{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T08:46:42Z","timestamp":1785746802694,"version":"3.56.0"},"reference-count":49,"publisher":"MDPI AG","issue":"15","license":[{"start":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T00:00:00Z","timestamp":1785715200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002858","name":"China Postdoctoral Science Foundation","doi-asserted-by":"publisher","award":["2025M783217"],"award-info":[{"award-number":["2025M783217"]}],"id":[{"id":"10.13039\/501100002858","id-type":"DOI","asserted-by":"publisher"}]},{"award":["2025M783217"],"award-info":[{"award-number":["2025M783217"]}],"id":[{"id":"https:\/\/ror.org\/0426zh255","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background: This study aimed to examine trends in physical fitness among 10\u201312-year-old children in Ningxia, China, from 2019 to 2024 and to investigate associations between dietary behaviors and physical fitness outcomes using repeated cross-sectional data from the National Student Physical Fitness and Health Survey. Methods: This repeated cross-sectional study included 3970 children aged 10\u201312 years from Ningxia, China (1960 boys and 2010 girls), based on data from the National Student Physical Fitness and Health Survey conducted in 2019 and 2024. Physical fitness indicators and dietary behaviors (breakfast consumption, egg intake, milk intake, and sugar-sweetened beverage consumption) were assessed using standardized assessments and questionnaires. Sex-stratified t-tests and multivariable linear regression models were performed to examine temporal changes and associations between dietary behaviors and physical fitness outcomes, adjusting for age, BMI, survey year, physical activity, and sleep duration. Results: From 2019 to 2024, both boys and girls showed improvements in multiple physical fitness indicators, including lung capacity, muscular endurance, and speed\u2013agility performance, accompanied by increases in BMI. Adjusted analyses showed modest associations between dietary behaviors and specific fitness outcomes. Egg and breakfast consumption were associated with some measures of muscular endurance, whereas sugary beverage consumption showed associations with several fitness indicators, particularly among girls. Conclusion: Children in Ningxia experienced improvements in physical fitness from 2019 to 2024, alongside changes in body mass status. The observed associations between dietary behaviors and fitness outcomes highlight the potential relevance of modifiable lifestyle factors during late childhood. Integrated school-based strategies combining physical activity promotion, healthy dietary behaviors, and weight monitoring may support healthy development in this population.<\/jats:p>","DOI":"10.3390\/nu18152510","type":"journal-article","created":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T08:04:59Z","timestamp":1785744299000},"page":"2510","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Trends and Associations of Physical Fitness and Dietary Behaviors Among Children Aged 10\u201312 Years in Ningxia Between 2019 and 2024"],"prefix":"10.3390","volume":"18","author":[{"given":"Junying","family":"Liu","sequence":"first","affiliation":[{"name":"Faculty of Education, Shaanxi Normal University, Xi\u2019an 710119, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1730-8573","authenticated-orcid":false,"given":"Xinxin","family":"Zhang","sequence":"additional","affiliation":[{"name":"School of Physical Education, Shaanxi Normal University, Xi\u2019an 710119, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1186\/1479-5868-7-40","article-title":"Systematic Review of the Health Benefits of Physical Activity and Fitness in School-Aged Children and Youth","volume":"7","author":"Janssen","year":"2010","journal-title":"Int. J. Behav. Nutr. Phys. Act."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1038\/sj.ijo.0803774","article-title":"Physical Fitness in Childhood and Adolescence: A Powerful Marker of Health","volume":"32","author":"Ortega","year":"2008","journal-title":"Int. J. Obes."