Physical fitness as a moderator in the relationship between adiposity and cardiometabolic risk factors in children and adolescents

BACKGROUND: The aim of this study was to verify the moderator role of physical fitness in the relationship between adiposity and cardiometabolic risk factors in normal weight and overweight/obese children and adolescents. METHODS: Cross-sectional study comprising 2482 children and adolescents, aged 7-17 years. Physical fitness was evaluated according the procedures of Projeto Esporte Brazil, and waist circumference (WC) with an inelastic tape. Cardiometabolic risk score was defined by the z-score sum of glucose, total cholesterol, high-density lipoprotein cholesterol and low-density lipoprotein cholesterol. Moderation analysis was done through linear regression models. RESULTS: Significant interaction term for cardiorespiratory fitness (CRF)xWC with cardiometabolic risk factors (P<0.001), as well as for lower limbs strength (LLS)xWC (P<0.001) and agility x WC (P=.01) in normal weight girls. For normal weight boys it was found a significant interaction term for CRFxWC with cardiometabolic risk factor (P=0.007), and also for agility x WC (P=0.003), while overweight/obese boys showed a significant interaction term only for agility x WC with cardiometabolic risk factor (P=0.001). CONCLUSIONS: CRF, LLS and agility are moderators in the relationship between WC and cardiometabolic risk factors in normal weight girls, while CRF and agility were moderators for normal weight boys and only agility for overweight/obese boys.