Associations between body mass index, physical activity, and motor competence in children aged 3–12 years: a systematic literature review

Jurnal Riset Tindakan Indonesia July 03, 2026 Volume 11, Number 1 5 authors

Abstract

This systematic literature review was designed to synthesize the latest research on the associations among BMI, physical activity and motor competence in children aged 3–12 years and to present the methodological map of this field. Following the PRISMA 2020 format, this review undertook a structured Scopus database search of publications from 2020 to 2026 (search conducted on 30 June 2026). Upon elimination of non-English and document-type-ineligible records (43), a total of 520 records were screened by title and abstract. Of these, 120 reports were retrieved and 111 were full-text assessed. Fifty studies were finally included in the synthesis after application of the predefined eligibility and quality (FICO) criteria. Four thematic findings were revealed. To begin with, the link between higher BMI and poorer motor competence was not only consistent, but could also be traced down to very early childhood years. Secondly, physical activity and motor competence were mutually beneficial and positively related, quite often their relationship was indirect and going through physical fitness. Thirdly, both motor-skill and multicomponent interventions brought about improvements in motor competence as well as adiposity-related outcomes, especially in children with problems of overweight or obesity. Fourthly, motor competence correlates existed on the level of individual, family and environment. Conceptually the results push forward reciprocal and developmental frameworks of motor competence; on the other hand, they give support to the idea of early, skill-centered physical-activity promotion in educational and community settings. Further studies would do well to focus on longitudinal, compositional, and intervention designs that regulate the use of motor-assessment tools in an effort to identify causal relationships and help the formulation of policies that can be implemented on a large scale.

Authors

  1. Eni Rispayanti

    Universitas Negeri Padang

  2. Tjung Hauw Sin

    Universitas Negeri Padang

  3. Wilda Welis

    Universitas Negeri Padang

  4. Anton Komaini

    Universitas Negeri Padang

  5. Sri Gusti Handayani

    Universitas Negeri Padang

Keywords

Body mass indexPhysical activityMotor competenceFundamental movement skillsChildren

