{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T19:26:25Z","timestamp":1793993185335,"version":"4.8.0"},"reference-count":30,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T00:00:00Z","timestamp":1773705600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T00:00:00Z","timestamp":1777507200000},"content-version":"vor","delay-in-days":44,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100009392","name":"Prince Sattam bin Abdulaziz University","doi-asserted-by":"publisher","award":["2025\/03\/38911"],"award-info":[{"award-number":["2025\/03\/38911"]}],"id":[{"id":"10.13039\/100009392","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Childhood obesity is associated with impaired physical fitness and increased future cardiometabolic risk. Aerobic capacity and muscular strength are key components of health-related fitness; however, their interrelationship across weight status remains underexplored in Middle Eastern pediatric populations. This study aimed to examine the association between aerobic capacity and muscular strength among obese and non-obese children aged 10\u201315 years in the Riyadh region, Kingdom of Saudi Arabia. A cross-sectional study was conducted among 200 children (52% boys and 48% girls) selected from screened government and private school students in Riyadh, comprising 100 obese and 100 non-obese participants for balanced group comparison. Obesity was defined using World Health Organization age- and sex-specific BMI percentiles. Aerobic capacity was assessed using the 20-m shuttle run test, with estimated VO2max calculated from performance. Muscular strength was measured using handgrip dynamometry, and relative strength was derived by normalizing grip strength to body weight. Group comparisons were performed using independent t-tests. Associations between aerobic capacity and muscular strength were analyzed using correlation and multivariable linear regression adjusting for age, sex, and BMI. Obese children demonstrated significantly lower shuttle run performance and estimated VO2max compared with non-obese children (p\u2009&lt;\u20090.001). Absolute handgrip strength was higher in obese children (p\u2009=\u20090.01), whereas relative muscular strength was significantly lower (p\u2009&lt;\u20090.001). Aerobic capacity showed moderate to strong positive correlations with both absolute and relative muscular strength in both groups, with stronger associations observed for relative strength. In multivariable regression analyses conducted using separate models to avoid mathematical coupling, relative muscular strength independently predicted VO2max after adjusting for age and sex (\u03b2\u2009=\u20090.47, p\u2009&lt;\u20090.001), explaining 52% of variance. In a separate adiposity model, BMI was inversely associated with aerobic capacity (\u03b2 = \u22120.51, p\u2009&lt;\u20090.001), explaining 56% of variance. Obese children aged 10\u201315 years exhibited reduced aerobic capacity and lower relative muscular strength despite higher absolute strength. Both adiposity and functional muscular strength were independently associated with aerobic fitness when modeled separately. The stronger predictive value of relative muscular strength highlights the importance of improving strength relative to body mass, alongside aerobic conditioning, in pediatric obesity prevention and intervention programs.<\/jats:p>","DOI":"10.1038\/s41598-026-43515-7","type":"journal-article","created":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T17:25:50Z","timestamp":1773768350000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Association of aerobic capacity and handgrip strength in obese and non-obese children aged 10\u201315 years in Riyadh region, KSA\u2013a cross sectional study"],"prefix":"10.1038","volume":"16","author":[{"given":"Gopal","family":"Nambi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mshari","family":"Alghadier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arul","family":"Vellaiyan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shahul Hameed Pakkir","family":"Mohamed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vijayamurugan","family":"Eswaramoorthi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramprasad","family":"Muthukrishnan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,3,17]]},"reference":[{"key":"43515_CR1","doi-asserted-by":"publisher","DOI":"10.3390\/sports13090309","volume":"13","author":"M