Recommended levels and intensities of physical activity to avoid low‐cardiorespiratory fitness in European adolescents: The HELENA study

OBJECTIVES: The purpose of this study was to determine the sex-specific physical activity (PA) intensity thresholds that best discriminate between unhealthy/healthy cardiorespiratory fitness (CRF). METHODS: Participants included 1,808 adolescents (964 girls), aged 12.5-17.5 years, from the HELENA study. We measured PA by accelerometer and calculated the time spent at light, moderate, vigorous, and moderate-to-vigorous (MVPA) intensities. CRF was assessed by the 20-m shuttle-run test. Adolescents were dichotomized (unhealthy/healthy) based on sex- and age-specific FITNESSGRAM standards. Receiver operating characteristic (ROC) analysis was used to determine thresholds that best discriminate between CRF categories. RESULTS: ROC analyses revealed that the PA thresholds that best discriminate between unhealthy/healthy CRF were ≥152, ≥33, ≥13, and ≥52 min/day in light, moderate, vigorous, and MVPA, respectively. In boys, the PA thresholds associated with a healthy CRF were ≥37, ≥19, and ≥56 min/day in moderate, vigorous, and MVPA, respectively, whereas in girls were ≥152, ≥34, ≥12, and ≥51 min/day in light, moderate, vigorous, and MVPA, respectively. Spending at least 60 min/day in MVPA was also associated with a healthy CRF (odds ratios: 1.75, 1.94, and 1.57, all P < 0.05, for the whole sample, boys, and girls, respectively). CONCLUSIONS: This study shows sex- and intensity-specific PA thresholds to discriminate between adolescents with a healthy CRF from those with a less favorable or unhealthy CRF level.