Our understanding of the relationships between cardiometabolic risk factors in young people and lifestyle, physiology and genetics continues to grow. This review examines research published during the past 12 months addressing these relationships. Recent studies continue to support the hypothesis that vigorous physical activity is particularly beneficial to the cardiometabolic risk profile. The impact of resistance training on cardiometabolic biomarkers requires additional study. Adiposity and fitness continue to be identified as mediators of the relationship. The roles of predisposing factors such as genetics, race, sex and socio-economic status are complex and require continued investigation. Our understanding of these biomarkers in youth will be advanced by increased use of objective measures of physical activity, such as accelerometry, and measurement of body composition rather than total body mass.