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Health-related criterion-referenced cut-points for cardiorespiratory fitness among youth: A systematic review

Citation

Rollo, S and Fraser, B and Seguin, N and Sampson, M and Lang, JJ and Tomkinson, GR and Tremblay, MS, Health-related criterion-referenced cut-points for cardiorespiratory fitness among youth: A systematic review, Sports Medicine, 52, (1) pp. 101-122. ISSN 0112-1642 (2022) [Refereed Article]

Copyright Statement

The Author(s), under exclusive licence to Springer Nature Switzerland AG 2021

DOI: doi:10.1007/s40279-021-01537-3

Abstract

Background: Cardiorespiratory fitness (CRF), which reflects the overall aerobic capacity of the cardiovascular, respiratory, and muscular systems, is significantly related to health among youth.

Objective: The aim of this systematic review was to identify health-related criterion-referenced cut-points for CRF among youth aged 5-17 years.

Methods: A systematic search of two electronic databases (MEDLINE and SPORTDiscus) was conducted in September 2020. Only peer-reviewed studies that developed health-related criterion-referenced cut-points for CRF among youth were eligible provided they included (1) youth aged 5-17 years from the general population; (2) at least one quantitative assessment of CRF (e.g., peak oxygen uptake [VO2peak]); (3) at least one quantitative assessment of health (e.g., cardiometabolic risk); (4) a criterion for health; and (5) a quantitative analysis (e.g., receiver operating characteristic [ROC] curve) of at least one health-related cut-point for CRF. A narrative synthesis was used to describe the results of the included studies.

Results: Collectively, 29 included studies developed health-related criterion-referenced cut-points for CRF among 193,311 youth from 23 countries. CRF cut-points, expressed as VO2peak, estimated using the 20-m shuttle run test, demonstrated high discriminatory ability (median area under the curve [AUC] ≥ 0.71) for both cardiometabolic and obesity risk. Cut-points derived from maximal cycle-ergometer tests demonstrated moderate discriminatory ability (median AUC 0.64-0.70) for cardiometabolic risk, and low discriminatory ability for early subclinical atherosclerosis (median AUC 0.56-0.63). Cut-points for CRF using submaximal treadmill exercise testing demonstrated high discriminatory ability for cardiometabolic risk, but only moderate discriminatory ability for obesity risk. CRF cut-points estimated using submaximal step testing demonstrated high discriminatory ability for cardiometabolic risk and moderate discriminatory ability for high blood pressure, while those for the 9-min walk/run test demonstrated moderate-to-high discriminatory ability for obesity risk. Collectively, CRF cut-points, expressed as [VO2peak, demonstrated moderate-to-high discriminatory ability (median AUC ≥ 0.64) for cardiometabolic risk, obesity risk, and high blood pressure.

Conclusions: Currently, there is too wide a range of health-related criterion-referenced cut-points for CRF among youth to suggest universal age- and sex-specific thresholds. To further inform the development of universal cut-points, there is a need for additional research, using standardized testing protocols and health-risk definitions, that examines health-related criterion-referenced cut-points for CRF that are age, sex, and culturally diverse.

Item Details

Item Type:Refereed Article
Keywords:cardiorespiratory fitness; childhood; epidemiology; prevention; epidemiology
Research Division:Health Sciences
Research Group:Epidemiology
Research Field:Behavioural epidemiology
Objective Division:Health
Objective Group:Specific population health (excl. Indigenous health)
Objective Field:Adolescent health
UTAS Author:Fraser, B (Dr Brooklyn Fraser)
ID Code:152876
Year Published:2022
Web of Science® Times Cited:3
Deposited By:Menzies Institute for Medical Research
Deposited On:2022-08-25
Last Modified:2022-11-15
Downloads:0

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