Health-Related Fitness as a Predictor of Anxiety Levels Among School Adolescents: An observational cross-sectional study

Sandro Legey1, Alberto Souza Sá Filho2, 9, Ali Yadollahpour3, 9, Fabio Garcia-Garcia4, 9, Claudio Imperatori5, 9, Eric Murillo-Rodriguez6, 9, Antonio Egidio Nardi1, João Lucas Lima7, Sergio Machado7, 8, 9, *
1 Laboratory of Panic and Respiration, Institute of Psychiatry, Federal University of Rio de Janeiro;, Rio de Janeiro, Brazil
2 Post Graduate Program of University Center of Anápolis (UniEVANGÉLICA), Anápolis, Brazil;
3 Department of Psychology, University of Sheffield, Sheffield, United Kingdom;
4 Biomedicine Department, Health Science Institute, Veracruzana University, Xalapa, Veracruz, Mexico;
5 Department of Human Sciences, European University of Rome, Rome, Italy;
6 Laboratorio De Neurociencias Moleculares E Integrativas, Escuela De Medicina, División Ciencias De La Salud, Universidad Anáhuac Mayab, Mérida, Mexico;
7 Laboratory of Physical Activity Neuroscience, Neurodiversity Institute, Queimados-RJ, Brazil;
8 Department of Sports Methods and Techniques, Federal University of Santa Maria, Santa Maria, Brazil;
9 Intercontinental Neuroscience Research Group, Mérida, México.

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© 2022 Legey et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Department of Sports Methods and Techniques, Federal University of Santa Maria, Santa Maria, Brazil; E-mail:



There is an inverse association between cardiorespiratory fitness and general anxiety levels in adolescents. Obesity also is associated with a higher risk of anxiety in this population. However, little is known about the association between other health-related fitness elements with anxiety symptoms in this population. The authors explored the relationship between health-related fitness and anxiety symptoms in a large sample of Brazilian youth.


This was an observational cross-sectional study with a sample comprised of 257 school adolescents, who were 136 girls (52.9%) and 121 boys (47.1%). The health-related fitness elements were evaluated by FitnessGram® test and anxiety levels by Multidimensional Anxiety Scale for Children - 39. Hierarchical regression analyses were used to determine the association between health-related fitness elements and anxiety symptoms in both sexes.


In male adolescents, only the cardiorespiratory fitness was significantly associated with anxiety symptoms (F(1, 119) = 6.472; P = 0.012; R2 = 0.052; adjusted R2 = 0.044). In turn, the anxiety symptoms showed an inverse small relationship with cardiorespiratory fitness (r = - 0.227; P < 0.01). However, in female adolescents, no association was found between health-related fitness elements and anxiety symptoms.


The level of cardiorespiratory fitness may represent a marker of anxiety in male adolescents.

Keywords: Adolescents, Anxiety, Epidemiology, Fitness, Mental health, Physical activity.