RT Journal Article SR Electronic T1 Association between physical activity, cardiorespiratory fitness and clustered cardiovascular risk in South African children from disadvantaged communities: results from a cross-sectional study JF BMJ Open Sport & Exercise Medicine JO BMJ OPEN SP EX MED FD BMJ Publishing Group Ltd SP e000823 DO 10.1136/bmjsem-2020-000823 VO 6 IS 1 A1 Ivan Müller A1 Cheryl Walter A1 Rosa Du Randt A1 Ann Aerts A1 Larissa Adams A1 Jan Degen A1 Stefanie Gall A1 Nandi Joubert A1 Siphesihle Nqweniso A1 Sarah Des Rosiers A1 Danielle Smith A1 Harald Seelig A1 Peter Steinmann A1 Christina Wadhwani A1 Nicole Probst-Hensch A1 Jürg Utzinger A1 Uwe Pühse A1 Markus Gerber YR 2020 UL http://bmjopensem.bmj.com/content/6/1/e000823.abstract AB Background/Aim Physical inactivity (PIA) is a growing global health problem and evidence suggests that PIA is a key driver for cardiovascular and chronic diseases. Recent data from South Africa revealed that only about half of the children achieved recommended daily physical activity (PA) levels. Assessing the intensity of PA in children from low socioeconomic communities in low-income and middle-income countries is important to estimate the extent of cardiovascular risk and overall impact on health.Methods We conducted a cross-sectional survey in eight quintile 3 primary schools in disadvantaged communities in the Port Elizabeth region, South Africa. Children aged 10–15 years were subjected to PA, blood pressure, cholesterol, blood glucose and skinfold thickness assessments. Cardiovascular risk markers were converted into standardised z-scores and summed, to obtain a clustered cardiovascular risk score.Results Overall, 650 children had complete data records. 40.8% of the children did not meet recommended PA levels (ie, logged <60 min of moderate-to-vigorous physical activity (MVPA) per day). If quartiles were developed based on children’s cardiorespiratory fitness (CRF) and MVPA levels, a significant difference was found in clustered cardiovascular risk among children in the highest versus lowest fitness (p<0.001) or MVPA (p<0.001) quartiles.Conclusions CRF and objectively assessed PA are closely linked with children’s clustered cardiovascular risk. Given that 4 out of 10 South African schoolchildren from marginalised communities do not meet international PA recommendations, efforts should be made to ensure that promoting a physically active lifestyle is recognised as an important educational goal in primary schools.Trial registration numbers ISRCTN68411960 and H14-HEA-HMS-002.