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Associations between physical fitness, physical activity, sedentary behavior and executive function in preschoolers

Pediatric Research (2025)Cite this article

Abstract

Background

This study examined the association between individual physical fitness (PF) components, overall fitness scores, and executive function (EF) indicators in preschoolers. Additionally, it explored the relationship between objectively measured physical activity (PA), sedentary behavior (SB), and EF.

Methods

This cross-sectional study included 241 preschoolers (121 males, 50%) aged 3–5 years from two different schools. Physical fitness was assessed using the PREFIT battery, which measures lower- and upper-body muscular strength (handgrip strength [HGS] and standing long jump [SLJ]), speed/agility (4 × 10 m), and cardiorespiratory fitness (CRF). The test scores for each student were standardized by age and sex. Individual z-scores were then calculated, and the sum of these z-scores constituted the overall PF. EF (including visual-spatial working memory, phonological working memory, inhibition, and cognitive shifting) was assessed using the one-on-one iPad-based Early Year Toolbox. Total PA, SB, and SB were objectively measured using a tri-axial GENEActiv Original accelerometer worn for six consecutive days.

Results

Preschoolers with higher overall PF showed significantly better performance in visual-spatial working memory (β = 0.574, p < 0.001), phonological working memory (β = 0.317, p < 0.001), inhibition (β = 0.379, p < 0.001) and cognitive shifting (β = 0.395, p < 0.001). Similarly, greater engagement in total PA was associated with higher scores in visual-spatial working memory (β = 0.179, p = 0.016), phonological working memory (β = 0.237, p = 0.036), and inhibition (β = 0.148, p = 0.045), which had higher scores on inhibitory control and working memory tasks.

Conclusion

These findings highlight the significant influence of PF and PA levels on cognitive performance. Therefore, educational and public health programs must implement strategies to encourage regular PA and improve PF. Such efforts could contribute to better cognitive development and overall health outcomes.

Impact

  • This study emphasizes the importance of physical fitness, particularly muscular strength, speed agility, and cardiorespiratory fitness, in supporting executive function (EF) development in preschool-aged children. Early childhood education policies should prioritize structured physical activity programs to enhance cognitive functions such as working memory, inhibition, and cognitive flexibility.

  • A direct inverse relationship between sedentary behavior and EF was observed. Limiting sedentary activities and encouraging movement in early childhood settings may yield significant cognitive benefits, suggesting that teachers and caregivers should promote more active environments for children.

  • The findings indicate that overall physical fitness supports cognitive abilities rather than isolated fitness components.

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Fig. 1: The early years Toolbox assessment.
Fig. 2: Physical fitness component groups (i.e., unfit and fit) and executive function (EF) indicators.
Fig. 3: Associations between overall physical fitness and total PA levels with executive function (EF) indicators.

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Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author upon reasonable request.

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Acknowledgements

We are especially grateful to the children and their families who participated in this study. This work was supported by the Department of Education of the Government of Navarra (Spain), Grant/Award Number CENEDUCA1/2019, and the Instituto de Salud Carlos III.

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Author notes

  1. These authors contributed equally: Robinson Ramírez-Vélez, Mikel Izquierdo, Alicia M. Alonso-Martínez.

Authors and Affiliations

  1. Navarrabiomed, Hospital Universitario de Navarra (HUN), Universidad Pública de Navarra (UPNA), Pamplona, Spain

    Yesenia García-Alonso, Robinson Ramírez-Vélez, Gaizka Legarra-Gorgoñon, Mikel Izquierdo & Alicia M. Alonso-Martínez

  2. CIBER of Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain

    Robinson Ramírez-Vélez & Mikel Izquierdo

Authors
  1. Yesenia García-Alonso
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  2. Robinson Ramírez-Vélez
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  4. Mikel Izquierdo
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  5. Alicia M. Alonso-Martínez
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Contributions

Y.G.-A., R.R.-V., A.A.-M., M.I.: study concept and design; G.L.-G., Y.G.-A., L.A.-M.: data collection; R.R.-V.: statistical analysis; Y.G.-A., A.A.-M., R.R.-V.: interpretation of data; G.L.-G., Y.G.-A., L.A.-M., A.A.M., R.R.-V., M.I.: drafting of the manuscript. All authors have contributed to the manuscript and approved the submitted version.

Corresponding author

Correspondence to Mikel Izquierdo.

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The authors declare no competing interests.

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Parents or legal guardians received comprehensive information about the study's aims and provided signed informed consent.

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García-Alonso, Y., Ramírez-Vélez, R., Legarra-Gorgoñon, G. et al. Associations between physical fitness, physical activity, sedentary behavior and executive function in preschoolers. Pediatr Res (2025). https://doi.org/10.1038/s41390-025-03946-w

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