Why the greatest benefits to cardiorespiratory fitness come from sustained physical activities like running walking and cycling?

1. Ross R, Blair SN, Arena R, Church TS, Després J-P, Franklin BA, Haskell WL, Kaminsky LA, Levine BD, Lavie CJ, Myers J, Niebauer J, Sallis R, Sawada SS, Sui X, Wisløff U, American Heart Association Physical Activity Committee of the Council on L, Cardiometabolic H, Council on Clinical C, Council on E, Prevention, Council on C, Stroke N, Council on Functional G, Translational B and Stroke C. Importance of Assessing Cardiorespiratory Fitness in Clinical Practice: A Case for Fitness as a Clinical Vital Sign: A Scientific Statement From the American Heart Association. Circulation. 2016;134:e653–e699. [PubMed] [Google Scholar]

2. Caspersen CJ, Powell KE and Christenson GM. Physical activity, exercise, and physical fitness: definitions and distinctions for health-related research. Public Health Reports (Washington, DC: 1974). 1985;100:126–31. [PMC free article] [PubMed] [Google Scholar]

3. Lang JJ, Belanger K, Poitras V, Janssen I, Tomkinson GR and Tremblay MS. Systematic review of the relationship between 20m shuttle run performance and health indicators among children and youth. J Sci Med Sport. 2018;21:383–397. [PubMed] [Google Scholar]

4. Ortega FB, Ruiz JR, Castillo MJ and Sjostrom M. Physical fitness in childhood and adolescence: a powerful marker of health. International Journal of Obesity (London). 2008;32:1–11. [PubMed] [Google Scholar]

5. Hogstrom G, Nordstrom A and Nordstrom P. High aerobic fitness in late adolescence is associated with a reduced risk of myocardial infarction later in life: a nationwide cohort study in men. Eur Heart J. 2014;35:3133–40. [PubMed] [Google Scholar]

6. Santana CCA, Azevedo LB, Cattuzzo MT, Hill JO, Andrade LP and Prado WL. Physical fitness and academic performance in youth: A systematic review. Scand J Med Sci Sports. 2017;27:579–603. [PubMed] [Google Scholar]

7. Lubans D, Richards J, Hillman C, Faulkner G, Beauchamp M, Nilsson M, Kelly P, Smith J, Raine L and Biddle S. Physical Activity for Cognitive and Mental Health in Youth: A Systematic Review of Mechanisms. Pediatrics. 2016;138. [PubMed] [Google Scholar]

8. Gahche J, Fakhouri T, Carroll DD, Burt VL, Wang CY and Fulton JE. Cardiorespiratory fitness levels among U.S. youth aged 12–15 years: United States, 1999–2004 and 2012. NCHS Data Brief. 2014:1–8. [PubMed] [Google Scholar]

9. Tomkinson GR, Lang JJ and Tremblay MS. Temporal trends in the cardiorespiratory fitness of children and adolescents representing 19 high-income and upper middle-income countries between 1981 and 2014. British Journal of Sports Medicine. 2019;53:478–486. [PubMed] [Google Scholar]

10. Moraes Ferrari GL, Bracco MM, Matsudo VK and Fisberg M. Cardiorespiratory fitness and nutritional status of schoolchildren: 30-year evolution. J Pediatr (Rio J). 2013;89:366–73. [PubMed] [Google Scholar]

11. Tomkinson GR and Olds TS. Secular changes in pediatric aerobic fitness test performance: the global picture. Med Sport Sci. 2007;50:46–66. [PubMed] [Google Scholar]

12. Prince SA, Adamo KB, Hamel ME, Hardt J, Connor Gorber S and Tremblay M. A comparison of direct versus self-report measures for assessing physical activity in adults: a systematic review. International Journal of Behavioral Nutrition and Physical Activity 2008;5. [PMC free article] [PubMed] [Google Scholar]

13. Longmuir PE, Brothers JA, de Ferranti SD, Hayman LL, Van Hare GF, Matherne GP, Davis CK, Joy EA and McCrindle BW. Promotion of physical activity for children and adults with congenital heart disease: a scientific statement from the American Heart Association. Circulation. 2013;127:2147–59. [PubMed] [Google Scholar]

14. 2018 Physical Activity Guidelines Advisory Committee. 2018 Physical Activity Guidelines Advisory Committee Scientific Report. Washington, DC: U.S. Department of Health and Human Services, 2018. [Google Scholar]

15. Committee on Fitness Measures and Health Outcomes in Youth; Food and Nutrition Board, Fitness Measures and Health Outcomes in Youth. 2012.

16. Norton K, Norton L and Sadgrove D. Position statement on physical activity and exercise intensity terminology. Journal of Science and Medicine in Sport. 2010;13:496–502. [PubMed] [Google Scholar]

17. Butte NF, Watson KB, Ridley K, Zakeri IF, McMurray RG, Pfeiffer KA, Crouter SE, Herrmann SD, Bassett DR, Long A, Berhane Z, Trost SG, Ainsworth BE, Berrigan D and Fulton JE. A Youth Compendium of Physical Activities: Activity Codes and Metabolic Intensities. Med Sci Sports Exerc. 2018;50:246–256. [PMC free article] [PubMed] [Google Scholar]

18. Eather N, Ridley K and Leahy A. Physiological health benefits of physical activity for young people In: Brusseau T, Fairclough S and Lubans DR, eds. The Routledge Handbook of Physical Activity for Youth Oxon, UK: Routledge; 2020: 103–120. [Google Scholar]

19. Malina RM, Bouchard C and Bar-Or O. Growth, Maturation, and Physical Activity: Human kinetics; 2004. [Google Scholar]

20. McArdle WD, Katch FI and Katch VI. Exercise physiology: energy, nutrition and human performance. Baltimore, MA: Lipponcott Williams & Wilkins; 2015. [Google Scholar]

21. Armstrong N and Barker AR. Endurance training and elite young athletes. Medicine and Sport Sciences. 2011;56:59–83. [PubMed] [Google Scholar]

22. Rowland T, Unnithan V, Fernhall B, Baynard T and Lange C. Left ventricular response to dynamic exercise in young cyclists. Med Sci Sports Exerc. 2002;34:637–642. [PubMed] [Google Scholar]

