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This study compares the prevalence of overweight and obesity between WHO/IOTF criteria. A total of 17,277 Portuguese children aged 3-10 years old were analysed. The prevalences of overweight-obesity were higher at WHO classification (19.8%-20.7%) than at IOTF classification (8.2%-16.1%), (p<0.001). Agreement between the criteria were substantial for overweight (Kappa= 0.67, p<0.001) and moderate for obesity (Kappa= 0.47, p<0.001). The prevalences ratio for inequality between criteria were greater for boys than for girls and lesser for children aged 6-7 than children aged 8-10 years old. The disparities between the two criteria and the higher overweight obesity prevalences highlight the needs to develop more studies.

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OBJECTIVES: The environment is believed to be key in obesity prevention, yet it is unclear how factors in the neighborhood influence weight-related behaviors. The present study aimed to investigate the influence of parental perceived environment on physical activity (PA), television (TV) time, active play and Body Mass Index (BMI) z score, and the mediating role of these weight-related behaviors on the relationship between neighborhood characteristics and children's BMI. METHODS: Data of 8472 Portuguese preschool (aged 3-6, n = 3819) and school-aged children (aged 7-11 years, n = 4653) were collected during 2016/2017. Structural equation modeling was used to estimate the associations between parents perceived neighborhood characteristics (latent variables: unsafety and built/physical environment) and child's BMI z score, PA and TV time. RESULTS: Among preschoolers, the latent variables of the perceived environment were not associated with the BMI, TV time, extracurricular PA, and active play. Among schoolchildren, the unsafety environment was positively associated with both the BMI (SC = 0.050, P = .008) and the time spent watching TV (SC = 0.052, P = .031) and negatively associated with extracurricular PA (SC = -0.125, P < .001). The latent variable Favorable Built Environment for PA (ie, environmental facilitating elements) was positively associated with active play (SC = 0.041, P = .031). Moreover, the TV time was a marginally significant mediator of the relationship between the perceived unsafe environment and the BMI of school-aged children (B = 0.002, P = .096). CONCLUSIONS: In conclusion, changes in the environment to targeting parental perception of neighborhood safety could have positive effects on the promotion of healthy weight and the adoption of a healthy lifestyle in school-aged children.

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ABSTRACT Introduction: Aging causes alterations in various executive and cognitive functions, mainly related to the incidence of dementia, especially Alzheimer's disease (AD). Several studies mention physical exercise as a preventive resource for depressive symptoms. Objective: To investigate the cognitive and behavioral alterations related to AD that are capable of slowing disease progression and its complications. Methods: The sample consisted of 10 male Wistar rats, divided into 2 groups (n = 5), swimming and Alzheimer + swimming, with a 6-day intervention protocol. The elevated plus maze test was used to assess anxiety, the Morris water maze for spatial memory, the isolation box for aversive memory, and the open field test to assay motor behavior. Results: There was improvement in spatial memory in the Swimming group (169 ± 142.9 x 24.2 ± 31.3), but motor behavior deteriorated after exercise. An increase in anxious behavior (8 ± 13.03 x 67.8 ± 48.1) was observed in the animals with AD. This is a relevant characteristic of the disease, which did not improve after acute exercise. By analyzing the size effect, it was possible to observe a difference in the Alzheimer + swimming group in terms of reduced anxiety and improved motor behavior after exercise. Despite the benefits of physical exercise for AD symptoms, there is still no consensus on the type of physical exercise and length of intervention necessary to achieve a positive response as a treatment method, since studies are yet to confirm this fact in an acute or chronic manner. Conclusion: Acute physical exercise was not fully effective as a means of treating behavioral alterations related to AD, but had a mean effect on the size effect analysis of motor behavior and anxiety, specifically. Level of evidence IV; Investigation of treatment outcomes.

