Low cardiorespiratory fitness is a strong predictor for clustering of cardiovascular disease risk factors in children independent of country, age and sex.
METHODS
Few studies have investigated the association between maximal cardiorespiratory capacity (fitness) and the clustered cardiovascular disease (CVD) risk in children and youth from culturally diverse countries. This cross-sectional study examined the association between fitness and clustered CVD risk in children and adolescents from three European countries.


METHODS
Participants were 2845 randomly selected school children aged 9 or 15 years from Portugal (n=944), Denmark (n=849) and Estonia (n=1052). Cardiorespiratory fitness was determined during a maximal test on a cycle ergometer. CVD risk factors selected to assess the degree of clustering were the total cholesterol/high-density lipoprotein cholesterol ratio, plasma triglycerides, insulin resistance (homeostasis model assessment), sum of four skinfolds, and systolic blood pressure.


RESULTS
There was a strong association between cardiorespiratory fitness and the clustering of CVD risk factors. The odds ratios for clustering in each quartile of fitness, using the quartile with the highest fitness as reference, were 13.0 [95% confidence interval (CI) 8.8-19.1]; 4.8 (95% CI 3.2-7.1) and 2.5 (95% CI 1.6-3.8), respectively, after adjusting for country, age, sex, socio-economic status, pubertal stage, family history of CVD and diabetes. In stratified analyses by age group, sex and country, similar strong patterns were observed.


CONCLUSIONS
Low cardiorespiratory fitness is strongly associated with the clustering of CVD risk factors in children independent of country, age and sex.
Department of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway. sigmund.anderssen@nih.no
Sigmund A
SA
Anderssen
Ashley R
AR
Cooper
Chris
C
Riddoch
Luis B
LB
Sardinha
Maarike
M
Harro
Søren
S
Brage
Lars B
LB
Andersen
D000293:Adolescent; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000503:physiopathology; D002648:Child; D003430:Cross-Sectional Studies; D003718:Denmark / Q000453:epidemiology; D004957:Estonia / Q000453:epidemiology; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D010809:Physical Fitness; D011174:Portugal / Q000453:epidemiology; D011237:Predictive Value of Tests; D012307:Risk Factors