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Objective: To determine if processed and ultra-processed foods consumed by children in Colombia are associated with lower-quality nutrition profiles than less processed foods.Design: We obtained information on sociodemographic and anthropometric variables and dietary information through dietary records and 24 h recalls from a convenience sample of the Bogotá School Children Cohort. Foods were classified into three categories: (i) unprocessed and minimally processed foods, (ii) processed culinary ingredients and (iii) processed and ultra-processed foods. We also examined the combination of unprocessed foods and processed culinary ingredients.Setting: Representative sample of children from low- to middle-income families in Bogotá, Colombia.Subjects: Children aged 5-12 years in 2011 Bogotá School Children Cohort.Results: We found that processed and ultra-processed foods are of lower dietary quality in general. Nutrients that were lower in processed and ultra-processed foods following adjustment for total energy intake included: n-3 PUFA, vitamins A, B12, C and E, Ca and Zn. Nutrients that were higher in energy-adjusted processed and ultra-processed foods compared with unprocessed foods included: Na, sugar and trans-fatty acids, although we also found that some healthy nutrients, including folate and Fe, were higher in processed and ultra-processed foods compared with unprocessed and minimally processed foods.Conclusions: Processed and ultra-processed foods generally have unhealthy nutrition profiles. Our findings suggest the categorization of foods based on processing characteristics is promising for understanding the influence of food processing on children's dietary quality. More studies accounting for the type and degree of food processing are needed. [ABSTRACT FROM AUTHOR]

Objective: Long-chain n-3 fatty acid intake in Colombia is low because fish consumption is limited. Vegetable oils with high n-3 fatty acid content are recommended, but their concentrations of trans fats were high in previous studies. Thus, regular monitoring of the fatty acid composition of vegetable oils is required. Our objective was to quantify the fatty acid composition in commercially available oils in Bogota, Colombia and determine if composition changed from 2008 to 2013.Design: Cross-sectional study. We obtained samples of all commercially available oils reported in a survey of low- and middle-income families with a child participating in the Bogota School Children Cohort.Setting: Bogota, Colombia.Subjects: Not applicable.Results: Sunflower oil had the highest trans-fatty acid content (2.18%). Canola oil had the lowest proportion of trans-fatty acids (0.40%) and the highest n-3 fatty acid content (9.37%). In terms of percentage reduction from 2008 to 2013 in 18:1 and 18:2 trans-fatty acids, canola oil had 89% and 65% reduction, mixed oils had 44% and 48% reduction, and sunflower oil had 25% and 51 % reduction, respectively. Soyabean oil became widely available in 2013.Conclusions: The content of trans-fatty acids decreased in all oils from 2008 to 2013, suggesting a voluntary reduction by industry. We believe that regular monitoring of the fatty acid composition of oils is warranted. [ABSTRACT FROM AUTHOR]

Background: Early menarche is a risk factor for cardiometabolic disease and cancer. Latitude, which influences sun exposure, is inversely related to age at menarche. This association might be related to vitamin D, but to our knowledge it has not been investigated in prospective epidemiologic studies. Objective: We studied the association between vitamin D status and the occurrence of menarche in a prospective study in girls from Bogota, Colombia. Design: We measured plasma 25-hydroxyvitamin D [25(OH)D] concentrations in a random sample of 242 girls (mean ± SD age: 8.8 ± 1.6 y) and followed them for a median of 30 mu. Girls were asked periodically about the occurrence and date of menarche. Baseline 25(OH)D concentrations were categorized as <50 nmolI/L (deficient), ⩾50 and <75 nmolIL, or ⩾75 nmolI/L (sufficient). The incidence of menarche was compared between groups by using time-to-event analyses. Results: A total of 57% of girls in the vitamin D-deficient group reached menarche during follow-up compared with 23% of girls in the vitamin D-sufficient group (P-trend = 0.0004). The estimated mean (±SE) ages at menarche in the same groups were 11.8 ± 0.2 y and 12.6 ± 0.2 y, respectively (P = 0.0009). After adjustment for baseline age and BMI-for-age z score in a Cox proportional hazards model, the probability of menarche was twice as high in vitamin D-deficient girls than in girls who were vitamin D-sufficient (HR: 2.05; 95% CI: 1.03, 4.07; P = 0.04). Similar results were obtained in girls aged ⩾9 y at baseline (HR: 2.39; 95% Cl: 1,14, 5.00; P = 0.02). Conclusion: Vitamin D deficiency is associated with earlier menarche. [ABSTRACT FROM AUTHOR]

