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Low physical fitness in childhood is linked with poor health now and in later life. This study estimated temporal trends in physical fitness for Hong Kong children aged 6–12 years from 2003–04 to 2015–16. Objectively measured body size and physical fitness data for 27,513 children were obtained from four population-representative surveys of Hong Kong primary school students. Temporal trends in means were estimated by population-weighted linear regression. Trends in distributional characteristics were visually described. Overall, there was a small increase in mean height (effect size (ES) = 0.20 (95%CI: 0.13, 0.28)), with a negligible increase (ES &lt; 0.2) in mean body mass. When adjusted for trends in age, gender, and body size, there was a small decline in sit-and-reach performance (ES = –0.43 (95%CI: −0.43, −0.42)), a small improvement in 9-min run/walk performance (9-to-12-year-olds, ES = 0.26 (95%CI: 0.26, 0.27)), with negligible declines in handgrip strength, 6-min run/walk (6-to 8-year-olds), and sit-ups performance. Temporal trends were not always uniform across the population distribution, with declines in run/walk, sit-ups, and sit-and-reach performance generally largest in children with low fitness. Increased national health promotion strategies that address culturally specific factors are encouraged to further improve the existing trends, especially for children with low fitness.

Temporal trends in the physical fitness of Hong Kong children aged 6–12 years between 2003–04 and 2015–16