RESUMO Introdução: O envelhecimento causa alterações de diversas funções executivas e cognitivas, principalmente relacionadas à incidência de demências, em especial, a doença Alzheimer (DA). Diversos estudos mencionam o exercício físico como um recurso preventivo de sintomas de depressão. Objetivo: Investigar as alterações cognitivas e comportamentais relacionadas à DA capazes de retardar a progressão da doença e suas complicações. Métodos: A amostra foi composta por 10 ratos Wistar machos divididos em 2 grupos (n = 5), Natação e Alzheimer+Natação, com protocolo de 6 dias de intervenção. Foram realizadas avaliações da ansiedade pelo teste de labirinto elevado em cruz, memória espacial pelo labirinto aquático de Morris, memória aversiva pelo teste de aversão em caixa de isolamento e comportamento motor por meio do teste Open Field. Resultados: No grupo Natação houve melhora na memória espacial (169 ± 142,9 x 24,2 ± 31,3), porém verificou-se comportamento motor pior depois do exercício. Igualmente, observou-se aumento do comportamento de ansiedade (8 ± 13,03 x 67,8 ± 48,1) nos animais com DA, característica relevante da doença, que não apresentou melhora após o exercício agudo. Através da análise do Size effect foi possível observar que houve diferença no grupo Alzheimer+Natação na diminuição da ansiedade e melhora do comportamento motor após o exercício. Apesar dos benefícios do exercício físico para os sintomas da DA, ainda não existe um consenso sobre o tipo de exercício e o tempo de intervenção necessários para que se tenha uma resposta positiva como método de tratamento, uma vez que ainda não existem estudos que comprovem esse fato de maneira aguda ou crônica. Conclusão: O exercício físico de forma aguda não se mostrou totalmente eficaz como tratamento das alterações comportamentais com relação à DA, porém obteve um efeito médio na análise pelo Size effect sobre o comportamento motor e a ansiedade, especificamente. Nível de evidência IV; Investigação dos resultados do tratamento.

RESUMEN Introducción: El envejecimiento causa cambios de diversas funciones ejecutivas y cognitivas, relacionadas con la incidencia de demencias, en especial, la enfermedad de Alzheimer (EA). Diversos estudios mencionan el ejercicio físico como un recurso preventivo de síntomas de depresión. Objetivo: Investigar las alteraciones cognitivas y de comportamiento relacionadas a la EA capaces de retardar la progresión de la enfermedad y sus complicaciones. Métodos: Diez ratas Wistar machos divididas en 2 grupos (n = 5), Natación y Alzheimer+natación, con protocolo de intervención de 6 días. Se realizaron evaluaciones de la ansiedad por la prueba del laberinto elevado en cruz, memoria espacial por el laberinto acuático de Morris, memoria aversiva por la prueba de aversión en caja de aislamiento y comportamiento motor por de la prueba de campo abierto. Resultados: En el grupo Natación hubo mejoría en la memoria espacial (169 ± 142,9 x 24,2 ± 31,3), pero se observó comportamiento motor peor después del ejercicio. También se observó un aumento del comportamiento de ansiedad (8 ± 13,03 x 67,8 ± 48,1) en los animales con EA, característica relevante de la enfermedad, que no presentó mejoría después del ejercicio agudo. A través del análisis del Size effect fue posible observar que hubo diferencia en el grupo Alzheimer+Natación en la reducción de la ansiedad y de mejora del comportamiento motor después del ejercicio. A pesar de los beneficios del ejercicio físico en los síntomas de la EA, todavía no hay consenso sobre el tipo de ejercicio físico y el tiempo de intervención necesarios para tener una respuesta positiva como método de tratamiento, ya que aún no existen estudios que demuestren ese tipo de hecho agudo o crónico. Conclusión: El ejercicio físico de forma aguda no fue totalmente eficaz como tratamiento de las alteraciones de comportamiento con relación a la EA, pero obtuvo un efecto promedio en el análisis por el Size effect sobre el comportamiento motor y la ansiedad, específicamente. Nivel de evidencia IV; Investigación de los resultados del tratamiento.

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STUDY OBJECTIVES: Sleep is a behavior with the potential to affect cardiovascular health. Given the fact that adiposity and physical activity seem to be related to cardiovascular risk factors during growth, it is still unclear whether sleep quality could affect arterial thickness among adolescents. Thus, the objective of the current study was to analyze the effect of sleep quality on arterial thickness and identify the possible mediation role of physical activity and trunk fat in adolescents. METHODS: This was a longitudinal study (12-month follow-up) composed of 71 adolescents with ages ranging from 11 to 14 years at baseline (absence of any known chronic diseases, and no regular medicine use). All variables were assessed twice (baseline and 12-month follow-up): (1) sleep quality was reported using the Mini Sleep Questionnaire (MSQ); (2) physical activity was estimated using pedometers; (3) trunk fat was assessed using a densitometry scanner; and (4) carotid intima-media thickness (CIMT) and femoral intima-media thickness (FIMT) were assessed using ultrasonography. RESULTS: Adolescents who presented poor sleep quality demonstrated significantly increased FIMT (r = .299, 95% confidence interval .071 to .498) and for every point increase in the MSQ score from baseline to follow-up there was a 1.12% (95% confidence interval 0.26 to 1.98) increase in FIMT over time. Moreover, trunk fat and physical activity did not mediate the association between sleep quality and arterial thickness, but FIMT had a positive and independent relationship only with trunk fat. CONCLUSIONS: Sleep quality was positively associated with FIMT among adolescents, whereas physical activity and adiposity did not mediate this process.

