Individual and school correlates of body mass index and cardiorespiratory fitness in primary school children from the REACT project: A multivariate multilevel analysis.

OBJECTIVE: This paper examines the relationship between body mass index (BMI) and cardiorespiratory fitness (CRF) using a multivariate multilevel approach and investigates the links between individual and school-related correlates with children's BMI and CRF.

METHODS: This cross-sectional sample included 1014 children (6-10 years) from 25 Portuguese primary schools. BMI was calculated, and CRF was assessed with the PACER test. Fundamental movement skills (FMS) included five object control tasks. Moderate-to-vigorous physical activity (MVPA), sleep, and sedentary time were assessed with the ActiGraph wGT3X-BT accelerometer. Socioeconomic status (SES) and school variables were also obtained. A multivariate multilevel model was used, and alpha was set at 5%.

RESULTS: BMI and CRF systematically increased with age. Most of the joint variance (94.4%) was explained at the child level, and BMI and CRF were correlated at this level (ρ = -.37). More active children demonstrated higher CRF levels and had lower BMI levels; sedentary and sleep time were not significantly associated with BMI or CRF. FMS were positively associated with CRF but were not significantly associated with BMI. Children at higher SES were more fit and had lower BMI than their peers of lower SES. Finally, school-level variables were not significantly related to BMI and CRF.

CONCLUSION: BMI and CRF had a low but statistically significant negative correlation in this sample of children. Most of the variation in BMI and CRF was explained by child-level characteristics.