title: The effects of changes in physical fitness on academic performance among New York City youth.
abstract: OBJECTIVE
  To evaluate whether a change in fitness is associated with academic outcomes in New York City (NYC) middle-school students using longitudinal data and to evaluate whether this relationship is modified by student household poverty.
  
  
  METHODS
  This was a longitudinal study of 83,111 New York City middle-school students enrolled between 2006-2007 and 2011-2012. Fitness was measured as a composite percentile based on three fitness tests and categorized based on change from the previous year. The effect of the fitness change level on academic outcomes, measured as a composite percentile based on state standardized mathematics and English Language Arts test scores, was estimated using a multilevel growth model. Models were stratified by sex, and additional models were tested stratified by student household poverty.
  
  
  RESULTS
  For both girls and boys, a substantial increase in fitness from the previous year resulted in a greater improvement in academic ranking than was seen in the reference group (girls: .36 greater percentile point improvement, 95% confidence interval: .09-.63; boys: .38 greater percentile point improvement, 95% confidence interval: .09-.66). A substantial decrease in fitness was associated with a decrease in academics in both boys and girls. Effects of fitness on academics were stronger in high-poverty boys and girls than in low-poverty boys and girls.
  
  
  CONCLUSIONS
  Academic rankings improved for boys and girls who increased their fitness level by >20 percentile points compared to other students. Opportunities for increased physical fitness may be important to support academic performance.
authors.affiliation: Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts.
authors.forename: Carla P
authors.initials: CP
authors.lastname: Bezold
authors.affiliation: Division of Epidemiology, New York City Department of Health and Mental Hygiene, New York, New York. Electronic address: kkonty@health.nyc.gov.
authors.forename: Kevin J
authors.initials: KJ
authors.lastname: Konty
authors.affiliation: Division of Epidemiology, New York City Department of Health and Mental Hygiene, New York, New York.
authors.forename: Sophia E
authors.initials: SE
authors.lastname: Day
authors.affiliation: Healthfirst, New York, New York.
authors.forename: Magdalena
authors.initials: M
authors.lastname: Berger
authors.affiliation: Office of School Wellness Programs, New York City Department of Education, New York, New York.
authors.forename: Lindsey
authors.initials: L
authors.lastname: Harr
authors.affiliation: Office of School Wellness Programs, New York City Department of Education, New York, New York.
authors.forename: Michael
authors.initials: M
authors.lastname: Larkin
authors.affiliation: Department of Epidemiology, University of North Carolina Gillings School of Public Health, Chapel Hill, North Carolina.
authors.forename: Melanie D
authors.initials: MD
authors.lastname: Napier
authors.affiliation: Division of the First Deputy Commissioner, New York City Department of Health and Mental Hygiene, New York, New York.
authors.forename: Cathy
authors.initials: C
authors.lastname: Nonas
authors.affiliation: Office of School Wellness Programs, New York City Department of Education, New York, New York.
authors.forename: Subir
authors.initials: S
authors.lastname: Saha
authors.affiliation: Division of Epidemiology, New York City Department of Health and Mental Hygiene, New York, New York.
authors.forename: Tiffany G
authors.initials: TG
authors.lastname: Harris
authors.affiliation: Department of Epidemiology, Pfizer, New York, New York.
authors.forename: James H
authors.initials: JH
authors.lastname: Stark
mesh_terms: D000124:Achievement; D000293:Adolescent; D000294:Adolescent Behavior; D004521:Educational Measurement / Q000379:methods / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009519:New York City; D010809:Physical Fitness; D011203:Poverty / Q000706:statistics & numerical data; D017678:Sex Distribution; D013334:Students / Q000706:statistics & numerical data*
keywords: Academic performance; Obesity; Physical activity; Physical fitness
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