Relationship of physical activity, fitness, and fatness with clustered metabolic risk in children and adolescents: the European youth heart study.

OBJECTIVES: To examine the associations of physical activity (PA) at different levels and intensities and cardiorespiratory fitness (CRF) with a clustering of metabolic risk factors in children and adolescents with special consideration of body fat.

STUDY DESIGN: Total PA and intensity levels were measured by accelerometry in children (9 years, n = 273) and adolescents (15 years, n = 256). CRF was measured with a maximal ergometer bike test. Measured outcomes included fasting insulin, glucose, triglycerides, total and high-density lipoprotein cholesterol, blood pressure, and body fat. A metabolic risk score (MRS) was computed as the mean of the standardized outcome scores. A "non-obesity-MRS" was computed omitting body fat from the MRS. Analysis of variance and multiple regressions were used in the analysis.

RESULTS: Total and vigorous PA was inversely significantly associated with MRS in adolescent girls, the group with lowest PA, becoming insignificant when CRF was introduced in the analysis. Significant regression coefficients of total PA and CRF on non-obesity-MRS diminished when body fat was entered in the analysis.

CONCLUSIONS: CRF is more strongly correlated to metabolic risk than total PA, whereas body fat appears to have a pivotal role in the association of CRF with metabolic risk.