Cardiorespiratory Fitness Cut-Points Related to Body Adiposity Parameters in Macedonian Children

Keywords: epidemiology, obesity, weight status, children, adolescents


Background and Objectives: There is a shortage of criteria referent standards for tests of logistic application meant to estimate the cardiorespiratory fitness (CRF) of children and adolescents in the Republic of North Macedonia. The goal of the research was twofold: (1) To identify the ability of CRF estimated by the 20-m shuttle-run test (20mSRT) to discriminate between “healthy” and “unhealthy” phenotypes (by adiposity measures such as WC and WHR) in children; (2) To determine the correlation between obesity and relatively maximum oxygen consumption (VO2 peak) tested on a relatively large respondents’ sample of Macedonian children. The research was conducted on a sample of 1,863 respondents, 957 (51.4%) of whom were boys, and 906 (48.6%) were girls at the age of 7 to 10 years. All of them were from 19 primary schools in the central and eastern parts of the Republic of North Macedonia. 

Materials and Methods: The waist circumference (WC) and waist-to-height ratio (WHtR) were used to identify body adiposity markers. CRF was measured using the 20mSRT (VO2 peak). Receiver operating characteristic curves and logistic regression were applied in order to establish the discriminative power of CRF in anticipating the parameters of body adiposity markers. 

Results: With regard both to the boys and girls, VO2 peak showed considerable predictive power of identifying the body adiposity (area under the curve [AUC] > 0.66). In boys, when considering the full sample (7-10 years), the best cut-point for VO2 peak to detect body fat by WC were 48.8 to mL•kg−1•min−1 and WHtR were 47.4 to mL•kg−1•min−1. For girls, when considering the full sample (7-10 years), the best cut-point to detect body fat by WC were 47.4 to mL•kg−1•min−1 and WHtR were 47.1 to mL•kg−1•min−1

Conclusions: According to these cut-points, adolescents with low CRF were more likely to be obese either by WC or WHtR. The border values (cut-points) of CRF can be used as quantitative markers of children of healthier body characteristics from the Republic of North Macedonia. 


Download data is not yet available.

Author Biographies

Abdulla Elezi, University of Pristina

Faculty of Physical Education and Sport,
Industrial Zone, Pristina, 10000, Kosovo

Valon Kadriu, University Clinical Center of Kosovo

Pristina, 10000, Kosovo

Gresa Elezi, American Hospital, Pristina

Industrial Zone, Pristina, 10000, Kosovo

Georgi Georgiev, Ss. Cyril and Methodius University of Skopje

Faculty of Physical Education, Sport and Health,
Dimce Mircev, 3, Skopje, 1000, Republic of North Macedonia

Seryozha Gontarev, Ss. Cyril and Methodius University of Skopje

Faculty of Physical Education, Sport and Health,
Dimce Mircev, 3, Skopje, 1000, Republic of North Macedonia


Gontarev, S. & Kalac, R. (2016). Prediction of physical activity factors in macedonian adolescents. Journal of Physical Education and Sport.

Gontarev, S., Kalac, R., Ameti, V., & Redjepi, A. (2016). Factors associated with physical activity among Macedonian adolescents in albanian ethnic community. Iranian journal of public health, 45(4), 474.

Gontarev, S., Kalac, R., Velickovska, L. A., & Zivkovic, V. (2018). Physical Fitness Reference Standards in Macedonian Children And Adolescent: The Makfit Study. Nutricion hospitalaria, 35(6),1275-128.

Sahoo, K., Sahoo, B., Choudhury, A. K., Sofi, N. Y., Kumar, R., & Bhadoria, A. S. (2015). Childhood obesity: causes and consequences. Journal of family medicine and primary care, 4(2), 187.

Balagopal, P., De Ferranti, S. D., Cook, S., Daniels, S. R., Gidding, S. S., Hayman, L. L., ... & Steinberger, J. (2011). Nontraditional risk factors and biomarkers for cardiovascular disease: mechanistic, research, and clinical considerations for youth: a scientific statement from the American Heart Association. Circulation, 123(23), 2749-2769.

Kaminsky, L. A., Arena, R., Ellingsen, Ø., Harber, M. P., Myers, J., Ozemek, C., & Ross, R. (2019). Cardiorespiratory fitness and cardiovascular disease-The past, present, and future. Progress in cardiovascular diseases, 62(2), 86-93.

Mintjens, S., Menting, M. D., Daams, J. G., van Poppel, M. N., Roseboom, T. J., & Gemke, R. J. (2018). Cardiorespiratory fitness in childhood and adolescence affects future cardiovascular risk factors: a systematic review of longitudinal studies. Sports Medicine, 48(11), 2577-2605.

Pillsbury, L., Oria, M., & Pate, R. (Eds.). (2013). Fitness measures and health outcomes in youth.
Lee, S. J., & Arslanian, S. A. (2007). Cardiorespiratory fitness and abdominal adiposity in youth. European journal of clinical nutrition, 61(4), 561-565.

