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Background We examined: (i) the usefulness of the International Fitness Scale (IFIS) to correctly rank adolescents into physical fitness levels; (ii) the capacity of the IFIS for predicting cardiovascular disease (CVD) risk; and (iii) the reliability of the IFIS in adolescents.

Methods The study comprised 3059 adolescents (aged 12.5–17.5 years) from nine European countries (HELENA study). Blood samples were collected in one-third of the participants (randomly selected, n = 981). Test–retest reliability of the IFIS was studied in a separate sample of 277 adolescents. Physical fitness—cardiorespiratory fitness (CRF), muscular fitness (MF), speed–agility (SP–AG), flexibility and overall fitness—was self-reported using 5-point Likert-scale questions (1 = very poor, 5 = very good) and measured using standard field-based tests. The CVD risk factors measured included total/central adiposity indices …