Comparative Cardiorespiratory Fitness in Children: Racial Disparity May Begin Early in Childhood

Neha Bansal, Deemah R. Mahadin, Roxann Smith, Michelle French, Peter P. Karpawich, Sanjeev Aggarwal

Research output: Contribution to journalArticlepeer-review

8 Scopus citations


African American (AA) adults are reported to have lower levels of cardiorespiratory fitness (CRF) as compared to Caucasian adults. CRF is linked to cardiovascular morbidity and mortality. We hypothesized that the disparities start early in childhood. This was a retrospective analysis of the cardiopulmonary exercise test (CPET). We included normal healthy children, ≤ 18 years of age, who had normal electrocardiograms and normal cardiac function. We excluded patients with congenital heart disease, obesity and suboptimal exercise test. The entire cohort was divided into two groups based on race (Caucasian vs. AA) and then further subcategorized by gender. The cohort of 248 patients had a mean ± SD age of 14.4 ± 2.1 years. 158 (60.8%) were males and 158 (60.8%) were Caucasians. Oxygen consumption was higher among Caucasian children when compared to the AA children (48.7 ± 7.9 vs. 45.4 ± 7 mL/kg/min, p = 0.01). This racial disparity continued to persist when comparisons were performed separately for girls and boys. Upon comparing the four groups, the AA females were found to have the lowest values of VO2max, exercise time and METS (p = 0.001). Thus, in conclusion, the AA children have significantly lower level of CRF, as measured by VO2max and exercise time. The racial disparity is independent of gender. African American females show the lowest level of aerobic capacity. The findings of our study suggest that the racial disparity in the CRF levels seen in the adult population may begin early in childhood.

Original languageEnglish
Pages (from-to)1183-1189
Number of pages7
JournalPediatric Cardiology
Issue number6
StatePublished - 15 Aug 2019
Externally publishedYes


  • Cardiorespiratory fitness
  • Exercise stress testing
  • Pediatric exercise
  • Racial disparity


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