title: Cardiorespiratory fitness is negatively associated with metabolic risk factors independently of the adherence to a healthy dietary pattern.
abstract: OBJECTIVE
  Cardiorespiratory fitness (CRF) and diet have been involved as significant factors towards the prevention of cardio-metabolic diseases. This study aimed to assess the impact of the combined associations of CRF and adherence to the Southern European Atlantic Diet (SEADiet) on the clustering of metabolic risk factors in adolescents.
  
  
  RESULTS
  A cross-sectional school-based study was conducted on 468 adolescents aged 15-18, from the Azorean Islands, Portugal. We measured fasting glucose, insulin, total cholesterol (TC), HDL-cholesterol, triglycerides, systolic blood pressure, waits circumference and height. HOMA, TC/HDL-C ratio and waist-to-height ratio were calculated. For each of these variables, a Z-score was computed by age and sex. A metabolic risk score (MRS) was constructed by summing the Z scores of all individual risk factors. High risk was considered when the individual had ≥ 1 SD of this score. CRF was measured with the 20 m-Shuttle-Run-Test. Adherence to SEADiet was assessed with a semi-quantitative food frequency questionnaire. Logistic regression showed that, after adjusting for potential confounders, unfit adolescents with low adherence to SEADiet had the highest odds of having MRS (OR = 9.4; 95%CI:2.6-33.3) followed by the unfit ones with high adherence to the SEADiet (OR = 6.6; 95% CI: 1.9-22.5) when compared to those who were fit and had higher adherence to SEADiet.
  
  
  CONCLUSIONS
  Unfit adolescents showed higher odds of having high MRS, regardless of the adherence to SEADiet suggesting that high CRF may overcome the deleterious effects of low adherence to a healthy dietary pattern in adolescents.
authors.affiliation: Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Rua Dr. Plácido Costa, 91, 4200-450 Porto, Portugal. carla_m_moreira@sapo.pt
authors.forename: C
authors.initials: C
authors.lastname: Moreira
authors.forename: R
authors.initials: R
authors.lastname: Santos
authors.forename: P
authors.initials: P
authors.lastname: Moreira
authors.forename: F
authors.initials: F
authors.lastname: Lobelo
authors.forename: J R
authors.initials: JR
authors.lastname: Ruiz
authors.forename: S
authors.initials: S
authors.lastname: Vale
authors.forename: P C
authors.initials: PC
authors.lastname: Santos
authors.forename: S
authors.initials: S
authors.lastname: Abreu
authors.forename: J
authors.initials: J
authors.lastname: Mota
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000208:ethnology; D001394:Azores / Q000453:epidemiology; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000208:ethnology / Q000209:etiology / Q000517:prevention & control; D002320:Cardiovascular Physiological Phenomena; D003430:Cross-Sectional Studies; D004032:Diet / Q000009:adverse effects / Q000208:ethnology; D005260:Female; D006293:Health Promotion; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology / Q000208:ethnology / Q000209:etiology / Q000517:prevention & control*; D018673:Nutrition Policy; D009765:Obesity / Q000453:epidemiology / Q000208:ethnology / Q000503:physiopathology / Q000517:prevention & control; D050177:Overweight / Q000453:epidemiology / Q000208:ethnology / Q000503:physiopathology / Q000517:prevention & control; D010349:Patient Compliance / Q000208:ethnology; D010809:Physical Fitness; D015995:Prevalence; D012143:Respiratory Physiological Phenomena; D012307:Risk Factors