23. Nottin S, Vinet A, Stecken F, N’Guyen LD, Ounissi F, Lecoq AM and Obert P. Central and peripheral cardiovascular adaptations to exercise in endurance-trained children. Acta Physiol Scand. 2002;175:85–92. [PubMed] [Google Scholar]

24. Rowland T, Wehnert M and Miller K. Cardiac responses to exercise in competitive child cyclists. Medicine and Science in Sports and Exercise. 2000;32:747–752. [PubMed] [Google Scholar]

25. Rowland TW, Unnithan VB, MacFarlane NG, Gibson NG and Paton JY. Clinical manifestations of the ‘athlete’s heart’ in prepubertal male runners. Int J Sports Med. 1994;15:515–519. [PubMed] [Google Scholar]

26. Tomkinson GR, Leger LA, Olds TS and Cazorla G. Secular trends in the performance of children and adolescents (1980–2000): an analysis of 55 studies of the 20m shuttle run test in 11 countries. Sports Medicine (Auckland, NZ). 2003;33:285–300. [PubMed] [Google Scholar]

27. Tomkinson GR, Lang JJ, Tremblay MS, Dale M, LeBlanc AG, Belanger K, Ortega FB and Leger L. International normative 20 m shuttle run values from 1 142 026 children and youth representing 50 countries. Br J Sports Med. 2017;51:1545–1554. [PubMed] [Google Scholar]

28. Takken T, Mylius CF, Paap D, Broeders W, Hulzebos HJ, Van Brussel M and Bongers BC. Reference values for cardiopulmonary exercise testing in healthy subjects - an updated systematic review. Expert Rev Cardiovasc Ther. 2019;17:413–426. [PubMed] [Google Scholar]

29. Plowman SA and Meredith MD. Fitnessgram/Activitygram Reference Guide (4th Edition). Dallas, TX: The Cooper Institute; 2013. [Google Scholar]

30. Fick A Ueber die Messung des Blutquantums in den Herzventrikeln. Wurzburg: Sitx. der Physik-Med. Ges.; 1870. [Google Scholar]

31. Shephard RJ, Allen C, Benade AJ, Davies CT, Di Prampero PE, Hedman R, Merriman JE, Myhre K and Simmons R. The maximum oxygen intake. An international reference standard of cardiorespiratory fitness. Bull World Health Organ. 1968;38:757–764. [PMC free article] [PubMed] [Google Scholar]

32. Wold B, and Hendry L. Social and environmental factors associated with physical activity in young people In: Biddle S, Sallis J, and Cavill N, ed. Young People and Health-Enhancing Physical Activity: Evidence and Implications London: Health Education Authority; 1998: 119–132. [Google Scholar]

33. Rowland TW. Does peak VO2 reflect VO2max in children?: evidence from supramaximal testing. Medicine and Science in Sports and Exercise. 1993;25:689–693. [PubMed] [Google Scholar]

34. Armstrong N, Welsman J and Winsley R. Is peak VO2 a maximal index of children’s aerobic fitness? Int J Sports Med. 1996;17:356–9. [PubMed] [Google Scholar]

35. Hansen AW, Marinus N, Remans M, Courtois I, Cools F, Calsius J, Massa G and Takken T. Exercise tolerance in obese vs. lean adolescents: a systematic review and meta-analysis. Obes Rev. 2014;15:894–904. [PubMed] [Google Scholar]

36. Werneck AO, Conde J, Coelho ESMJ, Pereira A, Costa DC, Martinho D, Duarte JP, Valente-Dos-Santos J, Fernandes RA, Batista MB, Ohara D, Cyrino ES and Ronque ERV. Allometric scaling of aerobic fitness outputs in school-aged pubertal girls. BMC Pediatr. 2019;19:96. [PMC free article] [PubMed] [Google Scholar]

37. Cooper DM. Rethinking exercise testing in children: a challenge. Am J Respir Crit Care Med. 1995;152:1154–7. [PubMed] [Google Scholar]

38. Batista MB, Romanzini CLP, Castro-Pinero J and Ronque ERV. Validity of Field Tests to Estimate Cardiorespiratory Fitness in Children and Adolescents: A Systematic Review. Rev Paul Pediatr. 2017;35:222–233. [PMC free article] [PubMed] [Google Scholar]

39. Léger LA, Mercier D, Gadoury C and Lambert J. The multistage 20 metre shuttle run test for aerobic fitness. J Sports Sci. 1988;6:93–101. [PubMed] [Google Scholar]

40. Léger L, Lambert J, Goulet A, Rowan C and Dinelle Y. Aerobic capacity of 6 to 17-year-old Quebecois--20 meter shuttle run test with 1 minute stages. Can J Appl Sport Sci. 1984;9:64–69. [PubMed] [Google Scholar]

41. Tomkinson GR, Lang JJ, Blanchard J, Leger LA and Tremblay MS. The 20-m Shuttle Run: Assessment and Interpretation of Data in Relation to Youth Aerobic Fitness and Health. Pediatr Exerc Sci. 2019;31:1–12. [PubMed] [Google Scholar]

42. Ruiz JR, Silva G, Oliveira N, Ribeiro JC, Oliveira JF and Mota J. Criterion-related validity of the 20-m shuttle run test in youths aged 13–19 years. J Sports Sci. 2009;27:899–906. [PubMed] [Google Scholar]

43. Castro-Pinero J, Espana-Romero V, Ortega FB, Sjostrom M, Suni J and Ruiz JR. Criterion-related validity of field-based fitness tests in youth: a systematic review. Br J Sports Med. 2010;44:934–43. [PubMed] [Google Scholar]

44. Mayorga-Vega D, Bocanegra-Parrilla R, Ornelas M and Viciana J. Criterion-Related Validity of the Distance- and Time-Based Walk/Run Field Tests for Estimating Cardiorespiratory Fitness: A Systematic Review and Meta-Analysis. PLoS One. 2016;11. [PMC free article] [PubMed] [Google Scholar]

45. Welk GJ, De Saint-Maurice Maduro PF, Laurson KR and Brown DD. Field evaluation of the new FITNESSGRAM(R) criterion-referenced standards. Am J Prev Med. 2011;41:S131–42. [PubMed] [Google Scholar]

46. Mayorga-Vega D, Aguilar-Soto P and Viciana J. Criterion-Related Validity of the 20-M Shuttle Run Test for Estimating Cardiorespiratory Fitness: A Meta-Analysis. J Sports Sci Med. 2015;14:536–47. [PMC free article] [PubMed] [Google Scholar]

