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Preplanned Studies: Variations in Rope Skipping Counts Among Rural Primary and Secondary School Students — China, 2013–2021

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  • Summary

    What is already known about this topic?

    Physical fitness is closely associated with children’s development. Limited research has been published on the changes in physical fitness among Chinese children during the implementation of the Nutrition Improvement Program for Rural Compulsory Education Students (NIPRCES).

    What is added by this report?

    This research utilized data from the NIPRCES between 2013 and 2021 to examine alterations in children’s physical fitness levels. Over this period, there was a significant increase in the number of rope skipping counts among children. In 2021, variations in these counts were observed, which depended on factors such as age, gender, geographic location, and region.

    What are the implications for public health practice?

    Physical fitness has been linked to a multitude of non-communicable diseases. Enhanced nutritional measures for children lead to significant improvements in their overall physical fitness, as evidenced by NIPRCES findings. It is crucial for policymakers to implement comprehensive interventions aimed at promoting and advancing children’s physical fitness.

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  • [1] Zhang Q. Ten-year review and prospect of nutrition and health improvement of primary and secondary school students in China. J Hyg Res 2022;51(5):696 − 9. http://dx.doi.org/10.19813/j.cnki.weishengyanjiu.2022.05.003 (In Chinese). CrossRef
    [2] Deuster PA, Silverman MN. Physical fitness: a pathway to health and resilience. US Army Med Dep J 2013; 24–35. https://pubmed.ncbi.nlm.nih.gov/24146240
    [3] Yang XF, Lee J, Gu XL, Zhang XX, Zhang T. Physical fitness promotion among adolescents: effects of a jump rope-based physical activity afterschool program. Children 2020;7(8):95. http://dx.doi.org/10.3390/children7080095CrossRef
    [4] Trecroci A, Cavaggioni L, Caccia R, Alberti G. Jump rope training: balance and motor coordination in preadolescent soccer players. J Sports Sci Med 2015;14(4):792 − 8.
    [5] Zhao R, Gan Q, Hu ZL, Xu PP, Li L, Yang TT, et al. Changes in fitness of rural primary school students from southwest China after two-year’s nutrition intervention. Nutrients 2021;13(10):3544. http://dx.doi.org/10.3390/nu13103544CrossRef
    [6] Cintineo HP, Arent MA, Antonio J, Arent SM. Effects of protein supplementation on performance and recovery in resistance and endurance training. Front Nutr 2018;5:83. http://dx.doi.org/10.3389/fnut.2018.00083CrossRef
  • FIGURE 1.  Rope skipping counts among students by gender, residential area, region, and age in 2021. (A) by gender and age; (B) by residential area type and age; (C) by region and age.

    TABLE 1.  Rope skipping counts per minute among Chinese students in rural areas, 2013–2021.

    Variable2013201420152016201720192021P value*
    NMP25P75NMP25P75NMP25P75NMP25P75NMP25P75NMP25P75NMP25P75
    Total42,107774910243,534815610837,641855810924,709815610531,519866110845,7108259107100,2438960118<0.0001
    Gender
    Male21,85272429822,581785010219,555815310612,716785210116,183835910423,633805610551,6598657115<0.0001
    Female20,255815610720,953866211218,086886211211,993866110915,336876511022,077856111048,5849265120<0.0001
    Grade
    15,2763620605,5124321714,4924421733,1174625753,6764727756,16048247512,052502877<0.0001
    26,2305632796,2536236844,7596235873,6116438854,3456842896,36068458813,996684491<0.0001
    36,1197346946,4827755985,4737753983,6717856984,907959996,60878569914,4808056102<0.0001
    46,33382591056,57987681085,37186641083,78585641044,72486651086,620856410514,7018965111<0.0001
    56,30089651126,64592721205,49994721163,71692681134,92190701146,300906911114,8949977123<0.0001
    66,41488681136,63996761245,64496751203,77396751185,11397771206,475957411514,75310481130<0.0001
    71,84997781291,815104781332,23210379133982100761211,327105891232,408117821484,98212695150<0.0001
    81,861102781371,762106791422070110881351,138102791401,373103871262,471117841514,85813098155<0.0001
    91,725106801401,847110801472,10110285140916105841501,350107951402,308121821555,527144103163<0.0001
    Region
    Central10,295794810612,49684571089,18082571099,07988671117,767866310814,274856110732,9388759112<0.0001
    Western31,812764910031,071805510828,461855810915,630785010123,752856010831,436815710767,3059062120<0.0001
    Abbreviation: N=number; M=median; P25=25th percentile; P75=75th percentile.
    * Comparison of rope skipping counts from 2013 to 2021.
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Variations in Rope Skipping Counts Among Rural Primary and Secondary School Students — China, 2013–2021

View author affiliation

Summary

What is already known about this topic?

Physical fitness is closely associated with children’s development. Limited research has been published on the changes in physical fitness among Chinese children during the implementation of the Nutrition Improvement Program for Rural Compulsory Education Students (NIPRCES).

