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Cardiorespiratory endurance Cardiorespiratory (aerobic) endurance 
reflects the functioning of the pulmonary and cardiovascular systems 
to deliver oxygen and the ability of tissues (primarily skeletal muscle) to 
extract oxygen from the blood. Defined clinically as the maximum oxygen 
consumption during a maximal graded exercise test, in practice it is usually 
measured indirectly as performance on a field test of endurance, such as 
1- or 2-mile run time (IOM, 2012a). During childhood, aerobic capacity 
approximately doubles in both boys and girls, although girls on average 
possess a lower capacity. Males continue to improve during adolescence, 
up to ages 17-18, while aerobic capacity plateaus around age 14 in females 
(Malina et al., 2004), resulting in an approximately 20 percent difference 
between males and females (Rowland, 2005). 
Favorable associations have been found between aerobic endurance and 
high-density lipoproteins, systolic blood pressure, diastolic blood pressure, 
BMI, measures of fatness, arterial stiffness, and measures of insulin sensi-
tivity (Boreham et al., 2004; Imperatore et al., 2006; Hussey et al., 2007; 
Ondrak et al., 2007). Some evidence suggests a decline in aerobic endurance 
among U.S. youth in recent decades (Eisenmann, 2003; Carnethon et al., 

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