47. Ebbeling CB, Ward A, Puleo EM, Widrick J and Rippe JM. Development of a single-stage submaximal treadmill walking test. Med Sci Sports Exerc. 1991;23:966–73. [PubMed] [Google Scholar]

48. Nemeth BA, Carrel AL, Eickhoff J, Clark RR, Peterson SE and Allen DB. Submaximal treadmill test predicts VO2max in overweight children. J Pediatr. 2009;154:677–81. [PubMed] [Google Scholar]

49. Åstrand P-O and Ryhming I. A nomogram for calculation of aerobic capacity (physical fitness) from pulse rate during submaximal work. J Appl Physiol. 1954;7:218–221. [PubMed] [Google Scholar]

50. Woynarowska B The validity of indirect estimations of maximal oxygen uptake in children 11–12 years of age. European Journal of Applied Physio Occupied Physiology. 1980;43:19–23. [PubMed] [Google Scholar]

51. Bland J, Pfeiffer K and Eisenmann JC. The PWC170: comparison of different stage lengths in 11–16 year olds. Eur J Appl Physiol. 2012;112:1955–61. [PubMed] [Google Scholar]

52. Bartels B, de Groot JF and Terwee CB. The six-minute walk test in chronic pediatric conditions: a systematic review of measurement properties. Phys Ther. 2013;93:529–41. [PubMed] [Google Scholar]

53. Holland AE, Spruit MA, Troosters T, Puhan MA, Pepin V, Saey D, McCormack MC, Carlin BW, Sciurba FC, Pitta F, Wanger J, MacIntyre N, Kaminsky DA, Culver BH, Revill SM, Hernandes NA, Andrianopoulos V, Camillo CA, Mitchell KE, Lee AL, Hill CJ and Singh SJ. An official European Respiratory Society/American Thoracic Society technical standard: field walking tests in chronic respiratory disease. The European Respiratory Journal. 2014;44:1428–46. [PubMed] [Google Scholar]

54. Committee ATS on Proficiency Standards for Clinical Pulmonary Function Laboratories: guidelines for the six-minute walk test. Am J Respir Crit Care Med. 2002;166:111–7. [PubMed] [Google Scholar]

55. Mylius CF, Paap D and Takken T. Reference value for the 6-minute walk test in children and adolescents: a systematic review. Expert Rev Respir Med. 2016;10:1335–1352. [PubMed] [Google Scholar]

56. Lammers AE, Diller GP, Odendaal D, Tailor S, Derrick G and Haworth SG. Comparison of 6-min walk test distance and cardiopulmonary exercise test performnce in children with pulmonary hypertension. Arch Dis Child. 2011;96:141–147. [PubMed] [Google Scholar]

57. Takken T Six-minute walk test is a poor predictor of maximum oxygen uptake in children. Acta Paediatr. 2010;99:958; author reply 958–9. [PubMed] [Google Scholar]

58. Kasch FW. A comparison of the exercise tolerance of post-rheumatic and normal boys. J Assoc Phys Mental Rehabil. 1961;15:35–40. [Google Scholar]

59. Hayes RM, Maldonado D, Gossett T, Shepherd T, Mehta SP and Flesher SL. Developing and Validating a Step Test of Aerobic Fitness among Elementary School Children. Physiother Can. 2019;71:187–194. [PMC free article] [PubMed] [Google Scholar]

60. Francis K and Feinstein R. A simple height-specific and rate-specific step test for children. South Med J. 1991;84:169–74. [PubMed] [Google Scholar]

61. Ortega FB, Ruiz JR, Espana-Romero V, Vicente-Rodriguez G, Martinez-Gomez D, Manios Y, Beghin L, Molnar D, Widhalm K, Moreno LA, Sjostrom M and Castillo MJ. The International Fitness Scale (IFIS): usefulness of self-reported fitness in youth. Int J Epidemiol. 2011;40:701–711. [PubMed] [Google Scholar]

62. Ramirez-Velez R, Cruz-Salazar SM, Martinez M, Cadore EL, Alonso-Martinez AM, Correa-Bautista JE, Izquierdo M, Ortega FB and Garcia-Hermoso A. Construct validity and test-retest reliability of the International Fitness Scale (IFIS) in Colombian children and adolescents aged 9–17.9 years: the FUPRECOL study. PeerJ. 2017;5:e3351. [PMC free article] [PubMed] [Google Scholar]

63. Sarzynski MA, Ghosh S and Bouchard C. Genomic and transcriptomic predictors of response levels to endurance exercise training. The Journal of Physiology. 2017;595:2931–2939. [PMC free article] [PubMed] [Google Scholar]

64. Pfeiffer KA, Dowda M, Dishman RK, Sirard JR and Pate RR. Physical fitness and performance. Cardiorespiratory fitness in girls-change from middle to high school. Med Sci Sports Exerc. 2007;39:2234–41. [PubMed] [Google Scholar]

65. Howard EN, Frierson GM, Willis BL, Haskell WL, Powell-Wiley TM and Defina LF. The impact of race and higher socioeconomic status on cardiorespiratory fitness. Med Sci Sports Exerc. 2013;45:2286–91. [PMC free article] [PubMed] [Google Scholar]

66. Judice PB, Silva AM, Berria J, Petroski EL, Ekelund U and Sardinha LB. Sedentary patterns, physical activity and health-related physical fitness in youth: a cross-sectional study. Int J Behav Nutr Phys Act. 2017;14:25. [PMC free article] [PubMed] [Google Scholar]

67. Shikany JM, Jacobs DR Jr., Lewis CE, Steffen LM, Sternfeld B, Carnethon MR and Richman JS. Associations between food groups, dietary patterns, and cardiorespiratory fitness in the Coronary Artery Risk Development in Young Adults study. Am J Clin Nutr. 2013;98:1402–9. [PMC free article] [PubMed] [Google Scholar]

68. Mendelson M, Michallet AS, Tonini J, Favre-Juvin A, Guinot M, Wuyam B and Flore P. Low Cardiorespiratory Fitness is Partially Linked to Ventilatory Factors in Obese Adolescents. Pediatr Exerc Sci. 2016;28:87–97. [PubMed] [Google Scholar]