What is added by this report?

This research utilized data from the NIPRCES between 2013 and 2021 to examine alterations in children’s physical fitness levels. Over this period, there was a significant increase in the number of rope skipping counts among children. In 2021, variations in these counts were observed, which depended on factors such as age, gender, geographic location, and region.

What are the implications for public health practice?

Physical fitness has been linked to a multitude of non-communicable diseases. Enhanced nutritional measures for children lead to significant improvements in their overall physical fitness, as evidenced by NIPRCES findings. It is crucial for policymakers to implement comprehensive interventions aimed at promoting and advancing children’s physical fitness.

  • 1. National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
  • Corresponding author:

    Juan Xu, xujuan@ninh.chinacdc.cn

    Online Date: June 16 2023
    Issue Date: June 16 2023
    doi: 10.46234/ccdcw2023.102
  • Beginning in 2011, the Nutrition Improvement Program for Rural Compulsory Education Students (NIPRCES) was established to enhance the nutrition and health of students in rural areas and promote educational equity. The central government offers nutritional meal subsidies to compulsory education students, aged 6–15 years, in underdeveloped counties. Monitoring and evaluation have been conducted annually from 2012 to 2017 and in 2019 and 2021. Additionally, data regarding the nutritional and health status of students in the national pilot areas have been regularly collected from 2012 to 2021. NIPRCES has effectively mitigated growth retardation and anemia among rural children (1).

    The current study also aimed to explore whether the implementation of NIPRCES has positively impacted children’s physical fitness, which is strongly associated with their growth. Optimal physical fitness provides numerous physiological and psychological benefits, offers protection against potential stressors, and prevents many chronic diseases (2). The primary objective was to evaluate changes in physical fitness among Chinese rural children and adolescents during the implementation of NIPRCES. Utilizing rope skipping counts as the indicator, an increase in children’s performance was observed from 2013 to 2021. In 2021, the counts varied among students based on age, gender, area, and region. This study offers valuable scientific evidence for policymakers to develop effective strategies aimed at improving the physical fitness of children and adolescents.

    From 2012 to 2019, key monitoring was conducted in the rural areas of 50 national pilot counties of the NIPRCES across 22 provincial-level administrative divisions (PLADs) in western and central China. In 2021, both rural and urban areas of 70 national pilot counties, 60 local pilot counties of the NIPRCES, and 30 non-pilot counties conducted key monitoring in eastern, western, and central China. This study used data on students’ physical fitness extracted from end-of-semester physical education class test results in 2013, 2014, 2015, 2016, 2017, 2019, and 2021. In each key monitoring county, two primary and two secondary schools were selected. For each grade, from 1st grade (children aged 6–7 years in primary school) to 9th grade (children aged 14–15 years in junior high school), one class of approximately 40 students was chosen. Exam items in physical education classes included the standing long jump, 50-meter dash, and rope skipping, among others. Rope skipping was selected as the physical fitness indicator in this study (recorded as counts/minute) since all students from 1st to 9th grade test rope skipping in China.

    For cross-sectional analysis, all data in 2021 were used. For comparisons from 2013 to 2021, data in 2021 were selected as representing the rural areas in key monitoring counties in central and western China. Rope skipping counts were described by median, 25th percentile (P25), and 75th percentile (P75) for each year. Non-parametric Wilcoxon or Kruskal-Wallis rank sum tests were employed to determine differences between groups. When differences between groups were statistically significant, the Dwass-Steel-Critchlow-Fligner test was used for pairwise comparisons between groups. The inspection level was set at α=0.05. All analyses were conducted using SAS (version 9.4, SAS Institute Inc., Cary, NC, USA).

    Table 1 shows the median, P25 and P75 of rope skipping counts among students by gender, grade, and region for each year from 2013 to 2021. Students’ rope skipping counts displayed a general increasing trend, from 77 counts/min in 2013 to 89 counts/min in 2021, marking an increase of 15.6%. Between 2013 and 2021, the counts for male improved by 14 counts, which was more than the improvement for female (11 counts). Ninth-grade students experienced an increase of 38 counts, considerably higher than students in other grades (7–29 counts). Moreover, students in the western regions demonstrated an increase of 14 counts, surpassing those in the central regions (8 counts).

