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Introduction: Cardiorespiratory fitness (CRF) is a key marker of early childhood health, yet its determinants are poorly understood. This study aimed to identify the multi-dimensional impacts of physical activity (PA), motor competence, and muscle strength on CRF in preschoolers, considering age and sex differences. Methods: A total of 329 preschoolers (aged 3.0-6.9 years) were initially recruited in China between April and June in 2024, with a final sample of 300 children included in the analysis. CRF, PA levels (light, moderate, and vigorous), and motor competence components (manual dexterity, aiming and catching, and balance) were assessed with the PREFIT 20 m shuttle run, the ActiGraph GT3X+ accelerometer (for seven consecutive days), and the Movement Assessment Battery for Children-Second edition (MABC-2), respectively. Upper- and lower- limb strength was evaluated by grip dynamometer and standing long jump test, respectively. Generalized linear mixed models and hierarchical regressions were employed to analyze the data, stratified by age and sex. Results: Hierarchical models showed that demographics explained 32.3% of CRF variance, motor competence 7.6%, muscle strength 3.0% and PA added 2.3%. Specifically, manual dexterity, balance, handgrip strength, standing long jump, and VPA were identified as significant independent predictors. Stratified analyses revealed that manual dexterity and VPA were the primary predictors for boys and girls, respectively, with muscle strength emerging as an additional key determinant for both sexes in the older cohort. Discussion: CRF in preschoolers is influenced by an interplay of factors, with VPA, motor competence, and muscle strength being key. The pattern of predictors varies by age and sex, highlighting the need for tailored interventions to promote CRF effectively.
Gao et al. (Thu,) studied this question.