Cardiorespiratory fitness cut points to avoid cardiovascular disease risk in children and adolescents; what level of fitness should raise a red flag? A systematic review and meta-analysis. Issue 23 (26th September 2016)

• Record Type: Journal Article
• Authors: Ruiz, Jonatan R; Cavero-Redondo, Ivan; Ortega, Francisco B; Welk, Gregory J; Andersen, Lars B; Martinez-Vizcaino, Vicente
• Is Part Of: British journal of sports medicine. Volume 50:Issue 23(2016)
• Page Start: 1451
• Page End: 1458
• Publication Date: 2016-09-26
• Subjects: Aerobic fitness -- Children -- Adolescent -- Cardiovascular -- Exercise testing; Sports medicine -- Periodicals; 617.1027
• DOI: 10.1136/bjsports-2015-095903
• Languages: English
• ISSNs: 0306-3674

Abstract

Abstract : Background: Poor cardiorespiratory fitness is associated with cardiovascular disease risk factors. Aim: To perform a systematic review and meta-analysis of the relationship between poor cardiorespiratory fitness and cardiovascular disease risk in children and adolescents. Methods: Systematic literature search (1980 to 11 April 2015) for studies that determined a cardiorespiratory fitness cut point that predicted cardiovascular disease risk in children and adolescents. Results: We identified 7 studies that included 9280 children and adolescents (49% girls) aged 8–19 years from 14 countries. Cardiovascular disease risk was already present in boys (6–39%) and girls (6–86%). Boys with low fitness (<41.8 mL/kg/min) had a 5.7 times greater likelihood of having cardiovascular disease risk (95% CI 4.8 to 6.7). The comparable diagnostic OR for girls with low fitness (<34.6 mL/kg/min) was 3.6 (95% CI 3.0 to 4.3). The 95% confidence region of cardiorespiratory fitness associated with low cardiovascular disease risk ranges, 41.8–47.0 mL/kg/min in boys (eg, stages 6–8 for a boy aged 15 years) and 34.6–39.5 mL/kg/min in girls (eg, stages 3–5 for a girl aged 15 years). The cardiorespiratory fitness cut point to avoid cardiovascular disease risk ranged 41.8 mL/kg/min in boys and was 34.6 mL/kg/min in girls. Summary: Fitness levels below 42 and 35 mL/kg/min for boys and girls, respectively, should raise a red flag. These translate to 6 and 3 stages on the shuttle run test for a boy and a girl, both aged 15 years, respectively. These cut points identify children and adolescents who may benefit from primary and secondary cardiovascular prevention programming.