Background: Obesity is associated with increased risk of cardiovascular disease (CVD) in adults and less favourable CVD risk factor status in children. These relationships have not been extensively studied in young subjects on a population-base with the use of objective methods. Methods: Cross-sectional study of 170 (92 boys and 78 girls) children aged 8-11 years, recruited from a population-based cohort. Total fat mass (TBF) and abdominal fat (AFM) were measured by Dual-energy x-ray absorptiometry. Total body fat was expressed as TBFs percentage of total body mass (BF%) and body fat distribution was calculated as AFM/TBF. Maximal oxygen uptake (VO2PEAK) was assessed by indirect calorimetry during a maximal exercise test. Blood was sampled and blood pressure (BP), mean artery pressure (MAP) and pulse pressure (PP) and resting heart rate (HR) were measured. Echocardiography was performed and left atrial size (LA) was measured, and left ventricular mass (LVM) and relative wall thickness (RWT) were calculated. Z-scores (Value for the individual-mean value for group)/SD) were calculated. Sum of z-scores for triglycerides and lipoprotein concentrations, systolic and diastolic BP, MAP, PP, HR, LVM, LA, RWT and -VO2PEAK were calculated in boys and girls, separately, and used as an indices of clustered risk. Results: Mean BF% was 18.8±8.9% (range 6.2-44.7) and mean AFM was 2.7 kg (range 0.4-11.4). Pearson correlations between ln BF%, ln AFM and AFM/TBF versus indices of clustered risk were in boys (r=0.56, 0.57 and 0.43, P < 0.05), and in girls (r=0.57, 0.63 and 0.61, P < 0.05). One-way ANOVA analysis indicated significant differences between different tertiles of BF%, AFM and AFM/TBF. Higher BF% and AFM and negative body fat distribution were associated with higher clustered risk for CVD in both genders (P < 0.001). Conclusion: Findings from this population-based cohort of young children shows that total body fat, abdominal fat and negative body fat distribution were associated with a clustering of CVD risk factors in both boys and girls at a young age.