The reciprocal relationship between body mass index categories and physical fitness: A 4-year prospective cohort study of 20 000 Chinese children

Frederick K. Ho, Hung Kwan So, Rosa S. Wong, Keith T.S. Tung, Lobo H T LOUIE, Joanna Tung, Sheena Mirpuri, Bik Chu CHOW, Wilfred H.S. Wong, Albert Lee, Patrick Ip*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Introduction: Body mass index (BMI) categories and physical fitness are associated but the reciprocal relationship between BMI categories and physical fitness has not been investigated. This study aims to investigate the longitudinal reciprocal relationship between BMI categories and physical fitness. Methods: This is a population-based 4-year cohort study in 48 elementary schools. Children aged 6 to 9 years at recruitment were included. BMI categories and physical fitness including handgrip strength, core muscle endurance, flexibility, and cardiorespiratory fitness were measured using standard equipment and protocol. Results: Among 26 392 eligible participants, 19 504 (73.9%) were successfully followed for 3 years. Baseline obesity prevalence was 5.9%. After 3 years, those who were unfit at baseline had an increased risk of obesity (risk ratio [RR] 1.41, 95% CI 1.16-1.71, P <.001) and those who were fit at baseline had a decreased risk of obesity (RR 0.69, 95% CI 0.60-0.80, P <.001) compared with moderately fit children. Furthermore, improvement of fitness predicted decreased risk of obesity. Similarly, normal body weight also predicted better physical fitness. The path analysis confirmed a strong reciprocal relationship between physical fitness and obesity. Conclusions: Better physical fitness was prospectively associated with normal weight and vice versa. Physically fit children were more likely to maintain a healthy weight and those with a healthy weight were more likely to be physically fit, which is important for healthy development.

Original languageEnglish
Article numbere12646
JournalPediatric obesity
Volume15
Issue number9
DOIs
Publication statusPublished - 1 Sep 2020

Scopus Subject Areas

  • Pediatrics, Perinatology, and Child Health
  • Health Policy
  • Nutrition and Dietetics
  • Public Health, Environmental and Occupational Health

User-Defined Keywords

  • body mass index
  • physical fitness
  • prospective cohort study
  • reciprocal relationship

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