youth fitness survey and in youth fitness tests conducted in other settings. Cut-points (cutoff scores) are critical to interpretation of the results of health-related fitness tests since they serve as a way to distinguish individuals and populations that may be at risk of poor health outcomes from those that are not. As explained in Chapter 3, the committee concluded that a criterion-referenced method using cut-points associated with health outcomes or health markers is the ideal approach. Except for BMI, however, insufficient evidence exists with which to develop age- and gender-specific criterion-referenced cut-points related to health outcomes for any of the recommended tests; instead, age- and gender-specific interim cut-points corresponding to percentiles for youth or for adults should be used until enough data have been collected to enable establishing age- and gender-specific criterion-referenced cut-points. The committee provides general guidance for developing cut-points and interpreting performance results in Chapter 3; specific recommendations for developing cut-points depend on data available for each of the components of fitness. The following is a summary of the basis for the committee’s recommendations for deriving interim cut-points2 (additional explanation can be found in the chapters on the fitness components [Chapters 4-7]):

  • Body composition—BMI cut-points were set based on the already established 2000 Centers for Disease Control and Prevention (CDC) growth charts and percentiles. Until population-based evidence in youth is available for skinfolds and waist circumference, the 85th percentile (borrowed from the BMI percentiles) should be used to derive interim cut-points for these measures.
  • Cardiorespiratory endurance—Until population-based evidence in youth is available, the recommended interim cut-points should be based on data from both youth and adult populations on the relationship between treadmill test performance and health outcomes. For adults, the lowest quintile has been determined as appropriate (Blair et al., 1989). For youth, the 30th percentile has been established as identifying those at risk of poor health outcomes (Lobelo et al., 2009; Welk et al., 2011). Based on those two determinations, the committee recommends that interim cut-points be derived from

2Depending on the nature of the test, the risk of a poor health outcome is defined by an individual’s being either below or above a specific percentile of a population. For BMI, for example, individuals above the 85th percentile of the 2000 Centers for Disease Control and Prevention (CDC) growth charts are considered to be overweight or obese and therefore at risk of a poor health outcome. In contrast, for cardiorespiratory endurance tests, those below a certain percentile (e.g., 20th percentile) of the population are the ones who are less able to perform exercise without fatigue and therefore at risk of a poor health outcome.

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