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1055\/s-2002-28458","article-title":"Physical Fitness and Physical Activity during Adolescence as Predictors of Cardiovascular Disease Risk in Young Adulthood. Danish Youth and Sports Study. An Eight-Year Follow-Up Study","volume":"23","author":"Hansen","year":"2002","journal-title":"Int. J. Sports Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1016\/S2352-4642(19)30323-2","article-title":"Global Trends in Insufficient Physical Activity among Adolescents: A Pooled Analysis of 298 Population-Based Surveys with 1\u00b76 Million Participants","volume":"4","author":"Guthold","year":"2020","journal-title":"Lancet Child Adolesc. Health"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"704","DOI":"10.1001\/jama.2012.156","article-title":"International Children\u2019s Accelerometry Database (ICAD) Collaborators Moderate to Vigorous Physical Activity and Sedentary Time and Cardiometabolic Risk Factors in Children and Adolescents","volume":"307","author":"Ekelund","year":"2012","journal-title":"JAMA"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"478","DOI":"10.1136\/bjsports-2017-097982","article-title":"Temporal Trends in the Cardiorespiratory Fitness of Children and Adolescents Representing 19 High-Income and Upper Middle-Income Countries between 1981 and 2014","volume":"53","author":"Tomkinson","year":"2019","journal-title":"Br. J. Sports Med."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1016\/S0140-6736(19)32497-3","article-title":"Dynamics of the Double Burden of Malnutrition and the Changing Nutrition Reality","volume":"395","author":"Popkin","year":"2020","journal-title":"Lancet"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1321","DOI":"10.1136\/bjsports-2020-102261","article-title":"Physical Activity and Health in Chinese Children and Adolescents: Expert Consensus Statement (2020)","volume":"54","author":"Chen","year":"2020","journal-title":"Br. J. Sports Med."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"103321","DOI":"10.1016\/j.ijedudev.2025.103321","article-title":"The Impact of China\u2019s \u201cDouble Reduction\u201d Policy on Primary School Students\u2019 Subjective Well-Being and Academic Achievement","volume":"117","author":"Zhou","year":"2025","journal-title":"Int. J. Educ. Dev."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"4229","DOI":"10.1038\/s41598-023-31190-x","article-title":"Secular Trends in Physical Fitness of Rural Chinese Children and Adolescents Aged 7-18 Years from 1985 to 2019","volume":"13","author":"Li","year":"2023","journal-title":"Sci. Rep."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Wang, L., Ma, W., Li, X., Zhu, W., Zhang, X., and Sun, Y. (2025). Urban\u2013Rural Disparities in the Association between Dietary Patterns and Physical Fitness among Chinese Children, Adolescents, and Young Adults. Nutrients, 17.","DOI":"10.3390\/nu17172755"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1016\/j.healthplace.2016.09.008","article-title":"Urbanization, Socioeconomic Status and Health Disparity in China","volume":"42","author":"Miao","year":"2016","journal-title":"Health Place"},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Runacres, A., Mackintosh, K.A., Knight, R.L., Sheeran, L., Thatcher, R., Shelley, J., and McNarry, M.A. (2021). Impact of the COVID-19 Pandemic on Sedentary Time and Behaviour in Children and Adults: A Systematic Review and Meta-Analysis. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph182111286"},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Ruiz-Roso, M.B., de Carvalho Padilha, P., Mantilla-Escalante, D.C., Ulloa, N., Brun, P., Acevedo-Correa, D., Arantes Ferreira Peres, W., Martorell, M., Aires, M.T., and de Oliveira Cardoso, L. (2020). COVID-19 Confinement and Changes of Adolescent\u2019s Dietary Trends in Italy, Spain, Chile, Colombia and Brazil. Nutrients, 12.","DOI":"10.3390\/nu12061807"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"437","DOI":"10.1016\/j.ypmed.2006.07.007","article-title":"Association of Access to Parks and Recreational Facilities with the Physical Activity of Young Children","volume":"43","author":"Roemmich","year":"2006","journal-title":"Prev. Med."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.orcp.2019.12.002","article-title":"Skipping Breakfast Is Associated with Overweight and Obesity: A Systematic Review and Meta-Analysis","volume":"14","author":"Ma","year":"2020","journal-title":"Obes. Res. Clin. Pract."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1111\/1747-0080.12522","article-title":"Breakfast Skipping in Greek Schoolchildren Connected to an Unhealthy Lifestyle Profile. Results from the National Action for Children\u2019s Health Program","volume":"76","author":"Tambalis","year":"2019","journal-title":"Nutr. Diet."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"859","DOI":"10.5114\/aoms.2012.31296","article-title":"Prevalence of Obesity in Children Aged 6\u201312 Years in Greece: Nutritional Behaviour and Physical Activity","volume":"8","author":"Kyriazis","year":"2012","journal-title":"Arch. Med. Sci."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"590S","DOI":"10.3945\/an.115.010256","article-title":"The Effects of Breakfast and Breakfast Composition on Cognition in Children and Adolescents: A Systematic Review","volume":"7","author":"Adolphus","year":"2016","journal-title":"Adv. Nutr."