title: Determinant factors of physical fitness in European children.
abstract: OBJECTIVE
  This study was designed to explore the determinants of physical fitness in European children aged 6-11 years, cross-sectionally and longitudinally.
  
  
  METHODS
  There were sufficient data on 4903 children (50.6 % girls) on measured physical fitness (cardio-respiratory, muscular strength, flexibility, balance, and speed) and possible determinants related to child characteristics, child lifestyle and parental factors. Multivariate and mixed linear regression models were conducted.
  
  
  RESULTS
  Age, sex, children's BMI and physical activity were independent and strong determinants of children's fitness. Significant but small effects were found for low maternal BMI, high psychosocial well-being and fruit and vegetable intake as protective determinants. Sleep duration, breakfast intake, parental age and education and paternal BMI did not have a consistently significant effect on physical fitness. The role of determinants depended on children's sex and the specific PF component. Longitudinal analyses especially highlighted the importance of child's BMI as physical fitness determinant, independent of physical activity.
  
  
  CONCLUSIONS
  BMI together with physical activity, diet and psychosocial factors are modifiable targets to enhance physical fitness. This calls for policy approaches that combine these factors in a systematic way.
authors.affiliation: Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium. mahmoud.zaqout@ugent.be.
authors.forename: Mahmoud
authors.initials: M
authors.lastname: Zaqout
authors.affiliation: Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
authors.forename: Krishna
authors.initials: K
authors.lastname: Vyncke
authors.affiliation: GENUD (Growth, Exercise, Nutrition and Development) Research Group, EU Ciencias de la Salud, Universidad de Zaragoza, Saragossa, Spain.
authors.forename: Luis A
authors.initials: LA
authors.lastname: Moreno
authors.affiliation: GENUD (Growth, Exercise, Nutrition and Development) Research Group, EU Ciencias de la Salud, Universidad de Zaragoza, Saragossa, Spain.
authors.forename: Pilar
authors.initials: P
authors.lastname: De Miguel-Etayo
authors.affiliation: Epidemiology and Population Genetics, Institute of Food Sciences-CNR, Avellino, Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Lauria
authors.affiliation: Department of Pediatrics, University of Pécs, Pécs, Hungary.
authors.forename: Denes
authors.initials: D
authors.lastname: Molnar
authors.affiliation: Section for Epidemiology and Social Medicine (EPSO), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Lauren
authors.initials: L
authors.lastname: Lissner
authors.affiliation: Section for Epidemiology and Social Medicine (EPSO), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Monica
authors.initials: M
authors.lastname: Hunsberger
authors.affiliation: Department of Chronic Diseases, National Institute for Health Development, Tallinn, Estonia.
authors.forename: Toomas
authors.initials: T
authors.lastname: Veidebaum
authors.affiliation: Research and Education Institute of Child Health, Strovolos, Cyprus.
authors.forename: Michael
authors.initials: M
authors.lastname: Tornaritis
authors.affiliation: Department of Intercultural Communication and Management, Copenhagen Business School, Frederiksberg, Denmark.
authors.forename: Lucia A
authors.initials: LA
authors.lastname: Reisch
authors.affiliation: Institute for Public Health and Nursing Research, Faculty for Human and Health Sciences, University of Bremen, Bremen, Germany.|Leibniz-Institute for Prevention Research and Epidemiology BIPS, Bremen, Germany.
authors.forename: Karin
authors.initials: K
authors.lastname: Bammann
authors.affiliation: Leibniz-Institute for Prevention Research and Epidemiology BIPS, Bremen, Germany.
authors.forename: Ole
authors.initials: O
authors.lastname: Sprengeler
authors.affiliation: Leibniz-Institute for Prevention Research and Epidemiology BIPS, Bremen, Germany.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Ahrens
authors.affiliation: Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Michels
mesh_terms: D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005060:Europe; D005260:Female; D006801:Humans; D008019:Life Style; D008137:Longitudinal Studies; D008297:Male; D010808:Physical Examination / Q000379:methods*; D010809:Physical Fitness / Q000502:physiology*
keywords: Body mass index; Children; IDEFICS; Lifestyle; Parental determinants; Physical fitness