69. Ortega FB, Ruiz JR, Labayen I, Martinez-Gomez D, Vicente-Rodriguez G, Cuenca-Garcia M, Gracia-Marco L, Manios Y, Beghin L, Molnar D, Polito A, Widhalm K, Marcos A, Gonzalez-Gross M, Kafatos A, Breidenassel C, Moreno LA, Sjostrom M and Castillo MJ. Health inequalities in urban adolescents: role of physical activity, diet, and genetics. Pediatrics. 2014;133:e884–95. [PubMed] [Google Scholar]

70. Santos R, Mota J, Okely AD, Pratt M, Moreira C, Coelho-e-Silva MJ, Vale S and Sardinha LB. The independent associations of sedentary behaviour and physical activity on cardiorespiratory fitness. Br J Sports Med. 2014;48:1508–1512. [PubMed] [Google Scholar]

71. Hoehner CM, Handy SL, Yan Y, Blair SN and Berrigan D. Association between neighborhood walkability, cardiorespiratory fitness and body-mass index. Soc Sci Med. 2011;73:1707–16. [PMC free article] [PubMed] [Google Scholar]

72. Ombrellaro KJ, Perumal N, Zeiher J, Hoebel J, Ittermann T, Ewert R, Dorr M, Keil T, Mensink GBM and Finger JD. Socioeconomic Correlates and Determinants of Cardiorespiratory Fitness in the General Adult Population: a Systematic Review and Meta-Analysis. Sports Med Open. 2018;4:25. [PMC free article] [PubMed] [Google Scholar]

73. Bai Y, Saint-Maurice PF, Welk GJ, Allums-Featherston K and Candelaria N. Explaining Disparities in Youth Aerobic Fitness and Body Mass Index: Relative Impact of Socioeconomic and Minority Status. The Journal of School Health. 2016;86:787–793. [PubMed] [Google Scholar]

74. Bouchard C, Rankinen T and Timmons JA. Genomics and genetics in the biology of adaptation to exercise. Compr Physiol. 2011;1:1603–48. [PMC free article] [PubMed] [Google Scholar]

75. Williams CJ, Williams MG, Eynon N, Ashton KJ, Little JP, Wisloff U and Coombes JS. Genes to predict VO2max trainability: a systematic review. BMC Genomics. 2017;18:831. [PMC free article] [PubMed] [Google Scholar]

76. Bouchard C, An P, Rice T, Skinner JS, Wilmore JH, Gagnon J, Perusse L, Leon AS and Rao DC. Familial aggregation of VO(2max) response to exercise training: results from the HERITAGE Family Study. Journal of Applied Physiology (Bethesda, Md: 1985). 1999;87:1003–8. [PubMed] [Google Scholar]

77. Bouchard C, Sarzynski MA, Rice TK, Krause WE, Church TS, Sung YJ, Rao DC and Rankinen T. Genomic predictors of the maximal O(2) uptake response to standardized exercise training programs. J Appl Physiol. 1985;110:1160–1170. [PMC free article] [PubMed] [Google Scholar]

78. Venezia AC and Roth SM. Recent Research in the Genetics of Exercise Training Adaptation. Med Sport Sci. 2016;61:29–40. [PubMed] [Google Scholar]

79. Rankinen T, Fuku N, Wolfarth B, Wang G, Sarzynski MA, Alexeev DG, Ahmetov II, Boulay MR, Cieszczyk P, Eynon N, Filipenko ML, Garton FC, Generozov EV, Govorun VM, Houweling PJ, Kawahara T, Kostryukova ES, Kulemin NA, Larin AK, Maciejewska-Karlowska A, Miyachi M, Muniesa CA, Murakami H, Ospanova EA, Padmanabhan S, Pavlenko AV, Pyankova ON, Santiago C, Sawczuk M, Scott RA, Uyba VV, Yvert T, Perusse L, Ghosh S, Rauramaa R, North KN, Lucia A, Pitsiladis Y and Bouchard C. No Evidence of a Common DNA Variant Profile Specific to World Class Endurance Athletes. PLoS One. 2016;11:e0147330. [PMC free article] [PubMed] [Google Scholar]

80. Armstrong N and Welsman J. Development of peak oxygen uptake from 11–16 years determined using both treadmill and cycle ergometry. Eur J Appl Physiol. 2019;119:801–812. [PMC free article] [PubMed] [Google Scholar]

81. Catley MJ and Tomkinson GR. Normative health-related fitness values for children: analysis of 85347 test results on 9–17-year-old Australians since 1985. Br J Sports Med. 2013;47:98–108. [PubMed] [Google Scholar]

82. Ortega FB, Artero EG, Ruiz JR, Espana-Romero V, Jimenez-Pavon D, Vicente-Rodriguez G, Moreno LA, Manios Y, Beghin L, Ottevaere C, Ciarapica D, Sarri K, Dietrich S, Blair SN, Kersting M, Molnar D, Gonzalez-Gross M, Gutierrez A, Sjostrom M and Castillo MJ. Physical fitness levels among European adolescents: the HELENA study. Br J Sports Med. 2011;45:20–9. [PubMed] [Google Scholar]

83. Winsley RJ, Fulford J, Roberts AC, Welsman JR and Armstrong N. Sex difference in peak oxygen uptake in prepubertal children. J Sci Med Sport. 2009;12:647–51. [PubMed] [Google Scholar]

84. Tarnopolsky MA, Rennie CD, Robertshaw HA, Fedak-Tarnopolsky SN, Devries MC and Hamadeh MJ. Influence of endurance exercise training and sex on intramyocellular lipid and mitochondrial ultrastructure, substrate use, and mitochondrial enzyme activity. American Journal of Physiology Regulatory, Integrative and Comparative Physiology. 2007;292:R1271–8. [PubMed] [Google Scholar]

85. Swift DL, Johannsen NM, Earnest CP, Newton RL Jr., McGee JE and Church TS. Cardiorespiratory Fitness and Exercise Training in African Americans. Prog Cardiovasc Dis. 2017;60:96–102. [PubMed] [Google Scholar]

86. Ong KC, Loo CM, Ong YY, Chan SP, Earnest A and Saw SM. Predictive values for cardiopulmonary exercise testing in sedentary Chinese adults. Respirology. 2002;7:225–231. [PubMed] [Google Scholar]

87. Pandey A, Park BD, Ayers C, Das SR, Lakoski S, Matulevicius S, de Lemos JA and Berry JD. Determinants of Racial/Ethnic Differences in Cardiorespiratory Fitness (from the Dallas Heart Study). The American Journal of Cardiology. 2016;118:499–503. [PubMed] [Google Scholar]

