Parental influence on children’s cardiometabolic risk factors and cardiorespiratory fitness


  • Andrea Casolo Catholic University of Sacred Heart, Italy
  • Stefano Nuccio University of Rome “Foro Italico”, Italy
  • Ester Tommasini Catholic University of Sacred Heart, Italy
  • Francesco Casolo Catholic University of Sacred Heart, Italy
  • Christel Galvani Catholic University of Sacred Heart, Italy


Health-related risk factors, Physical fitness, Parental influence, School-children, Waist-to-high ratio (WHtR), Six-minute walking test (6MWT)


The parental influence on children’s cardiometabolic risk factors (CMRF) and cardiorespiratory fitness (CRF) has been only marginally investigated. Hence, this study aimed to investigate whether parental CMRF and CRF were associated with those of their school-aged children. This cross-sectional analysis included 53 Italian school-children along with their parents. CMRF were assessed by measuring the waist circumference (WC) and by computing the waist-to-height ratio (WHtR), whereas CRF was estimated with the six-minute walking test (6MWT). A multiple stepwise backward elimination regression analysis was performed to investigate associations between parental and children’s features. Both parental WC and WHtR were associated with children’s ones (R2 = 0.28, p = .005; R2 = 0.18, p = .041). Maternal WC and WHtR strongly predicted primary-school children’s CMRF (R2 = 0.54, p = .005; R2 = 0.67, p = .001). No significant parental influence was observed for CRF. This study investigated, for the first time, the associations between parental CMRF and CRF, and those of their children. Our results suggest that children’s WC and WHtR, but not CRF, can be predicted by their parent’s parameters. Maternal CMRF may have a stronger influence on children’s ones, compared to fathers, particularly during primary-school years.


Università Cattolica del Sacro Cuore


Download data is not yet available.


American Thoracic Society, 2002. ATS Statement: Guidelines for the Six-Minute Walk Test. Am. J. Respir. Crit. Care Med. 166, 111-117.

Anderssen, S.A., Cooper, A.R., Riddoch, C., Sardinha, L.B., Harro, M., Brage, S., Andersen, L.B., 2007. Low cardiorespiratory fitness is a strong predictor for clustering of cardiovascular disease risk factors in children independent of country, age and sex. Eur. J. Cardiovasc. Prev. Rehabil. 14, 526-531.

Ashwell, M., 2009. Obesity risk: importance of the waist-to-height ratio. Nurs. Stand. 23, 49-54.

Ashwell, M., Gunn, P., Gibson, S., 2012. Waist-to-height ratio is a better screening tool than waist circumference and BMI for adult cardiometabolic risk factors: systematic review and meta-analysis. Obes. Rev. 13, 275-286.

Borg, G.A.V., 1982. Psychophysical bases of perceived exertion. Med. Sci. Sports Exerc. 14, 377-381.

Börnhorst, C., Russo, P., Veidebaum, T., Tornaritis, M., Molnár, D., Lissner, L., Mårild, S., De Henauw, S., Moreno, L.A., Floegel, A., Ahrens, W., Wolters, M., 2020. The role of lifestyle and non-modifiable risk factors in the development of metabolic disturbances from childhood to adolescence. Int. J. Obes.

Bray, G.A., 2004. Don't throw the baby out with the bath water. Am. J. Clin. Nutr. 79, 347-349.

Casolo, A., Sagelv, E.H., Bianco, M., Casolo, F., Galvani, C., 2019. Effects of a structured recess intervention on physical activity levels, cardiorespiratory fitness, and anthropometric characteristics in primary school children. J. Phys. Educ. Sport 19, 1796-1805.

Chetta, A., Zanini, A., Pisi, G., Aiello, M., Tzani, P., Neri, M., Olivieri, D., 2006. Reference values for the 6-min walk test in healthy subjects 20-50 years old. Respir. Med. 100, 1573-1578.

Christofaro, D.G.D., Andersen, L.B., Andrade, S.M. de, Barros, M.V.G. de, Saraiva, B.T.C., Fernandes, R.A., Ritti‐Dias, R.M., 2018. Adolescents' physical activity is associated with previous and current physical activity practice by their parents. J. Pediatr. (Versão em Port. 94, 48-55.

Cleland, V., Venn, A., Fryer, J., Dwyer, T., Blizzard, L., 2005. Parental exercise is associated with Australian children's extracurricular sports participation and cardiorespiratory fitness: A cross-sectional study. Int. J. Behav. Nutr. Phys. Act. 2, 1-9.

Cole, T.J., 2000. Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ 320, 1240-1240.

Cole, T.J., Flegal, K.M., Nicholls, D., Jackson, A.A., 2007. Body mass index cut offs to define thinness in children and adolescents: international survey. BMJ 335, 194.

Farajian, P., Panagiotakos, D.B., Risvas, G., Malisova, O., Zampelas, A., 2014. Hierarchical analysis of dietary, lifestyle and family environment risk factors for childhood obesity: the GRECO study. Eur. J. Clin. Nutr. 68, 1107-1112.

Farrell, S.W., Braun, L., Barlow, C.E., Cheng, Y.J., Blair, S.N., 2002. The Relation of Body Mass Index, Cardiorespiratory Fitness, and All-Cause Mortality in Women. Obes. Res. 10, 417-423.

Farrell, S.W., Finley, C.E., Radford, N.B., Haskell, W.L., 2013. Cardiorespiratory Fitness, Body Mass Index, and Heart Failure Mortality in Men. Circ. Hear. Fail. 6, 898-905.