Background. There are few recent reports on the prevalence and risk factors of stunting and thinness among schoolchildren in Latin America. Objective. To determine the prevalence and sociodemographic correlates of stunting and thinness among school-age children in Bogotá, Colombia, and to examine whether these nutritional indices are associated with the risk of respiratory and diarrheal morbidity symptoms, visits to the doctor, and school absenteeism during the school year in a prospective study. Methods. We obtained information on anthropometric and maternal sociodemographic characteristics of 3,100 children 5 to 12 years of age who attended public primary schools in 2006 and who came from low- and middle-income households. Data on the incidence of common gastrointestinal and respiratory symptoms were collected prospectively on morbidity diaries throughout the year. Results. The prevalence rates of stunting and thinness were 9.9% and 8.7%, respectively. There were inverse, statistically significant trends in the prevalence of stunting by categories of child's birth and current weight; maternal education level, height, and body mass index (BMI); and household socioeconomic stratum. A strong positive association was found with maternal parity (p for trend < .0001). Thinness was positively associated with the child's and the mother's age and inversely associated with birthweight and maternal BMI. Stunting was associated with a 44% increase in the incidence of cough with fever during the school year (p = .04). Conclusions. Child stunting in Bogotá is associated with poor socioeconomic and maternal nutritional status and predicts symptoms of respiratory infection. [ABSTRACT FROM AUTHOR]

In 2004, Bogotá's Secretary of Education (SED) initiated a snack program in public primary schools. A midmorning food ration was provided free of charge to children to supplement 30 and 50% of their daily requirements of energy and iron, respectively. The purpose of this study, an observational investigation of 3202 children ages 5-12 y, was to examine whether the snack program improved children's nutritional and health status. We measured micronutrient levels Iplasma ferritin and vitamin B-i 2, and erythrocyte folatel, anthropometry, and reported morbidity during the first semester of the 2006 school year. After adjusting for socioeconomic status and other school interventions, children at schools receiving the snack In = 1803) had greater increases in plasma vitamin B-12 (42 pmol/L; P <0.0001) from baseline to 3 mo of follow-up than children at schools not receiving the snack In = 13991. They also experienced a smaller decrease in height-for-age Z-scores than children who did not receive the snack (P = 0.001). Provision of the SED snack was associated with significantly fewer reported days with morbidity symptoms (e.g. cough with fever, diarrhea with vomiting), 44% fewer doctor visits (P = 0.021, and 23% fewer days of school absenteeism (P = 0.03). The snack was not related to ferritin or folate levels. In conclusion, provision of a school-administered snack was related to improved vitamin B-12 status and linear growth and decreased reported morbidity. Although provision of the snack was not related to BMI changes over a 4-mo period, snack components such as candy and sugar-sweetened beverages should be replaced with healthier options, as the rates of child overweight in Colombia are not negligible. [ABSTRACT FROM AUTHOR]