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"631","DOI":"10.1093\/eurpub\/cky043","article-title":"Associations between Physical Fitness and Adherence to the Mediterranean Diet with Health-Related Quality of Life in Adolescents: Results from the LabMed Physical Activity Study","volume":"28","author":"Evaristo","year":"2018","journal-title":"Eur. J. Public Health"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Ram\u00edrez-V\u00e9lez, R., Correa-Bautista, J.E., Ojeda-Pardo, M.L., Sandoval-Cuellar, C., Garc\u00eda-Hermoso, A., Carrillo, H.A., Gonz\u00e1lez-Ru\u00edz, K., Prieto-Benavides, D.H., Tordecilla-Sanders, A., and Martink\u0117nas, A. (2018). Optimal Adherence to a Mediterranean Diet and High Muscular Fitness Are Associated with a Healthier Cardiometabolic Profile in Collegiate Students. Nutrients, 10.","DOI":"10.3390\/nu10040511"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"871","DOI":"10.1016\/S2352-4642(19)30302-5","article-title":"Trends in Physical Fitness, Growth, and Nutritional Status of Chinese Children and Adolescents: A Retrospective Analysis of 1\u00b75 Million Students from Six Successive National Surveys between 1985 and 2014","volume":"3","author":"Dong","year":"2019","journal-title":"Lancet Child Adolesc. Health"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Zhang, X., Mao, C., Tan, Y., Lu, Z., Li, Z., Zhang, L., Sun, Y., and Zhu, W. (2022). Association between Dietary Patterns and Physical Fitness among Chinese Children and Adolescents in Shaanxi Province. Nutrients, 14.","DOI":"10.3390\/nu14183677"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"15995","DOI":"10.1038\/s41598-025-99046-0","article-title":"Comparison of Physical Activity, Sedentary Time, and Physical Fitness among Chinese Children and Adolescents in Qinghai between 2019 and 2023","volume":"15","author":"Zhang","year":"2025","journal-title":"Sci. Rep."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1090","DOI":"10.1080\/17461391.2017.1347963","article-title":"The Relationship between Physical Activity, Fitness, Physical Complaints and BMI in German Adults\u2014Results of a Longitudinal Study","volume":"17","author":"Tittlbach","year":"2017","journal-title":"Eur. J. Sport Sci."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"e70","DOI":"10.1164\/rccm.201908-1590ST","article-title":"Standardization of Spirometry 2019 Update. An Official American Thoracic Society and European Respiratory Society Technical Statement","volume":"200","author":"Graham","year":"2019","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_27","unstructured":"Group of China Obesity Task Force (2004). Body Mass Index Reference Norm for Screening Overweight and Obesity in Chinese Children and Adolescents. Chin. J. Epidemiol., 25, 97\u2013102."},{"key":"ref_28","unstructured":"McKay, K.B. (2004). Hypertensive Self Care: An Educational Tool for Advanced Practice Nurses. [Ph.D Thesis, Walden University]."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Wang, H., Guan, Y., Du, H., Dai, P., Zhong, J., Yu, M., and Li, N. (2025). Association of Breakfast Consumption Frequency with Depression and Anxiety Symptoms Among School Students: A Cross-Sectional Study in Eastern China. Nutrients, 17.","DOI":"10.3390\/nu17071271"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"87","DOI":"10.15585\/mmwr.su7304a10","article-title":"Skipping Breakfast and Academic Grades, Persistent Feelings of Sadness or Hopelessness, and School Connectedness Among High School Students\u2014Youth Risk Behavior Survey, United States, 2023","volume":"73","author":"Sliwa","year":"2024","journal-title":"MMWR Suppl."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Chen, T.-Y., Kao, C.-W., Cheng, S.-M., and Liu, C.-Y. (2024). Translation, Adaptation, and Validation of a Chinese Version of the Hypertension Self-Care Activity Level Effects (H-SCALE) for Patients with Hypertension. BMC Nurs., 23.","DOI":"10.1186\/s12912-024-01993-y"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1095","DOI":"10.2105\/AJPH.2017.303762","article-title":"Consumption of Carbonated Soft Drinks Among Young Adolescents Aged 12 to 15 Years in 53 Low- and Middle-Income Countries","volume":"107","author":"Yang","year":"2017","journal-title":"Am. J. Public Health"},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Zhu, W., Zhang, L., Zhang, L., Qiu, L., Guo, J., Li, Z., and Sun, Y. (2022). Association of Physical Activity and Sedentary Behaviors with the Risk of Refractive Error in Chinese Urban\/Rural Boys and Girls. Sustainability, 14.","DOI":"10.3390\/su14095539"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"2430","DOI":"10.1056\/NEJMoa1503840","article-title":"Body-Mass Index in 2.3 Million Adolescents and Cardiovascular Death in Adulthood","volume":"374","author":"Twig","year":"2016","journal-title":"N. Engl. J. Med."