Cardiorespiratory Fitness and Cardiometabolic Risk Factors in Children and Adolescents From Southwest Colombia: Association Patterns Considering Adiposity

Background: Little is known about the cardiorespiratory fitness (CRF)-cardiometabolic risk relationship in Latin American pediatric populations across different age/sex groups, especially when considering the potential effects of adiposity on the association. We evaluated cross-sectional associations between VO_2max and cardiometabolic risk variables (CMRV), and verified whether the associations were independent of adiposity markers in school-aged children and adolescents from Cali, Colombia. Methods: The sample consisted of 1206 children aged 5–17 years. CMRV were fasting glucose, HDL and LDL cholesterol, triglycerides, systolic, and diastolic pressure. Logistic regressions were conducted for associations of age/sex-specific tertiles of VO_2max with age/sex-specific highest tertiles of CMRV (except HDL-C, lowest tertile) and a CMR cluster (> 2 CMRV in extreme tertiles), adjusting for socioeconomic stratum, and adiposity markers (BMI, body fat percentage, and waist circumference). Results: Overweight/obesity ranged from 15% to 18% with no difference by sex. In children aged 5–11 years, high VO_2max (highest tertile vs. lowest) was inversely associated with the CMR cluster [Odds ratio (95% confidence interval): 0.18 (0.06–0.47), p < 0.05] independently of adjustment for any adiposity marker in boys but not in girls. In the age group of 12–17 years, there were initially significant VO_2max- CMR cluster and VO_2max- CMRV associations but attenuated by adiposity adjustment. In girls, high VO_2max was inversely associated with high systolic blood pressure regardless of adjustment for adiposity markers. Conclusion: VO_2max is inversely associated with cardiometabolic risk, but adiposity influences the association. The adiposity-independent association among younger boys requires further research. Interventions to tackle cardiometabolic risk in childhood may primarily focus on reducing excess adiposity, and secondarily on improvement of CRF.