Criterion-referenced mCAFT cut-points to identify metabolically healthy cardiorespiratory fitness among adults aged 18–69 years: An analysis of the Canadian Health Measures Survey

Objective: This study aimed to develop and validate health-related criterion-referenced cutpoints for the modified Canadian Aerobic Fitness Test (mCAFT), a field-based measure to predict cardiorespiratory fitness (CRF) among adults (18–69 years). Methods: Criterionreferenced mCAFT cut-points were developed using nationally representative data from cycles 1 (2007–09) and 2 (2009–11) of the Canadian Health Measures Survey (CHMS). Receiver operating characteristic curves were used to identify age- and sex-specific cut-points for measured waist circumference, blood pressure, and high-density lipoprotein. Cut-points were validated against metabolic syndrome using a fasted sub-sample (n=1,093) from cycle 5 (2016– 17). Results: 4,967 participants (50% women) were retained for the main analyses. The mCAFT cut-points ranged from 28 to 43 mL•kg–1•min–1 (AUC: 0.60-0.87) among men, and 23 to 37 mL•kg–1•min–1 (AUC: 0.61-0.86) among women. The likelihood of meeting the new mCAFT cut-points decreased with an increase in the presence of metabolic risk factors. In total, 54% (95%CI: 42 to 67%) of Canadian adults met the new mCAFT cut-points in 2016–17. Conclusion: This study developed and validated the first health-related criterion-referenced mCAFT cutpoints for metabolic health among Canadian adults aged 18–69 years. These mCAFT cut-points may be useful in health surveillance, clinical, and public health settings. Novelty bullets We developed and validated new criterion-referenced cut-points for the modified Canadian Aerobic Fitness Test to help identify adults at potential risk of poor metabolic health. These new cut-points could help support national health surveillance efforts