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ABSTRACT The aim of the present study was to verify the level of concordance between Body Adiposity Index (BAI) and Dual-energy X-ray Absorptiometry (DEXA) in the evaluation of body fat percentage in adolescents with type-1 diabetes mellitus (DM1). The sample consisted of 34 adolescents (16 boys and 18 girls) aged 10-15 years. Height and hip circumference data were collected for BAI calculation, and fat percentage was evaluated using DEXA. The Shapiro Wilk test was used to verify data normality. The Wilcoxon test was performed to compare age, anthropometric and BMI, BAI z score and DEXA between sexes. The correlation of variables (BAI vs DEXA) was evaluated by the Spearman correlation coefficient. For the analysis of residual scores, the Bland-Altman test was applied. The Kappa coefficient (k) was performed to assess the level of concordance between BAI and DEXA. Therefore, weak and non-significant correlation between BAI and DEXA in boys (r= 0.19, p= 0.46), and girls (r= 0.10, p= 0.73) was observed. Thus, weak concordance was observed (k= 0.09) for both sexes. It was concluded that BAI is not recommended to estimate fat percentage in adolescents with DM1.

Resumo O objetivo do presente estudo foi verificar o nível de concordância entre o Absortometria de Raio-x de Dupla Energia (DEXA) na avaliação do percentual de gordura de adolescentes com diabetes mellitus tipo 1 (DM1). A amostra foi constituída por 34 adolescentes (16 meninos e 18 meninas) com idades entre 10 e 15 anos. Coletaram-se os dados de estatura e circunferência do quadril para cálculo do IAC, bem como avaliação do percentual de gordura via DEXA. O teste de Shapiro Wilk foi utilizado para verificar a normalidade dos dados. O teste de Wilcoxon foi realizado para comparar as variáveis de idade, antropométricas e IMC score Z, IAC e DEXA entre sexos. A correlação das variáveis (IAC vs DEXA) foi avaliada pelo coeficiente de correlação de Spearman. Para análise dos escores residuais aplicou-se o teste de Bland-Altman. O coeficiente de Kappa (k) foi realizado para avaliar o nível de concordância entre o IAC e DEXA. Sendo assim, foi encontrada correlação fraca e não significante entre IAC e DEXA tanto nos meninos (r=0,19; p=0,46), quanto nas meninas (r=0,10; p=0,73). Dessa forma, foi possível perceber concordância fraca (k= 0,09) para ambos os sexos. Conclui-se que o IAC não é recomendado para estimar percentual de gordura em adolescentes com DM1.

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OBJECTIVE: The aim of this study was to analyse whether changes in physical activity and body fatness are related to modifications in cardiovascular risk factors among adolescents. Material and methods A sample of 89 healthy adolescents was recruited for this study. We assessed habitual physical activity, body fat percentage, arterial thickness, blood sample, and biological maturation. Multivariate models were used to analyse the relationships between independent and dependent variables. RESULTS: Physical activity (mean difference: 429.4 steps [95% confidence interval=-427 to 1286]) and body fatness (mean difference: -0.7% [95% confidence interval=-1.6-0.2]) remained stable during the study period. Independent of changes in physical activity, for each percentage increase in body fatness, femoral intima-media thickness increased by 0.007 mm (ß=0.007 [95% confidence interval=0.001-0.013]). Longitudinal relationships were found for high-density lipoprotein-cholesterol (ß=-0.477 mg/dl [95% confidence interval=-0.805 to -0.149]) and triacylglycerol (ß=2.329 mg/dl [95% confidence interval=0.275-4.384]). CONCLUSION: Changes in body fatness are more important than the amount of physical activity on cardiovascular and metabolic risks.

