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The National Health and Nutrition Examination Survey (NHANES) evaluated fitness by estimating V\u0307O<jats:sub>2<\/jats:sub>max from submaximal measurements of heart rate (HR) during graded treadmill exercise. Our aims were (a) to examine how well NHANES methodology used to <jats:italic>estimate<\/jats:italic> V\u0307O<jats:sub>2<\/jats:sub>max correlated with <jats:italic>actual<\/jats:italic> VO<jats:sub>2<\/jats:sub>max and (b) to evaluate a novel fitness metric using actual data collected during exercise and its relationship to physical activity and sedentary time, lipid profiles, and body composition.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Fifty\u2010three adolescents completed NHANES submaximal exercise protocol and maximal graded cardiopulmonary exercise testing. We used a novel approach to quantifying fitness (\u0394velocity\u00a0\u00d7\u00a0incline\u00a0\u00d7\u00a0body mass (VIM)\/\u0394HR slopes) and evaluated its relationship to physical activity and sedentary time using NHANES data (n\u00a0=\u00a04498). In a subset (n\u00a0=\u00a0740), we compared \u0394VIM\/\u0394HR slopes to NHANES estimated V\u0307O<jats:sub>2<\/jats:sub>max and examined their relationship to cardiovascular risk factors (BMI percentiles and lipid levels).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Measured V\u0307O<jats:sub>2<\/jats:sub>peak was moderately correlated with NHANES estimated V\u0307O<jats:sub>2<\/jats:sub>max (<jats:italic>r<\/jats:italic>\u00a0=\u00a00.53, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.01). Significantly higher \u0394VIM\/\u0394HR slopes were associated with increased physical activity and decreased sedentary time. \u0394VIM\/\u0394HR slopes were negatively associated with LDL, triglycerides, and BMI percentiles (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.01). In general, the two fitness models were similar; however, \u0394VIM\/\u0394HR was more discriminating than NHANES in quantifying the relationship between fitness and LDL levels.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>We found that the NHANES estimated V\u0307O<jats:sub>2<\/jats:sub>max accounted for approximately 28% of the variability in the measured V\u0307O<jats:sub>2<\/jats:sub>peak. Our approach to estimating fitness (\u0394VIM\/\u0394HR slopes) using actual data provided similar relationships to lipid levels. We suggest that fitness measurements based on actually measured data may produce more accurate assessments of fitness and, ultimately, better approaches linking exercise to health in children.<\/jats:p><\/jats:sec>","DOI":"10.1111\/sms.13461","type":"journal-article","created":{"date-parts":[[2019,5,7]],"date-time":"2019-05-07T19:11:01Z","timestamp":1557256261000},"page":"1392-1401","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["A new approach to estimate aerobic fitness using the NHANES dataset"],"prefix":"10.1111","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2507-6370","authenticated-orcid":false,"given":"Kim D.","family":"Lu","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Pediatric Exercise and Genomics Research Center (PERC) University of California, Irvine School of Medicine Irvine California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ronen","family":"Bar\u2010Yoseph","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Pediatric Exercise and Genomics Research Center (PERC) University of California, Irvine School of Medicine Irvine California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shlomit","family":"Radom\u2010Aizik","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Pediatric Exercise and Genomics Research Center (PERC) University of California, Irvine School of Medicine Irvine California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dan M.","family":"Cooper","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Pediatric Exercise and Genomics Research Center (PERC) University of California, Irvine School of Medicine Irvine California"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,6,3]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajhb.22919"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/ijo.2016.61"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/oby.22199"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.14814\/phy2.12338"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12969-016-0110-8"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.3171\/2016.5.PEDS16139"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2015.6309"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/cts.12194"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/bjsm.22.4.141"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1080\/02701367.2002.10608993"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.4103\/2229-3485.192046"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdent.2003.10.001"},{"issue":"1","key":"e_1_2_8_14_1","first-page":"134","article-title":"Advantages and limitations of meta\u2010analytic regressions of clinical trials data","volume":"3","author":"Berlin JA","year":"1994","journal-title":"Online J Curr Clin Trials"},{"issue":"10","key":"e_1_2_8_15_1","article-title":"Adjustment for physical activity in studies of sedentary behaviour","volume":"12","author":"Page A","year":"2015","journal-title":"Emerg Themes Epidemiol"},{"issue":"1","key":"e_1_2_8_16_1","first-page":"6","article-title":"Pediatric exercise testing: value and implications of peak oxygen uptake","volume":"4","author":"Pianosi P","year":"2017","journal-title":"Child (Basel, Switzerland)"},{"key":"e_1_2_8_17_1","unstructured":"Centers for Disease Control and Prevention.National Health and Nutrition Examination Survey (NHANES 2003\u20132004): Cardiovascular Fitness Procedures Manual. 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