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Aim The present cross-sectional study aimed at assessing muscle strength of hands, the dominant arm and legs in Spanish institutionalized elderly people according to sex, age and cognitive status. Methods A total of 153 elderly subjects (102 females, 51 males, mean age 83.6 ± 6.8 years) living in the region of Madrid were measured for handgrip strength (kg) with a Takei TKK 5101 digital dynamometer (range 5-100 kg, precision 0.1 kg), and arm and leg endurance strength (repetitions) according to the Rikli and Jones tests. Cognitive status was determined with the Mini- Mental State Examination ( MMSE). Results The values for men and women were, respectively: 23.5 ± 7.3 kg and 11.6 ± 4.6 kg (right handgrip), 22.0 ± 7.8 kg and 10.7 ± 4.8 kg (left handgrip), 13 ± 5 and 10 ± 5 repetitions (arm strength), 8 ± 5 and 5 ± 4 repetitions (legs strength), and 21 ± 6 and 17 ± 7 ( MMSE score). All parameters were significantly higher for men ( P ≤ 0.01), but strength decline with age was less pronounced in women. In all MMSE groups, lower strength was associated with lower cognitive status. Conclusions Strength values were lower in older subjects in both sexes; this difference was higher in men than in women. Higher strength values were associated with better cognitive status, which was the most influencing variable, even more than sex and age. Geriatr Gerontol Int 2013; 13: 1026-1034. [ABSTRACT FROM AUTHOR]

We aimed to describe the sleep patterns in Spanish adolescents and to examine the relationships of sleep duration and morning tiredness with participation in leisure-time physical-sporting activities (LT-PA) and television (TV) watching. Sleep duration, morning tiredness, participation in LT-PA and time spent on watching TV were reported by 2,179 (1,139 females) Spanish adolescents (AVENA study). Data were analyzed by binary logistic regression. One-fifth of the adolescents reported insufficient night sleep (<8 h) on school days. The review of the literature (30 studies) showed that the Spanish adolescents sleep as long as adolescents from central Europe, and longer than those from other Mediterranean countries, South Africa, Asia and North America. Insufficient sleep duration doubled the odds of excessive TV watching (≥3 h/day) in males, regardless of morning tiredness (OR 2.15, 95% CI 1.42-3.27). Morning tiredness reduced the odds of participating in any LT-PA in both males and females (0.49, 0.34-0.70 and 0.49, 0.35-0.69, respectively), and increased the odds of excessive TV watching in females, regardless of sleep duration (2.49, 1.64-3.79). We conclude that non-participation in LT-PA is associated with morning tiredness in male and female adolescents, while excessive TV watching is more associated with short sleep or morning tiredness depending on gender. [ABSTRACT FROM AUTHOR]

Cycling competitions represent an important physical overload even for well-trained individuals. In six professional cyclists, we studied the adaptive oxidative and anti-inflammatory response to a 4-day road cycling competition and its relationship with melatonin, an antioxidant and anti-inflammatory stress hormone. Blood and urine samples were collected before and after the competition. Plasma lipid peroxidation, cytokines (interleukin-1β, interleukin-6, and tumour necrosis factor-α), creatine kinase and other metabolic markers, melatonin, erythrocyte glutathione, and glutathione peroxidase and reductase activities were measured. Urinary excretion of 6-sulphatoxymelatonin was analysed. Lipid peroxidation increased after the competition, but the erythrocyte glutathione pool remained unchanged. Changes in both glutathione peroxidase and reductase activities probably account for the recycling of glutathione after exercise. Interleukin-6 (216%) and tumour necrosis factor-α (159%) but not interleukin-1β increased after exercise. A parallel increase in plasma melatonin concentrations was detected, whereas metabolic markers, including creatine kinase, showed minor modifications. Thus, professional cyclists display an adaptative response to the physical overloads in the competitions for which they are trained. Consequently, they seem to be able to regulate efficiently the intracellular oxidative stress, and prevent an exaggerated pro-inflammatory cytokines induction. A modulator role of melatonin in these adaptive responses is also supported. [ABSTRACT FROM AUTHOR]