References

  1. Almeida, M. B. D., Leandro, C. G., Queiroz, D. D. R., José-da-Silva, M., Pessôa dos Prazeres, T. M., Pereira, G. M., das-Neves, G. S., Carneiro, R. C., Figueredo-Alves, A. D., Nakamura, F. Y., Henrique, R. D. S., & Moura-dos-Santos, M. A. (2021). Plyometric training increases gross motor coordination and associated components of physical fitness in children. European Journal of Sport Science, 21(9), 1263–1272. https://doi.org/10.1080/17461391.2020.1838620
  2. Barros, W. M. A., Silva, K. G. D., Silva, R. K. P., Souza, A. P. D. S., Silva, A. B. J. D., Silva, M. R. M., Fernandes, M. S. D. S., Souza, S. L. D., & Souza, V. D. O. N. (2022). Effects of Overweight/Obesity on Motor Performance in Children: A Systematic Review. Frontiers in Endocrinology, 12, Article 759165. https://doi.org/10.3389/fendo.2021.759165
  3. Behan, S., Belton, S., Peers, C., O’connor, N. E., & Issartel, J. (2022). Exploring the relationships between fundamental movement skills and health related fitness components in children. European Journal of Sport Science, 22(2), 171–181. https://doi.org/10.1080/17461391.2020.1847201
  4. Berleze, A., & Valentini, N. C. (2022). Intervention for Children with Obesity and Overweight and Motor Delays from Low-Income Families: Fostering Engagement, Motor Development, Self-Perceptions, and Playtime. International Journal of Environmental Research and Public Health, 19(5), Article 2545. https://doi.org/10.3390/ijerph19052545
  5. Bongiovanni, T., Trecroci, A., Cavaggioni, L., Rossi, A., Perri, E., Pasta, G., Iaia, F. M., & Alberti, G. (2021). Importance of anthropometric features to predict physical performance in elite youth soccer: a machine learning approach. Research in Sports Medicine, 29(3), 213–224. https://doi.org/10.1080/15438627.2020.1809410
  6. Brown, V., Moodie, M., Sultana, M., Hunter, K. E., Byrne, R., Zarnowiecki, D., Seidler, A. L., Golley, R., Taylor, R. W., Hesketh, K. D., & Matvienko-Sikar, K. (2022). A scoping review of outcomes commonly reported in obesity prevention interventions aiming to improve obesity-related health behaviors in children to age 5 years. Obesity Reviews, 23(5), Article e13427. https://doi.org/10.1111/obr.13427
  7. Calcaterra, V., Marin, L., Vandoni, M., Rossi, V., Pirazzi, A., Grazi, R., Patané, P., Silvestro, G. S., Carnevale Pellino, V., Albanese, I., Fabiano, V., Febbi, M., Silvestri, D., & Zuccotti, G. (2022). Childhood Obesity and Incorrect Body Posture: Impact on Physical Activity and the Therapeutic Role of Exercise. International Journal of Environmental Research and Public Health, 19(24), Article 16728. https://doi.org/10.3390/ijerph192416728
  8. Carcamo-Oyarzun, J., Herrmann, C., Gerlach, E., Salvo-Garrido, S., & Estevan, I. (2025). Motor competence, motivation and enjoyment in physical education to profile children in relation to physical activity behaviors. Physical Education and Sport Pedagogy, 30(6), 675–690. https://doi.org/10.1080/17408989.2023.2265399
  9. Chambonnière, C., Fearnbach, N., Pelissier, L., Genin, P., Fillon, A., Boscaro, A., Bonjean, L., Bailly, M., Siroux, J., Guirado, T., Pereira, B., Thivel, D., & Duclos, M. (2021). Adverse collateral effects of COVID-19 public health restrictions on physical fitness and cognitive performance in primary school children. International Journal of Environmental Research and Public Health, 18(21), Article 11099. https://doi.org/10.3390/ijerph182111099
  10. Coe, D. P. (2020). Means of Optimizing Physical Activity in the Preschool Environment. American Journal of Lifestyle Medicine, 14(1), 16–23. https://doi.org/10.1177/1559827618818419
  11. Comeras-Chueca, C., Marin-Puyalto, J., Matute-Llorente, A., Vicente-Rodriguez, G., Casajus, J. A., & Gonzalez-Aguero, A. (2021a). The effects of active video games on health-related physical fitness and motor competence in children and adolescents with healthy weight: A systematic review and meta-analysis. International Journal of Environmental Research and Public Health, 18(13), Article 6965. https://doi.org/10.3390/ijerph18136965
  12. Comeras-Chueca, C., Marin-Puyalto, J., Matute-Llorente, A., Vicente-Rodriguez, G., Casajus, J. A., & Gonzalez-Aguero, A. (2021b). Effects of active video games on health-related physical fitness and motor competence in children and adolescents with overweight or obesity: Systematic review and meta-Analysis. JMIR Serious Games, 9(4), Article e29981. https://doi.org/10.2196/29981