Grøntved, A., Ried-Larsen, M., Møller, N. C., Kristensen, P. L., Froberg, K., Brage, S., & Andersen, L. B. (2015). Muscle strength in youth and cardiovascular risk in young adulthood (the European Youth Heart Study). British journal of sports medicine, 49(2), 90-94.

Silva, D. A. S., Lang, J. J., Barnes, J. D., Tomkinson, G. R., & Tremblay, M. S. (2018). Cardiorespiratory fitness in children: evidence for criterion-referenced cut-points. PLoS One, 13(8), e0201048.

Pireva, A., Selimi, M., Gontarev, S., & Georgiev, G. (2018). Association between aerobic fitness and high blood pressure in adolescents in Macedonia evidence for criterion-referenced cut-points. Journal of Physical Education and Sport 18(2), 853 – 861.

Schwandt, P., & Haas, G. M. (2016). Is the ratio waist circumference to height (WHtR) of 0.5 a universal measure for abdominal adiposity in children and adolescents?. International Journal of Obesity, 40(7), 1141-1142.

de Oliveira, R. G., & Guedes, D. P. (2018). Performance of anthropometric indicators as predictors of metabolic syndrome in Brazilian adolescents. BMC pediatrics, 18(1), 1-9.

de Ferranti, S. D., Gauvreau, K., Ludwig, D. S., Neufeld, E. J., Newburger, J. W., & Rifai, N. (2004). Prevalence of the metabolic syndrome in American adolescents: findings from the Third National Health and Nutrition Examination Survey. Circulation, 110(16), 2494-2497.

Ashwell, M., & Gibson, S. (2016). Waist-to-height ratio as an indicator of ‘early health risk’: simpler and more predictive than using a ‘matrix’based on BMI and waist circumference. BMJ open, 6(3), e010159.

Leger, L. A., Mercier, D., Gadoury, C., & Lambert, J. (1988). The multistage 20 metre shuttle run test for aerobic fitness. Journal of sports sciences, 6(2), 93-101.

Ramírez-Vélez, R., Rodrigues-Bezerra, D., Correa-Bautista, J. E., Izquierdo, M., & Lobelo, F. (2015). Reliability of health-related physical fitness tests among Colombian children and adolescents: the FUPRECOL study. PloS one, 10(10), e0140875.

Swets, J. A. (1973). The relative operating characteristic in psychology: a technique for isolating effects of response bias finds wide use in the study of perception and cognition. Science, 182(4116), 990-1000.

Boddy, L. M., Thomas, N. E., Fairclough, S. J., Tolfrey, K., Brophy, S., Rees, A., ... & Stratton, G. (2012). ROC generated thresholds for field-assessed aerobic fitness related to body size and cardiometabolic risk in schoolchildren.

Prieto-Benavides, D. H., García-Hermoso, A., Izquierdo, M., Alonso-Martínez, A. M., Agostinis-Sobrinho, C., Correa-Bautista, J. E., & Ramírez-Vélez, R. (2019). Cardiorespiratory fitness Cut-Points are related to body adiposity parameters in Latin American adolescents. Medicina, 55(9), 508.

Lang, J. J., Tremblay, M. S., Ortega, F. B., Ruiz, J. R., & Tomkinson, G. R. (2019). Review of criterion-referenced standards for cardiorespiratory fitness: what percentage of 1 142 026 international children and youth are apparently healthy?. British Journal of Sports Medicine, 53(15), 953-958.

Ruiz, J. R., Cavero-Redondo, I., Ortega, F. B., Welk, G. J., Andersen, L. B., & Martinez-Vizcaino, V. (2016). 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. British journal of sports medicine, 50(23), 1451-1458.

Lang, J. J., Belanger, K., Poitras, V., Janssen, I., Tomkinson, G. R., & Tremblay, M. S. (2018a). Systematic review of the relationship between 20 m shuttle run performance and health indicators among children and youth. Journal of Science and Medicine in Sport, 21(4), 383-397.

Pozuelo-Carrascosa, D. P., García-Hermoso, A., Álvarez-Bueno, C., Sánchez-López, M., & Martinez-Vizcaino, V. (2018). Effectiveness of school-based physical activity programmes on cardiorespiratory fitness in children: a meta-analysis of randomised controlled trials. British journal of sports medicine, 52(19), 1234-1240.

Physical Activity Guidelines Advisory Committee. (2018). 2018 physical activity guidelines advisory committee scientific report.

Lang, J. J., Tomkinson, G. R., Janssen, I., Ruiz, J. R., Ortega, F. B., Léger, L., & Tremblay, M. S. (2018b). Making a case for cardiorespiratory fitness surveillance among children and youth. Exercise and sport sciences reviews, 46(2), 66-75.
0 article
How to Cite
Elezi, A., Kadriu, V., Elezi, G., Georgiev, G., & Gontarev, S. (2022). Cardiorespiratory Fitness Cut-Points Related to Body Adiposity Parameters in Macedonian Children. Teorìâ Ta Metodika Fìzičnogo Vihovannâ, 22(1), 48-55.