Objective: To examine the sociodemographic correlates of overweight and obesity as well as body shape perception in women from Bogotá, Colombia. Methods: The sample ( n = 671) represented low-income and middle-income women, aged 21–55 years, living in Bogotá, who had children in the public school system. We measured height and weight to calculate body mass index (BMI, kg/m2) and defined two dichotomous outcomes: overweight/obesity (BMI ≥25) and obesity (BMI ≥30). Women reported sociodemographic information and used the Stunkard Figure Rating Scale to identify the silhouette that most closely resembled their body shape (current), what they would like to look like (ideal), and what they considered healthiest (healthiest). We estimated body dissatisfaction by subtracting the ideal from the current scores. Results: The prevalences of overweight/obesity and obesity, based on measured height and weight, were 41.9% and 11.6%, respectively. Age, being married, and being born in Bogotá were positively associated with overweight/obesity but not with obesity alone, whereas the number of household assets and parity were both positively related to obesity. Women with higher education or who lived in wealthier neighborhoods identified ideal shapes that were thinner than those identified by their less educated or poorer counterparts ( p = 0.03 and p = 0.004, respectively). Higher education was also associated with the selection of thinner body shapes as healthiest ( p = 0.02). BMI and education were both positively related to body dissatisfaction ( p < 0.0001 and p = 0.04, respectively). Conclusions: Indicators of higher socioeconomic status (SES) (e.g., having more household assets) are associated with obesity. Perception of slimmer body shapes as ideal and healthiest and higher body dissatisfaction are associated with higher education. [ABSTRACT FROM AUTHOR]

Background. In Latin America, the burden of vitamin A and iron deficiencies has been documented primarily in preschool-age children. There are few recent reports on the vitamin A and iron status of school-age children. Objective. We aimed to determine the prevalence and predictors of vitamin A and iron deficiencies in Colombian school-children. Methods. We examined plasma retinol and ferritin concentrations in relation to socioeconomic and anthropometric factors in a representative sample of 2,811 low- and middle-income children 5 to 12 years of age in Bogotá, Colombia. Results. The prevalence rates of deficiencies of vitamin A (plasma retinol < 0.70 μmol/L) and iron (plasma ferritin < 15 μg/L) were 14% and 3%, respectively. In multivariate analysis, plasma retinol concentrations were positively associated with child's age and household's socioeconomic stratum, whereas ferritin concentrations were positively related to child's age, number of home assets, and having a nonsingle mother. Ferritin concentrations were much lower among girls than boys in the 11- and 12-year-old age group, whereas there were only small positive differences between girls and boys in younger children (p for interaction < .0001). Both vitamin A and iron deficiencies were independently associated with lower z-scores for body-mass-index-for-age, after adjustment for sociodemographic factors and C-reactive protein concentrations. Neither vitamin A nor iron status was related to height-for-age. Conclusions. The prevalence rates of vitamin A and iron deficiencies among schoolchildren from Bogotá, Colombia, are not negligible. Both vitamin A and iron status are positively associated with socioeconomic status and anthropometric indices. The effect of improving vitamin A and iron status on physical growth and other functional outcomes needs to be further examined in this age group. [ABSTRACT FROM AUTHOR]

The objectives of this study were to estimate the prevalence of overweight in school-aged children from Bogota, Colombia and to examine its associations with sociodemographic characteristics, dietary patterns, and indicators of physical activity. We measured height and weight in 3075 children between 5 and 12 y of age who attended public primary schools in 2006 and we obtained information on maternal sociodemographic and anthropometric characteristics. The survey was representative of children from low and middle socioeconomic backgrounds. The prevalences of child overweight (including obesity) and obesity according to the International Obesity Task Force criteria were 11.1 and 1.8%, respectively. The prevalence of stunting was 9.8%. In multivariate analysis, child overweight was positively associated with indicators of higher socioeconomic status (SES), including low maternal parity and ownership of household assets. The prevalence of overweight was 3.6 times greater in children whose mothers were obese compared with children whose mothers had an adequate BMI (adjusted prevalence ratio = 3.61; 95% Cl = 2.64, 4.93). Child overweight was positively associated with adherence to a "snacking" dietary pattern (P-trend = 0.06) and to frequent intake of hamburgers or hot dogs (adjusted prevalence ratio for at least once per week vs. never = 1.93; 95% Cl = 1.03, 3.621, independent of total energy intake and other potential confounders. Time spent viewing television or playing outside the household were not significantly related to the prevalence of child overweight. In conclusion, child overweight in Bogota is more common than stunting and is associated with higher SES, maternal obesity, and a snacking dietary pattern. [ABSTRACT FROM AUTHOR]