88. Shaibi GQ, Ball GD and Goran MI. Aerobic fitness among Caucasian, African-American, and Latino youth. Ethn Dis. 2006;16:120–125. [PubMed] [Google Scholar]

89. Lang JJ, Tremblay MS, Leger L, Olds T and Tomkinson GR. International variability in 20 m shuttle run performance in children and youth: who are the fittest from a 50-country comparison? A systematic literature review with pooling of aggregate results. Br J Sports Med. 2018;52:276. [PubMed] [Google Scholar]

90. Bansal N, Mahadin DR, Smith R, French M, Karpawich PP and Aggarwal S. Comparative Cardiorespiratory Fitness in Children: Racial Disparity May Begin Early in Childhood. Pediatric Cardiology. 2019;40:1183–1189. [PubMed] [Google Scholar]

91. Ferreira I, Gbatu PT and Boreham CA. Gestational Age and Cardiorespiratory Fitness in Individuals Born At Term: A Life Course Study. Journal of the American Heart Association. 2017;6. [PMC free article] [PubMed] [Google Scholar]

92. Welsh L, Kirkby J, Lum S, Odendaal D, Marlow N, Derrick G and Stocks J. The EPICure study: maximal exercise and physical activity in school children born extremely preterm. Thorax. 2010;65:165–72. [PubMed] [Google Scholar]

93. Edwards MO, Kotecha SJ, Lowe J, Watkins WJ, Henderson AJ and Kotecha S. Effect of preterm birth on exercise capacity: A systematic review and meta-analysis. Pediatr Pulmonol. 2015;50:293–301. [PubMed] [Google Scholar]

94. Ruiz JR, Rizzo NS, Hurtig-Wennlöf A, Ortega FB, W àrnberg J and Sjöström M. Relations of total physical activity and intensity to fitness and fatness in children: the European Youth Heart Study. American Journal of Clinical Nutrition. 2006;84:299–303. [PubMed] [Google Scholar]

95. Gralla MH, McDonald SM, Breneman C, Beets MW and Moore JB. Associations of objectively measured vigorous physical activity with body composition, cardiorespiratory fitness, and cardiometabolic health in youth: a review. Am J Lifestyle Med. 2019;13:61–97. [PMC free article] [PubMed] [Google Scholar]

96. Hussey J, Bell C, Bennett K, O’Dwyer J and Gormley J. Relationship between the intensity of physical activity, inactivity, cardiorespiratory fitness and body composition in 7–10-year-old Dublin children. British Journal of Sports Medicine. 2007;41:311–316. [PMC free article] [PubMed] [Google Scholar]

97. Gutin B, Yin Z, Humphries MC and Barbeau P. Relations of moderate and vigorous physical activity to fitness and fatness in adolescents. The American Journal Of Clinical Nutrition. 2005;81:746–50. [PubMed] [Google Scholar]

98. Baquet G, van Praagh E and Berthoin S. Endurance training and aerobic fitness in young people. Sports Medicine (Auckland, NZ). 2003;33:1127–43. [PubMed] [Google Scholar]

99. Armstrong N, Tomkinson G and Ekelund U. Aerobic fitness and its relationship to sport, exercise training and habitual physical activity during youth. Br J Sports Med. 2011;45:849–858. [PubMed] [Google Scholar]

100. Costigan SA, Eather N, Plotnikoff RC, Taaffe DR and Lubans DR. High intensity interval training for improving health-related fitness in adolescents: a systematic review and meta-analysis. Br J Sports Med. 2015;49:1253–1261. [PubMed] [Google Scholar]

101. Janssen X, Mann KD, Basterfield L, Parkinson KN, Pearce MS, Reilly JK, Adamson AJ and Reilly JJ. Development of sedentary behavior across childhood and adolescence: longitudinal analysis of the Gateshead Millennium Study. Int J Behav Nutr Phys Act. 2016;13:88. [PMC free article] [PubMed] [Google Scholar]

102. Yang L, Cao C, Kantor ED, Nguyen LH, Zheng X, Park Y, Giovannucci EL, Matthews CE, Colditz GA and Cao Y. Trends in Sedentary Behavior Among the US Population, 2001–2016. JAMA. 2019;321:1587–1597. [PMC free article] [PubMed] [Google Scholar]

103. Young DR, Hivert MF, Alhassan S, Camhi SM, Ferguson JF, Katzmarzyk PT, Lewis CE, Owen N, Perry CK, Siddique J and Yong CM. Sedentary Behavior and Cardiovascular Morbidity and Mortality: A Science Advisory From the American Heart Association. Circulation. 2016;134:e262–79. [PubMed] [Google Scholar]

104. Ekelund U, Steene-Johannessen J, Brown WJ, Fagerland MW, Owen N and Powell KE. Does physical activity attenuate, or even eliminate, the detrimental association of sitting time with mortality? A harmonised meta-analysis of data from more than 1 million men and women. The Lancet. 2016;388:1302–1310. [PubMed] [Google Scholar]

105. Aggio D, Ogunleye AA, Voss C and Sandercock GR. Temporal relationships between screen-time and physical activity with cardiorespiratory fitness in English schoolchildren: a 2-year longitudinal study. Prev Med. 2012;55:37–9. [PubMed] [Google Scholar]

106. Martinez-Gomez D, Ortega FB, Ruiz JR, Vicente-Rodriguez G, Veiga OL, Widhalm K, Manios Y, Beghin L, Valtuena J, Kafatos A, Molnar D, Moreno LA, Marcos A, Castillo MJ and Sjostrom M. Excessive sedentary time and low cardiorespiratory fitness in European adolescents: the HELENA study. Arch Dis Child. 2011;96:240–6. [PubMed] [Google Scholar]

107. Grund A, Krause H, Siewers M, Rieckert H and Muller MJ. Is TV viewing an index of physical activity and fitness in overweight and normal weight children? Public Health Nutr. 2001;4:1245–51. [PubMed] [Google Scholar]

108. Hardy LL, Dobbins TA, Denney-Wilson EA, Okely AD and Booth ML. Sedentariness, small-screen recreation, and fitness in youth. Am J Prev Med. 2009;36:120–5. [PubMed] [Google Scholar]

