Waist-to-height ratio identifies children with lower physical activity and reduced cardiorespiratory fitness: Longitudinal evidence from Norwegian primary schools – The Health Oriented Pedagogical Project (HOPP)
Year: 2026
Type: article
Study design: Observational Study
Abstract: OBJECTIVES: Childhood obesity and physical inactivity are major global health concerns because of their links to cardiometabolic risk factors that may persist into adulthood. Waist-to-height ratio (WHtR) has emerged as a practical indicator of central adiposity and metabolic risk. Moderate-to-vigorous physical activity (MVPA) and cardiorespiratory fitness are important factors in reducing obesity-related risk. This study investigated the association between WHtR, physical activity, and fitness in children aged 6-12 years. METHODS: The Health Oriented Pedagogical Project (HOPP) is a longitudinal cohort study conducted from 2015 to 2020 and including 2297 Norwegian children. WHtR was examined as the main time-varying exposure. Separate linear mixed models were fitted for MVPA, sedentary time, Andersen intermittent running test performance, and VO₂peak as outcomes, with age, sex, and socioeconomic status included as covariates. RESULTS: Each 0.1 unit increase in WHtR was linked to a -0.62 min/day reduction in average MVPA. Higher WHtR was associated with lower MVPA and lower cardiorespiratory fitness, including both Andersen test performance and VO₂peak. No clear association was observed between WHtR and sedentary time. CONCLUSION: In this longitudinal cohort, higher WHtR was associated with lower physical activity and lower cardiorespiratory fitness. WHtR may therefore serve as a simple screening indicator for identifying children who may warrant closer assessment of fitness, physical activity, and cardiometabolic risk.
Source: PLoS ONE
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,382
OpenAlex ID: W7165178105