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OBJECTIVES: To describe the degree of disability, anthropometric variables, quality of life (QoL), and school backpack weight in boys and girls aged 11-17 years. The differences in QoL between those who did or did not report low back pain (LBP) were also analyzed. METHODS: Eighty-six girls (13.9 ± 1.9 years of age) and 63 boys (13.7 ± 1.7 years of age) participated. LBP was assessed by questionnaire, and disability using the Roland-Morris Disability Questionnaire. QoL was assessed by the Pediatric Quality of Life Inventory (PedsQL). Multivariate analyses of variance and covariance were used to assess differences between groups. RESULTS: Girls reported higher disability than boys (p = 0.01), and lower QoL in the domains of physical (p < 0.001) and emotional functioning (p < 0.01), psychosocial health (p = 0.02) and physical health summary score (p < 0.001), and on the total PedsQL score (p < 0.01). School backpack weight was similar in both genders (p = 0.61) and in participants with and without LBP (p = 0.15). After adjustments, participants with LBP reported lower physical functioning (p < 0.01), influencing lower physical health summary score (p < 0.01). CONCLUSIONS: Girls had higher disability and lower QoL than boys in the domains of physical and emotional functioning, psychosocial health, and physical health summary scores, and on the total PedsQL score; however, similar school backpack weight was reported. Participants with LBP revealed lower physical functioning and physical health summary score, yet had similar school backpack weight to those without LBP. .

OBJETIVOS: Descrever o grau de incapacidade, as variáveis antropométricas, a qualidade de vida (QV) e o peso das mochilas escolares em meninos e meninas com 11-17 anos. Também são analisadas as diferenças na QV entre os que relataram ou não lombalgia (LBP). MÉTODOS: 86 meninas (13,9 ± 1,9 anos) e 63 meninos (13,7 ± 1,7 anos) participaram. A LBP foi avaliada por um questionário e a incapacidade pelo Questionário Roland-Morris. A QV foi avaliada pelo Questionário Pediátrico sobre Qualidade de Vida (PedsQL). As análises de variância e de covariância multivariadas foram usadas para avaliar as diferenças entre os grupos. RESULTADOS: As meninas relataram maior incapacidade do que os meninos (p = 0,01) e menor QV nos domínios de funcionamento físico (p < 0,001) e emocional (p < 0,01), no escore sumário de saúde psicossocial (p = 0,02) e saúde física (p < 0,001) e no escore total no PedsQL (p < 0,01). O peso das mochilas escolares era semelhante para ambos os sexos (p = 0,61) e para os participantes com e sem LBP (p = 0,15). Após ajustes, os participantes com LBP relataram menor funcionamento físico (p < 0,01), o que influenciou um menor escore sumário de saúde física (p < 0,01). CONCLUSÕES: As meninas tiveram maior incapacidade e menor QV do que os meninos nos domínios de funcionamento físico e emocional, nos escores sumários de saúde psicossocial e física e no escore total no PedsQL; contudo, foi relatado um peso semelhante das mochilas escolares. Os participantes com LBP revelaram menor funcionamento físico e escore sumário de saúde física, mesmo carregando mochilas escolares de mesmo peso do que aqueles sem LBP. .

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OBJECTIVES: To describe the degree of disability, anthropometric variables, quality of life (QoL), and school backpack weight in boys and girls aged 11-17 years. The differences in QoL between those who did or did not report low back pain (LBP) were also analyzed. METHODS: Eighty-six girls (13.9 ± 1.9 years of age) and 63 boys (13.7 ± 1.7 years of age) participated. LBP was assessed by questionnaire, and disability using the Roland-Morris Disability Questionnaire. QoL was assessed by the Pediatric Quality of Life Inventory (PedsQL). Multivariate analyses of variance and covariance were used to assess differences between groups. RESULTS: Girls reported higher disability than boys (p = 0.01), and lower QoL in the domains of physical (p < 0.001) and emotional functioning (p < 0.01), psychosocial health (p = 0.02) and physical health summary score (p < 0.001), and on the total PedsQL score (p < 0.01). School backpack weight was similar in both genders (p = 0.61) and in participants with and without LBP (p = 0.15). After adjustments, participants with LBP reported lower physical functioning (p < 0.01), influencing lower physical health summary score (p < 0.01). CONCLUSIONS: Girls had higher disability and lower QoL than boys in the domains of physical and emotional functioning, psychosocial health, and physical health summary scores, and on the total PedsQL score; however, similar school backpack weight was reported. Participants with LBP revealed lower physical functioning and physical health summary score, yet had similar school backpack weight to those without LBP.