Objectives: To provide reference values for haematological indices in Spanish adolescents according to age and gender. Methods: A cross sectional study conducted in five Spanish cities was performed. Blood was drawn from a representative sample of 581 adolescents with age ranging from 13 to 17–18.5 yr. Age- and gender-specific means, standard deviations and percentiles were determined for the following parameters: total red blood cell counts (RBC), haemoglobin concentration (Hb), haematocrit percentage (Hct), mean corpuscular volume (MCV), mean corpuscular haemoglobin, mean corpuscular haemoglobin concentration, red cell distribution width and total white blood cell (WBC) counts as well as counts and percentage of neutrophils, lymphocytes, monocytes, eosinophils and basophils; platelet count (PLT), mean platelet volume and plateletcrit percentage. Results: Younger male subjects presented lower RBC, Hb, Hct and MCV means that their older counterpart. By contrast these differences were not observed in female subjects. As expected, RBC, Hb and Hct mean values in males were found significantly higher than in girls for all studied age groups. No significant differences were observed in WBC by age and gender. PLT values gradually decreased with age, except for females aged 17–18.5 yr. Conclusion: The present study provides reference data on the distribution of haematological indices of Spanish adolescents. These data can be useful biomarkers of the nutritional status in adolescents. [ABSTRACT FROM AUTHOR]

Background: This study aimed: (i) to describe the patterns of commuting to school in urban Spanish adolescents; and (ii) to examine the associations between active commuting to school (ACS) and socio-economic factors. [ABSTRACT FROM PUBLISHER]

The differential interferometric SAR (DInSAR) technique has proved its capability to detect small surface deformations in several types of applications. In this paper, its use as a quantitative subsidence monitoring tool is addressed to. A complete procedure is described, giving emphasis to the algorithms that have a major impact on the quality of the DInSAR results: the calibration of the InSAR geometry based on ground control points, which guarantees a high accuracy of the InSAR geometric model; a filtering procedure suitable to reduce the atmospheric effects in small-scale subsidences; and a data fusion procedure for multiple observations, which represents a key step to improve the quality of the DInSAR products. The procedure was used in the analysis of a small-scale urban subsidence located in Catalonia, northeastern Spain. The validation of the results, which was based on the comparison with precise and independent reference data, is discussed in detail. [ABSTRACT FROM AUTHOR]

Abstract: Objective: We assessed the individual association of sedentary behaviors with the risk of overweight and excess body fat (overfat) in adolescents. Methods: A representative sample (1960 subjects, 1012 males, age 13–18.5 y) of Spanish adolescents was studied within the framework of the Alimentación y Valoración del Estado Nutricional de los Adolescentes (AVENA) study. Television (TV) watching, videogame and computer usage, doing homework, and the way students got to school, physical activity, and socioeconomic status were analyzed. Anthropometrics were measured to describe overweight (International Obesity Task Force cutoffs for body mass index) and overfat (body fat percentage >85th percentile). Results: When all subjects were considered as an entire group, the overweight risk increased by 15.8% (P < 0.05) per increasing hour of TV watching. The overweight risks decreased by 32.5% in females, 22% per increasing year of age, and 12.5% by increasing socioeconomic status by 1 U (all Ps < 0.05). The obesity risks decreased with age by 17.8% per year in males and 27.1% in females (both Ps < 0.05). The overfat risks increased by 26.8% and 9.4% per increasing hour of TV and weekend videogame usage, respectively (both Ps < 0.05). In males, the overfat risk increased by 21.5% per increasing hour in weekend videogame usage (P < 0.05). Each hour of TV use increased the overfat risks by 22% in males and 28.3% in females (both Ps < 0.05). Conclusions: Time spent watching TV increased the risk of overweight and obesity in Spanish adolescents, but the effect was influenced by age, sex, and socioeconomic status. Moreover, an excess of body fat was more directly explained by the time spent watching TV and playing videogames during the weekend. [Copyright &y& Elsevier]

The aim of this study is to propose national diagnostic reference levels (DRL) for updating in the field of interventional cardiology and to include technical details to help plan optimization. Medical physics experts and interventional cardiologists from 14 hospitals provided patient dose indicators from coronary angiography and percutaneous coronary interventions. Information about X-ray system dose settings and image quality was also provided. The dose values from 30,024 procedures and 26 interventional laboratories were recorded. The national DRLs proposed for coronary angiography and percutaneous coronary interventions were respectively 39 and 78 Gy·cm 2 for air kerma area product (P KA ), 530 and 1300 mGy for air kerma at reference point (K a,r ), 6.7 and 15 min of fluoroscopy time and 760 and 1300 cine images. 36% of the KAP meters required correction factors from 10 to 35%. The dose management systems should allow these corrections to be included automatically. The dose per image in cine in reference conditions differed in a factor of 5.5. Including X-ray system dose settings in the methodology provides an insight into the differences between hospitals. The DRLs proposed for Spain in this work were similar to those proposed in the last European survey. The poor correlation between X-ray systems dose settings and patient dose indicators highlights that other factors such as operation protocols and complexity may have more impact in patient dose indicators, which allows a wide margin for optimization. Dose reduction technology together with appropriate training programs will be determinant in the future reduction of patient dose indicators., (Copyright © 2020 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.)