    Variable2013201420152016201720192021P value*
    NMP25P75NMP25P75NMP25P75NMP25P75NMP25P75NMP25P75NMP25P75
    Total42,107774910243,534815610837,641855810924,709815610531,519866110845,7108259107100,2438960118<0.0001
    Gender
    Male21,85272429822,581785010219,555815310612,716785210116,183835910423,633805610551,6598657115<0.0001
    Female20,255815610720,953866211218,086886211211,993866110915,336876511022,077856111048,5849265120<0.0001
    Grade
    15,2763620605,5124321714,4924421733,1174625753,6764727756,16048247512,052502877<0.0001
    26,2305632796,2536236844,7596235873,6116438854,3456842896,36068458813,996684491<0.0001
    36,1197346946,4827755985,4737753983,6717856984,907959996,60878569914,4808056102<0.0001
    46,33382591056,57987681085,37186641083,78585641044,72486651086,620856410514,7018965111<0.0001
    56,30089651126,64592721205,49994721163,71692681134,92190701146,300906911114,8949977123<0.0001
    66,41488681136,63996761245,64496751203,77396751185,11397771206,475957411514,75310481130<0.0001
    71,84997781291,815104781332,23210379133982100761211,327105891232,408117821484,98212695150<0.0001
    81,861102781371,762106791422070110881351,138102791401,373103871262,471117841514,85813098155<0.0001
    91,725106801401,847110801472,10110285140916105841501,350107951402,308121821555,527144103163<0.0001
    Region
    Central10,295794810612,49684571089,18082571099,07988671117,767866310814,274856110732,9388759112<0.0001
    Western31,812764910031,071805510828,461855810915,630785010123,752856010831,436815710767,3059062120<0.0001
    Abbreviation: N=number; M=median; P25=25th percentile; P75=75th percentile.
    * Comparison of rope skipping counts from 2013 to 2021.

    Table 1.  Rope skipping counts per minute among Chinese students in rural areas, 2013–2021.

    In 2021, the number of rope-skipping counts demonstrated variation based on age, gender, residential area, and region. Among 1st to 6th grade primary school students, female exhibited higher counts than male, while counts appeared similar for both genders in 7th and 8th grades but were lower for female in the 9th grade (Figure 1A). First-grade students from urban areas demonstrated 11 more counts than their counterparts in rural areas, representing the largest difference among all grade levels (ranging from 2 to 7 counts; Figure 1B). Throughout the primary school years, students from eastern China consistently had higher counts compared to those from central and western China. In contrast, during the junior high school period, this difference was reversed (Figure 1C). All identified differences were deemed statistically significant (P<0.05).

    Figure 1. 

    Rope skipping counts among students by gender, residential area, region, and age in 2021. (A) by gender and age; (B) by residential area type and age; (C) by region and age.

    • This study indicated that the implementation of NIPRCES led to improvements in children’s and adolescents’ physical fitness, as evidenced by enhanced rope skipping performance. Nevertheless, there were still marked disparities in scores among students from different regions and areas.

      In the present study, rope skipping counts were selected as a measure of students’ physical fitness, given that this activity engages the entire body (upper and lower regions) and calls for rhythm, coordination, agility, speed, and strength. As students engage in rope skipping, they must maintain continuous arm rotation and coordinate their bodies during rhythmic, repetitive vertical hops (3). The body also needs to re-establish balance and generate propelling force throughout successive jumps. Previous research has demonstrated the benefits of rope skipping for both cardiovascular and respiratory systems (4).

      In the NIPRCES study, our approach to enhancing students’ health was through the implementation of school feeding programs. Evidence has demonstrated that these programs positively impact the physical fitness of children and adolescents, as well as their overall athletic performance. A two-year intervention that involved increasing children’s intake of eggs and dairy products during school breakfasts effectively improved their strength (as measured by broad jump scores) and endurance [based on their performance in the 50 (8-meter round trip) test] of children and adolescents in China (5). Cintineo’s research also indicated that protein supplementation led to increased muscle volume, muscle fiber cross-sectional area, muscle strength, and muscle explosiveness (6). By increasing the consumption of meat and eggs, which are rich sources of high-quality protein, NIPRCES’s school feeding program may have aided in improving the muscle strength and rope-skipping performance of participating students.

      In addition to NIPRCES, the Chinese government has placed significant emphasis on enhancing physical activity among compulsory education students. The national policy, “Notice on School Physical Education Under the Current Epidemic Situation,” was introduced in 2023. This policy highlighted the need for public health practitioners to increase efforts in promoting nutrition and physical education to improve students’ habits and overall physical fitness. Moving forward, NIPRCES will persist in its efforts to promote and maintain the nutritional and physical well-being of children in targeted counties throughout the nation.

      This study faced several limitations. First, the investigation solely utilized rope skipping as an indicator of physical fitness. In future research, additional assessments, such as the 50-meter dash, standing long jump, and sit-and-reach, should be incorporated to provide a comprehensive evaluation of children and adolescents’ physical fitness. Second, the accuracy of the results may be influenced by students’ attitudes during the physical examinations, potentially leading to biased outcomes.

      In conclusion, the findings from the present study suggest that children’s and adolescents’ physical fitness has improved during the NIPRCES period. Nonetheless, disparities in physical fitness levels were observed among children and adolescents across various regions and areas. Consequently, it is imperative that future policies implement comprehensive strategies aimed at enhancing children’s health and reducing these discrepancies.

    • No conflicts of interest.

    • Project teams from China CDC, provincial, city, and county level CDCs and Departments of Education, local school staff, and all participants. Feitong Wu for comments and suggestions.

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