The purpose of this study was to analyze the relationships between physical activity (ACT), including sports participation (SP) and antecedent risk factors for coronary heart disease (CHD), in a representative sample of adolescents from Northern Ireland, a region of high coronary mortality. Biological and behavioral risk factors were measured in a random sample of 1015 school children aged 12 and 15 yr. ACT and SP were assessed by self-report questionnaire, and relationships with biological risk factors were analyzed with stepwise multiple linear regression after controlling for potential confounders. Results showed that in 15-yr-old males ACT was beneficially associated with systolic blood pressure (P < 0.05), lipid profile, and cardiorespiratory fitness (both P < 0.01). In 15-yr-old females, SP was associated beneficially with fatness and cardiorespiratory fitness. Odds ratios calculated from logistic regression revealed that for the older children, a relatively small drop (-20%) in ACT (boys) or SP (girls) was significantly related to the probability of exposure to multiple risk factors. Overall, relationships were stronger for males rather than females and for older rather than younger children. This study provides further evidence for beneficial associations between ACT, SP, and CHD risk status in adolescents.