammar
Achraf Ammar
Achraf Ammar
Khaled Trabelsi
Khaled Trabelsi
Khaled Trabelsi
Liwa Masmoudi
Noha El-Gyar
Amira M. Shalaby
Osama Abdelkarim
author_facet Mohamed Aly
Achraf Ammar
Achraf Ammar
Achraf Ammar
Khaled Trabelsi
Khaled Trabelsi
Khaled Trabelsi
Liwa Masmoudi
Noha El-Gyar
Amira M. Shalaby
Osama Abdelkarim
author_sort Mohamed Aly
collection DOAJ
description BackgroundPhysical inactivity among children is a growing public health concern, particularly in Mediterranean countries, where lifestyle changes have contributed to declining physical fitness levels. Structured school-based interventions have shown promise in improving children’s health-related physical fitness (HRF), but cross-cultural differences in intervention effectiveness remain understudied. This study, conducted within the DELICIOUS project, evaluates the impact of a standardized physical activity (PA) intervention on HRF components among children (8–10 years) and early adolescents (11–14 years) from five Mediterranean countries: Egypt, Italy, Lebanon, Portugal, and Spain.MethodsA total of 937 participants aged 8–14 years took part in a six-month school-based PA program designed to enhance speed, agility, muscular strength, cardiovascular endurance, and coordination. Physical fitness was assessed using the International Physical Performance Test Profile (IPPTP) before and after the intervention. A three-way repeated measures ANOVA (Time × Age × Country) assessed intervention effects on anthropometric and fitness variables, while a two-way ANOVA (Age × Country) examined the percentage changes in these HRF across age groups and countries.ResultsSignificant improvements were observed across multiple health-related fitness components, particularly in speed, lower-body power, coordination, muscular endurance, and cardiovascular endurance. Early adolescents (11–14 years) generally showed greater gains than younger children (8–10 years). The magnitude of improvement in fitness outcomes varied by country. Lebanon and Portugal recorded the most substantial gains in sprint, strength, and endurance. Spain and Italy showed relatively smaller improvements, especially among younger participants, whereas Egyptian students demonstrated notable gains in sprint performance and endurance, particularly among early adolescents, along with the most significant BMI reduction observed in the study. BMI remained stable across participants, suggesting that fitness improvements were achieved alongside healthy growth, without adverse changes in body composition.ConclusionA structured PA intervention can effectively improve HRF in children across Mediterranean countries, though outcomes vary by age and cultural context. These findings highlight the need for tailored, school-based PA programs that consider baseline fitness levels and regional factors. Implementing such interventions could play a crucial role in addressing physical inactivity and fostering long-term health benefits in children.
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spelling doaj-art-3e232cce1b234252b60f036bd57dd0932025-08-20T02:24:22ZengFrontiers Media S.A.Frontiers in Public Health2296-25652025-06-011310.3389/fpubh.2025.16030431603043School-based physical activity and health-related fitness in Mediterranean students: findings from the DELICIOUS projectMohamed Aly0Achraf Ammar1Achraf Ammar2Achraf Ammar3Khaled Trabelsi4Khaled Trabelsi5Khaled Trabelsi6Liwa Masmoudi7Noha El-Gyar8Amira M. Shalaby9Osama Abdelkarim10Faculty of Sport Sciences, Assiut University, Assiut, EgyptDepartment of Training and Movement Science, Institute of Sport Science, Johannes Gutenberg University Mainz, Mainz, GermanyHigh Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, TunisiaResearch Laboratory, Molecular Bases of Human Pathology, Faculty of Medicine of Sfax, University of Sfax, Sfax, TunisiaHigh Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, TunisiaResearch Laboratory Education, Motricity, Sport and Health, EM2S, High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, TunisiaDepartment of Movement Sciences and Sports Training, School of Sport Science, The University of Jordan, Amman, JordanHigh Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, TunisiaFaculty of Medicine, Department of Pediatrics, Assiut University, Assiut, EgyptFaculty of Medicine, Department of Pediatrics, Assiut University, Assiut, EgyptFaculty of Sport Sciences, Assiut University, Assiut, EgyptBackgroundPhysical inactivity among children is a growing public health concern, particularly in Mediterranean countries, where lifestyle changes have contributed to declining physical fitness levels. Structured school-based interventions have shown promise in improving children’s health-related physical fitness (HRF), but cross-cultural differences in intervention effectiveness remain understudied. This study, conducted within the DELICIOUS project, evaluates the impact of a standardized physical activity (PA) intervention on HRF components among children (8–10 years) and early adolescents (11–14 years) from five Mediterranean countries: Egypt, Italy, Lebanon, Portugal, and Spain.MethodsA total of 937 participants aged 8–14 years took part in a six-month school-based PA program designed to enhance speed, agility, muscular strength, cardiovascular endurance, and coordination. Physical fitness was assessed using the International Physical Performance Test Profile (IPPTP) before and after the intervention. A three-way repeated measures ANOVA (Time × Age × Country) assessed intervention effects on anthropometric and fitness variables, while a two-way ANOVA (Age × Country) examined the percentage changes in these HRF across age groups and countries.ResultsSignificant improvements were observed across multiple health-related fitness components, particularly in speed, lower-body power, coordination, muscular endurance, and cardiovascular endurance. Early adolescents (11–14 years) generally showed greater gains than younger children (8–10 years). The magnitude of improvement in fitness outcomes varied by country. Lebanon and Portugal recorded the most substantial gains in sprint, strength, and endurance. Spain and Italy showed relatively smaller improvements, especially among younger participants, whereas Egyptian students demonstrated notable gains in sprint performance and endurance, particularly among early adolescents, along with the most significant BMI reduction observed in the study. BMI remained stable across participants, suggesting that fitness improvements were achieved alongside healthy growth, without adverse changes in body composition.ConclusionA structured PA intervention can effectively improve HRF in children across Mediterranean countries, though outcomes vary by age and cultural context. These findings highlight the need for tailored, school-based PA programs that consider baseline fitness levels and regional factors. Implementing such interventions could play a crucial role in addressing physical inactivity and fostering long-term health benefits in children.https://www.frontiersin.org/articles/10.3389/fpubh.2025.1603043/fullphysical fitnessexercise interventionMediterranean regioncross-cultural studyyouth health promotionearly adolescents
spellingShingle Mohamed Aly
Achraf Ammar
Achraf Ammar
Achraf Ammar
Khaled Trabelsi
Khaled Trabelsi
Khaled Trabelsi
Liwa Masmoudi
Noha El-Gyar
Amira M. Shalaby
Osama Abdelkarim
School-based physical activity and health-related fitness in Mediterranean students: findings from the DELICIOUS project
Frontiers in Public Health
physical fitness
exercise intervention
Mediterranean region
cross-cultural study
youth health promotion
early adolescents
title School-based physical activity and health-related fitness in Mediterranean students: findings from the DELICIOUS project
title_full School-based physical activity and health-related fitness in Mediterranean students: findings from the DELICIOUS project
title_fullStr School-based physical activity and health-related fitness in Mediterranean students: findings from the DELICIOUS project
title_full_unstemmed School-based physical activity and health-related fitness in Mediterranean students: findings from the DELICIOUS project
title_short School-based physical activity and health-related fitness in Mediterranean students: findings from the DELICIOUS project
title_sort school based physical activity and health related fitness in mediterranean students findings from the delicious project
topic physical fitness
exercise intervention
Mediterranean region
cross-cultural study
youth health promotion
early adolescents
url https://www.frontiersin.org/articles/10.3389/fpubh.2025.1603043/full
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