“Leaner and less fit” children have a better cardiometabolic profile than their “heavier and more fit” peers: The Healthy Growth Study G. Moschonis a , V. Mougios b , C. Papandreou a , C. Lionis c , G.P. Chrousos d , E. Malandraki a , Y. Manios a, * a Department of Nutrition and Dietetics, Harokopio University of Athens, 70, El.Venizelou Ave, 17671 Kallithea, Athens, Greece b Department of Physical Education and Sport Science, Aristotle University of Thessaloniki, Thessaloniki, Greece c Clinic of Social and Family Medicine, School of Medicine, Heraklion, University of Crete, Crete, Greece d First Department of Pediatrics, Athens University Medical School, “Aghia Sophia” Children’s Hospital, Athens, Greece Received 30 May 2012; received in revised form 22 November 2012; accepted 26 November 2012 KEYWORDS Cardiometabolic risk; Body mass index; Fitness; Children Abstract Background and aims: To examine differences in cardiometabolic risk factors be- tween children of different BMI and fitness levels. Methods and results: From a representative sample of 1222 boys and 1188 girls, aged 9e13 years, anthropometric, body composition, physical activity, cardiorespiratory fitness, biochem- ical and blood pressure data was collected. The prevalence of overweight and obesity was 29.9% and 11.8% respectively. In both genders, plasma HDL cholesterol concentration was higher in the ‘leaner and less fit’ group (lowest quartile of BMI and lowest quartile of fitness) compared to the ‘heavier and more fit’ (highest quartile of BMI and highest quartile of fitness) and intermediate (all other children) groups (p < 0.05). Furthermore, the ‘leaner and less fit’ groups in both gen- ders had lower triacylglycerol concentration, total-to-HDL cholesterol ratio, HOMA-IR, insulin and systolic blood pressure levels compared to the ‘heavier and more fit’ and/or intermediate groups. Similar trends were observed for hypertension in boys and insulin resistance for both gen- ders. Finally, the effect size of being ‘leaner and less fit’ on serum levels of cardiometabolic risk indices was mainly small to medium (i.e. Cohen’s d 0.2e0.5). Conclusion: Leaner and less fit boys and girls had better cardiometabolic risk profiles than their heavier and more fit peers, probably suggesting a higher importance of leanness over fitness in children from a cardiometabolic health benefit perspective. ª 2013 Elsevier B.V. All rights reserved. * Corresponding author. Tel.: þ30 210 9549156; fax: þ30 210 9514759. E-mail address: manios@hua.gr (Y. Manios). + MODEL Please cite this article in press as: Moschonis G, et al., “Leaner and less fit” children have a better cardiometabolic profile than their “heavier and more fit” peers: The Healthy Growth Study, Nutrition, Metabolism & Cardiovascular Diseases (2013), http://dx.doi.org/ 10.1016/j.numecd.2012.11.010 0939-4753/$ - see front matter ª 2013 Elsevier B.V. All rights reserved. http://dx.doi.org/10.1016/j.numecd.2012.11.010 Available online at www.sciencedirect.com journal homepage: www.elsevier.com/locate/nmcd Nutrition, Metabolism & Cardiovascular Diseases (2013) xx,1e8