Top Things to Know: Cardiorespiratory Fitness in Youth
Published: July 20, 2020
- Incorporation of cardiorespiratory fitness (CRF) measurements periodically in all youth in office and field settings can help identify those who are at increased risk of premature cardiovascular disease.
- Optimal cardiorespiratory fitness (CRF), currently met by only 40 percent of US youth, is an important marker of physical wellness, mental health and academic achievement.
- Inherited factors, such as individual response to physical training, influence CRF, but, specific genes that explain observed variances in CRF have not yet been elucidated.
- Racial/ethnic differences in CRF show associations with extrinsic factors such as lifestyle, cardiovascular disease (CVD) risk factors, and socioeconomic status.
- Physical activity (PA), especially vigorous activity, influences CRF in youth via adaptations in the oxygen transport system. However, there is little evidence to suggest that sedentary behavior is related to CRF in youth, once adjusted for objectively measured PA.
- The most accurate measure of CRF in youth is gas-analyzed peak oxygen uptake during a cardiopulmonary exercise test. The 20-meter shuttle run test is the best field-based measure. Step tests can be a good alternative when space is limited.
- In youth, optimal CRF is protective for metabolic syndrome, type 2 diabetes-mellitus, nonalcoholic fatty liver disease, and other cardiometabolic conditions and is associated with better cognitive function, self-worth, and life satisfaction.
- Office-based CRF testing is objective, feasible to perform without formal training using low-cost equipment, and is superior to PA recall for predicting health outcomes.
- As part of a yearly physical, CRF testing may identify youth missed by PA recall, anthropometric, or CVD risk factor measures. CRF test results should be shared between schools and clinicians.
- Public health measures and school policies that support repeated bursts of vigorous PA, including high-intensity interval training known to improve CRF in youth, are expected to result in physical, mental health, and cognitive benefits.
Citation
Raghuveer G, Hartz J, Lubans DR, Takken T, Wiltz JL, Mietus-Snyder M, Perak AM, Baker-Smith C, Pietris N, Edwards NM; on behalf of the American Heart Association Young Hearts Athero, Hypertension and Obesity in the Young Committee of the Council on Lifelong Congenital Heart Disease and Heart Health in the Young. Cardiorespiratory fitness in youth: an important marker of health: a scientific statement from the American Heart Association published online ahead of print July 20, 2020. Circulation. doi: 10.1161/CIR.0000000000000866.