Interaction of sedentary behaviour, sports participation and fitness with weight status in elementary school children.

Even though the effect of single components contributing to weight gain in children have been addressed only limited research is available on the combined association of sports participation, physical fitness and time spent watching TV with body weight in children. Baseline data from 1594 children (809 male; 785 female), 7.1 ± 0.6 years of age participating in a large school-based intervention in southern Germany was used. Height and weight was measured and body mass index (BMI) percentiles (BMIPCT) were determined accordingly. Sports participation and time spent watching TV was assessed via parent questionnaire while fitness was determined via a composite fitness test. Combined and single associations of sports participation, TV time and fitness with BMIPCT and weight status were assessed via ANCOVA as well as logistic regression analysis, controlling for age and sex. A significant interaction of TV time, sports participation and fitness on BMIPCT occurred, despite low correlations among the three components. Further, there was a combined association of sports participation and TV time on BMIPCT. TV time and fitness were also independently associated with BMIPCT. Similarly, only increased TV time and lower fitness were associated with a higher odds ratio for overweight/obesity. These results underline the complex interaction of TV time, sports participation and fitness with BMIPCT. In children, TV time and fitness have a stronger influence on BMIPCT compared to sports participation. Sports participation, however, may not reflect overall activity levels of children appropriately. More research is necessary to examine the complex interaction of various behaviours and fitness with BMIPCT.