Vitamin B-12 is related to neurocognitive function in school-age children, yet sociodemographic and dietary correlates of vitamin B-12 status in this age group are not well characterized. The prevalences of vitamin B-12 or folate deficiencies in Colombia are unknown. We conducted a cross-sectional study in a representative sample of 2800 low- and middle-income children aged 5-12 y from Bogotá's public schools. Plasma vitamin B-12 and erythrocyte folate concentrations (mean ± SDI were 327 ± i 06 pmol/L and 858 ± 256 nmol/L, respectively. The prevalence of vitamin B-12 deficiency (<148 pmol/L) was i .6% and the prevalence of marginal status (148-221 pmol/L) was 15.0%. Only 2 children had folate deficiency (<305 nmol/L). In multivariate analysis, mean vitamin B-12 concentrations significantly decreased with age and were 15 pmol/L higher in girls than boys (95%Cl = 8, 23). Vitamin B-12 was inversely related to the mother's parity and positively associated with the amount of money spent on food per person per day at home and the household's neighborhood socioeconomic status (SES) classification. Folate concentrations were lower in girls than in boys and significantly increased with the household's SES. We identified 4 dietary patterns with principal components analysis of a FFQ in a random subsample (n = 972). Plasma vitamin B-12 was strongly, positively associated with a pattern that included frequent intake of beef, chicken, and dairy products in a dose-response manner (P-trend, adjusted, = 0.008). Low vitamin B-12 status is not negligible in Colombian school children and is associated with poverty and marginal intake of animal food sources. [ABSTRACT FROM AUTHOR]

The aims of this study were to determine the sociodemographic and dietary correlates of household and child food insecurity in Bogotá, Colombia and to examine whether food insecurity is a risk factor for underweight or overweight in this population. We analyzed data from 2359 families with 2526 children 5-12 y of age who completed a cross-sectional survey conducted in 2006. The survey was representative of low- and middle-income families who had children enrolled in the public primary school system of Bogotá. We used a 16-item food insecurity scale, modified from the United States Household Food Security Survey Module, assessed children's dietary intake with a FFQ, and measured their height and weight. Mothers' anthropometry was obtained through self-report. We estimated adjusted prevalence ratios and 95% CI from binomial regression models. Household food insecurity with hunger and child food insecurity were each positively associated with maternal age, parity, and single parent status and inversely related to mean household income and number of home assets. Animal protein and snack food intake were inversely related to child food insecurity. In multivariate analyses, food-insecure children were 3 times more likely to be underweight than food-secure children (95% CI = 1.6, 5.4; P = 0.0007). Hunger in the household was significantly associated with maternal underweight. Food insecurity was not related to child stunting, child overweight, or maternal overweight. The prevalence of food insecurity in Bogotá is high and related to poverty. Food insecurity does not necessarily predict overweight in countries undergoing the nutrition transition. [ABSTRACT FROM AUTHOR]

We conducted a survey of cooking fat usage in a representative sample of mothers from low and middle income families in Bogota, Colombia (n=2368). The fatty acid composition of the most commonly available cooking fats (n=30) in the market was analyzed by gas chromatography. 87% of the surveyed population consumed at least one of these 30 cooking fats. The types of fat primarily used for cooking were mixed vegetable oils, 69%; sunflower oil, 22%; margarine, 2.4%; palm shortening, 2.8%; and chicken fat, 1.4%. The trans fat content of sunflower oil was unexpectedly high (mean, 4.2%; range, 2.2-8.6), compared to that in the vegetable mixtures (mean, 2.6%; range, 1.2-5.1). Overall, 35% and 18% of the families used cooking fats with >2% and >4% trans fatty acids, respectively. In multivariate analysis, usage of sunflower oil as the primary cooking fat was positively related to the number of household assets, the amount of money spent on food per person/day at home, and maternal education and inversely associated with an index of household food insecurity. Paradoxically, oblivious to the high trans content of sunflower oil, "health" was the main reason reported by the mothers to choose sunflower over other oils. The high trans content of sunflower oil, and the belief that sunflower oil is healthier than others may result in an elevated intake of trans fats. Regulation of trans fat content in foods is urgently needed in Colombia. [ABSTRACT FROM AUTHOR]