  13. Comeras-Chueca, C., Villalba-Heredia, L., Perez-Lasierra, J. L., Marín-Puyalto, J., Lozano-Berges, G., Matute-Llorente, Á., Vicente-Rodríguez, G., Gonzalez-Aguero, A., & Casajús, J. A. (2022). Active Video Games Improve Muscular Fitness and Motor Skills in Children with Overweight or Obesity. International Journal of Environmental Research and Public Health, 19(5), Article 2642. https://doi.org/10.3390/ijerph19052642
  14. Cornish, K., Fox, G., Fyfe, T., Koopmans, E., Pousette, A., & Pelletier, C. A. (2020). Understanding physical literacy in the context of health: a rapid scoping review. BMC Public Health, 20(1), Article 1569. https://doi.org/10.1186/s12889-020-09583-8
  15. Crumbley, C. A., Ledoux, T. A., & Johnston, C. A. (2020). Physical Activity During Early Childhood: The Importance of Parental Modeling. American Journal of Lifestyle Medicine, 14(1), 32–35. https://doi.org/10.1177/1559827619880513
  16. Draper, C. E., Tomaz, S. A., Cook, C. J., Jugdav, S. S., Ramsammy, C., Besharati, S., Heerden, A., Vilakazi, K., Cockcroft, K., Howard, S. J., & Okely, A. D. (2020). Understanding the influence of 24-hour movement behaviours on the health and development of preschool children from low-income South African settings: The SUNRISE pilot study. South African Journal of Sports Medicine, 32(1). https://doi.org/10.17159/2078-516X/2020/v32i1a8415
  17. Drenowatz, C., Hinterkörner, F., & Greier, K. (2021). Physical Fitness and Motor Competence in Upper Austrian Elementary School Children—Study Protocol and Preliminary Findings of a State-Wide Fitness Testing Program. Frontiers in Sports and Active Living, 3, Article 635478. https://doi.org/10.3389/fspor.2021.635478
  18. Dugdale, J. H., Sanders, D., Myers, T., Williams, A. M., & Hunter, A. M. (2021). Progression from youth to professional soccer: A longitudinal study of successful and unsuccessful academy graduates. Scandinavian Journal of Medicine and Science in Sports, 31(S1), 73–84. https://doi.org/10.1111/sms.13701
  19. Duncan, M. J., Hall, C., Eyre, E., Barnett, L. M., & James, R. S. (2021). Pre-schoolers fundamental movement skills predict BMI, physical activity, and sedentary behavior: A longitudinal study. Scandinavian Journal of Medicine and Science in Sports, 31(S1), 8–14. https://doi.org/10.1111/sms.13746
  20. D’Anna, C., Forte, P., & Pugliese, E. (2024). Trends in Physical Activity and Motor Development in Young People—Decline or Improvement? A Review. Children, 11(3), Article 298. https://doi.org/10.3390/children11030298
  21. Estevan, I., Menescardi, C., García-Massó, X., Barnett, L. M., & Molina-García, J. (2021). Profiling children longitudinally: A three-year follow-up study of perceived and actual motor competence and physical fitness. Scandinavian Journal of Medicine and Science in Sports, 31(S1), 35–46. https://doi.org/10.1111/sms.13731
  22. Fühner, T., Kliegl, R., Arntz, F., Kriemler, S., & Granacher, U. (2021). An Update on Secular Trends in Physical Fitness of Children and Adolescents from 1972 to 2015: A Systematic Review. Sports Medicine, 51(2), 303–320. https://doi.org/10.1007/s40279-020-01373-x
  23. García-Hermoso, A., Alonso-Martínez, A. M., Ramírez-Vélez, R., Pérez-Sousa, M. Á., Ramírez-Campillo, R., & Izquierdo, M. (2020). Association of Physical Education with Improvement of Health-Related Physical Fitness Outcomes and Fundamental Motor Skills among Youths: A Systematic Review and Meta-analysis. JAMA Pediatrics, 174(6), Article e200223. https://doi.org/10.1001/jamapediatrics.2020.0223
  24. He, Y., Zhou, L., Liang, W., Liu, Q., Liu, W., & Wang, S. (2024). Individual, family, and environmental correlates of fundamental motor skills among school-aged children: a cross-sectional study in China. BMC Public Health, 24(1), Article 208. https://doi.org/10.1186/s12889-024-17728-2
  25. Hewitt, L., Kerr, E., Stanley, R. M., & Okely, A. D. (2020). Tummy time and infant health outcomes: A systematic review. Pediatrics, 145(6), Article e20192168. https://doi.org/10.1542/peds.2019-2168
  26. Isaacs, A., Neve, K., & Hawkes, C. (2022). Why do parents use packaged infant foods when starting complementary feeding? Findings from phase one of a longitudinal qualitative study. BMC Public Health, 22(1), Article 2328. https://doi.org/10.1186/s12889-022-14637-0
  27. Joensuu, L., Kujala, U. M., Kankaanpää, A., Syväoja, H. J., Kulmala, J., Hakonen, H., Oksanen, H., Kallio, J., & Tammelin, T. H. (2021). Physical fitness development in relation to changes in body composition and physical activity in adolescence. Scandinavian Journal of Medicine and Science in Sports, 31(2), 456–464. https://doi.org/10.1111/sms.13847