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1016\/j.amepre.2011.05.002","article-title":"Sedentary Behavior and Dietary Intake in Children, Adolescents, and Adults: A Systematic Review","volume":"41","author":"Pearson","year":"2011","journal-title":"Am. J. Prev. Med."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1016\/j.maturitas.2011.08.005","article-title":"Tracking of Obesity-Related Behaviours from Childhood to Adulthood: A Systematic Review","volume":"70","author":"Craigie","year":"2011","journal-title":"Maturitas"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1207","DOI":"10.3168\/jds.S0022-0302(06)72190-7","article-title":"Major Scientific Advances with Dairy Foods in Nutrition and Health","volume":"89","author":"Huth","year":"2006","journal-title":"J. Dairy Sci."},{"key":"ref_38","unstructured":"Organisation Mondiale de la Sant\u00e9 (2018). Global Action Plan on Physical Activity 2018-2030: More Active People for a Healthier World, World Health Organization."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"20965311241265123","DOI":"10.1177\/20965311241265123","article-title":"Examining China\u2019s \u201cDouble Reduction\u201d Policy: Promises and Challenges for Balanced and Quality Development in Compulsory Education","volume":"9","author":"Chen","year":"2024","journal-title":"ECNU Rev. Educ."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1038\/s41430-020-0674-8","article-title":"Nutrition Transition and Related Health Challenges over Decades in China","volume":"75","author":"Huang","year":"2021","journal-title":"Eur. J. Clin. Nutr."},{"key":"ref_41","first-page":"374","article-title":"Energy and Protein Intake and Its Relationship with Pulmonary Function in Chronic Obstructive Pulmonary Disease (COPD) Patients","volume":"48","author":"Yazdanpanah","year":"2010","journal-title":"Acta Med. Iran."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1016\/j.metabol.2005.10.012","article-title":"Level of Dietary Protein Impacts Whole Body Protein Turnover in Trained Males at Rest","volume":"55","author":"Gaine","year":"2006","journal-title":"Metabolism"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"320","DOI":"10.1177\/1942602X11417310","article-title":"Sports Drinks and Energy Drinks for Children and Adolescents\u2014Are They Appropriate? A Summary of the Clinical Report","volume":"26","author":"Galemore","year":"2011","journal-title":"NASN Sch. Nurse"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1016\/j.ajcnut.2022.11.008","article-title":"Sugar-Sweetened Beverage Consumption and Weight Gain in Children and Adults: A Systematic Review and Meta-Analysis of Prospective Cohort Studies and Randomized Controlled Trials","volume":"117","author":"Nguyen","year":"2023","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"1397","DOI":"10.1056\/NEJMoa1203034","article-title":"A Trial of Sugar-Free or Sugar-Sweetened Beverages and Body Weight in Children","volume":"367","author":"Olthof","year":"2012","journal-title":"N. Engl. J. Med."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"e12276","DOI":"10.1111\/mcn.12276","article-title":"Strategies to Increase Children\u2019s Vegetable Intake in Home and Community Settings: A Systematic Review of Literature","volume":"13","author":"Hendrie","year":"2017","journal-title":"Matern. Child. Nutr."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1093\/nutrit\/nux061","article-title":"Effectiveness of Behavioral Interventions to Reduce the Intake of Sugar-Sweetened Beverages in Children and Adolescents: A Systematic Review and Meta-Analysis","volume":"76","author":"Jomaa","year":"2018","journal-title":"Nutr. Rev."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"547","DOI":"10.1111\/obr.12277","article-title":"What Childhood Obesity Prevention Programmes Work? A Systematic Review and Meta-Analysis","volume":"16","author":"Wang","year":"2015","journal-title":"Obes. Rev. Off. J. Int. Assoc. Study Obes."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"703","DOI":"10.1136\/bmj.39320.843947.BE","article-title":"Effectiveness of Interventions to Promote Physical Activity in Children and Adolescents: Systematic Review of Controlled Trials","volume":"335","author":"McMinn","year":"2007","journal-title":"BMJ"}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/18\/15\/2510\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T08:10:18Z","timestamp":1785744618000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/18\/15\/2510"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,3]]},"references-count":49,"journal-issue":{"issue":"15","published-online":{"date-parts":[[2026,8]]}},"alternative-id":["nu18152510"],"URL":"https:\/\/doi.org\/10.3390\/nu18152510","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,3]]}}}