An Alternative to Ratio Scaling for the Interpretation of Aerobic Fitness in Children

Traditional and New Perspectives on Youth Cardiorespiratory Fitness

PURPOSE

This study aimed to review traditional and new perspectives in the interpretation of the development of youth cardiorespiratory fitness (CRF).

METHODS

We analyzed data from (i) the literature which for 80 yr has been traditionally based on interpretations of peak oxygen uptake (V˙O2) in ratio with body mass (BM) and (ii) recent multilevel allometric models founded on 994 (475 from girls) determinations of 10- to 16-yr-olds' peak V˙O2 with measures of age, maturity status, and morphological covariates (BM and fat-free mass), and from 10 to 13 yr, 110 peak V˙O2 determinations of maximum cardiovascular covariates (stroke volume, cardiac output, and arteriovenous oxygen difference).

RESULTS

The application of ratio scaling of physiological variables requires satisfying specific statistical assumptions that are seldom met. In direct conflict with the ratio-scaled data interpretation of CRF, multilevel allometric modeling shows that with BM controlled, peak V˙O2 increases with age but the effect is smaller in girls than boys. Maturity status exerts a positive effect on peak V˙O2, in addition to those of age and BM. Changes in maximum cardiovascular covariates contribute to explaining the development of CRF, but fat-free mass (as a surrogate for active muscle mass) is the most powerful single influence. With age, maturity status, morphological covariates, and maximum cardiovascular covariates controlled, there remains an unexplained ~4% to ~9% sex difference in peak V˙O2.

CONCLUSIONS

The traditional interpretation of peak V˙O2 in ratio with BM is fallacious and leads to spurious correlations with other health-related variables. Studies of the development of CRF require analyses of sex-specific, concurrent changes in age- and maturation-driven morphological and maximum cardiovascular covariates. Multilevel allometric modeling provides a rigorous, flexible, and sensitive method of data analysis.

Interpreting Youth Aerobic Fitness: Promoting Evidence-Based Discussion–A Response to Dotan (2019)

We welcome Raffy Dotan’s Letter to the Editor (14) as it gives us another opportunity to promote evidence-based discussion of the development of youth aerobic fitness. Readers of our contributions to the 2019 Special Issue of Pediatric Exercise Science (6,27,28) will recall that we concluded with, “The authors encourage all pediatric exercise scientists to engage with this discussion, to share ideas and methods, and be willing to explore alternatives. There are many issues to resolve and constructive, collaborative debate will speed our collective aim toward a better understanding of pediatric aerobic fitness in health and disease” (27, p. 256). Not the words of authors preaching a “gospel” with “evangelistic persistence” as Dotan (14) suggests, but of scientists genuinely seeking to stimulate evidence-based discussion of the development of youth aerobic fitness and its relationship with health and well-being.