The present study investigated the relationships among metabolic risk factors, major lifestyle factors, and serum cytokines in a sample of Korean children. In a cross-sectional design, we studied a total of 275 children (130 boys and 145 girls) aged 12–13 years. Measured variables included anthropometrics, blood pressures (BP), VO2max, physical activity (PA), dietary intakes, lipids, glucose, and insulin. We explored the extent to which dietary intakes, VO2max, PA, and serum cytokines explained variance in a clustered risk score, which is a sum of Z scores for waist circumference, BP, TG, HDLC, and HOMA-IR, using a stepwise linear regression by blocks. VO2max, vigorous PA (VPA), and leptin were independent predictors for the clustered risk score while adjusting for age and Tanner stage. Our findings suggest that the clustered risk score is associated not only with low levels of VO2max and VPA, but also with elevated serum leptin in Korean children.