Researchers from Basel in Switzerlandcarried carried out a cross-sectional analysis of 502 first and fifth graders and measured cardiorespiratory fitness (CRF) and PA and noted the neighbourhood (rural vs urban) environment. Outcome measures included BMI, sum of four skinfold thicknesses, homeostasis model assessment of insulin resistance (HOMA-IR) and a standardised clustered metabolic risk score. CONCLUSION: Reduced CRF, low PA and an urban environment are independently associated with an increase in metabolic risk markers in children.