Geiger, R., Strasak, A., Treml, B., Gasser, K., Kleinsasser, A., Fischer, V., Geiger, H., Loeckinger, A., Stein, J.I., 2007. Six-Minute Walk Test in Children and Adolescents. J. Pediatr. 150, 395-399.e2.

Han, T.S., Hart, C.L., Haig, C., Logue, J., Upton, M.N., Watt, G.C.M., Lean, M.E.J., 2015. Contributions of maternal and paternal adiposity and smoking to adult offspring adiposity and cardiovascular risk: the Midspan Family Study. BMJ Open 5, e007682.

Jago, R., Baranowski, T., Watson, K., Baranowski, J.C., Nicklas, T., Zakeri, I.F., 2004. Relationships Between Maternal and Child Cardiovascular Risk Factors. Arch. Pediatr. Adolesc. Med. 158, 1125.

Janssen, I., Katzmarzyk, P.T., Ross, R., Leon, A.S., Skinner, J.S., Rao, D.C., Wilmore, J.H., Rankinen, T., Bouchard, C., 2004. Fitness Alters the Associations of BMI and Waist Circumference with Total and Abdominal Fat. Obes. Res. 12, 525-537.

Jelastopulu, E., Kallianezos, P., Merekoulias, G., Alexopoulos, E.C., Sapountzi-Krepia, D., 2012. Prevalence and risk factors of excess weight in school children in West Greece. Nurs. Health Sci. 14, 372-380.

Koster, A., Leitzmann, M.F., Schatzkin, A., Mouw, T., Adams, K.F., van Eijk, J.T.M., Hollenbeck, A.R., Harris, T.B., 2008. Waist Circumference and Mortality. Am. J. Epidemiol. 167, 1465-1475.

Lee, C.Y., Ledoux, T.A., Johnston, C.A., Ayala, G.X., O'Connor, D.P., 2019. Association of parental body mass index (BMI) with child's health behaviors and child's BMI depend on child's age. BMC Obes. 6, 11.

Lee, S., Kuk, J.L., Katzmarzyk, P.T., Blair, S.N., Church, T.S., Ross, R., 2005. Cardiorespiratory Fitness Attenuates Metabolic Risk Independent of Abdominal Subcutaneous and Visceral Fat in Men. Diabetes Care 28, 895-901.

Li, A.M., 2005. The six-minute walk test in healthy children: reliability and validity. Eur. Respir. J. 25, 1057-1060.

Lo, K., Wong, M., Khalechelvam, P., Tam, W., 2016. Waist-to-height ratio, body mass index and waist circumference for screening paediatric cardio-metabolic risk factors: a meta-analysis. Obes. Rev. 17, 1258-1275.

Magnússon, K.T., Sveinsson, T., Arngrímsson, S.Á., Johannsson, E., 2008. Predictors of fatness and physical fitness in nine-year-old Icelandic school children. Int. J. Pediatr. Obes. 3, 217-225.

McCarthy, H., Jarrett, K., Crawley, H., 2001a. The development of waist circumference percentiles in British children aged 5.0-16.9 y. Eur. J. Clin. Nutr. 55, 902-907.

McCarthy, S. N., Harrington, K. E., Kiely, M., Flynn, A., Robson, P. J., Livingstone, M. B., Gibney, M. J., 2001b. Analyses of the anthropometric data from the North/South Ireland Food Consumption Survey. Public Health Nutr. 4(5A), 1099–1106.

Ortega, F.B., Tresaco, B., Ruiz, J.R., Moreno, L.A., Martin-Matillas, M., Mesa, J.L., Warnberg, J., Bueno, M., Tercedor, P., Gutiérrez, Á., Castillo, M.J., 2007. Cardiorespiratory Fitness and Sedentary Activities Are Associated with Adiposity in Adolescents*. Obesity 15, 1589-1599.

Parrett, A.L., Valentine, R.J., Arngrímsson, S.Á., Castelli, D.M., Evans, E.M., 2011. Adiposity and aerobic fitness are associated with metabolic disease risk in children. Appl. Physiol. Nutr. Metab. 36, 72-79.

Qin, Y.-Y., Steier, J., Jolley, C., Moxham, J., Zhong, N.-S., Luo, Y.-M., 2010. Efficiency of Neural Drive During Exercise in Patients With COPD and Healthy Subjects. Chest 138, 1309-1315.

Schoeppe, S., Röbl, M., Liersch, S., Krauth, C., Walter, U., 2016. Mothers and Fathers Both Matter: The Positive Influence of Parental Physical Activity Modeling on Children's Leisure-Time Physical Activity. Pediatr. Exerc. Sci. 28, 466-472.

Unnithan, V.B., Murray, L.A., Timmons, J.A., Buchanan, D., Paton, J.Y., 1995. Reproducibility of cardiorespiratory measurements during submaximal and maximal running in children. Br. J. Sports Med. 29, 66-71.

Vandoni, M., Correale, L., Puci, M.V., Galvani, C., Codella, R., Togni, F., La Torre, A., Casolo, F., Passi, A., Orizio, C., Montomoli, C., 2018. Six minute walk distance and reference values in healthy Italian children: A cross-sectional study. PLoS One 13, e0205792.

Wang, Y., Lobstein, T., 2006. Worldwide trends in childhood overweight and obesity. Int. J. Pediatr. Obes. 1, 11-25.

World Health Organization, 2000. The Asia-Pacific perspective: redefining obesity and its treatment.



How to Cite

Casolo, A., Nuccio, S., Tommasini, E., Casolo, F., & Galvani, C. (2020). Parental influence on children’s cardiometabolic risk factors and cardiorespiratory fitness. Journal of Human Sport and Exercise, 15(4proc), S1354-S1366. Retrieved from