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Physical fitness is an important component in the development and health of children and adolescents. Given the equivocal results of previous research regarding the influence of the living environment on physical fitness, this study examined differences in physical fitness in urban and rural elementary school children in Upper Austria. A total of 18,168 (51% male) children between 6 and 11 years of age participated in anthropometric assessments and completed eight fitness tests that assessed cardiorespiratory endurance, muscular power, speed, agility, flexibility, and ball handling skills during a single test session in the school's gymnasium. Urban living environment was associated with higher body weight ( p = 0.01) and lower physical fitness ( p &lt; 0.01), except for flexibility, which was better in urban children ( p &lt; 0.01) and upper body strength (no difference), even after accounting for differences in body weight. Furthermore, it was shown that urban-rural differences in physical fitness are more pronounced in normal weight children and that these differences increase with age. These results highlight the potential of the living environment for the promotion of an active lifestyle that enhances physical fitness. The availability of safe spaces that facilitate unstructured and structured physical activity, as well as active transportation provide viable options for the promotion of physical fitness in children.

Physical Fitness in Upper Austrian Children Living in Urban and Rural Areas: A Cross-Sectional Analysis with More Than 18,000 Children