Changes in children's physical fitness, BMI and health-related quality of life after the first 2020 COVID-19 lockdown in England: A longitudinal study

We aimed to assess one-year changes in physical fitness, health-related quality of life (HRQoL) and body mass index (BMI), encompassing the 2020 COVID-19 UK lockdowns. Data were collected (October 2019, November 2020) from 178 8-10-year-olds in Newcastle-upon-Tyne, England, 85% from England's most deprived quintile. Twenty-metre shuttle run test performance (20mSRT), handgrip strength (HGS), standing broad jump (SBJ), sit-and-reach, height, body mass, HRQoL (Kidscreen-27 questionnaire) and sports club participation were measured. BMI z-scores and overweight/obesity were calculated (≥85th centile). Paired t-tests and linear regression assessed change, adjusting for baseline BMI. Significant (p<0.001) changes were observed: increases in mean BMI (+1.5kg·m^-2), overweight/obesity (33% to 47%), SBJ (+6.8cm) and HGS (+1.5kg); decreases in 20mSRT performance (-3 shuttles), sit-and-reach (-1.8cm). More children at follow-up were categorized "very low" for 20mSRT performance (35% baseline v 51%). Increased BMI z-score was associated with decreased "Physical Wellbeing" HRQoL. Follow-up sports club participation was associated with better 20mSRT performance (p=0.032), and "Autonomy & Parents" (p=0.011), "Social Support & Peers" (p=0.038) HRQoL. Children's 20mSRT performance and BMI changed adversely over one year; national lockdowns potentially made negative contributions. Physical fitness, physical activity and sports programmes should be part of children's physical and mental recovery from the pandemic.

The association between physical fitness, sports club participation and body mass index on health-related quality of life in primary school children from a socioeconomically deprived area of England

We examined associations between physical fitness components, body mass index (BMI) and sports club participation on health-related quality of life (HRQoL) in 8- to 11-year-old children from a socioeconomically deprived region of England. From May-October 2019, 432 children completed the HRQoL questionnaire Kidscreen-27 and Leisure Time Physical Activity Survey, and a physical fitness testing battery of 20 m shuttle run test (20mSRT), handgrip strength (Handgrip), standing broad jump (Broad Jump), and sit-and-reach. Height, body mass, BMI and somatic maturity data were collected. Comparisons with reference populations were undertaken using a quintile framework. Linear and quantile regression assessed associations between physical fitness components and HRQoL variables. Using English Indices of Multiple Deprivation, 90% of children were from the most deprived quintile and 39% were overweight or obese. More children scored poorly on the Physical Wellbeing (40%) and Psychological Wellbeing (45%) HRQoL domains than the reference population (31%). Physical fitness scores were generally classed as 'low'-'very low' (42-58%). 20mSRT and Broad Jump performance explained an additional 10.7% of variance in Physical Wellbeing after adjusting for BMI z-score, sex and age (total R² 21.2%). Quantile regression identified a subset of children who rated Physical Wellbeing as high regardless of 20mSRT performance. Sports club participation was associated with better 20mSRT and Broad Jump performance, and all domains of HRQoL. Our data indicate that some physical fitness components and sports club participation are positively associated with HRQoL of children from socioeconomically deprived areas, irrespective of BMI z-score. Interventions to improve HRQoL should consider both aspects.