Article Text

Download PDFPDF
Predictive validity of health-related fitness in youth: a systematic review
  1. J R Ruiz1,2,
  2. J Castro-Piñero3,
  3. E G Artero2,
  4. F B Ortega1,2,
  5. M Sjöström1,
  6. J Suni4,
  7. M J Castillo2
  1. 1
    Department of Biosciences and Nutrition at NOVUM, Unit for Preventive Nutrition, Karolinska Institutet, Huddinge, Sweden
  2. 2
    Department of Physiology, School of Medicine, University of Granada, Granada, Spain
  3. 3
    Department of Physical Education, School of Education, University of Cadiz, Puerto Real, Spain
  4. 4
    UKK Institute for Health Promotion Research, Tampere, Finland
  1. Correspondence to Dr R J Ruiz, Department of Biosciences and Nutrition, Unit for Preventive Nutrition, NOVUM, Huddinge, Sweden, SE-14157; ruizj{at}


The objective of the present systematic review was to investigate whether physical fitness in childhood and adolescence is a predictor of cardiovascular disease (CVD) risk factors, events and syndromes, quality of life and low back pain later in life. Physical fitness-related components were: cardiorespiratory fitness, musculoskeletal fitness, motor fitness and body composition. Adiposity was considered as both exposure and outcome. The results of 42 studies reporting the predictive validity of health-related physical fitness for CVD risk factors, events and syndromes as well as the results of five studies reporting the predictive validity of physical fitness for low back pain in children and adolescents were summarised. Strong evidence was found indicating that higher levels of cardiorespiratory fitness in childhood and adolescence are associated with a healthier cardiovascular profile later in life. Muscular strength improvements from childhood to adolescence are negatively associated with changes in overall adiposity. A healthier body composition in childhood and adolescence is associated with a healthier cardiovascular profile later in life and with a lower risk of death. The evidence was moderate for the association between changes in cardiorespiratory fitness and CVD risk factors, and between cardiorespiratory fitness and the risk of developing the metabolic syndrome and arterial stiffness. Moderate evidence on the lack of a relationship between body composition and low back pain was found. Due to a limited number of studies, inconclusive evidence emerged for a relationship between muscular strength or motor fitness and CVD risk factors, and between flexibility and low back pain.

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Additional material is published online only at

  • Funding This work was supported by the European Union, in the framework of the Public Health Programme (ALPHA project, ref 2006120), the Swedish Council for Working Life and Social Research (FAS) and the Spanish Ministry of Education (EX-2007-1124, AP-2004-2745 and AP2005-4358).

  • Competing interests None.

  • Contributors JRR drafted the manuscript. JRR and JC-P read all the manuscripts and scored each of them. JRR and JS contributed to the concept and design of the systematic review. All the authors contributed to the interpretation and discussion of the results. JRR, JS, MS and MJC contributed to the concept and design of the ALPHA study. All the authors critically revised the manuscript.

Linked Articles