%0 Journal Article %A Jonatan R Ruiz %A Ivan Cavero-Redondo %A Francisco B Ortega %A Gregory J Welk %A Lars B Andersen %A Vicente Martinez-Vizcaino %T 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 %D 2016 %R 10.1136/bjsports-2015-095903 %J British Journal of Sports Medicine %P bjsports-2015-095903 %X Background Poor cardiorespiratory fitness is associated with cardiovascular disease risk factors.Aim To perform a systematic review and meta-analysis of the relationship between poor cardiorespiratory fitness and cardiovascular disease risk in children and adolescents.Methods Systematic literature search (1980 to 11 April 2015) for studies that determined a cardiorespiratory fitness cut point that predicted cardiovascular disease risk in children and adolescents.Results We identified 7 studies that included 9280 children and adolescents (49% girls) aged 8–19 years from 14 countries. Cardiovascular disease risk was already present in boys (6–39%) and girls (6–86%). Boys with low fitness (<41.8 mL/kg/min) had a 5.7 times greater likelihood of having cardiovascular disease risk (95% CI 4.8 to 6.7). The comparable diagnostic OR for girls with low fitness (<34.6 mL/kg/min) was 3.6 (95% CI 3.0 to 4.3). The 95% confidence region of cardiorespiratory fitness associated with low cardiovascular disease risk ranges, 41.8–47.0 mL/kg/min in boys (eg, stages 6–8 for a boy aged 15 years) and 34.6–39.5 mL/kg/min in girls (eg, stages 3–5 for a girl aged 15 years). The cardiorespiratory fitness cut point to avoid cardiovascular disease risk ranged 41.8 mL/kg/min in boys and was 34.6 mL/kg/min in girls.Summary Fitness levels below 42 and 35 mL/kg/min for boys and girls, respectively, should raise a red flag. These translate to 6 and 3 stages on the shuttle run test for a boy and a girl, both aged 15 years, respectively. These cut points identify children and adolescents who may benefit from primary and secondary cardiovascular prevention programming. %U https://bjsm.bmj.com/content/bjsports/early/2016/08/23/bjsports-2015-095903.full.pdf