The central focus of this statement is to raise clinicians’ awareness of the importance of CRF in predicting current and future health in otherwise healthy youth, knowing that CRF measurements provide an objective measure of health as opposed to physical activity recall, which is the current practice. Consistent with this sentiment, a recent American Heart Association statement suggests that CRF be assigned as a vital sign because it has the power to predict mortality in adults similar to traditionally assessed risk factors such as tobacco use, type 2 diabetes mellitus, hypertension, and hypercholesterolemia. 1, 9 Whereas self-reported physical activity levels can be unreliable 12 and provide only a snapshot of behavior, assessments of CRF provide a more robust measure of cardiovascular health. CRF is an objective measure of health that can be tracked over time and compared across populations. 9, 11Īlthough CRF is assessed at times in certain youth such as those with congenital heart disease, asthma, and cystic fibrosis, assessment of CRF has a broader range of applications. 9–11 Although the reasons for this decline are not well understood, an increase in obesity, increased sedentary time, decreased levels of moderate to vigorous physical activity, and social and economic changes may have contributed. 8 In addition, over the past 6 decades, CRF has declined, both in the United States and internationally. 4, 7 Unfortunately, only 40% of 12- to 15-year-olds in United States currently are believed to have healthy CRF.
1 In youth, CRF is a predictor of a number of health indicators, including cardiometabolic health, 3, 4 premature CVD, 5 academic achievement, 6 and mental health. 1, 2 Low or unhealthy CRF is a strong, independent predictor of cardiovascular disease (CVD) and all-cause mortality in adults.
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