Cardiorespiratory Fitness in Indonesian Adolescents: Limited Role of BMI and Dominant Influence of Age and Sex in a Large Cross-Sectional Study
DOI:
https://doi.org/10.17977/um086v4i12026p127-136Keywords:
Adolescents, body mass index, cardiorespiratory fitness, school-based health screeningAbstract
Background: Cardiorespiratory fitness (CRF) is a crucial indicator of long-term cardiovascular and metabolic health. Whether body mass index (BMI) independently predicts CRF beyond demographic factors in large, real-world adolescent cohorts remains inconsistently defined. Objective: To determine the independent contributions of body mass index (BMI), age, and sex to cardiorespiratory fitness among Indonesian adolescents using a large community-based dataset.. Methods: A cross-sectional study was conducted using community-based fitness screening data from Central Java, Indonesia. A total of 2,730 adolescents aged 10-18 years (mean 13.3 +/- 2.2 years; 49.6% male) were included. The primary outcome was CRF measured by the 1,600-meter run time (seconds). BMI was analyzed as both a continuous and a categorical variable. Multivariable linear regression models, including non-linear Restricted Cubic Spline (RCS) modeling, were applied. Result: The median run time was 453.0 seconds (IQR 360.6-660.0). Males ran significantly faster than females (491.4 vs. 658.6 seconds; t = -3.02, p = 0.003). BMI category was not significantly associated with run time (ANOVA F = 0.34, p = 0.799) or in adjusted models (beta = 3.8, p = 0.621). Age (beta = 56.7 s/year, p < 0.001) and sex (beta = 156.5 s, p = 0.005) were the sole significant predictors. Neither linear nor non-linear BMI modeling improved model fit (adjusted R2 ~1.0%). Conclusion: BMI did not independently predict CRF in this large Indonesian adolescent cohort. Age and sex were the dominant predictors. These findings challenge the use of BMI as a CRF surrogate in school-based health screening and call for direct fitness assessments with age- and sex-standardized benchmarks.
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