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The reciprocal relationship between body mass index categories and physical fitness: A 4‐year prospective cohort study of 20 000 Chinese children
Author(s) -
Ho Frederick K.,
So HungKwan,
Wong Rosa S.,
Tung Keith T. S.,
Louie Lobo H. T.,
Tung Joanna,
Mirpuri Sheena,
Chow Bik,
Wong Wilfred H. S.,
Lee Albert,
Ip Patrick
Publication year - 2020
Publication title -
pediatric obesity
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.226
H-Index - 69
eISSN - 2047-6310
pISSN - 2047-6302
DOI - 10.1111/ijpo.12646
Subject(s) - cardiorespiratory fitness , medicine , physical fitness , body mass index , obesity , population , demography , prospective cohort study , physical therapy , cohort study , cohort , longitudinal study , overweight , environmental health , pathology , sociology
Summary 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.