title: Cardiorespiratory fitness and ideal cardiovascular health in European adolescents.
abstract: OBJECTIVE
  We studied in European adolescents (i) the association between cardiorespiratory fitness and ideal cardiovascular health as defined by the American Heart Association and (ii) whether there is a cardiorespiratory fitness threshold associated with a more favourable cardiovascular health profile.
  
  
  METHODS
  Participants included 510 (n=259 girls) adolescents from 9 European countries. The 20 m shuttle run test was used to estimate cardiorespiratory fitness. Ideal cardiovascular health was defined as meeting ideal levels of the following components: four behaviours (smoking, body mass index, physical activity and diet) and three factors (total cholesterol, blood pressure and glucose).
  
  
  RESULTS
  Higher levels of cardiorespiratory fitness were associated with a higher number of ideal cardiovascular health components in both boys and girls (both p for trend ≤0.001). Levels of cardiorespiratory fitness were significantly higher in adolescents meeting at least four ideal components (13% higher in boys, p<0.001; 6% higher in girls, p=0.008). Receiver operating characteristic curve analyses showed a significant discriminating accuracy of cardiorespiratory fitness in identifying the presence of at least four ideal cardiovascular health components (43.8 mL/kg/min in boys and 34.6 mL/kg/min in girls, both p<0.001).
  
  
  CONCLUSIONS
  The results suggest a hypothetical cardiorespiratory fitness level associated with a healthier cardiovascular profile in adolescents. The fitness standards could be used in schools as part of surveillance and/or screening systems to identify youth with poor health behaviours who might benefit from intervention programmes.
authors.affiliation: Department of Physical Education and Sports, Faculty of Sport Sciences, PROmoting FITness and Health through physical activity research group (PROFIT), University of Granada, Granada, Andalucia, Spain Department of Biosciences and Nutrition at NOVUM, Unit for Preventive Nutrition, Karolinska Institutet, Huddinge, Sweden.
authors.forename: Jonatan R
authors.initials: JR
authors.lastname: Ruiz
authors.affiliation: Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium International Agency for Research on Cancer (IARC/WHO), Lyon, France.
authors.forename: Inge
authors.initials: I
authors.lastname: Huybrechts
authors.affiliation: Department of Medical Physiology, School of Medicine, University of Granada, Granada, Spain.
authors.forename: Magdalena
authors.initials: M
authors.lastname: Cuenca-García
authors.affiliation: Department of Education, Area of Physical Education and Sport, University of Almería, Almería, Spain.
authors.forename: Enrique G
authors.initials: EG
authors.lastname: Artero
authors.affiliation: Department of Nutrition and Food Science, University of the Basque Country, UPV/EHU, Vitoria, Spain.
authors.forename: Idoia
authors.initials: I
authors.lastname: Labayen
authors.affiliation: Inserm, UMR744; Institut Pasteur de Lille; Lille, Univ Lille Nord de France, Lille; UDSL, Lille, France.
authors.forename: Aline
authors.initials: A
authors.lastname: Meirhaeghe
authors.affiliation: GENUD "Growth, Exercise, NUtrition and Development" Research Group, Universidad de Zaragoza, Spain Faculty of Health and Sport Science (FCSD), Department of Physiatry and Nursing, Universidad de Zaragoza, Ronda Misericordia 5, 22001-Huesca, Spain.
authors.forename: German
authors.initials: G
authors.lastname: Vicente-Rodriguez
authors.affiliation: Agricultural Research Council-Research Center on Food and Nutrition-(C.R.A. NUT formerly INRAN), Rome, Italy.
authors.forename: Angela
authors.initials: A
authors.lastname: Polito
authors.affiliation: Department of Nutrition and Dietetics, Harokopio University, Athens, Greece.
authors.forename: Yannis
authors.initials: Y
authors.lastname: Manios
authors.affiliation: ImFine Research Group. Facultad de Ciencias de la Actividad Física y del Deporte-INEF, Universidad Politécnica de Madrid, Madrid, Spain CIBER: CB12/03/30038 Fisiopatología de la Obesidad y la Nutrición, CIBERobn, Instituto de Salud Carlos III (ISCIII), Spain.
authors.forename: Marcela
authors.initials: M
authors.lastname: González-Gross
authors.affiliation: Immunonutrition Research Group, Department of Metabolism and Nutrition, Instituto del Frio, Institute of Food Science, Technology and Nutrition, Spanish National Research Council, Madrid, Spain.
authors.forename: Ascensión
authors.initials: A
authors.lastname: Marcos
authors.affiliation: Department of Pediatrics, Division of Clinical Nutrition, Medical University of Vienna, Vienna, Austria.
authors.forename: Kurt
authors.initials: K
authors.lastname: Widhalm
authors.affiliation: Department of Pediatrics, University of Pecs, Pecs, Hungary.
authors.forename: Denes
authors.initials: D
authors.lastname: Molnar
authors.affiliation: Preventive Medicine and Nutrition Unit, School of Medicine, University of Crete, Crete, Greece.
authors.forename: Anthony
authors.initials: A
authors.lastname: Kafatos
authors.affiliation: Department of Biosciences and Nutrition at NOVUM, Unit for Preventive Nutrition, Karolinska Institutet, Huddinge, Sweden.
authors.forename: Michael
authors.initials: M
authors.lastname: Sjöström
authors.affiliation: GENUD "Growth, Exercise, NUtrition and Development" Research Group, Universidad de Zaragoza, Spain Faculty of Health Sciences, University of Zaragoza, Zaragoza, Spain.
authors.forename: Luis A
authors.initials: LA
authors.lastname: Moreno
authors.affiliation: Department of Medical Physiology, School of Medicine, University of Granada, Granada, Spain.
authors.forename: Manuel J
authors.initials: MJ
authors.lastname: Castillo
authors.affiliation: Department of Physical Education and Sports, Faculty of Sport Sciences, PROmoting FITness and Health through physical activity research group (PROFIT), University of Granada, Granada, Andalucia, Spain Department of Biosciences and Nutrition at NOVUM, Unit for Preventive Nutrition, Karolinska Institutet, Huddinge, Sweden.
authors.forename: Francisco B
authors.initials: FB
authors.lastname: Ortega
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D000367:Age Factors; D019540:Area Under Curve; D001786:Blood Glucose / Q000032:analysis; D001794:Blood Pressure; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D002784:Cholesterol / Q000097:blood; D003430:Cross-Sectional Studies; D004032:Diet / Q000009:adverse effects; D005060:Europe; D015444:Exercise; D005080:Exercise Test; D005260:Female; D015438:Health Behavior; D006304:Health Status; D006801:Humans; D008019:Life Style; D008297:Male; D010809:Physical Fitness; D011237:Predictive Value of Tests; D012372:ROC Curve; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects
chemical_list: D001786:Blood Glucose; D002784:Cholesterol