Helme","year":"2025","unstructured":"Helme, M., Cowburn, I. & Till, K. Developing the physical fitness of children: A systematic scoping review of pedagogy in research. Sports 13, 309. https:\/\/doi.org\/10.3390\/sports13090309 (2025).","journal-title":"Sports"},{"key":"43515_CR2","doi-asserted-by":"publisher","first-page":"478","DOI":"10.1136\/bjsports-2017-097982","volume":"53","author":"GR Tomkinson","year":"2019","unstructured":"Tomkinson, G. R., Lang, J. J. & Tremblay, M. S. Temporal trends in the cardiorespiratory fitness of children and adolescents representing 19 high-income and upper middle-income countries between 1981 and 2014. Br. J. Sports Med. 53, 478\u2013486. https:\/\/doi.org\/10.1136\/bjsports-2017-097982 (2019).","journal-title":"Br. J. Sports Med."},{"key":"43515_CR3","doi-asserted-by":"publisher","first-page":"2205","DOI":"10.1519\/JSC.0000000000000547","volume":"28","author":"T Spiteri","year":"2014","unstructured":"Spiteri, T. et al. Mechanical determinants of faster change of direction and agility performance in female basketball athletes. J. Strength. Cond Res. 28, 2205\u20132214. https:\/\/doi.org\/10.1519\/JSC.0000000000000547 (2014).","journal-title":"J. Strength. Cond Res."},{"key":"43515_CR4","doi-asserted-by":"publisher","first-page":"663","DOI":"10.1080\/02640414.2018.1515905","volume":"37","author":"JM Sheppard","year":"2019","unstructured":"Sheppard, J. M. & Young, W. B. Agility literature review: Classifications, training and testing. J. Sports Sci. 37, 663\u2013677. https:\/\/doi.org\/10.1080\/02640414.2018.1515905 (2019).","journal-title":"J. Sports Sci."},{"key":"43515_CR5","doi-asserted-by":"publisher","first-page":"99046","DOI":"10.1038\/s41598-025-99046-0","volume":"15","author":"L Zhang","year":"2025","unstructured":"Zhang, L. et al. Comparison of physical activity, sedentary time, and physical fitness between obese and non-obese adolescents: a cross-sectional analysis. Sci. Rep. 15, 99046. https:\/\/doi.org\/10.1038\/s41598-025-99046-0 (2025).","journal-title":"Sci. Rep."},{"key":"43515_CR6","doi-asserted-by":"publisher","first-page":"800","DOI":"10.1249\/MSS.0000000000003358","volume":"57","author":"S King-Dowling","year":"2025","unstructured":"King-Dowling, S. et al. Developmental coordination disorder and early childhood trajectories of physical activity. Med. Sci. Sports Exerc. 57, 800\u2013806. https:\/\/doi.org\/10.1249\/MSS.0000000000003358 (2025).","journal-title":"Med. Sci. Sports Exerc."},{"key":"43515_CR7","doi-asserted-by":"publisher","first-page":"909","DOI":"10.1136\/bjsm.2008.056499","volume":"43","author":"JR Ruiz","year":"2009","unstructured":"Ruiz, J. R. et al. Predictive validity of health-related fitness in youth: A systematic review. Br. J. Sports Med. 43, 909\u2013923. https:\/\/doi.org\/10.1136\/bjsm.2008.056499 (2009).","journal-title":"Br. J. Sports Med."},{"key":"43515_CR8","doi-asserted-by":"publisher","first-page":"871","DOI":"10.1136\/bjsports-2011-090333","volume":"45","author":"LB Andersen","year":"2011","unstructured":"Andersen, L. B., Riddoch, C., Kriemler, S. & Hills, A. Physical activity and cardiovascular risk factors in children. Br. J. Sports Med. 45, 871\u2013876. https:\/\/doi.org\/10.1136\/bjsports-2011-090333 (2011).","journal-title":"Br. J. Sports Med."},{"key":"43515_CR9","doi-asserted-by":"publisher","first-page":"50","DOI":"10.2196\/preprints.9883","volume":"12","author":"HM Al-Hazzaa","year":"2018","unstructured":"Al-Hazzaa, H. M. Physical inactivity in Saudi Arabia revisited: A systematic review of inactivity prevalence and perceived barriers to active living. Int. J. Health Sci. 12, 50\u201364. https:\/\/doi.org\/10.2196\/preprints.9883 (2018).","journal-title":"Int. J. Health Sci."},{"key":"43515_CR10","doi-asserted-by":"publisher","first-page":"1889","DOI":"10.1186\/s12889-025-1889","volume":"25","author":"L Jiang","year":"2025","unstructured":"Jiang, L. et al. Reference values for waist circumference percentile curves and abdominal obesity cutoff points in children and adolescents aged 6\u201320 years in Macao. BMC Public. Health. 25, 1889. https:\/\/doi.org\/10.1186\/s12889-025-1889 (2025).","journal-title":"BMC Public. Health"},{"key":"43515_CR11","doi-asserted-by":"publisher","first-page":"405","DOI":"10.1519\/JSC.0b013e3181c7b8c1","volume":"24","author":"J Castro-Pi\u00f1ero","year":"2010","unstructured":"Castro-Pi\u00f1ero, J. et al. Assessing muscular strength in youth: usefulness of handgrip strength. J. Strength. Cond Res. 24, 405\u2013412. https:\/\/doi.org\/10.1519\/JSC.0b013e3181c7b8c1 (2010).","journal-title":"J. Strength. Cond Res."