109. Denton SJ, Trenell MI, Plotz T, Savory LA, Bailey DP and Kerr CJ. Cardiorespiratory fitness is associated with hard and light intensity physical activity but not time spent sedentary in 10–14 year old schoolchildren: the HAPPY study. PLoS One. 2013;8:e61073. [PMC free article] [PubMed] [Google Scholar]

110. Cliff DP, Hesketh KD, Vella SA, Hinkley T, Tsiros MD, Ridgers ND, Carver A, Veitch J, Parrish AM, Hardy LL, Plotnikoff RC, Okely AD, Salmon J and Lubans DR. Objectively measured sedentary behaviour and health and development in children and adolescents: systematic review and meta-analysis Obes Rev. 2016;17:330–344. [PubMed] [Google Scholar]

111. Pate RR, Wang CY, Dowda M, Farrell SW and O’Neill JR. Cardiorespiratory fitness levels among US youth 12 to 19 years of age: findings from the 1999–2002 National Health and Nutrition Examination Survey. Arch Pediatr Adolesc Med. 2006;160:1005–12. [PubMed] [Google Scholar]

112. Byrd-Williams CE, Shaibi GQ, Sun P, Lane CJ, Ventura EE, Davis JN, Kelly LA and Goran MI. Cardiorespiratory fitness predicts changes in adiposity in overweight Hispanic boys. Obesity (Silver Spring). 2008;16:1072–7. [PMC free article] [PubMed] [Google Scholar]

113. Schnurr TM, Gjesing AP, Sandholt CH, Jonsson A, Mahendran Y, Have CT, Ekstrom CT, Bjerregaard AL, Brage S, Witte DR, Jorgensen ME, Aadahl M, Thuesen BH, Linneberg A, Eiberg H, Pedersen O, Grarup N, Kilpelainen TO and Hansen T. Genetic Correlation between Body Fat Percentage and Cardiorespiratory Fitness Suggests Common Genetic Etiology. PLoS One. 2016;11:e0166738. [PMC free article] [PubMed] [Google Scholar]

114. Browning MG, Bean MK, Wickham EP, Stern M and Evans RK. Cardiometabolic and Fitness Improvements in Obese Girls Who Either Gained or Lost Weight during Treatment. The Journal of Pediatrics. 2015;166:1364–9. [PMC free article] [PubMed] [Google Scholar]

115. Howe AS, Skidmore PM, Parnell WR, Wong JE, Lubransky AC and Black KE. Cardiorespiratory fitness is positively associated with a healthy dietary pattern in New Zealand adolescents. Public Health Nutr. 2016;19:1279–87. [PubMed] [Google Scholar]

116. Zaqout M, Vyncke K, Moreno LA, De Miguel-Etayo P, Lauria F, Molnar D, Lissner L, Hunsberger M, Veidebaum T, Tornaritis M, Reisch LA, Bammann K, Sprengeler O, Ahrens W and Michels N. Determinant factors of physical fitness in European children. International journal of public health. 2016;61:573–82. [PubMed] [Google Scholar]

117. Gonzalez-Freire M, Scalzo P, D’Agostino J, Moore ZA, Diaz-Ruiz A, Fabbri E, Zane A, Chen B, Becker KG, Lehrmann E, Zukley L, Chia CW, Tanaka T, Coen PM, Bernier M, de Cabo R and Ferrucci L. Skeletal muscle ex vivo mitochondrial respiration parallels decline in vivo oxidative capacity, cardiorespiratory fitness, and muscle strength: The Baltimore Longitudinal Study of Aging. Aging Cell. 2018;17. [PMC free article] [PubMed] [Google Scholar]

118. Delille HK, Alves R and Schrader M. Biogenesis of peroxisomes and mitochondria: linked by division. Histochem Cell Biol. 2009;131:441–6. [PubMed] [Google Scholar]

119. Trevino-Saldana N and Garcia-Rivas G. Regulation of Sirtuin-Mediated Protein Deacetylation by Cardioprotective Phytochemicals. Oxid Med Cell Longev. 2017;2017:1750306. [PMC free article] [PubMed] [Google Scholar]

120. Larsen FJ, Schiffer TA, Borniquel S, Sahlin K, Ekblom B, Lundberg JO and Weitzberg E. Dietary inorganic nitrate improves mitochondrial efficiency in humans. Cell Metab. 2011;13:149–59. [PubMed] [Google Scholar]

121. Albarwani S, Al-Hashmi K, Al-Abri M, Jaju D and Hassan MO. Effects of overweight and leisure-time activities on aerobic fitness in urban and rural adolescents. Metab Syndr Relat Disord. 2009;7:369–74. [PubMed] [Google Scholar]

122. Blackorby C and Donaldson D. A theoretical treatmetn of indices of absolute inequality. International Economic Review. 1980;21. [Google Scholar]

123. Kodama S, Saito K, Tanaka S, Maki M, Yachi Y, Asumi M, Sugawara A, Totsuka K, Shimano H, Ohashi Y, Yamada N and Sone H. Cardiorespiratory fitness as a quantitative predictor of all-cause mortality and cardiovascular events in healthy men and women: a meta-analysis. JAMA. 2009;301:2024–35. [PubMed] [Google Scholar]

124. Imboden MT, Harber MP, Whaley MH, Finch WH, Bishop DL and Kaminsky LA. Cardiorespiratory Fitness and Mortality in Healthy Men and Women. J Am Coll Cardiol. 2018;72:2283–2292. [PubMed] [Google Scholar]

125. Benjamin EJ, Muntner P, Alonso A, Bittencourt MS, Callaway CW, Carson AP, Chamberlain AM, Chang AR, Cheng S, Das SR, Delling FN, Djousse L, Elkind MSV, Ferguson JF, Fornage M, Jordan LC, Khan SS, Kissela BM, Knutson KL, Kwan TW, Lackland DT, Lewis TT, Lichtman JH, Longenecker CT, Loop MS, Lutsey PL, Martin SS, Matsushita K, Moran AE, Mussolino ME, O’Flaherty M, Pandey A, Perak AM, Rosamond WD, Roth GA, Sampson UKA, Satou GM, Schroeder EB, Shah SH, Spartano NL, Stokes A, Tirschwell DL, Tsao CW, Turakhia MP, VanWagner LB, Wilkins JT, Wong SS, Virani SS, American Heart Association Council on E, Prevention Statistics C and Stroke Statistics S. Heart Disease and Stroke Statistics-2019 Update: A Report From the American Heart Association. Circulation. 2019;139:e56–e66. [PubMed] [Google Scholar]

