Fitness, body composition, and metabolic risk scores in children and adolescents: the UP&DOWN study Sánchez Delgado, Alejandro Girela Rejón, María José Cardiovascular disease Aerobic capacity Muscular strength Youth Adiposity We aimed to analyse the longitudinal association between physical fitness (PF) and body composition (BC) with a metabolic risk score (Met4) in children and adolescents and to elucidate whether the association between PF and Met4 differs when using relativized or absolute fitness variables. A total of 188 children (86 females) and 195 adolescents (97 females) were included. Cardiorespiratory fitness (CRF) was determined by the 20-m shuttle run test, and muscular fitness (MF) was determined by hand grip and standing long jump tests. Height and weight were measured, and the body mass index (Kg/ m2) was calculated. Triceps and subscapular skinfolds were assessed to compute body fat percentage. Met4 was computed from systolic blood pressure, triglycerides, high-density lipoprotein cholesterol, and glucose levels. Relative CRF was longitudinally and negatively associated with Met4 in female children (β = −0.031, p = 0.025), while absolute CRF was positively associated with Met4 in male children and adolescents (β = 0.000, p < 0.05). Relative upper and lower-body MF were longitudinally and negatively associated with Met4 in female adolescents (β = −1.347, β = −0.005, p < 0.05), while absolute lower-body MF was positively associated with Met4 in male children (β = 0.000, p = 0.019). BC was longitudinally and positively associated with Met4 in male children (β-ranging from 0.011 to 0.055, all p < 0.05) and male adolescents (β-ranging from 0.011 to 0.046, all p < 0.05). Conclusion: BC is more strongly associated with Met4 than PF in children and adolescents. An optimal body weight status should be considered the main objective of health-promoting programs at childhood and adolescence. Furthermore, the way of expressing the fitness variables determines the direction of the association with Met4. 2022-12-22T07:51:52Z 2022-12-22T07:51:52Z 2022-11-29 journal article Sánchez-Delgado, A... [et al.]. Fitness, body composition, and metabolic risk scores in children and adolescents: the UP&DOWN study. Eur J Pediatr (2022). [https://doi.org/10.1007/s00431-022-04707-1] https://hdl.handle.net/10481/78601 10.1007/s00431-022-04707-1 eng http://creativecommons.org/licenses/by/4.0/ open access Atribución 4.0 Internacional Springer