Objectives: Observational studies have reported an association among physical activity, fitness and lipid profile in youth. The purpose of this study was to analyse the effect of a school-based intervention focused on increasing the number and intensity of Physical Education (PE) sessions a week, on adolescents' lipid profile., Methods: A 4-month group-randomized controlled trial was conducted in 67 adolescents (12-14 years-old) from South-East Spain, 2007. Three school classes were randomly allocated into control group (CG), experimental group-1 (EG1) and experimental group-2 (EG2). The CG received the usual PE in Spain (2 sessions/week), the EG1 received 4 PE sessions/week, and the EG2 received 4 PE sessions/week of high intensity. The main study outcomes were fasting levels of total cholesterol, high-density lipoprotein cholesterol (HDLc), low-density lipoprotein cholesterol (LDLc) and triglycerides. All the analyses were adjusted for sex, sexual maturation, attendance and baseline value of the outcome studied., Results: The intervention did not positively affect cardio-metabolic parameters except for LDLc, that was marginally yet significantly reduced in EG2 (-10.4 mg/dl), compared with the CG (+4.1 mg/dl) (p = 0.04); no differences were observed however for the LDLc/HDLc ratio. No significant effects were observed in EG1., Discussion: Overall, a 4-month school-based physical activity intervention did not substantially influence lipid profile in adolescents. However, the results suggest that increasing both frequency and intensity of PE sessions had a modest effect on LDLc in youth. Future studies involving larger sample sizes and longer interventions should focus on the separate effects of volume and intensity of PE., (Copyright © AULA MEDICA EDICIONES 2013. Published by AULA MEDICA. All rights reserved.)

Background: Cobalamin deficiency is a common problem in the elderly. There is no consensus about adequate doses for supplementation., Subjects/methods: We performed an intervention study in order to establish the efficacy of a supplement providing 500 µg cyanocobalamin for four weeks in sixty-four institutionalized elderly residents, over 60 years of age, in Madrid (Spain). Before and after treatment, concentrations of serum cobalamin, serum holotranscobalamin, serum total homocysteine, and serum and red blood cell folate were analyzed. Clusters were built according to the initial cobalamin status and differences in the effect of supplementation were checked using a general linear model for repeated measures., Results: Cobalamin and holotranscobalamin increased highly significantly from 308 to 558 pmol/L and from 54 to 96 pmol/L (p < 0.001) in the whole study group as well as in each subgroup (clustered by initial cobalamin levels, all p < 0.01), with the highest relative change in the subgroup with the lowest initial cobalamin values. Total homocysteine decreased from 15 to 13 µmol/l, p < 0.001). Only the change of cobalamin (F = 4.61, p < 0.01), but not of holotranscobalamin nor total homocysteine, depended on the initial serum cobalamin status., Conclusions: A supplementation with an oral supplement solution of 500 µg cyanocobalamin daily for only four weeks, a shorter period than that found in former studies, may be considered suitable in institutionalized elderly.

Background: Physical activity is necessary for bone mass development in adolescence. There are few studies quantifying the associations between physical activity and bone mass in adolescents., Purpose: To assess the relationship between moderate-to-vigorous physical activity (MVPA) and vigorous physical activity (VPA) and bone mass in adolescents., Methods: Bone mass was measured by dual-energy X-ray absorptiometry and physical activity by accelerometers in 380 healthy Spanish adolescents (189 boys, aged 12.5-17.5 years) from the HELENA-CSS (2006-2007). Subjects were classified according to the recommended amount of MVPA (<60 minutes or ≥60 minutes of MVPA/day). Receiver operating characteristic curve analysis was applied to calculate the relationship between physical activity and bone mass., Results: Less than 41 and 45 minutes of MVPA/day are associated with reduced bone mass at the trochanter and femoral neck. More than 78 minutes of MVPA/day is associated with increased bone mineral density (BMD) at the femoral neck. Regarding VPA, more than 28 minutes/day for the hip and intertrochanter and more than 32 minutes/day for the femoral neck are associated with increased BMD., Conclusions: The recommended amount of physical activity (minutes/day) seems insufficient to guarantee increased bone mass. With some minutes of VPA/day, bone adaptations could be obtained at different bone sites., (Copyright © 2011 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.)