126. Ehrman JK, Brawner CA, Al-Mallah MH, Qureshi WT, Blaha MJ and Keteyian SJ. Cardiorespiratory Fitness Change and Mortality Risk Among Black and White Patients: Henry Ford Exercise Testing (FIT) Project. Am J Med. 2017;130:1177–1183. [PubMed] [Google Scholar]

127. Soric M, Jembrek Gostovic M, Gostovic M, Hocevar M and Misigoj-Durakovic M. Tracking of BMI, fatness and cardiorespiratory fitness from adolescence to middle adulthood: the Zagreb Growth and Development Longitudinal Study. Ann Hum Biol. 2014;41:238–43. [PubMed] [Google Scholar]

128. Van Oort C, Jackowski SA, Eisenmann JC, Sherar LB, Bailey DA, Mirwald R and Baxter-Jones AD. Tracking of aerobic fitness from adolescence to mid-adulthood. Ann Hum Biol. 2013;40:547–53. [PubMed] [Google Scholar]

129. Trudeau F, Shephard RJ, Arsenault F and Laurencelle L. Tracking of physical fitness from childhood to adulthood. Can J Appl Physiol. 2003;28:257–71. [PubMed] [Google Scholar]

130. Campbell PT, Katzmarzyk PT, Malina RM, Rao DC, Perusse L and Bouchard C. Prediction of physical activity and physical work capacity (PWC150) in young adulthood from childhood and adolescence with consideration of parental measures. American Journal of Human Biology: The Official Journal of the Human Biology Council. 2001;13:190–6. [PubMed] [Google Scholar]

131. Hogstrom G, Nordstrom A and Nordstrom P. Aerobic fitness in late adolescence and the risk of early death: a prospective cohort study of 1.3 million Swedish men. Int J Epidemiol. 2016;45:1159–1168. [PubMed] [Google Scholar]

132. Hogstrom G, Nordstrom A, Eriksson M and Nordstrom P. Risk factors assessed in adolescence and the later risk of stroke in men: a 33-year follow-up study. Cerebrovasc Dis. 2015;39:63–71. [PubMed] [Google Scholar]

133. Lindgren M, Aberg M, Schaufelberger M, Aberg D, Schioler L, Toren K and Rosengren A. Cardiorespiratory fitness and muscle strength in late adolescence and long-term risk of early heart failure in Swedish men. European Journal of Preventive Cardiology. 2017;24:876–884. [PubMed] [Google Scholar]

134. Rabiee R, Agardh E, Kjellberg K and Falkstedt D. Low cardiorespiratory fitness in young adulthood and future risk of disability pension: a follow-up study until 59 years of age in Swedish men. J Epidemiol Community Health. 2015;69:266–71. [PubMed] [Google Scholar]

135. Agbaje AO, Haapala EA, Lintu N, Viitasalo A, Barker AR, Takken T, Tompuri T, Lindi V and Lakka TA. Peak oxygen uptake cut-points to identify children at increased cardiometabolic risk - The PANIC Study. Scand J Med Sci Sports. 2018;29:16–24. [PubMed] [Google Scholar]

136. Ferreira I, Twisk JW, Stehouwer CD, van Mechelen W and Kemper HC. Longitudinal changes in VO2max: associations with carotid IMT and arterial stiffness. Med Sci Sports Exerc. 2003;35:1670–8. [PubMed] [Google Scholar]

137. Johnson MS, Figueroa-Colon R, Herd SL, Fields DA, Sun M, Hunter GR and Goran MI. Aerobic fitness, not energy expenditure, influences subsequent increase in adiposity in black and white children. Pediatrics. 2000;106:E50. [PubMed] [Google Scholar]

138. Koutedakis Y, Bouziotas C, Flouris AD and Nelson PN. Longitudinal modeling of adiposity in periadolescent Greek schoolchildren. Med Sci Sports Exerc. 2005;37:2070–4. [PubMed] [Google Scholar]

139. Sigal RJ, Alberga AS, Goldfield GS, Prud’homme D, Hadjiyannakis S, Gougeon R, Phillips P, Tulloch H, Malcolm J, Doucette S, Wells GA, Ma J and Kenny GP. Effects of aerobic training, resistance training, or both on percentage body fat and cardiometabolic risk markers in obese adolescents: the healthy eating aerobic and resistance training in youth randomized clinical trial. JAMA pediatrics. 2014;168:1006–14. [PubMed] [Google Scholar]

140. Agostinis-Sobrinho C, Ruiz JR, Moreira C, Abreu S, Lopes L, Oliveira-Santos J, Mota J and Santos R. Cardiorespiratory Fitness and Blood Pressure: A Longitudinal Analysis. The Journal of Pediatrics. 2018;192:130–135. [PubMed] [Google Scholar]

141. Kelishadi R, Cook SR, Amra B and Adibi A. Factors associated with insulin resistance and non-alcoholic fatty liver disease among youths. Atherosclerosis. 2009;204:538–43. [PubMed] [Google Scholar]

142. Schmidt MD, Magnussen CG, Rees E, Dwyer T and Venn AJ. Childhood fitness reduces the long-term cardiometabolic risks associated with childhood obesity. Int J Obes (Lond). 2016;40:1134–40. [PubMed] [Google Scholar]

143. Oliveira RG and Guedes DP. Physical Activity, Sedentary Behavior, Cardiorespiratory Fitness and Metabolic Syndrome in Adolescents: Systematic Review and Meta-Analysis of Observational Evidence. PLoS One. 2016;11:e0168503. [PMC free article] [PubMed] [Google Scholar]

144. McMurray RG, Bangdiwala SI, Harrell JS and Amorim LD. Adolescents with metabolic syndrome have a history of low aerobic fitness and physical activity levels. Dyn Med. 2008;7:5. [PMC free article] [PubMed] [Google Scholar]

145. Lang JJ, Tremblay MS, Ortega FB, Ruiz JR and Tomkinson GR. Review of criterion-referenced standards for cardiorespiratory fitness: what percentage of 1,142,026 international children and youth are apparently healthy? Br J Sports Med. 2019;53:953–958. [PubMed] [Google Scholar]

