Motor competence and body mass index in the preschool years: a pooled cross-sectional analysis of 5545 children from eight countries

Clarice Martins, Vicente Romo-Perez, Elizabeth Webster, Michael Duncan, Luis Lemos, Amanda Staiano, Anthony Okely, Daniele Magistro, Fabio Carlevaro, Farid Bardid, Francesca Magno, Glauber C. Nobre, Isaac Estevan, Jorge Mota, Ke Ning, Leah Robinson, Matthieu Lenoir, Minghui Quan, Nadia Cristina Valentini, Penny CrossRachel Jones, Rafael Henrique, Si-Tong Chen, Yucui Diao, Paulo Bandeira, Lisa Barnett

Research output: Contribution to journalArticlepeer-review

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Background: One in five preschool children are overweight/obese, and increased weight status over time increases the risks of poorer future health. Motor skill competence (MC) may be a protective factor - giving children the ability to participate in health enhancing physical activity. Yet we do not know when the relationship between motor competence and weight status first emerges or whether it is evident across the body mass index (BMI) spectrum. This study examined the association between MC and BMI in a multi-country sample of 5545 preschoolers (54.36 ± 9.15 months of age; 50.5% boys) from eight countries. Methods: Quantile regression analyses were used to explore the associations between MC (assessed using the Test of Gross Motor Development -2nd/3rd edition), and quantiles of BMI (15th; 50th; 85th; and 97th percentiles), adjusted for sex, age in months, and country. Results: Negative associations of locomotor skills, ball skills, and overall MC with BMI percentiles (p < .005) were seen, which became stronger at the higher end of the BMI distribution (97th percentile). Regardless of sex, for each raw score point increase in locomotor skills, ball skills and overall MC scores, BMI is reduced by 8.9%, 6.8%, and 5.1%, respectively, for those preschoolers at the 97th BMI percentile onwards. Conclusion: Public health policies should position MC as critical for children´s obesity prevention from early childhood onwards. Robust longitudinal and experimental designs are encouraged to explore a possible causality pathway between MC and BMI from early childhood.
Original languageEnglish
Pages (from-to)(In-Press)
Number of pages32
JournalSports Medicine
Early online date25 Sept 2023
Publication statusE-pub ahead of print - 25 Sept 2023


I.E. was supported by the Generalitat Valenciana, Conselleria de Innovación, Universidades, Ciencia y Sociedad Digital (project APE/2021/013).
A.E. S. and L.K.W. were supported by NIH NICHD R21HD095035; Gulf States-HPC from the NIHMD NIH (U54MD008602), P30DK072476, U54GM104940, and the LSU Biomedical Collaborative Research Program
L.E.R. was partially supported by The National Institute of Health partially supported this work under National Heart, Lung, and Blood Institute [1R01HL132979]
A.O; P.C; and R.J were supported by The Australian data from New South Wales, using funding from the National Health and Medical Research Council of Australia (APP1062433)
L.M.B. accessed data from The Melbourne INFANT Program follow-ups which were funded by a National Health and Medical Research Council Project Grant (GNT1008879).
P.R.B. was supported by the Scholarship Program for Productivity in Research and Stimulus to Interiorization and Technological Innovation – BPI (04-2022).


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