  28. Julian, V., Haschke, F., Fearnbach, N., Gomahr, J., Pixner, T., Furthner, D., Weghuber, D., & Thivel, D. (2022). Effects of Movement Behaviors on Overall Health and Appetite Control: Current Evidence and Perspectives in Children and Adolescents. Current Obesity Reports, 11(1), 10–22. https://doi.org/10.1007/s13679-021-00467-5
  29. Landgraff, H. W., Riiser, A., Lihagen, M., Skei, M., Leirstein, S., & Hallén, J. (2021). Longitudinal changes in maximal oxygen uptake in adolescent girls and boys with different training backgrounds. Scandinavian Journal of Medicine and Science in Sports, 31(S1), 65–72. https://doi.org/10.1111/sms.13765
  30. Laukkanen, A., Bardid, F., Lenoir, M., Lopes, V. P., Vasankari, T., Husu, P., & Sääkslahti, A. (2020). Comparison of motor competence in children aged 6-9 years across northern, central, and southern European regions. Scandinavian Journal of Medicine and Science in Sports, 30(2), 349–360. https://doi.org/10.1111/sms.13578
  31. Liberati, A., Altman, D. G., Tetzlaff, J., Mulrow, C., Gøtzsche, P. C., Ioannidis, J. P. A., Clarke, M., Devereaux, P. J., Kleijnen, J., & Moher, D. (2009). The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions. PLoS Medicine, 6(7), e1000100. https://doi.org/10.1371/journal.pmed.1000100
  32. Liu, C., Cao, Y., Zhang, Z., Gao, R., & Qu, G. (2023). Correlation of fundamental movement skills with health-related fitness elements in children and adolescents: A systematic review. Frontiers in Public Health, 11, Article 1129258. https://doi.org/10.3389/fpubh.2023.1129258
  33. Ma, F.-F., & Luo, D.-M. (2023). Relationships between physical activity, fundamental motor skills, and body mass index in preschool children. Frontiers in Public Health, 11, Article 1094168. https://doi.org/10.3389/fpubh.2023.1094168
  34. Martins, C., Romo-Perez, V., Webster, E. K., Duncan, M., Lemos, L. F., Staiano, A. E., Okely, A., Magistro, D., Carlevaro, F., Bardid, F., Magno, F., Nobre, G., Estevan, I., Mota, J., Ning, K., Robinson, L. E., Lenoir, M., Quan, M., Valentini, N. C., … Barnett, L. M. (2024). Motor Competence and Body Mass Index in the Preschool Years: A Pooled Cross-Sectional Analysis of 5545 Children from Eight Countries. Sports Medicine, 54(2), 505–516. https://doi.org/10.1007/s40279-023-01929-7
  35. Martínez-Vizcaíno, V., Pozuelo-Carrascosa, D. P., García-Prieto, J. C., Cavero-Redondo, I., Solera-Martínez, M., Garrido-Miguel, M., Díez-Fernández, A., Ruiz-Hermosa, A., & Sánchez-López, M. (2020). Effectiveness of a school-based physical activity intervention on adiposity, fitness and blood pressure: MOVI-KIDS study. British Journal of Sports Medicine, 54(5), 279–285. https://doi.org/10.1136/bjsports-2018-099655
  36. Morgan, P. J., Grounds, J. A., Ashton, L. M., Collins, C. E., Barnes, A. T., Pollock, E. R., Kennedy, S.-L., Rayward, A. T., Saunders, K. L., Drew, R. J., & Young, M. D. (2022). Impact of the ‘Healthy Youngsters, Healthy Dads’ program on physical activity and other health behaviours: a randomised controlled trial involving fathers and their preschool-aged children. BMC Public Health, 22(1), Article 1166. https://doi.org/10.1186/s12889-022-13424-1
  37. Mota, J. G., Clark, C. C. T., Bezerra, T. A., Lemos, L., Reuter, C. P., Mota, J. A. P. S., Duncan, M. J., & Martins, C. M. D. L. (2020). Twenty-four-hour movement behaviours and fundamental movement skills in preschool children: A compositional and isotemporal substitution analysis. Journal of Sports Sciences, 38(18), 2071–2079. https://doi.org/10.1080/02640414.2020.1770415
  38. Niemistö, D., Finni, T., Cantell, M., Korhonen, E., & Sääkslahti, A. (2020). Individual, family, and environmental correlates of motor competence in young children: Regression model analysis of data obtained from two motor tests. International Journal of Environmental Research and Public Health, 17(7), Article 2548. https://doi.org/10.3390/ijerph17072548
  39. Nilsen, A. K. O., Anderssen, S. A., Loftesnes, J. M., Johannessen, K., Ylvisaaker, E., & Aadland, E. (2020). The multivariate physical activity signature associated with fundamental motor skills in preschoolers. Journal of Sports Sciences, 38(3), 264–272. https://doi.org/10.1080/02640414.2019.1694128
  40. Okely, T., Reilly, J. J., Tremblay, M. S., Kariippanon, K. E., Draper, C. E., El Hamdouchi, A., Florindo, A. A., Green, J. P., Guan, H., Katzmarzyk, P. T., Lubree, H., Pham, B. N., Suesse, T., Willumsen, J., Basheer, M., Calleia, R., Chong, K. H., Cross, P. L., Nacher, M., … Widyastari, D. A. (2021). Cross-sectional examination of 24-hour movement behaviours among 3- And 4-year-old children in urban and rural settings in low-income, middle-income and high-income countries- And SUNRISE study protocol. BMJ Open, 11(10), Article e049267. https://doi.org/10.1136/bmjopen-2021-049267
