Exploring the moderating role of physical fitness on cardiometabolic risk in Chilean adolescents

Objective The objective of this study was to analyze the moderating role of physical fitness on cardiometabolic risk in Chilean adolescents. Methods A cross-sectional study was conducted with 7854 Chilean adolescents aged 15.8 ± 0.7 years (boys = 4356; girls = 3498). Physical fitness and cardiometabolic risk variables were evaluated using anthropometric indicators in accordance with the guidelines of the physical education quality measurement system (SIMCE-EF). A moderation analysis adjusted for sex and age was performed using a model that examined the association between cardiometabolic risk, as measured by the waist-to-height ratio (WHtR), and the interaction between body mass index (BMI) and physical fitness variables (VO₂max, trunk flexibility, horizontal jump, sit-ups, and push-ups). Variables with interaction were tested using the Johnson–Neyman model. Results The results suggest a relationship between the level of cardiometabolic risk (WHtR) and the interaction between BMI and VO₂max (β = −0.0002; p < 0.001), push-ups ( β = −0.00007; p < 0.001), and sit-ups ( β = −0.00005; p = 0.049). All variables were analyzed on their original scales. Standardized coefficients confirmed small-to-moderate interaction effects. Conclusions We conclude that physical fitness, especially VO₂max and muscular strength, plays a positive moderating role between nutritional status and cardiometabolic risk in adolescents. These results highlight the importance of developing physical fitness in adolescents to reduce cardiometabolic risk, underscoring the need for public policies that promote physical activity in schools to meet physical activity recommendations for this population.