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athletic performance ( Howley, 2001 ) , while the latter is linked to health and
are affected by habitual PA ( Suni et al., 1998 ) . Compared to performance-
related fitness, health-related fitness has been found to be significantly asso-
ciated with not only cardiovascular profile but also other important health
components, such as body adiposity, skeletal, and mental health status, in
children and adolescents ( Ortega et al., 2008 ). Moreover, it is believed that
the functional status of overall systems in humans can be assessed when per-
forming a health-related fitness test. As health-related PF is considered an
important indicator of health status in childhood and adolescence, and could
play a major role in health monitoring systems, this section focuses only on
the components of health-related PF.
In general, health-related PF comprises five components, namely: car-
diorespiratory fitness, muscular fitness (muscular strength and muscular
endurance), flexibility, body composition, and metabolic fitness with spe-
cific functions ( Percia, Davis, &Dwyer, 2012; Warburton et al., 2006 ) . Car-
diorespiratory fitness reflects the functional capabilities of the cardiovascular
and respiratory systems to meet the demands of the tissues while performing
specific exercise, while muscular fitness is the capacity to carry out work
against a resistance. Flexibility, on the other hand, refers to the ability of
a joint moving through normal and pain-free range of motions. Body com-
position relates to the relative proportion of fat and fat-free tissues in the
body ( Ortega et al., 2008; Percia et al., 2012; Ruiz et al., 2006 ) . Finally, met-
abolic fitness can be defined as “the ratio between mitochondrial capacity for
substrate utilization and maximum oxygen uptake of the muscles” ( Saltin &
Pilegaard, 2002 ) . Each of these components can be assessed by a variety of
methods, either in the laboratory or in the field.
4.2. Relationship between PF and PA
It is often assumed that PA is causally related to PF, suggesting that more
habitually active individuals are usually fitter. Therefore, these two compo-
nents are always presumed to be interchangeable especially in large epide-
miologic studies, with PF commonly accepted as a more accurate
measure of PA compared to the self-reported PA methods ( Warburton
et al., 2006; Williams, 2001 ) . However, the evidence for this relationship
remains inconclusive. Earlier studies suggested that the relationships
between regular PA and various indicators of PF had been reported to be
generally low to moderate in children ( Sallis, McKenzie, & Alcaraz,
1993 ) and adolescents ( Aaron et al., 1993 ) . Katzmarzyk, Malina, Song,
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