We examined whether abdominal and truncal adiposity, assessed with simple anthropometric indices, determines serum triglycerides and high-density lipoprotein (HDL)-cholesterol levels independently of total adiposity amount in adolescents. A total of 547 Spanish adolescents (284 males and 263 females) aged 13-18.5 years were included in this study. Measures of truncal adiposity included subscapular to triceps ratio, and trunk-to-total skinfolds ratio (TTS%). Waist circumference was used as a surrogate of abdominal adiposity, and BMI was used as a measure of total adiposity. The results of the regression models indicated that levels of triglycerides were positively associated with waist circumference and TTS% after controlling for age and Tanner stage in both sexes. Once BMI was entered in the model, these associations remained significant for waist circumference in females. HDL-cholesterol levels were negatively associated with waist circumference in both sexes, and with subscapular to triceps ratio and TTS% in males, after controlling for age and Tanner stage. Once BMI was entered in the model, these associations remained significant for subscapular to triceps ratio and for TTS% in males. The results of this study suggest that in male adolescents, truncal adiposity is negatively associated with levels of HDL-cholesterol, whereas in females, abdominal adiposity is positively associated with levels of triglycerides independently of total adiposity. These findings highlight the deleterious effect of both truncal and abdominal fat depots on the lipid profile already from the first decades of life.

Background: There is increasing evidence indicating that genes involved in certain metabolic processes of cardiovascular diseases may be of particular influence in people with low body weight at birth. We examined whether the apolipoprotein (APO) E, APOC3 and the peroxisome proliferator-activated receptor-gamma-2 (PPARgamma2) polymorphisms influence the association between low birth weight and blood lipid levels in healthy adolescents aged 13-18.5 years., Methods: A cross-sectional study of 502 Spanish adolescents born at term was conducted. Total (TC) and high density lipoprotein cholesterol (HDLc), triglycerides (TG), apolipoprotein (apo) A and B, and lipoprotein(a) [Lp(a)] were measured. Low density lipoprotein cholesterol (LDLc), TC-HDLc, TC/HDLc and apoB/apoA were calculated., Results: Low birth weight was associated with higher levels of TC, LDLc, apoB, Lp(a), TC-HDLc, TC/HDLc and apoB/apoA in males with the APOE epsilon3epsilon4 genotype, whereas in females, it was associated with lower HDLc and higher TG levels. In males with the APOC3 S1/S2 genotype, low birth weight was associated with lower apoA and higher Lp(a), yet this association was not observed in females. There were no associations between low birth weight and blood lipids in any of the PPARgamma2 genotypes., Conclusion: The results indicate that low birth weight has a deleterious influence on lipid profile particularly in adolescents with the APOE epsilon3/epsilon4 genotype. These findings suggest that intrauterine environment interact with the genetic background affecting the lipid profile in later life.

Background: Folate and cobalamin are responsible for healthy growth. However, the B-vitamin and homocysteine status of adolescents is not well known. The aim was to assess the status of folate, cobalamin, and homocysteine in healthy Spanish adolescents., Methods: Serum cobalamin, serum folate, homocysteine, methylenetetrahydrofolate reductase 677C>T variant, BMI, smoking habits, and Tanner stage were determined according to gender in 165 adolescents (84 females, 81 males; 13-18.5 years) using the Student's t test, Mann-Whitney U test and chi(2) test, respectively. Interactions between socioeconomic status, age group, methylenetetrahydrofolate reductase polymorphism, BMI, smoking habits, Tanner stage, and vitamin status, respectively, were examined by ANOVA or Kruskal-Wallis H test (p < 0.05)., Results: Boys had markedly higher homocysteine (males 8.92 (5.51-22.94) micromol/l; females 7.91 (5.09-13.86) micromol/l), whereas girls showed higher serum cobalamin concentrations (males 540.00 (268.00-946.47) pmol/l; females 594.82 (280.63-1,559.64) pmol/l). Data are shown as medians and the 2.5th to 97.5th percentiles in parentheses. Adolescents with the homozygous variant of methylenetetrahydrofolate reductase displayed significantly higher homocysteine and lower serum folate: normal 5.73 (3.09-10.73) ng/ml serum folate, 7.57 (4.94-12.94) micromol/l homocysteine; homozygous 4.10 (2.75-7.88) ng/ml serum folate, 10.83 (7.00-22.82) micromol/l homocysteine., Conclusion: The present study provides data on the folate, cobalamin, and homocysteine status of Spanish adolescents. To assure a better assessment, revision of references for adolescents is still needed., (2008 S. Karger AG, Basel.)

