Developmental pathways of change in fitness and motor competence are related to overweight and obesity status at the end of primary school

Objectives To test how different developmental pathways of health-related physical fitness and motor competence tests relate to weight status (overweight and obesity) at the end of primary school. Design Longitudinal study on growth, health-related physical fitness, and motor competence of 472 primary school children assessed yearly throughout 1st to 4th grade, with an average age of 6.3 ± 0.7 years of age at 1st grade. Methods Children's pathways of change on each of the fitness and motor competence tests were determined along the four years of the study. Participants were divided into three groups according to their rate of change in each test over time: Low Rate of Change, Average Rate of Change, and High Rate of Change. A logistic regression was used to predict the odds ratio of becoming overweight or obese, depending on the developmental pathway of change in fitness and motor competence across childhood. Results Children with a low or average rate of change in their developmental pathways of fitness and motor competence were several times more prone to become overweight or obese at the end of primary school (OR 2.0 to 6.3), independent of sex and body mass index at baseline. Specifically, a negative developmental pathway (Low Rate of Change) in cardiorespiratory fitness demonstrated over a six-fold elevated risk of being overweight or obese, compared to peers with a positive pathway. Conclusions Not all children improve their motor competence and fitness levels over time and many actually regress over time. Developing positive fitness and motor competence pathways during childhood protects from obesity and overweight.