},{"key":"43515_CR12","unstructured":"Malina, R. M. Growth, maturation, physical activity, and sport 3rd edn (Human Kinetics, 2025)."},{"key":"43515_CR13","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1016\/S2352-4642(19)30323-2","volume":"4","author":"R Guthold","year":"2020","unstructured":"Guthold, R., Stevens, G. A., Riley, L. M. & Bull, F. C. Global trends in insufficient physical activity among adolescents: A pooled analysis of 298 population-based surveys with 1.6 million participants. Lancet Child. Adolesc. Health 4, 23\u201335. https:\/\/doi.org\/10.1016\/S2352-4642(19)30323-2 (2020).","journal-title":"Lancet Child. Adolesc. Health"},{"key":"43515_CR14","doi-asserted-by":"publisher","first-page":"1209","DOI":"10.1007\/s40279-014-0196-4","volume":"44","author":"JJ Smith","year":"2014","unstructured":"Smith, J. J. et al. The health benefits of muscular fitness for children and adolescents. Sports Med. 44, 1209\u20131223. https:\/\/doi.org\/10.1007\/s40279-014-0196-4 (2014).","journal-title":"Sports Med."},{"key":"43515_CR15","doi-asserted-by":"publisher","first-page":"72","DOI":"10.1016\/j.neulet.2008.05.088","volume":"440","author":"E D\u2019Hondt","year":"2008","unstructured":"D\u2019Hondt, E., Deforche, B., De Bourdeaudhuij, I. & Lenoir, M. Childhood obesity affects fine motor skill performance under different postural constraints. Neurosci. Lett. 440, 72\u201375. https:\/\/doi.org\/10.1016\/j.neulet.2008.05.088 (2008).","journal-title":"Neurosci. Lett."},{"key":"43515_CR16","doi-asserted-by":"publisher","first-page":"116","DOI":"10.4236\/ojtr.2015.34016","volume":"3","author":"ZA Al-Asiri","year":"2015","unstructured":"Al-Asiri, Z. A. & Shaheen, A. A. Body mass index and health related physical fitness in Saudi girls and adolescents aged 8\u201315 years. Open J. Ther. Rehabil. 3, 116\u2013123. https:\/\/doi.org\/10.4236\/ojtr.2015.34016 (2015).","journal-title":"Open J. Ther. Rehabil."},{"key":"43515_CR17","doi-asserted-by":"publisher","DOI":"10.3390\/children12070899","volume":"12","author":"A Alonazi","year":"2025","unstructured":"Alonazi, A. et al. Gender differences in lower limb strength and endurance among Saudi adolescents: A cross-sectional study on the limited role of body mass index. Children 12, 899. https:\/\/doi.org\/10.3390\/children12070899 (2025).","journal-title":"Children"},{"key":"43515_CR18","doi-asserted-by":"publisher","DOI":"10.3389\/fphys.2025.1645483","volume":"16","author":"S Alotaibi","year":"2025","unstructured":"Alotaibi, S. et al. Handgrip strength predicts leg power but not cardiorespiratory fitness in children. Front. Physiol. 16, 1645483. https:\/\/doi.org\/10.3389\/fphys.2025.1645483 (2025).","journal-title":"Front. Physiol."},{"key":"43515_CR19","doi-asserted-by":"publisher","first-page":"1079","DOI":"10.1007\/s40279-019-01099-8","volume":"49","author":"A Garc\u00eda-Hermoso","year":"2019","unstructured":"Garc\u00eda-Hermoso, A., Ram\u00edrez-Campillo, R. & Izquierdo, M. Is muscular fitness associated with future health benefits in children and adolescents? A systematic review and meta-analysis. Sports Med. 49, 1079\u20131094. https:\/\/doi.org\/10.1007\/s40279-019-01099-8 (2019).","journal-title":"Sports Med."},{"key":"43515_CR20","doi-asserted-by":"publisher","first-page":"93","DOI":"10.1080\/02640418808729800","volume":"6","author":"LA L\u00e9ger","year":"1988","unstructured":"L\u00e9ger, L. A., Mercier, D., Gadoury, C. & Lambert, J. The multistage 20 metre shuttle run test for aerobic fitness. J. Sports Sci. 6, 93\u2013101. https:\/\/doi.org\/10.1080\/02640418808729800 (1988).","journal-title":"J. Sports Sci."},{"key":"43515_CR21","doi-asserted-by":"publisher","first-page":"2303","DOI":"10.1007\/s40279-025-02033-1","volume":"55","author":"AM Nevill","year":"2025","unstructured":"Nevill, A. M., Lang, J. J., Niemz, M. & Tomkinson, G. R. How should youth handgrip strength be normalized? New insights using 3-D allometry with \u201cgeneralizable\u201d norm-referenced values, data from NHANES. Sports Med. 55, 2303\u20132312. https:\/\/doi.org\/10.1007\/s40279-025-02033-1 (2025).","journal-title":"Sports Med."