Clustered Cardiometabolic Risk and the "Fat but Fit Paradox" in Adolescents: Cross-Sectional Study.

"Conflicts of Interest The authors declare no conflicts of interest."

"This research was supported by a grant for Research Support Plans from the Universidad Católica de Murcia (Spain), named: “H2PE: Promoting cardiometabolic health by 2 HIIT protocol, twice a week at Physical Education” (code: PMAFI-11/19); and by and contract/agreement with the Archena City Council (CO/AY/58-20)."

"This multicenter cross-sectional study was carried out in a secondary school in Murcia, Spain. The participants were aged between 12 and 13 years old. The inclusion criteria were (a) being physically active in physical education sessions; (b) agreeing to participate in the study and having the parent/guardian and adolescent sign the consent form; and (c) being present at the time of the assessments. The exclusion criteria were presenting any musculoskeletal, neurological, cardiological, metabolic, or rheumatic pathologies. A total of 230 adolescents were recruited, who had a mean age of 12.19 ± 0.49. Of these, 104 participants were male (45.2%), while 126 were female (54.8%). The participants showed a mean height of 152.71 ± 8.29 cm, a mean weight of 48.72 ± 12.56 kg, and a mean BMI of 20.69 ± 3.98 kg/m2. The trial design was registered at ClinicalTrial.gov (Code: NCT05544370) and followed the STrengthening the Reporting of OBservational studies in Epidemiology (STROBE) Statement. The ethical approval for this study was obtained from the Universidad Católica de Murcia (CE061914) and was implemented according to the guidelines for human research from the Helsinki Declaration."