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OBJECTIVE: To analyze the relationship between inflammatory markers and the lipid profile, blood flow, and artery structure in prepubertal adolescents stratified according to sports practice. STUDY DESIGN: The sample was composed of 120 adolescents (57 boys and 63 girls) with a mean age of 11.7 ± 0.7 years (ranging from 11 to 13 years). Intima-media thickness (IMT) and blood flow were measured with ultrasonography. The lipid profile and high-sensitivity C-reactive protein were measured after the subjects had fasted for 12 hours overnight. Trunk fatness was measured by dual-energy x-ray absorptiometry. Organized sports participation was analyzed as a categorical variable. Biological maturation was determined via the age at peak height velocity. RESULTS: In the adjusted model, high-sensitivity C-reactive protein was significantly related to high-density lipoprotein-cholesterol (ß = -5.797 [-11.500 to -0.093]), femoral IMT (ß = 0.062 [0.008-0.116]), and the sum of femoral and carotid IMT (ß = 1.107 [0.223-1.919]), but only in the group without sports participation. Slopes of the crude linear regression were greater in the group without sports participation for femoral IMT (t = 2.621; P = .009) and the sum of femoral and carotid IMT (t = 2.876; P = .004) when compared with the group with sports participation. CONCLUSION: Independent of body fatness and biological maturation, inflammatory status was related to artery IMT and dyslipidemia in prepubertal adolescents, modulated by sport participation.

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OBJECTIVES: A sedentary lifestyle is increasingly implicated in a negative metabolic health profile among youth. The present study examined relationships between clustered metabolic risk factors and TV viewing in female adolescents. METHODS: The sample comprised 262 girls 14-17 years. Height, weight, fasting glucose, insulin, HDL cholesterol, triglycerides, and blood pressure were measured. Body mass index (BMI) was calculated. TV viewing time and moderate-to-vigorous physical activity (MVPA) were estimated from a 3-day diary. Outcome variables were normalized and expressed as Z scores which were summed into a metabolic risk score. Multiple linear regression analysis was used. RESULTS: TV viewing was independently associated with increased prevalence of clustered metabolic risk in girls after adjustment for several confounders (i.e., chronological age, BMI, MVPA, and parental education). The final model also indicated that lower levels of MVPA, higher BMI, and lower mother education were associated with higher metabolic risk. CONCLUSIONS: Increased TV viewing had an adverse effect on metabolic health of adolescent girls. The findings highlight the potential importance of preventive actions to ameliorate metabolic risk in youth which target both sedentary and physically active behaviors.

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BACKGROUND: Associations of metabolic syndrome (MetS) with lifestyle behaviors in youth is potentially important for identifying subgroups at risk and encourage interventions. This study evaluates the associations among the clustering of metabolic risk factors and moderate-to-vigorous physical activity (MVPA) in youth. METHODS: The sample comprised 522 girls and 402 boys (N = 924) aged 11 to 17 years. Height, weight, waist circumference (WC), fasting glucose, high-density lipoprotein cholesterol, triglycerides, and blood pressures were measured. Cardiorespiratory fitness (CRF) was assessed using the 20-m shuttle run test. MVPA was estimated with a 3-day diary. Outcome variables were statistically normalized and expressed as z scores. A clustered metabolic risk score was computed as the mean of z scores. Multiple linear regression was used to test associations between metabolic risk and MVPA by sex, adjusted for age, WC, and CRF. RESULTS: After adjustment for potential confounders, MVPA was inversely associated with the clustering of metabolic risk factors in girls, but not in boys; in addition, after adjusting for WC, the statistical model of that relationship was substantially improved in girls. CONCLUSION: MVPA was independently associated with increased risk of MetS in girls. Additional efforts are needed to encourage research with different analytical approach and standardization of criteria for MetS in youth.

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OBJECTIVE: To verify if functional fitness (FF) is associated with the annual cost of medication consumption and mood states (MSt) in elderly people. METHODS: A cross-sectional study with 229 elderly people aged 65 years or more at Santa Casa de Misericórdia de Coimbra, Portugal. Seniors with physical and psychological limitations were excluded, as well as those using medication that limits performance on the tests. The Senior Fitness Test was used to evaluate FF, and the Profile of Mood States - Short Form to evaluate the MSt. The statistical analysis was based on Mancova, with adjustment for age, for comparison between men and women, and adjustment for sex, for comparison between cardiorespiratory fitness quintiles. The association between the variables under study was made with partial correlation, controlling for the effects of age, sex and body mass index. RESULTS: An inverse correlation between cardiorespiratory fitness and the annual cost of medication consumption was found (p < 0.01). FF is also inversely associated with MSt (p < 0.05). Comparisons between cardiorespiratory fitness quintiles showed higher medication consumption costs in seniors with lower aerobic endurance, as well as higher deterioration in MSt (p < 0.01). CONCLUSION: Elderly people with better FF and, specifically, better cardiorespiratory fitness present lower medication consumption costs and a more positive MSt.

