Cardiorespiratory fitness is negatively associated with metabolic risk factors independently of the adherence to a healthy dietary pattern C. Moreira a, *, R. Santos a , P. Moreira a,b , F. Lobelo c , J.R. Ruiz d,e , S. Vale a , P.C. Santos a,f , S. Abreu a , J. Mota a a Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Rua Dr. Pla´cido Costa, 91, 4200-450 Porto, Portugal b Faculty of Nutrition and Food Science, University of Porto, Portugal c Division of Nutrition, Physical Activity and Obesity, Physical Activity and Health Branch, Centers for Disease Control and Prevention, Atlanta, USA d Unit for Preventive Nutrition, Dept. Biosciences and Nutrition at NOVUM Karolinska Institute, Sweden e Department of Physical Activity and Sports, School of Sport Sciences, University of Granada, Granada, Spain f Department of Physiotherapy, School of Health Technology of Porto, IPP, Portugal Received 24 October 2011; received in revised form 19 January 2012; accepted 31 January 2012 KEYWORDS Metabolic syndrome; Diet; Adolescents Abstract Background and aim: Cardiorespiratory fitness (CRF) and diet have been involved as significant factors towards the prevention of cardio-metabolic diseases. This study aimed to assess the impact of the combined associations of CRF and adherence to the Southern Euro- pean Atlantic Diet (SEADiet) on the clustering of metabolic risk factors in adolescents. Methods and Results: A cross-sectional school-based study was conducted on 468 adolescents aged 15-18, from the Azorean Islands, Portugal. We measured fasting glucose, insulin, total cholesterol (TC), HDL-cholesterol, triglycerides, systolic blood pressure, waits circumfer- ence and height. HOMA, TC/HDL-C ratio and waist-to-height ratio were calculated. For each of these variables, a Z-score was computed by age and sex. A metabolic risk score (MRS) was constructed by summing the Z scores of all individual risk factors. High risk was considered when the individual had 1SD of this score. CRF was measured with the 20 m-Shuttle-Run- Test. Adherence to SEADiet was assessed with a semi-quantitative food frequency question- naire. Logistic regression showed that, after adjusting for potential confounders, unfit adolescents with low adherence to SEADiet had the highest odds of having MRS (OR Z 9.4; 95%CI:2.6e33.3) followed by the unfit ones with high adherence to the SEADiet (OR Z 6.6; 95% CI: 1.9e22.5) when compared to those who were fit and had higher adher- ence to SEADiet. * Corresponding author. Tel.: þ351 225 074 785; fax: þ351 225 500 689. E-mail address: carla_m_moreira@sapo.pt (C. Moreira). + MODEL Please cite this article in press as: Moreira C, et al., Cardiorespiratory fitness is negatively associated with metabolic risk factors independently of the adherence to a healthy dietary pattern, Nutrition, Metabolism & Cardiovascular Diseases (2012), doi:10.1016/ j.numecd.2012.01.011 0939-4753/$ - see front matter ª 2012 Elsevier B.V. All rights reserved. doi:10.1016/j.numecd.2012.01.011 Available online at www.sciencedirect.com journal homepage: www.elsevier.com/locate/nmcd Nutrition, Metabolism & Cardiovascular Diseases (2012) xx,1e7