Journal of physical activity & health · 2026
Association of Physical Fitness With Overweight and Obesity Among Chinese Children and Adolescents: A Multiprovincial Follow-Up Survey From 2019 to 2020.
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Cai Shan, Dang Jiajia, Liu Yunfei, Zhong Panliang, Shi Di, Chen Ziyue, Zhang Yihang, Dong Yanhui, Ma Jun, Song Yi
Аннотация
BACKGROUND: This study described the transition of overweight and obesity (OWOB) from 2019 to 2020 among Chinese children and adolescents and explored the association of physical fitness with OWOB incidence, persistence, and progression.
METHODS: A total of 4429 children and adolescents aged 9-18 years in China finished physical fitness assessments and anthropometric measurements in November 2019, with follow-up assessments of height and weight conducted in November 2020. The extended International Obesity Task Force standard was applied to classify nutritional status. Participants with normal nutrition in 2019 and newly identified as OWOB in 2020 were defined as having OWOB incidence. Individuals with OWOB in 2019 and remaining at the same level of nutrition in 2020 were defined as having OWOB persistence. Participants with OWOB in 2019 and progressing to a more severe level of nutrition in 2020 were defined as having OWOB progression. Physical fitness indicator (PFI) was computed by sex- and age-specific Z scores of 6 components as follows: PFI = Zforced vital capacity + Zsit-and-reach + (-Z50-m dash) + Zstanding long jump + (-Zendurance running) + Zbody muscle strength. The PFI values were then classified into low, low-middle, middle, middle-high, and high levels based on the sex- and age-specific quintiles.
RESULTS: The overall incidence of OWOB from 2019 to 2020 was 12.9%, with a higher incidence in children aged 9-12 years and boys. The percentages of OWOB persistence and progression were 10.7% and 1.8%, with children aged 9-12 years and boys at a higher risk for OWOB persistence, and boys at a higher risk for OWOB progression. Compared to individuals with a low-level PFI, children and adolescents with a high-level PFI were at a lower risk for OWOB incidence (OR = 0.55, 95% confidence interval [CI]: 0.36 to 0.83), while individuals with low-middle (OR = 0.65, 95% CI, 0.49 to 0.86), middle (OR = 0.34, 95% CI, 0.24 to 0.46), middle-high (OR = 0.32, 95% CI, 0.24 to 0.44), and high (OR = 0.14, 95% CI, 0.09 to 0.20) levels of PFI had a lower risk for OWOB persistence, and individuals with middle (OR = 0.21, 95% CI, 0.09 to 0.48), middle-high (OR = 0.34, 95% CI, 0.17 to 0.65), and high (OR = 0.16, 95% CI, 0.07 to 0.37) levels of PFI were at a lower risk for OWOB progression.
CONCLUSIONS: This longitudinal study found that a higher physical fitness level in children and adolescents was inversely associated with OWOB incidence, persistence, and progression, suggesting that enhancing physical fitness might serve as a promising intervention strategy to alleviate the OWOB burden in Chinese children and adolescents.
METHODS: A total of 4429 children and adolescents aged 9-18 years in China finished physical fitness assessments and anthropometric measurements in November 2019, with follow-up assessments of height and weight conducted in November 2020. The extended International Obesity Task Force standard was applied to classify nutritional status. Participants with normal nutrition in 2019 and newly identified as OWOB in 2020 were defined as having OWOB incidence. Individuals with OWOB in 2019 and remaining at the same level of nutrition in 2020 were defined as having OWOB persistence. Participants with OWOB in 2019 and progressing to a more severe level of nutrition in 2020 were defined as having OWOB progression. Physical fitness indicator (PFI) was computed by sex- and age-specific Z scores of 6 components as follows: PFI = Zforced vital capacity + Zsit-and-reach + (-Z50-m dash) + Zstanding long jump + (-Zendurance running) + Zbody muscle strength. The PFI values were then classified into low, low-middle, middle, middle-high, and high levels based on the sex- and age-specific quintiles.
RESULTS: The overall incidence of OWOB from 2019 to 2020 was 12.9%, with a higher incidence in children aged 9-12 years and boys. The percentages of OWOB persistence and progression were 10.7% and 1.8%, with children aged 9-12 years and boys at a higher risk for OWOB persistence, and boys at a higher risk for OWOB progression. Compared to individuals with a low-level PFI, children and adolescents with a high-level PFI were at a lower risk for OWOB incidence (OR = 0.55, 95% confidence interval [CI]: 0.36 to 0.83), while individuals with low-middle (OR = 0.65, 95% CI, 0.49 to 0.86), middle (OR = 0.34, 95% CI, 0.24 to 0.46), middle-high (OR = 0.32, 95% CI, 0.24 to 0.44), and high (OR = 0.14, 95% CI, 0.09 to 0.20) levels of PFI had a lower risk for OWOB persistence, and individuals with middle (OR = 0.21, 95% CI, 0.09 to 0.48), middle-high (OR = 0.34, 95% CI, 0.17 to 0.65), and high (OR = 0.16, 95% CI, 0.07 to 0.37) levels of PFI were at a lower risk for OWOB progression.
CONCLUSIONS: This longitudinal study found that a higher physical fitness level in children and adolescents was inversely associated with OWOB incidence, persistence, and progression, suggesting that enhancing physical fitness might serve as a promising intervention strategy to alleviate the OWOB burden in Chinese children and adolescents.