},{"key":"43515_CR22","doi-asserted-by":"publisher","first-page":"131","DOI":"10.1007\/978-3-031-XXXXX","volume":"1450","author":"S Garcia-Vicencio","year":"2024","unstructured":"Garcia-Vicencio, S. et al. Sex-related neuromuscular adaptations to youth obesity: force, muscle mass, and neural issues. Adv. Exp. Med. Biol. 1450, 131\u2013142. https:\/\/doi.org\/10.1007\/978-3-031-XXXXX (2024).","journal-title":"Adv. Exp. Med. Biol."},{"key":"43515_CR23","doi-asserted-by":"publisher","first-page":"435","DOI":"10.1186\/s12887-023-0435","volume":"23","author":"JL Alaniz-Arcos","year":"2023","unstructured":"Alaniz-Arcos, J. L. et al. Differences in absolute muscle strength and power of children and adolescents with overweight or obesity: a systematic review. BMC Pediatr. 23, 435. https:\/\/doi.org\/10.1186\/s12887-023-0435 (2023).","journal-title":"BMC Pediatr."},{"key":"43515_CR24","doi-asserted-by":"publisher","first-page":"512","DOI":"10.1016\/j.jpeds.2008.10.017","volume":"154","author":"JR Ruiz","year":"2009","unstructured":"Ruiz, J. R. et al. Muscular strength and adiposity as predictors of adulthood cardiovascular disease risk factors. J. Pediatr. 154, 512\u2013518. https:\/\/doi.org\/10.1016\/j.jpeds.2008.10.017 (2009).","journal-title":"J. Pediatr."},{"key":"43515_CR25","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1111\/sms.12639","volume":"27","author":"C Agostinis-Sobrinho","year":"2017","unstructured":"Agostinis-Sobrinho, C. et al. Muscular fitness and metabolic risk in youth: a systematic review and meta-analysis. Scand. J. Med. Sci. Sports. 27, 1\u201315. https:\/\/doi.org\/10.1111\/sms.12639 (2017).","journal-title":"Scand. J. Med. Sci. Sports"},{"key":"43515_CR26","doi-asserted-by":"publisher","first-page":"1143","DOI":"10.1002\/cphy.c110025","volume":"2","author":"FW Booth","year":"2012","unstructured":"Booth, F. W., Roberts, C. K. & Laye, M. J. Lack of exercise is a major cause of chronic diseases. Compr. Physiol. 2, 1143\u20131211. https:\/\/doi.org\/10.1002\/cphy.c110025 (2012).","journal-title":"Compr. Physiol."},{"key":"43515_CR27","doi-asserted-by":"publisher","first-page":"56","DOI":"10.1136\/bjsm.2009.068098","volume":"44","author":"AD Faigenbaum","year":"2010","unstructured":"Faigenbaum, A. D. & Myer, G. D. Resistance training among young athletes: Safety, efficacy and injury prevention effects. Br. J. Sports Med. 44, 56\u201363. https:\/\/doi.org\/10.1136\/bjsm.2009.068098 (2010).","journal-title":"Br. J. Sports Med."},{"key":"43515_CR28","unstructured":"World Health Organization. WHO guidelines on physical activity and sedentary behaviour (World Health Organization, 2020)."},{"key":"43515_CR29","doi-asserted-by":"publisher","first-page":"109","DOI":"10.1186\/s40798-022-00481-3","volume":"8","author":"B Ribeiro","year":"2022","unstructured":"Ribeiro, B. et al. The benefits of resistance training in obese adolescents: a systematic review and meta-analysis. Sports Med. Open. 8, 109. https:\/\/doi.org\/10.1186\/s40798-022-00481-3 (2022).","journal-title":"Sports Med. Open."},{"key":"43515_CR30","doi-asserted-by":"publisher","first-page":"407237","DOI":"10.1155\/2011\/407237","volume":"2011","author":"AO Musaiger","year":"2011","unstructured":"Musaiger, A. O. Overweight and obesity in the Eastern Mediterranean region: prevalence and possible causes. J. Obes. 2011, 407237. https:\/\/doi.org\/10.1155\/2011\/407237 (2011).","journal-title":"J. Obes."}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-026-43515-7","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-026-43515-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-026-43515-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T20:18:32Z","timestamp":1781641112000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-026-43515-7"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,17]]},"references-count":30,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["43515"],"URL":"https:\/\/doi.org\/10.1038\/s41598-026-43515-7","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,17]]},"assertion":[{"value":"30 January 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 March 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 March 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"The trial received acceptance from the department of ethical committee (DEC), Prince Sattam bin Abdulaziz University, Al-Kharj, Saudi Arabia with an approval number of RHPT\/024\/042. The DEC approved the subject consent form, treatment protocols and the outcome parameters measured in the study.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}}],"article-number":"13818"}}