title: Cardiorespiratory fitness effect may be under-estimated in 'fat but fit' hypothesis studies.
abstract: BACKGROUND
  Both cardiorespiratory fitness and body fat have been independently related to metabolic syndrome in adolescents; however, the strength of these relationships seems to be dependent on the outcome composition.
  
  
  OBJECTIVE
  To analyse the relationship between cardiorespiratory fitness and body fat combined with different indicators of metabolic risk in adolescents.
  
  
  METHODS
  The sample was composed of 957 adolescents (58.7% girls). Cardiorespiratory fitness was obtained using the 20-metre shuttle run test and skinfold thickness was collected for body fat estimation. Metabolic risk score was calculated from waist circumference, systolic and diastolic blood pressure, glucose, HDL cholesterol and triglycerides measurements and an alternative outcome without the central obesity indicator was adopted. Chronological age and somatic maturity were used as covariates.
  
  
  RESULTS
  Higher metabolic risk was observed in the highest fat/lowest fit adolescents (p < .05), regardless of sex and outcome. In the regression models, for full metabolic risk score, body fat presented higher coefficients compared to cardiorespiratory fitness in both sexes (boys: 0.501 vs -0.097; girls: 0.485 vs -0.087); however, in the metabolic risk without waist circumference, the coefficients became closer (boys: 0.290 vs -0.146; girls: 0.265 vs -0.120), with a concomitant decrease in body fat and increase in cardiorespiratory fitness coefficients.
  
  
  CONCLUSIONS
  These findings suggest that body fat is strongly related to cardiovascular risk, but, when the outcome is calculated without the central obesity indicator, cardiorespiratory fitness becomes more related to metabolic risk.
authors: a Study and Research Group in Metabolism, Nutrition, and Exercise - GEPEMENE, State University of Londrina - UEL , Londrina , Brazil.
authors: Danilo R
authors: DR
authors: Silva
authors: a Study and Research Group in Metabolism, Nutrition, and Exercise - GEPEMENE, State University of Londrina - UEL , Londrina , Brazil.
authors: André O
authors: AO
authors: Werneck
authors: b Bradford Institute for Health Research, Bradford NHS Foundation Trust , Bradford , UK.
authors: Paul J
authors: PJ
authors: Collings
authors: a Study and Research Group in Metabolism, Nutrition, and Exercise - GEPEMENE, State University of Londrina - UEL , Londrina , Brazil.
authors: David
authors: D
authors: Ohara
authors: c Scientific Research Group Related to Physical Activity (GICRAF), Laboratory of Investigation in Exercise (LIVE), Department of Physical Education , São Paulo State University (UNESP) , Presidente Prudente , Brazil.
authors: Rômulo A
authors: RA
authors: Fernandes
authors: d Department of Pathology, Clinical and Toxicological Analysis , Center of Health Sciences, University Hospital, State University of Londrina - UEL , Londrina , Brazil.
authors: Décio S
authors: DS
authors: Barbosa
authors: a Study and Research Group in Metabolism, Nutrition, and Exercise - GEPEMENE, State University of Londrina - UEL , Londrina , Brazil.
authors: Enio R V
authors: ERV
authors: Ronque
authors: e Exercise and Health Laboratory, Faculty of Human Movement , University of Lisbon , Portugal.
authors: Luís B
authors: LB
authors: Sardinha
authors: a Study and Research Group in Metabolism, Nutrition, and Exercise - GEPEMENE, State University of Londrina - UEL , Londrina , Brazil.
authors: Edilson S
authors: ES
authors: Cyrino
mesh_terms: D000273:Adipose Tissue / Q000378:metabolism*; D000293:Adolescent; D001938:Brazil / Q000453:epidemiology; D000072599:Cardiorespiratory Fitness; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology* / Q000209:etiology; D056128:Obesity, Abdominal / Q000453:epidemiology* / Q000209:etiology; D015995:Prevalence; D012307:Risk Factors
keywords: Metabolic syndrome; VO2max; fatness; obesity