Cardiorespiratory fitness in children: Evidence for criterion-referenced cut-points

PLoS One. 2018 Aug 1;13(8):e0201048. doi: 10.1371/journal.pone.0201048. eCollection 2018.


Introduction: Criterion-referenced cut-points for field-based cardiorespiratory fitness for children (CRF) are lacking. This study determined: (a) the association between CRF and obesity, (b) the optimal cut-points for low CRF associated with obesity in children, and (c) the association between obesity and peak oxygen uptake ([Formula: see text]) estimated from the 20-m shuttle run test using two different prediction equations.

Methods: A total of 8,740 children aged 10.1±1.2 were recruited from 11 sites across Canada. CRF was assessed using 20mSRT reported as running speed at the last completed stage, number of completed laps and predicted [Formula: see text], which was estimated at the age by sex level using the Léger et al. and FitnessGram equations. Body mass index and waist circumference z-scores were used to identify obesity. Receiver operating characteristic (ROC) curves and logistic regression determined the discriminatory ability of CRF for predicting obesity.

Results: 20mSRT had satisfactory predictive ability to detect obesity estimated by BMI, WC, and BMI and WC combined (area under the curve [AUC]>0.65). The FitnessGram equation (AUC>0.71) presented somewhat higher discriminatory power for obesity than the equation of Léger et al. (AUC>0.67) at most ages. Sensitivity was strong (>70%) for all age- and sex-specific cut-points, with optimal cut-points in 8- to 12-year-olds for obesity identified as 39 mL•kg-1•min-1 (laps: 15; speed: 9.0 km/h) and 41 mL•kg-1•min-1 (laps: 15-17; speed: 9.0 km/h) for girls and boys, respectively.

Conclusions: 20mSRT performance is negatively associated with obesity and CRF cut-points from ROC analyses have good discriminatory power for obesity.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Body Mass Index
  • Cardiorespiratory Fitness*
  • Child
  • Exercise Test
  • Female
  • Humans
  • Male
  • Obesity / diagnosis*
  • Obesity / physiopathology
  • Oxygen Consumption
  • Sensitivity and Specificity
  • Waist Circumference

Grants and funding

The funds for this study were provided by ParticipACTION, a Canadian charitable not-for-profit organization. ParticipACTION received funding for a much larger project (Learn to Play) from RBC (Royal Bank of Canada) and the Public Health Agency of Canada (PHAC, federal government). We were contracted by ParticipACTION to do the surveillance portion of the Learn to Play project. We received our funds from, and have our contract with, ParticipACTION. The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.