surveys and schools are the progressive shuttle run and mile run tests for cardiovascular endurance, measurement of body mass index (BMI) for assessment of body composition, the curl-up and push-up tests for muscular endurance, and the sit-and-reach tests for flexibility.

While the components of fitness measured and the specific test items included in protocols have varied considerably across test batteries and over time, youth fitness testing has become a well-established institution in school physical education programs during the past half-century. In a school context, tests are being used as institutional fitness assessment tools, as educational tools to teach youth and their families about the importance of physical fitness, and as communication tools to guide individuals on attainable goals for maintaining fitness and health. These efforts are costly in terms of not only human capacity and financial resources, but also the extensive training and organizational and communication skills required for their implementation. Most important, it is essential to use appropriate tests and understand the results in a health context to minimize misclassification and stigmatization of youth. Selection of the best tests is therefore a crucial process, and knowledge gaps in this area were an important motivator of the present study.

This study was undertaken in light of the past challenges encountered in identifying fitness tests related to health in youth, spurred by a renewed interest in fitness as one of the key tenets of health.

STUDY APPROACH

Given the gaps in knowledge noted above, the Institute of Medicine (IOM) convened an 11-member committee with expertise in fitness measures, body composition and maturity, physical activity, physical education, the development of cut-points (cutoff scores), motor development and skill, and modifiers of fitness to conduct this study. The committee was asked to assess the relationships between fitness tests and health outcomes in youth based on a review of the literature designed and conducted by the Centers for Disease Control and Prevention (CDC) (the committee’s statement of task is shown in Box S-1). The CDC search criteria included longitudinal, experimental study designs in which fitness and health were measured in healthy1 children aged 5-18 during 2000-2010. The CDC searches were conducted specifically for the fitness components cardiorespiratory endur-

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1The criteria included overweight and obese youth, but excluded youth with various disabilities or congenital diseases. Since the primary task for this study was to identify fitness tests appropriate for a national youth fitness survey of the general youth population, the committee did not review additional literature specific to populations with disabilities, such as those with cognitive or physical impairments, activity limitations, or participation restrictions (as defined in Appendix B).



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