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Date:  Sept. 27, 2012




BMI and Shuttle Run Among Techniques IOM Report Recommends for Youth Fitness Testing


WASHINGTON — Techniques ranging from running to push-ups to sit-and-reach tests have been used to measure various aspects of fitness in children and adults.  However, evidence is sparse on how well some of these techniques correspond to desired health outcomes in children, fueling debate about the best fitness measures for youth. 


Fitness testing has traditionally focused on four aspects: heart and lung function, body composition, muscular and skeletal fitness, and flexibility.  A committee convened by the Institute of Medicine undertook a comprehensive review of the science and found that it supports the use of specific ways to measure three of these components -- cardiorespiratory endurance, body composition, and musculoskeletal fitness -- in young people.  These measurements should be used in national youth fitness surveys and school-based fitness tests, says the committee's report.


Recent events underscore the importance of evaluating the evidence base for different elements of fitness testing.  Earlier this year, the Centers for Disease Control and Prevention launched the 2012 NHANES National Youth Fitness Survey, the first nationwide survey of fitness in young people since the mid-1980s.  And earlier this month, the President's Council on Fitness, Sports, and Nutrition announced it is adopting FITNESSGRAM, a battery of tests provided by the nonprofit Cooper Institute, as the assessment for the Presidential Youth Fitness Program.  This is the program under which much school-based fitness testing is conducted. 


"This report's recommendations offer helpful guidance to those designing fitness batteries targeted at children and adolescents," said committee chair Russell R. Pate, professor of exercise science, Norman J. Arnold School of Public Health, University of South Carolina, Columbia.  "Collecting more data through surveys and in schools will advance our understanding about how fitness in early years translates into better health throughout a lifetime."


Studies have found cardiorespiratory endurance to be associated with risk factors for developing heart disease later in life.  The progressive shuttle run -- an exercise in which participants sprint back and forth between two points -- is a good measure of cardiorespiratory endurance, the committee concluded.  If space is limited and resources permit, cycle ergometer and treadmill tests are valid and reliable alternatives for the shuttle run in national surveys. 


Body mass index (BMI), a calculation of body weight in relation to height, is related to young people's risk for obesity-related conditions such as diabetes.  BMI measurements can easily be done in both national surveys and schools to measure body composition, the committee said.  Those conducting national surveys should also measure each participant's waist circumference and skinfold thickness.  


Emerging evidence from studies involving children and adolescents suggests that musculoskeletal fitness is related to bone health and body composition.  Handgrip strength and the standing long jump should be used to measure musculoskeletal fitness by both national fitness surveys and schools, the report says.  The committee found insufficient evidence linking flexibility to health outcomes in young people and therefore did not recommend techniques to measure flexibility. 


Other techniques besides those recommended by the committee are commonly used in schools to measure fitness in youth.  Schools use fitness tests to teach children and their families about the importance of physical fitness and to guide individuals on ways to maintain fitness and health.  Tests such as a 1-mile run, modified pull-ups or push-ups, and sit-and-reach tests can have educational value and therefore could be used as supplementary measurements of fitness in schools, the committee said.  All methods that are used should be safe, reliable, and feasible to conduct in school settings.  The committee emphasized that school staff members need to take into consideration confidentiality, self-esteem, and other sensitivities surrounding physical fitness testing when they share test results with students and their families.  


The report was sponsored by the Robert Wood Johnson Foundation.  Established in 1970 under the charter of the National Academy of Sciences, the Institute of Medicine provides objective, evidence-based advice to policymakers, health professionals, the private sector, and the public.  The Institute of Medicine, National Academy of Sciences, National Academy of Engineering, and National Research Council together make up the independent, nonprofit National Academies.  For more information, visit or   A committee roster follows.



Christine Stencel, Senior Media Relations Officer

Luwam Yeibio, Media Relations Assistant

Office of News and Public Information

202-334-2138; e-mail


Additional resources: 

Full Report

Report Brief

Project Website

Pre-publication copies of Fitness Measures and Health Outcomes in Youth are available from the National Academies Press; tel. 202-334-3313 or 1-800-624-6242 or on the Internet at  Additional information is available at  Reporters may obtain a copy from the Office of News and Public Information (contacts listed above).

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Food and Nutrition Board


Committee on Fitness Measures and Health Outcomes in Youth


Russell R. Pate, Ph.D. (chair)


Department of Exercise Science

Arnold School of Public Health

University of South Carolina



Cameron Blimkie, Ph.D. 


Department of Kinesiology

McMaster University

Hamilton, Ontario



Darla Castelli, Ph.D. 

Associate Professor

Department of Kinesiology and Health Education

University of Texas



Charles B. Corbin, Ph.D. 

Professor Emeritus

Department of Exercise and Wellness

Arizona State University



Stephen R. Daniels, M.D., Ph.D. 

Professor and Chair

Department of Pediatrics

University of Colorado School of Medicine, and


Children’s Hospital Colorado



Harold W. Kohl III, Ph.D. 


Michael & Susan Dell Center for Healthy Living

School of Public Health

University of Texas Health Science Center at Houston, and

Professor of Kinesiology and Health Education

University of Texas



Robert Malina, Ph.D. 

Professor Emeritus

Department of Kinesiology and Health Education

University of Texas at Austin, and

Research Professor

Department of Kinesiology

Tarleton State University



Jennifer Sacheck, Ph.D. 

Associate Professor

John Hancock Research Center on Physical Activity, Nutrition, and Obesity Prevention

Friedman School of Nutrition Science and Policy

Tufts University



David Stodden, Ph.D. 

Associate Professor

Department of Health, Exercise, and Sport Sciences

Texas Tech University



Melicia Whitt-Glover, Ph.D.

President and CEO

Gramercy Research Group LLC

Winston-Salem, N.C.


Weimo Zhu, Ph.D.   


Department of Kinesiology and Community Health

College of Applied Health Sciences

University of Illinois





Maria P. Oria, Ph.D.

Study Director