Evidence map›Paper›PMID 42542448›Full record

ArticleEuropean journal of clinical nutrition2026

Food selection, cardiorespiratory fitness and the longitudinal association with adiposity among South African school children: the ExAMIN Youth SA study.

Herculina Salome Kruger, Cristian Ricci, Anita Elizabeth Pienaar, Makama Andries Monyeki, Tertia van Zyl, Hannah Ricci, Ruan Kruger

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Article in European journal of clinical nutrition, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

7 authors.

Herculina Salome KrugerCentre of Excellence for Nutrition, North-West University, Potchefstroom, South Africa. salome.kruger@nwu.ac.za.ORCID http://orcid.org/0000-0002-5365-1777
Cristian RicciAfrican Unit for Transdisciplinary Health Research, North-West University, Potchefstroom, South Africa.ORCID http://orcid.org/0000-0003-4113-8682
Anita Elizabeth PienaarPhysical Activity, Sport and Recreation Research Focus Area, North-West University, Potchefstroom, South Africa.
Makama Andries MonyekiPhysical Activity, Sport and Recreation Research Focus Area, North-West University, Potchefstroom, South Africa.
Tertia van ZylCentre of Excellence for Nutrition, North-West University, Potchefstroom, South Africa.
Hannah RicciAfrican Unit for Transdisciplinary Health Research, North-West University, Potchefstroom, South Africa.
Ruan KrugerMedical Research Council Research Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa.ORCID http://orcid.org/0000-0001-7680-2032

Funding

South African Medical Research Council (SAMRC) 86895
6 · The paper itself

Abstract

backgroundThe global pandemic of paediatric obesity, unhealthy diets and physical inactivity are important future health challenges. The purpose of this study was to determine 4-year changes in food selection, cardiorespiratory fitness (CRF), and the longitudinal association with the development of adiposity among South African primary school-age children.

methodsSchool children aged 5-9 years old in 2017 (n = 950) were followed up for four years. Parents indicated selection from healthy and unhealthy food groups in a validated questionnaire. Weight and height of the children were measured, and WHO BMI z-score (BAZ) was calculated. CRF was determined by the 20 m shuttle run test (20-m SRT). Changes in food selection frequency, CRF and BAZ were assessed. The association between frequency of food group selection, age, household income and CRF with 4-year change in BAZ was determined using mixed linear models.

resultsBAZ (p < 0.001) and age-adjusted performance in the 20-m SRT of boys (p = 0.04) increased at follow-up. The frequency of sugar-sweetened beverages (p < 0.001) and milk intake (p < 0.02) decreased, while the intake from fast-foods increased (p = 0.001). Daily intakes of vegetables and milk were associated with decreases in BAZ. A trend of a positive association was found between frequency of SSB intake and BAZ. CRF showed a strong negative association with BAZ over time (p < 0.001).

conclusionsHigher daily vegetable and milk intakes, as well as higher levels of CRF were protective against increasing adiposity among school-age children. The promotion of healthy eating and measures to improve CRF among school children are important priorities.

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.