Independent and combined associations of cardiorespiratory fitness and fatness with cardiovascular risk factors in Brazilian youth

Background: The purpose of this study was to examine the independent and combined influence of cardiorespiratory fitness (CRF)1body mass index (BMI) and percentage of fat (% fat) on total cholesterol (TC) and blood pressure (BP) in male and female youth. Methods: 1442 (721 girls) children and adolescents aged 7-12 years were randomly selected. CRF, BMI, % fat (predictor variables), TC, systolic (SBP) and diastolic blood pressure (DBP; outcome variables) were measured. Using standardized cut-off points, we created categories for each variable. Bivariate and multivariable analyses were used to test the independent influence of predictors on outcomes. Results: The prevalence of increased TC, SBP, and DBP were 34.4% (95% CI 31.9-37.0), 9.1% (95% CI 7.5-10.6), and 15.5% (95% CI 13.5-17.4), respectively. In multivariable analyses, CRF was a significant predictor of all outcome variables (P < .05). BMI was associated with SBP and DBP (P < .05) and % fat was associated only with SBP (P < .05). CRF had stronger associations with TC than BMI, whereas the opposite was observed for SBP and DBP. Conclusions: CRF and BMI are independently associated to TC and BP in male and female youth, and individuals unfit/overweight have greater likelihood of presenting these risk factors.