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

To test how different developmental pathways of health-related physical fitness and motorcompetence 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 472primary school children assessed yearly throughout 1st to 4th grade, with an average age of 6.3 ± 0.7years of age at 1st grade.Methods: Children’s pathways of change on each of the fitness and motor competence tests were deter-mined along the four years of the study. Participants were divided into three groups according to their rateof 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 onthe 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 andmotor competence were several times more prone to become overweight or obese at the end of pri-mary school (OR 2.0 to 6.3), independent of sex and body mass index at baseline. Specifically, a negativedevelopmental pathway (Low Rate of Change) in cardiorespiratory fitness demonstrated over a six-foldelevated 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 manyactually regress over time. Developing positive fitness and motor competence pathways during childhoodprotects from obesity and overweigh