In this issue, Sacheck and Hall discussed the key findings from the Final Report “Fitness Measures and Health Outcomes in Youth” developed by an expert committee appointed by the Institute of Medicine in 2011 and published in 2012. The findings from this report are more valuable when interpreted together with those from the EU-funded ALPHA project ( conducted from 2007 to 2010). The ALPHA project aimed to provide an evidence-based set of valid, reliable, feasible, and safe field-based fitness tests for the assessment of health-related physical fitness in youth to be used in public health monitoring in a comparable way within the European Union and around the globe. The ALPHA team conducted 4 reviews ( 3 of them systematic reviews) and 11 methodological studies, tested the battery in the school setting, and had several meetings with an international expert board to further discuss the development of the work. The evidence-based ALPHA fitness test battery was finally published in 2011. Several important methodological issues related to fitness assessment and its clinical value mainly derived from this project are discussed in the present article: the ALPHA-fitness test battery; Slaughter’s equations and normalization of fat indicators by height; absolute versus relative muscular strength; physical fitness reference data; health-related fitness cut-points; Self-reported fitness assessment: The International FItness Scale-IFIS; and fitness assessment in preschoolers: The PREFIT project.