Preschoolers with better health-related physical fitness (HRPF) have better cognitive and brain functioning. This study examined the associations between health-related physical fitness and cognitive domains in preschool children, including the independent role of fitness components, potential moderators, and links to low cognitive achievement. This was a cross-sectional study analyzing baseline data from a randomized controlled trial (MOVI-HIIT) including 522 preschoolers aged 3-5 years from 9 schools in Ciudad Real, Spain. Speed-agility, upper and lower body muscle strength, cardiorespiratory fitness (CRF), and balance were measured with the PREFIT battery. Cognition was measured using the Differential and General Aptitude Battery (numerical concepts and vocabulary), Flanker Task (inhibition), Dimensional Change Card Sort (cognitive flexibility), and Span of words (working memory); sex, age, socioeconomic status, and screen time were measured as covariates. All HRPF components were positively associated with all cognitive domains (r = 0.11-0.38; all p ≤ 0.050). ANCOVA models showed that children in higher categories of fitness components, except for lower body strength, had significantly better scores in numerical concepts, vocabulary, inhibition, and working memory. Cognitive flexibility was only associated with balance. Logistic regression models revealed that high levels of speed-agility, upper body strength, CRF, and balance were associated with reduced odds of low cognitive performance. HRPF was associated with cognitive performance in preschoolers, with variations by fitness and cognitive domains. Balance, CRF, and speed-agility emerged as key components associated with better cognitive outcomes. These findings support the relevance of HRPF in early cognitive development. Clinical Trial Registration (If Any): Mairena Sánchez-López NCT04863040. Deidentified individual participant data (including data dictionaries) will be made available, in addition to study protocols, the statistical analysis plan, and the informed consent form. The data will be made available upon publication to researchers who provide a methodologically sound proposal for use in achieving the goals of the approved proposal. Proposals should be submitted to mariaeugenia.visier@uclm.es.
Visier‐Alfonso et al. (2026) studied this question.