  41. O’Malley, G. C., Shultz, S. P., Thivel, D., & Tsiros, M. D. (2021). Neuromusculoskeletal Health in Pediatric Obesity: Incorporating Evidence into Clinical Examination. Current Obesity Reports, 10(4), 467–477. https://doi.org/10.1007/s13679-021-00463-9
  42. Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., Shamseer, L., Tetzlaff, J. M., Akl, E. A., Brennan, S. E., Chou, R., Glanville, J., Grimshaw, J. M., Hróbjartsson, A., Lalu, M. M., Li, T., Loder, E. W., Mayo-Wilson, E., McDonald, S., … Moher, D. (2021). The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. BMJ, 372, n71. https://doi.org/10.1136/bmj.n71
  43. Ramires, V. V., dos Santos, P. C., Filho, V. C. B., da Silva Bandeira, A., Tenório, M. C. M., de Camargo, E. M., de Paula Ravagnani, F. C., Sandreschi, P., de Oliveira, V. J. M., Hallal, P. C., & Silva, K. S. (2023). Physical Education for Health Among School-Aged Children and Adolescents: A Scoping Review of Reviews. Journal of Physical Activity and Health, 20(7), 586–599. https://doi.org/10.1123/jpah.2022-0395
  44. Rinaldo, N., Toselli, S., Gualdi-Russo, E., Zedda, N., & Zaccagni, L. (2020). Effects of anthropometric growth and basketball experience on physical performance in pre-adolescent male players. International Journal of Environmental Research and Public Health, 17(7), Article 2196. https://doi.org/10.3390/ijerph17072196
  45. Robinson, L. E., Wang, L., Colabianchi, N., Stodden, D. F., & Ulrich, D. (2020). Protocol for a two-cohort randomized cluster clinical trial of a motor skills intervention: The Promoting Activity and Trajectories of Health (PATH) Study. BMJ Open, 10(6), Article 37497. https://doi.org/10.1136/bmjopen-2020-037497
  46. Selph, S. S., Skelly, A. C., Wasson, N., Dettori, J. R., Brodt, E. D., Ensrud, E., Elliot, D., Dissinger, K. M., & McDonagh, M. (2021). Physical Activity and the Health of Wheelchair Users: A Systematic Review in Multiple Sclerosis, Cerebral Palsy, and Spinal Cord Injury. Archives of Physical Medicine and Rehabilitation, 102(12), 2464–2480. https://doi.org/10.1016/j.apmr.2021.10.002
  47. Smits-Engelsman, B. C. M., Bonney, E., Neto, J. L. C., & Jelsma, D. L. (2020). Feasibility and content validity of the PERF-FIT test battery to assess movement skills, agility and power among children in low-resource settings. BMC Public Health, 20(1), Article 1139. https://doi.org/10.1186/s12889-020-09236-w
  48. Smits-Engelsman, B., & Verbecque, E. (2022). Pediatric care for children with developmental coordination disorder, can we do better?. Biomedical Journal, 45(2), 250–264. https://doi.org/10.1016/j.bj.2021.08.008
  49. Thomas, J., & Harden, A. (2008). Methods for the thematic synthesis of qualitative research in systematic reviews. BMC Medical Research Methodology, 8, 45. https://doi.org/10.1186/1471-2288-8-45
  50. Tranfield, D., Denyer, D., & Smart, P. (2003). Towards a methodology for developing evidence-informed management knowledge by means of systematic review. British Journal of Management, 14(3), 207–222. https://doi.org/10.1111/1467-8551.00375
  51. Tsiros, M. D., Tian, E. J., Shultz, S. P., Olds, T., Hills, A. P., Duff, J., & Kumar, S. (2020). Obesity, the new childhood disability? An umbrella review on the association between adiposity and physical function. Obesity Reviews, 21(12), Article e13121. https://doi.org/10.1111/obr.13121
  52. Verbecque, E., Coetzee, D., Ferguson, G., & Smits-Engelsman, B. (2021). High bmi and low muscular fitness predict low motor competence in school-aged children living in low-resourced areas. International Journal of Environmental Research and Public Health, 18(15), Article 7878. https://doi.org/10.3390/ijerph18157878
  53. Wouters, M., Evenhuis, H. M., & Hilgenkamp, T. I. M. (2020). Physical fitness of children and adolescents with moderate to severe intellectual disabilities. Disability and Rehabilitation, 42(18), 2542–2552. https://doi.org/10.1080/09638288.2019.1573932
  54. Zahran, S., Visser, C., Ross-White, A., & Janssen, I. (2023). A systematic review of compositional analysis studies examining the associations between sleep, sedentary behaviour, and physical activity with health indicators in early childhood. Journal of Activity, Sedentary and Sleep Behaviors, 2(1), Article 1. https://doi.org/10.1186/s44167-022-00012-2