RECOMMENDATION 8-1.3 A national survey of health-related physical fitness in youth should include measures of cardiorespiratory endurance, body composition, and musculoskeletal fitness. The survey should include the following fitness test items: (1) measures of BMI, waist circumference, and skinfold thickness (triceps and subscapular sites) to assess body composition; (2) a progressive shuttle run, such as the 20-meter shuttle run (or a submaximal treadmill or cycle ergometer test if there are space limitations) to measure cardiorespiratory endurance; and (3) handgrip strength and standing long jump tests to measure musculoskeletal fitness.

RECOMMENDATION 8-2. Standard protocols for the administration of measures of youth fitness in national surveys should be developed and implemented. The focus should be on maximizing the measures’ reliability, validity, and safety. Trained personnel should be used for test administration and data collection.

RECOMMENDATION 8-3. Developers of fitness test batteries should use age- and sex-specific cut-points to determine which individuals are at risk of poor fitness-related health outcomes. Optimum cut-points should be based on criterion values when population-based evidence is available on the relationship between the level of performance on a fitness test and a health outcome or marker. In the absence of criterion values, interim population-based percentile values should be applied. These values might be derived from adults on tests for the same component or from youth on tests for a different or the same component. Specifically, the guidance of the committee should be applied as follows:

  • Body composition: For BMI, the CDC-established cut-points for underweight, overweight, and obesity evaluations should be used. Interim cut-points for skinfold and waist circumference measures could be derived from the CDC-established percentiles for BMI.
  • Cardiorespiratory endurance: For measures of cardiorespiratory endurance, interim cut-points could be derived from the lowest performers (e.g., 20th percentile) on the cardiorespiratory endurance distribution curve.
  • Musculoskeletal fitness: For musculoskeletal fitness tests, interim cut-points could be derived by borrowing the percentile (e.g., 20th percentile) from the cardiorespiratory endurance tests.


3The committee’s recommendations are numbered according to the chapter of the main text in which they appear.

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