Objective: To examine the association between cardiovascular fitness and homocysteine levels in adolescents., Design: Cross-sectional study., Setting: Madrid, Murcia, Granada, Santander, and Zaragoza, Spain., Participants: One hundred fifty-six Spanish adolescents (76 boys and 80 girls) aged (mean +/- SD) 14.8 +/- 1.4 years., Main Exposures: Cardiovascular fitness was measured by the 20-m shuttle run test. Pubertal stage, birth weight, smoking status, and socioeconomic status were determined, and the sum of 6 skinfold thickness measurements, and serum folic acid and vitamin B(12) levels were measured. Methylenetetrahydrofolate reductase (MTHFR; 677C>T genotype) polymorphism was done by DNA sequencing., Main Outcome Measure: Fasting homocysteine levels., Results: Mean values of homocysteine were significantly higher in the MTHFR 677CT and TT genotype subgroups compared with the CC genotype subgroup in adolescent boys, whereas in adolescent girls, mean values of homocysteine were significantly higher in the MTHFR 677CT and TT genotype subgroup compared with the CC and CT genotype subgroups. Multiple regression analyses showed that cardiovascular fitness was significantly associated with homocysteine levels in female adolescents after controlling for potential confounders including the MTHFR 677C>T genotype (beta = -0.40; semipartial correlation = -0.35; P = .007). No associations were found between cardiovascular fitness and homocysteine levels in male adolescents (beta = 0.12; semipartial correlation = 0.08; P = .51)., Conclusion: The results suggest that cardiovascular fitness is negatively associated with homocysteine levels in female adolescents after controlling for potential cofounders including MTHFR 677C>T genotype.

Background: Hyperhomocysteinemia is an accepted risk factor for cardiovascular disease, and possibly also for cognitive impairment and dementia. It has also been proposed as a marker for the status of the B vitamins, which participate in the metabolism of homocysteine. Therefore, especially in the elderly, it is important to know the prevalence of high homocysteine (tHcy) levels and the influence that B vitamins have on them., Material and Methods: 218 elderly of both sexes, aged 60-105, living in an elderly home in Granada (Spain), were screened for serum folate, red blood cell (RBC) folate, serum cobalamin (B12) (Abbott, IMx), holotranscobalamin II (Holo-TC II) (HoloTC RIA, Axis-Shield), methylmalonic acid (MMA) (MS-GC), total pyridoxine (B6) (HPLC), and total homocysteine (tHcy) (Abbott, IMx)., Results: Hyperhomocysteinemia (tHcy >12 pmol/L) was detected in 80.7%. Serum folate deficiency was severe (< or =4 ng/mL) in 19.3% and moderate (4-7 ng/mL) in 43.1%. In 14.2% of the elderly RBC folate was < or =175 ng/mL, and in 61.0% it was between 175-400 ng/mL. Vitamin B12, measured in serum (< or =200 pg/mL), was deficient in 15.8%, but if measured as Holo-TC II (< or =45 pmol/L), deficiency ranged up to 39.1%. MMA was high (> or =300 nmol/L) in 45.6%. Vitamin B6 (< 20 nmol/L) was low only in one person. In order to identify the factors that could predict tHcy levels, a multiple regression analysis was performed. Best results corresponded to the combination of log serum folate and log Holo-TC II, which gave values of R > 0.5. If analyzed independently, the highest correlation was with log serum folate (r = -0.290), followed by RBC folate (r = -0.263), Holo-TC II (r = -0.228), log B12 (r = -0.175), and log B6 (r = -0.078)., Conclusion: There is a high prevalence of vitamin B deficiency and hyperhomocysteinemia in the studied population. Our data confirm the influence of these vitamins, especially folate, on tHcy levels, but hyperhomocysteinemia cannot be used as the only diagnostic criterion to detect subclinical vitamin deficiency in elderly people, especially to detect vitamin B12 deficiency.

