Association between physical fitness and anthropometric, cardiovascular and socioeconomic risk factors in primary schoolchildren in KwaZulu‑Natal Province, South Africa

Background. Physical fitness (PF) status in children has been identified as a predictor of chronic disease risk factors, and has also been linked to various non-communicable diseases and an increased risk of premature death in adulthood. Studies have shown that PF has been declining. In South Africa (SA), a similar trend is noted and attributed to urbanisation and shifts from traditional active practices to sedentary lifestyles.  Objectives. To examine possible associations between PF levels and socioeconomic status (SES) and anthropometric and cardiovascular risk factors among 407 primary schoolchildren aged 6 - 13 years in KwaZulu-Natal Province, SA.  Methods. In a cross-sectional study, children’s PF scores were assessed using the Eurofit test battery: sit and reach, standing long jump (SLJ), sit-ups (SUs), 5 m shuttle run (5m-SRT) and cricket ball throw (CBT). SES was assessed using a structured questionnaire. Standardised procedures were used for anthropometric and cardiovascular measures.  Results. Girls weighed significantly more than boys (p=0.001) and had a significantly higher body mass index (BMI) (p<0.001), waist circumference (WC) (p<0.001) and hip circumference (HC) (p<0.001), while boys performed significantly better in SLJ (p=0.030), SUs (p=0.022), CBT (p<0.001) and 5m-SRT (p<0.001). A significant low negative correlation was found between PF and BMI (r=–0.151; p=0.002), WC (r=–0.107; p=0.031) and HC (r=0.123; p=0.013). Multinomial logistic regression analysis identified BMI as the main predictor of low PF (odds ratio 1.16; 95% confidence interval 1.01 - 1.33) in this cohort of primary schoolchildren. The occurrence of low PF status in children of primary school age may be influenced by gender and adiposity.  Conclusion. Assessment of PF at policy levels as part of the health screening process may help create a more explicit depiction of the health status of children and assist in early identification of risk factors.