0.5) for all cut-offs. Conclusions Aerobic fitness is easy to measure, and is an accurate tool for screening children with clustering of cardiovascular risk factors. Promoting physical activity in children with aerobic fitness level lower than the suggested cut-points might improve their health. There are many simple anthropometric (eg, body mass index; BMI) and physiological measures (eg, aerobic fitness level) that may predict the onset and progression of cardiovascular and metabolic diseases, yet widespread screening of schoolchildren is not in place.1 2 BMI, known to be associated with cardiovascular disease, is an accepted measure for this purpose. 2 However, aerobic fitness level is still not well recognised as a screening tool in paediatric populations. A growing body of evidence suggests that aerobic fitness level is inversely associated with the presence of clustering of cardiovascular risk
factors among children and adolescents1 3 4 and cardiometabolic events later in life. 5 By assessing aerobic fitness simple risk stratification can be performed in the school setting and a strategy for selecting children ‘at risk’ for potential further investigation can then be created. Most of the published cut-offs defi ning low aerobic fitness in childhood have been based on population distributions (0.90, p
