We agree with Dr Nasca that too many American youths fail to meet accepted standards for cardiorespiratory fitness; our study1 found that about one third of boys and girls in the United States failed to meet such standards. We also agree with her fundamental point that large-scale public health initiatives are needed to promote physical activity in America's children and youth.
Pate RR. US Youth Cardiorespiratory Fitness Levels: Challenges and Solutions—Reply. Arch Pediatr Adolesc Med. 2007;161(5):522-523. doi:10.1001/archpedi.161.5.522-b