Background. Previous research suggests that use of BMI as a screening tool to assess health in youth has limitations. Valid alternative measures to assess body composition are needed to accurately identify children who are aerobically fit, which is an indicator of health status. The purpose of this study was to examine the associations between select anthropometric measures and cardiorespiratory fitness test performance in middle-school students. Methods. Participants included 134 students (65 boys and 69 girls) recruited from the 6th, 7th, and 8th grades. Anthropometric measures consisted of BMI, waist circumference (WC), waist-to-height ratio (WHtR), and percent body fat estimated from two-site skinfolds (%BF-SKF), as well as the hand-held OMRON BIA device (%BF-BIA). Cardiorespiratory fitness tests included the one-mile run and PACER test. Data were collected on four separate testing days during the students’ physical education classes. Results. There were statistically significant moderate correlations between the %BF estimations, WHtR, and cardiorespiratory fitness test scores in both genders . BMI at best only displayed weak correlations with the cardiorespiratory fitness test scores. Conclusions. The results suggest that alternative measures such as %BF-SKF, %BF-BIA, and WHtR may be more valid indicators of youth aerobic fitness lending to their preferred use over BMI. 1. Introduction The current pediatric obesity epidemic manifests concerns for adverse cardiovascular risk factors among overweight youth. However, Eisenmann et al. [1], using body mass index (BMI) as the marker of adiposity, found that youth in both the low- and high-BMI categories were associated with a more favorable cardiovascular disease (CVD) risk-factor profile than individuals whose BMIs were in the “healthy” range. This paradox leads to a significant issue in assessing health and fitness in youth when using BMI. Research has also suggested that along with body composition, aerobic fitness must also be considered to accurately assess health status in a population. Lee et al. [2] found that unfit lean men had a higher risk of cardiovascular disease and all-cause mortality than fit but overweight men. These findings suggest that fitness offers some protection against CVD risk even if the individual is overweight. Similar results have been reported for the female population [3]. Using skinfold thickness as the measure of body fatness and stratifying youth into high-fat/high-fitness, high-fat/low-fitness, low-fat/high-fitness, and low-fat/low-fitness groups, it was found that
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