Defining Optimal Cut-Points for Cardiorespiratory Fitness Associated With Overweight/Obesity in Children: A School-Based Study.

Mario Kasović,Vesna Štemberger,Lovro Štefan,Vilko Petrić,Iva Blažević

doi:10.3389/fphys.2022.784787

Abstract

The main purpose of the study was to define optimal criterion-referenced cut-points for cardiorespiratory fitness (CRF) associated with overweight/obesity. In this cross-sectional study, participants were 1,612 children aged 7–14 years (mean age ± SD = 9.7 ± 2.4 years; 52.5% girls). CRF was assessed by the Maximal multistage 20-m shuttle run test, from which maximal oxygen uptake (VO2max) was estimated. Anthropometric indices included body-mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR). Receiver operating characteristic (ROC) curves were performed to determine cut-off points. In boys, the optimal cut-off points of CRF in defining overweight/obesity for BMI, WC, and WHtR were 44.6, 46.4, and 46.9 mlO2/kg/min. The areas under the curves (AUC) were 0.83 (95% CI 0.78–0.88, p < 0.001), 0.77 (95% CI 0.71–0.83, p < 0.001), and 0.90 (95% CI 0.86–0.93, p < 0.001). In girls, the optimal cut-off points were 41.0, 40.8, and 40.7 mlO2/kg/min for BMI, WC, and WHtR, with the AUCs of 0.86 (95% CI 0.82–0.90, p < 0.001), 0.83 (95% CI 0.79–0.88), and 0.88 (95% CI 0.84–0.93, p < 0.001). In conclusion, our newly developed cut-off points for CRF assessed by the Maximal multistage 20-m shuttle run test may adequately detect primary school-aged boys and girls with general and abdominal obesity.

Highlights

Childhood overweight and obesity have become a major public health concern worldwide [NCD Risk Factor Collaboration (NCD-RisC), 2017], and rising trends have been observed in both developed (Gomes et al, 2014) and less developed countries (Gupta et al, 2012)
Because of low-cost and simple to measure characteristics, these indicators of general and abdominal obesity are often recommended to be used in epidemiological studies
It could be concluded that VO2max estimated from the Maximal multistage 20-m shuttle run test accurately identified overweight/obesity in Croatian children aged 7–14 years

Summary

Introduction

Childhood overweight and obesity have become a major public health concern worldwide [NCD Risk Factor Collaboration (NCD-RisC), 2017], and rising trends have been observed in both developed (Gomes et al, 2014) and less developed countries (Gupta et al, 2012). Estimates suggest that the prevalence of overweight and obesity is between 20 and 45% in European children (Garrido-Miguel et al, 2019). According to the World Health Organization (2017), the rising proportion of overweight and obese children continued to increase in most European. Cardiorespiratory Fitness and Overweight/Obesity countries, with the highest prevalence in southern European and Mediterranean countries. Being overweight or obese in childhood leads to health-related consequences later in life, including premature mortality (Lindberg et al, 2020), higher prevalence of cardiovascular and metabolic diseases (Reilly and Kelly, 2011), and lower levels of cardiorespiratory fitness (CRF) during adolescence (Tuan et al, 2018). To measure overweight/obesity, several anthropometric indices have been proposed and validated (Santos et al, 2012), including body-mass index (BMI), waist circumference (WC), and waistto-height ratio (WHtR). Because of low-cost and simple to measure characteristics, these indicators of general and abdominal obesity are often recommended to be used in epidemiological studies

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