Objectives: To provide current reference values for serum lipid and lipoprotein levels in Spanish adolescents according to age and sex., Methods: A cross sectional study conducted in five representative Spanish cities (Granada, Madrid, Murcia, Santander and Zaragoza) including a representative sample of 581 adolescents (299 male and 282 female), aged 13 to 18.5 years. Age- and sex-specific means, standard deviations and percentiles were determined for: Total (TC), high density lipoprotein (HDLc) and low density lipoprotein (LDLc) cholesterol, triglycerides, apolipoprotein A-1 and B-100, and lipoprotein(a)., Results: The 90th percentile for TC was 4.95 mmol/L for males and 5.19 mmol/L for females. HDLc levels were significantly higher in females of all age groups. LDLc levels ranged from 2.32 to 2.54 mmol/L in males and from 2.38 to 2.62 mmol/L in females, peaking at 13 years of age in both sexes. Triglyceride levels tended to increase gradually and to peak at 17 years of age for both sexes. Apolipoprotein A-1 and B-100 levels paralleled those of HDLc and LDLc values, respectively. The geometric mean for lipoprotein(a) levels ranged from 0.44 to 0.57 micromol/L in males and from 0.50 to 0.67 pmol/L in females., Conclusions: The present study provides reference data on the distribution of lipid and lipoprotein levels of Spanish adolescents.

Background/aims: To explore in adolescents the associations between simple anthropometric variables with a continuously distributed summary score for lipid-related metabolic risk in both overweight and non-overweight adolescents, and to test whether these associations are modified by the level of cardiorespiratory fitness., Methods: Cardiorespiratory fitness, BMI, skinfold thicknesses, body circumferences, and a continuously distributed clustering of lipid- related metabolic risk (calculated from LDL and HDL cholesterol, triglycerides, and glucose) were measured in 524 adolescents (265 males, 259 females, 15.3 +/- 1.4 years) from the cross-sectional multicentric AVENA study. Participants were classified as overweight (including obesity) or non-overweight., Results: Most anthropometric parameters were univariately related to the continuous lipid-related metabolic risk. However, after multicollinear analysis and generalized linear modelling, suprailiac skinfold thickness in males (p < 0.001, explained variance 12.2%) and waist-to-height ratio in females (p < 0.001, explained variance 10.0%) were the best determinants of the continuous metabolic risk score, after adjustment for age, sexual maturation, and economic status. These associations were slightly weakened in overweight males (p = 0.034) and females (p = 0.087), and did not interact with cardiorespiratory fitness., Conclusion: Our data emphasize the usefulness of suprailiac skinfold thickness in males and waist-to-height ratio in females as simple anthropometric measurements associated to an overall lipid-related metabolic risk, mainly in non-overweight adolescents and regardless their cardiorespiratory status., (Copyright 2006 S. Karger AG, Basel.)

Introduction and Objectives: Several studies have demonstrated that physical fitness in childhood and adolescence is related to cardiovascular risk in adulthood. Current data on the physical fitness of Spanish adolescents are not available. Therefore, the aims of this study were: a) to assess the physical fitness of Spanish adolescents and establish reference values for use in health and educational settings as indicators of cardiovascular health, and b) to determine the percentage of Spanish adolescents below the minimum level of aerobic fitness needed to guarantee future cardiovascular health., Subjects and Method: The modified EUROFIT battery of tests was used to assess physical fitness in a representative sample of Spanish adolescents (n=2859; 1357 boys and 1502 girls) taking part in the AVENA (Alimentación y Valoración del Estado Nutricional de los Adolescentes) study., Results: Standard parameters for the physical condition of Spanish adolescents are reported in this study. The 5th percentile for maximum aerobic capacity (Course Navette test) ranged from 2.0-3.3 palier in boys and from 1.4-1.9 palier in girls. The findings indicate that, on the basis of aerobic fitness, approximately 20% of Spanish adolescents have an increased risk of future cardiovascular disease. This subgroup also performed poorly in all other tests of physical fitness used., Conclusions: The results reported in this study enable the level of physical fitness in adolescents to be interpreted as an indicator of future cardiovascular health. They also indicate that the physical fitness of Spanish adolescents must be improved to help protect against cardiovascular disease in adulthood.