We examined serum vitamin B12 and erythrocyte folate concentrations in a representative sample of low and middle income children aged 5-12 y from Bogota's 2006 public schools (n=2811; girls, 49.5%). Mean B12 and folate concentrations were 329 pmol/L (SD, 114, IQR, 249-390) and 848 nmol/L (SD, 246; IQR, 689-970), respectively. As per the IOM cutoff points, the prevalence of B12 deficiency (<150 pmol/L) was 1.8% while the prevalence of marginal deficiency (150-220 pmol/L) was 14.7%. Only 2 children had folate <305 nmol/L. In multivariate analysis, mean B12 concentrations significantly decreased with age (-6 pmol/L per y; 95%CI= -8, -3) and were 16 pmol/L higher in girls than boys (95%CI= 7, 24). B12 was inversely related to the mother's parity and a child's food insecurity index, and positively associated with the household's neighborhood socioeconomic status (SES) classification and the amount of money spent on food per person/day at home. Folate was lowest in children 6-8 y, and among girls, but it was not related to SES or food insecurity. We identified 4 dietary patterns by use of principal components factor analysis of a semiquantitative FFQ (n=951). B12 was positively associated with a pattern that included frequent intake of beef, chicken, and dairy products. Folate was not associated with any specific pattern. Vitamin B12 status is strongly related to SES and intake of animal foods in school children from Bogota. [ABSTRACT FROM AUTHOR]

Background: Animal and human adult studies indicate that long-term intake of trans fatty acids (TFAs) may be associated with weight gain. High intake of fast foods and snacks, which are rich in TFAs, is linked to overweight status among school-age children. However, the specific effects of TFAs in this population are unknown., Objective: We examined whether serum TFAs, used as biomarkers of intake, are associated with faster weight gain and linear growth during school years., Methods: We quantified TFAs by GLC in serum samples of 668 children aged 5-12 y at the time of recruitment into an ongoing cohort study performed in Bogota (Colombia) since 2006. Serum proportions of trans palmitoleic acid (16:1t), trans oleic acid (18:1t), trans linoleic acid (18:2t), and total TFAs were used as biomarkers of intake. Anthropometric characteristics were measured periodically for a median of 30 mo. Body mass index-for-age z scores (BAZs) and height-for-age z scores (HAZs) were calculated with the use of the WHO reference. We estimated mean changes in BAZs and HAZs over follow-up according to quartiles of each TFA at baseline by using mixed-effects regression models with restricted cubic splines., Results: Proportions of trans palmitoleic acid, trans oleic acid, trans linoleic acid, and total TFAs (mean ± SD, % of total serum FAs), were 0.22 ± 0.06, 0.91 ± 0.37, 0.96 ± 0.27, and 2.10 ± 0.59, respectively. Serum TFAs were not associated with changes in BAZs and HAZs after adjusting for sex, baseline age, and socioeconomic status. In a subgroup analysis by sex, serum trans palmitoleic acid was positively associated with the estimated change in HAZs from ages 6 to 14 y in boys (with use of the first quartile as the reference, differences in HAZs for trans palmitoleic acid quartiles were 0.73, 0.53, and 0.70, P-trend = 0.03)., Conclusions: Proportions of serum TFAs, used as biomarkers of TFA intake, were not associated with weight gain in children aged 6-14 y in low- and middle-income populations in Bogota. The proportion of trans palmitoleic acid was positively associated with linear growth in boys. Longer follow-up and studies in diverse cohorts with wider ranges of TFA intake are warranted., (© 2015 American Society for Nutrition.)

