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Updated: Jan 3, 2026
Assessment of Child Anthropometry in a Large Epidemiologic Study
Published on: February 2, 2017
Fitness and Fatness Are Both Associated with Cardiometabolic Risk in Preadolescents
Lee Stoner1, Herman Pontzer2, Bethany Barone Gibbs3
1Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC.
Insights
Cardiorespiratory fitness (CRF) and fatness impact different aspects of children's cardiometabolic risk. High CRF can reduce the negative effects of excess weight on health.
Area of Science:
- Pediatric Health
- Cardiovascular Health
- Metabolic Health
Background:
- Cardiorespiratory fitness (CRF) and fatness (overweight-obesity) are crucial health indicators in children.
- Understanding their independent and combined effects on cardiometabolic disease risk is vital for early intervention.
- Preadolescent children represent a key developmental stage for establishing lifelong health patterns.
Purpose of the Study:
- To investigate the associations between cardiorespiratory fitness (CRF) and fatness with cardiometabolic disease risk factors in preadolescent children.
- To identify specific components of cardiometabolic risk influenced by CRF and fatness.
- To examine potential interactions between CRF and fatness in relation to overall cardiometabolic risk.
Main Methods:
- Cross-sectional study of 392 children aged 8-10 years.
- Classification of overweight-obesity using WHO criteria; categorization of high CRF based on shuttle run test performance.
- Factor analysis to identify underlying cardiometabolic risk factors, followed by analysis of covariance to determine associations.
Main Results:
- Factor analysis identified four key risk components: blood pressure, cholesterol, vascular health, and carbohydrate metabolism.
- CRF was significantly associated with the blood pressure factor (P=.001).
- Fatness was associated with vascular health (P=.010) and carbohydrate metabolism (P=.005) factors. Crucially, high CRF mitigated cardiometabolic risk in overweight-obese children (P=.006), while high fatness increased risk in less fit children (P<.001).
Conclusions:
- CRF and fatness independently influence distinct aspects of cardiometabolic disease risk in preadolescent children.
- High cardiorespiratory fitness may act as a protective factor, moderating the adverse relationship between fatness and cardiometabolic health.
- These findings highlight the importance of promoting both fitness and healthy weight in childhood to prevent future cardiovascular and metabolic diseases.
Objective:
To determine the associations between cardiorespiratory fitness (CRF) and fatness (overweight-obesity) with cardiometabolic disease risk among preadolescent children.
Study Design:
This cross-sectional study recruited 392 children (50% female, 8-10 years of age). Overweight-obesity was classified according to 2007 World Health Organization criteria for body mass index. High CRF was categorized as a maximum oxygen uptake, determined using a shuttle run test, exceeding 35 mL·kg-1·minute-1 in girls and 42 mL·kg-1·minute-1 in boys. Eleven traditional and novel cardiometabolic risk factors were measured including lipids, glucose, glycated hemoglobin, peripheral and central blood pressure, and arterial wave reflection. Factor analysis identified underlying cardiometabolic disease risk factors and a cardiometabolic disease risk summary score. Two-way analysis of covariance determined the associations between CRF and fatness with cardiometabolic disease risk factors.
Results:
Factor analysis revealed four underlying factors: blood pressure, cholesterol, vascular health, and carbohydrate-metabolism. Only CRF was significantly (P = .001) associated with the blood pressure factor. Only fatness associated with vascular health (P = .010) and carbohydrate metabolism (P = .005) factors. For the cardiometabolic disease risk summary score, there was an interaction effect. High CRF was associated with decreased cardiometabolic disease risk in overweight-obese but not normal weight children (P = .006). Conversely, high fatness was associated with increased cardiometabolic disease risk in low fit but not high fit children (P < .001).
Conclusions:
In preadolescent children, CRF and fatness explain different components of cardiometabolic disease risk. However, high CRF may moderate the relationship between fatness and cardiometabolic disease risk.
Trial Registration:
ACTRN 12614000433606.
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