Share this article on:

Validity of Cardiorespiratory Fitness Criterion-Referenced Standards for Adolescents


Medicine & Science in Sports & Exercise: June 2009 - Volume 41 - Issue 6 - p 1222-1229
doi: 10.1249/MSS.0b013e318195d491
Basic Sciences

Purpose: The clinical utility of cardiorespiratory fitness (CRF) criterion-referenced standards (FITNESSGRAM) has not been tested in adolescents. We aimed to determine the ability of the FITNESSGRAM standards to discriminate between low and high cardiovascular disease (CVD) risk in a population-based sample of US adolescents.

Methods: Participants included 1247 adolescents (45.7% females) aged 12-19 yr. A submaximal walking treadmill test was used to estimate peak oxygen consumption as a measure of CRF. Participants were dichotomized based on meeting or failing the sex- and age-specific FITNESSGRAM standards. CVD risk factors included systolic blood pressure, sum of triceps and subscapular skinfolds, homeostatic model assessment (HOMA) of insulin resistance, triglycerides, and total cholesterol/high-density lipoprotein ratio. A sex- and age-specific CVD risk score was computed as the mean of these five standardized risk factors. A risk score >1 SD was considered to indicate a high CVD risk.

Results: One third of the adolescents fail to meet the FITNESSGRAM standards. Body fat and CVD risk score were significantly lower in adolescents meeting versus failing the FITNESSGRAM standards (all P < 0.003). Receiver operating characteristics curve analyses revealed that the CRF thresholds that best discriminated between low and high CVD risk were very similar to those established by FITNESSGRAM: 44.1 and 40.3 mL·kg−1·min−1 among 12- to 15- and 16- to 19-yr-old boys and 36.0 and 35.5 mL·kg−1·min−1 among 12- to 15- and 16- to 19-yr-old girls, respectively.

Conclusions: The CRF criterion-referenced standards established by FITNESSGRAM discriminate adolescents with a more favorable cardiovascular profile from those with a less favorable profile. Identification of children who fail to meet these standards can help detect the target population for pediatric CVD prevention strategies.

1Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC; 2Department of Epidemiology and Biostatistics and Center for Research on Nutrition and Health Disparities, Arnold School of Public Health, University of South Carolina, Columbia, SC; 3Unit for Preventive Nutrition, Department of Biosciences and Nutrition at NOVUM, Karolinska Institutet, Huddinge, SWEDEN; and 4Department of Physiology, School of Medicine, University of Granada, Granada, SPAIN

Address for correspondence: Russell R. Pate, Ph.D., Public Health Research Center, 921 Assembly St, Columbia, SC 29208; E-mail:

Submitted for publication June 2008.

Accepted for publication November 2008.

©2009The American College of Sports Medicine