146. Ruiz JR, Cavero-Redondo I, Ortega FB, Welk GJ, Andersen LB and Martinez-Vizcaino V. Cardiorespiratory fitness cut points to avoid cardiovascular disease risk in children and adolescents; what level of fitness should raise a red flag? A systematic review and meta-analysis. Br J Sports Med. 2016;50:1451–1458. [PubMed] [Google Scholar]

147. Hancox RJ and Rasmussen F. Does physical fitness enhance lung function in children and young adults? Eur Respir J. 2018;51:1701374. [PubMed] [Google Scholar]

148. Marques A, Santos DA, Hillman CH and Sardinha LB. How does academic achievement relate to cardiorespiratory fitness, self-reported physical activity and objectively reported physical activity: a systematic review in children and adolescents aged 6–18 years. Br J Sports Med. 2018;52:1039. [PubMed] [Google Scholar]

149. Sardinha LB, Marques A, Minderico C, Palmeira A, Martins S, Santos DA and Ekelund U. Longitudinal Relationship between Cardiorespiratory Fitness and Academic Achievement. Med Sci Sports Exerc. 2016;48:839–44. [PMC free article] [PubMed] [Google Scholar]

150. Wittberg RA, Northrup KL and Cottrell LA. Children’s aerobic fitness and academic achievement: a longitudinal examination of students during their fifth and seventh grade years. Am J Public Health. 2012;102:2303–2307. [PMC free article] [PubMed] [Google Scholar]

151. Hsieh SS, Tsai JR, Chang SH, Ho JY, Chen JF, Chen PH, Sung YT and Hung TM. The subject-dependent, cumulative, and recency association of aerobic fitness with academic performance in Taiwanese junior high school students. BMC Pediatr. 2019;19:25. [PMC free article] [PubMed] [Google Scholar]

152. Haapala EA. Cardiorespiratory fitness and motor skills in relation to cognition and academic performance in children - a review. Journal of Human Kinetics. 2013;36:55–68. [PMC free article] [PubMed] [Google Scholar]

153. Drollette ES, Pontifex MB, Raine LB, Scudder MR, Moore RD, Kao SC, Westfall DR, Wu CT, Kamijo K, Castelli DM, Khan NA, Kramer AF and Hillman CH. Effects of the FITKids physical activity randomized controlled trial on conflict monitoring in youth. Psychophysiology. 2018;55. [PMC free article] [PubMed] [Google Scholar]

154. Hillman CH, Pontifex MB, Castelli DM, Khan NA, Raine LB, Scudder MR, Drollette ES, Moore RD, Wu CT and Kamijo K. Effects of the FITKids randomized controlled trial on executive control and brain function. Pediatrics. 2014;134:e1063–71. [PMC free article] [PubMed] [Google Scholar]

155. Tacchi MJ, Heggelund J and Scott J. Predictive validity of objective measures of physical fitness for the new onset of mental disorders in adolescents and young adults. Early Intervention in Psychiatry. 2019. [PubMed] [Google Scholar]

156. Reddon H, Meyre D and Cairney J. Physical Activity and Global Self-worth in a Longitudinal Study of Children. Med Sci Sports Exerc. 2017;49:1606–1613. [PubMed] [Google Scholar]

157. Goldfield GS, Adamo KB, Rutherford J and Murray M. The effects of aerobic exercise on psychosocial functioning of adolescents who are overweight or obese. J Pediatr Psychol. 2012;37:1136–47. [PubMed] [Google Scholar]

158. Padilla-Moledo C, Castro-Pinero J, Ortega FB, Mora J, Marquez S, Sjostrom M and Ruiz JR. Positive health, cardiorespiratory fitness and fatness in children and adolescents. Eur J Public Health. 2012;22:52–6. [PubMed] [Google Scholar]

159. Rodriguez-Ayllon M, Cadenas-Sanchez C, Esteban-Cornejo I, Migueles JH, Mora-Gonzalez J, Henriksson P, Martin-Matillas M, Mena-Molina A, Molina-Garcia P, Estevez-Lopez F, Enriquez GM, Perales JC, Ruiz JR, Catena A and Ortega FB. Physical fitness and psychological health in overweight/obese children: A cross-sectional study from the ActiveBrains project. J Sci Med Sport. 2018;21:179–184. [PubMed] [Google Scholar]

160. Smpokos EA, Linardakis M, Papadaki A, Lionis C and Kafatos A. Secular trends in fitness, moderate-to-vigorous physical activity, and TV-viewing among first grade school children of Crete, Greece between 1992/93 and 2006/07. J Sci Med Sport. 2012;15:129–35. [PubMed] [Google Scholar]

161. Dyrstad SM, Aandstad A and Hallen J. Aerobic fitness in young Norwegian men: a comparison between 1980 and 2002. Scand J Med Sci Sports. 2005;15:298–303. [PubMed] [Google Scholar]

162. Andersen LB, Froberg K, Kristensen PL, Moller NC, Resaland GK and Anderssen SA. Secular trends in physical fitness in Danish adolescents. Scand J Med Sci Sports. 2010;20:757–63. [PubMed] [Google Scholar]

163. Garber CE, Blissmer B, Deschenes MR, Franklin BA, Lamonte MJ, Lee IM, Nieman DC, Swain DP and American College of Sports M. American College of Sports Medicine position stand. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: guidance for prescribing exercise. Med Sci Sports Exerc. 2011;43:1334–59. [PubMed] [Google Scholar]

164. Borg G Borg’s perceived exertion and pain scales. Champaign, IL.: Human Kinetics; 1998. [Google Scholar]

165. Tremblay MS, Aubert S, Barnes JD, Saunders TJ, Carson V, Latimer-Cheung AE, Chastin SFM, Altenburg TM and Chinapaw MJM. Sedentary behavior research network (SBRN)–terminology consensus project process and outcome. International Journal of Behavioral Nutrition and Physical Activity. 2017;14:75. [PMC free article] [PubMed] [Google Scholar]

166. Ainsworth BE, Haskell WL, Whitt MC, Irwin ML, Swartz AM, Strath SJ, O’Brien WL, Bassett DR Jr., Schmitz KH, Emplaincourt PO, Jacobs DR Jr., and Leon AS. Compedium of physical activities: An update of activity codes and MET intensities. Med Sci Sports Exerc. 2000;32:S498–S516. [PubMed] [Google Scholar]

Page 2

Categories of Physical Activity For Youth Aged 8–18 Years