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Objective: to verify if functional fitness (FF) is associated with the annual cost of medication consumption and mood states (MSt) in elderly people. Methods: a cross-sectional study with 229 elderly people aged 65 years or more at Santa Casa de Misericórdia de Coimbra, Portugal. Seniors with physical and psychological limitations were excluded, as well as those using medication that limits performance on the tests. The Senior Fitness Test was used to evaluate FF, and the Profile of Mood States - Short Form to evaluate the MSt. The statistical analysis was based on Mancova, with adjustment for age, for comparison between men and women, and adjustment for sex, for comparison between cardiorespiratory fitness quintiles. The association between the variables under study was made with partial correlation, controlling for the effects of age, sex and body mass index. Results: an inverse correlation between cardiorespiratory fitness and the annual cost of medication consumption was found (p < 0.01). FF is also inversely associated with MSt (p < 0.05). Comparisons between cardiorespiratory fitness quintiles showed higher medication consumption costs in seniors with lower aerobic endurance, as well as higher deterioration in MSt (p < 0.01). Conclusion: elderly people with better FF and, specifically, better cardiorespiratory fitness present lower medication consumption costs and a more positive MSt. .

Objetivo: verificar se a aptidão física funcional (AFF) tem associação com o custo anual de consumo de medicamentos e com os estados de humor (EH) em pessoas idosas. Métodos: estudo transversal com 229 idosos de 65 anos de idade ou mais da Instituição Santa Casa de Misericórdia de Coimbra, Portugal. Foram excluídos os idosos com limitações físicas e psicológicas e os que usavam medicamentos que condicionariam a realização dos testes. Foram utilizados a bateria Senior Fitness Test e o questionário Profile of Mood States - Short Form como instrumentos de coleta de dados. A análise estatística recorreu à Mancova, com ajuste de idade, para comparação entre homens e mulheres, e ajustada também para o sexo, para comparação entre quintis da aptidão cardiorrespiratória. A associação entre as variáveis de interesse foi feita com a correlação parcial, corrigindo o efeito da idade, do sexo e do índice de massa corpórea. Resultados: verificou-se a existência de correlação inversa entre a aptidão cardiorrespiratória e o custo anual de consumo de medicamentos (p < 0,01). A AFF associou-se também inversamente com os EH (p < 0,05). As comparações entre os quintis da aptidão cardiorrespiratória revelaram maior consumo de medicamentos em idosos com menor resistência aeróbia, assim como maior deterioração dos EH (p < 0,01). Conclusão: idosos com melhor AFF e, particularmente, melhor aptidão cardiorrespiratória apresentam menores custos com consumo de medicamentos e EH mais positivos. .

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BACKGROUND: Although the prevalence of metabolic syndrome (MetS) has increased in youth, the potential independent contribution of cardiorespiratory fitness (CRF) to the clustering of metabolic risk factors has received relatively little attention. AIM: This study evaluated associations between the clustering of metabolic risk factors and CRF in a sample of youth. SUBJECTS AND METHODS: Height, weight, BMI, fasting glucose, insulin, HDL-cholesterol, triglycerides and blood pressures were measured in a cross-sectional sample of 924 youth (402 males, 522 females) of 11-17 years. CRF was assessed using the 20-metre shuttle run test. Physical activity (PA) was measured with a 3-day diary. Outcome variables were statistically normalized and expressed as Z-scores. A MetS risk score was computed as the mean of the Z-scores. Multiple linear regression was used to test associations between CRF and metabolic risk, adjusted for age, sex, BMI, PA and parental education. RESULTS: CRF was inversely associated with MetS after adjustment for potential confounders. After adjusting for BMI, the relationship between CRF and metabolic risk has substantially improved. CONCLUSION: CRF was independently associated with the clustering of metabolic risk factors in youth of 11-17 years of age.

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