Abstract
Objectives1. to investigate whether 20 m multi-stage shuttle run performance (20mSRT), an indirect measure of aerobic fitness, could discriminate between healthy and overweight status in 9–10.9 yr old schoolchildren using Receiver Operating Characteristic (ROC) analysis; 2. Investigate if cardiometabolic risk differed by aerobic fitness group by applying the ROC cut point to a second, cross-sectional cohort.DesignAnalysis of cross-sectional data.Participants16,619 9–10.9 year old participants from SportsLinx project and 300 11–13.9 year old participants from the Welsh Schools Health and Fitness Study.Outcome MeasuresSportsLinx; 20mSRT, body mass index (BMI), waist circumference, subscapular and superilliac skinfold thicknesses. Welsh Schools Health and Fitness Study; 20mSRT performance, waist circumference, and clustered cardiometabolic risk.AnalysesThree ROC curve analyses were completed, each using 20mSRT performance with ROC curve 1 related to BMI, curve 2 was related to waist circumference and 3 was related to skinfolds (estimated % body fat). These were repeated for both girls and boys. The mean of the three aerobic fitness thresholds was retained for analysis. The thresholds were subsequently applied to clustered cardiometabolic risk data from the Welsh Schools study to assess whether risk differed by aerobic fitness group.ResultsThe diagnostic accuracy of the ROC generated thresholds was higher than would be expected by chance (all models AUC >0.7). The mean thresholds were 33 and 25 shuttles for boys and girls respectively. Participants classified as ‘fit’ had significantly lower cardiometabolic risk scores in comparison to those classed as unfit (p<0.001).ConclusionThe use of the ROC generated cut points by health professionals, teachers and coaches may provide the opportunity to apply population level ‘risk identification and stratification’ processes and plan for “at-risk” children to be referred onto intervention services.
Highlights
The combination of excessive adiposity and poor aerobic fitness confers significant disease risk to youth [1]
The diagnostic accuracy of the Receiver Operating Characteristic (ROC) generated thresholds was higher than would be expected by chance
The use of the ROC generated cut points by health professionals, teachers and coaches may provide the opportunity to apply population level ‘risk identification and stratification’ processes and plan for ‘‘at-risk’’ children to be referred onto intervention services
Summary
The combination of excessive adiposity and poor aerobic fitness confers significant disease risk to youth [1]. Thresholds for directly assessed aerobic fitness related to cardiometabolic risk were recently published using data from the European Youth Heart Study (EYHS) [8]. The generated cut points (37.0 mL/kg/min and 42.1 mL/kg/min for 9–10 yr old girls and boys respectively) are extremely valuable for researchers that conduct direct assessments of aerobic fitness with children. The authors suggested that aerobic fitness represented an accurate method of identifying children at increased cardiometabolic risk. Another recent study developed aerobic fitness standards for detecting risk of the metabolic syndrome using data from the National Health and Nutrition Examination Survey [5]. The resultant ROC generated thresholds for low risk ranged from 40–44 mL/kg/min for boys and 38–40 mL/kg/ min for girls [5]
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