Objective: Body image dissatisfaction (BID) in school-age children is positively associated with weight status in cross-sectional studies; however, it is uncertain whether BID is a risk factor for the development of adiposity over time. The aim of the present study was to examine the association of BID with changes in BMI in school-age children., Design: Longitudinal study. At recruitment, children were asked to indicate the silhouette that most closely represented their current and desired body shapes using child-adapted Stunkard scales. Baseline BID was calculated as the difference of current minus desired body image. Height and weight were measured at recruitment and then annually for a median of 2·5 years. Sex-specific BMI-for-age curves were estimated by levels of baseline BID, using mixed-effects models with restricted cubic splines., Setting: Public primary schools in Bogotá, Colombia., Subjects: Six hundred and twenty-nine children aged 5-12 years., Results: In multivariable analyses, thin boys who desired to be thinner gained an estimated 5·8 kg/m2 more BMI from age 6 to 14 years than boys without BID (P = 0·0004). Heavy boys who desired to be heavier or thinner gained significantly more BMI than boys without BID (P = 0·003 and P = 0·007, respectively). Thin girls who desired to be heavier or thinner gained significantly less BMI than girls without BID (P = 0·0008 and P = 0·05, respectively), whereas heavy girls who desired to be heavier gained an estimated 4·8 kg/m2 less BMI than girls without BID (P = 0·0006). BID was not related to BMI change in normal-weight children., Conclusions: BID is associated with BMI trajectories of school-age children in a sex- and weight-specific manner.

Objective: The aim of the present study was to identify correlates of body image perception and dissatisfaction among school-aged children from Colombia, a country undergoing the nutrition transition., Design: Cross-sectional study. Using child-adapted Stunkard scales, children were asked to indicate the silhouette that most closely represented their current and desired body shapes. Body image dissatisfaction (BID) score was estimated as current minus desired silhouette. Height and weight were measured in all children. Sociodemographic data were collected through questionnaires completed by the children's mothers., Setting: Public primary schools in Bogotá, Colombia., Subjects: Children aged 5-12 years (n 629) and their mothers., Results: Mean BID score was 0·1 (SD 1·7). The strongest predictor of BID was actual BMI-for-age Z-score (BAZ). Compared with children with BAZ ≥ -1 and < 1, those with BAZ ≥ 2 had a 1·9 units higher BID score (P for trend < 0·0001). BID tended to be higher in girls than boys at any level of BAZ. Other correlates of BID included child's height-for-age Z-score, maternal BMI and dissatisfaction with the child's body, and home ownership., Conclusions: Among school-aged children from a country experiencing the nutrition transition, body image perception was associated with the child's weight and height, and with maternal BMI, dissatisfaction with the child's body and socio-economic level.

Aim: To identify correlates of bias in self-reported anthropometry among reproductive-aged Colombian women and to correct overweight/obesity and obesity prevalence based on self-reported data using two calibration techniques., Subjects and Methods: Self-reported and objectively measured anthropometry were obtained from 597 women aged 21-55 years from Bogotá, Colombia. This study identified correlates of reporting bias (self-reported minus measured anthropometry) by examining its distribution across categories of sociodemographic characteristics, objectively measured anthropometry and body shape perception using linear regression. Next, weight status misclassification was assessed using self-reported anthropometry. Finally, multivariable linear regression and ROC curves were used to calibrate weight status misclassification from self-reported data; these techniques were applied in half of the study population and validated in the remaining half., Results: Women under-estimated weight by 2.0 ± 5.0 kg and over-estimated height by 0.6 ± 4.0 cm. Correlates of bias included objectively measured anthropometry and marital status. Self-reported BMI yielded spuriously low prevalences of overweight/obesity and obesity. The ROC approach effectively corrected overweight/obesity prevalence, while the regression method provided a more accurate estimate of obesity prevalence., Conclusions: Bias in self-reported anthropometry varied with respect to objectively measured anthropometry and sociodemographic characteristics. BMI from self-reported anthropometry under-estimates overweight/obesity and obesity prevalence; calibration methods can effectively correct reporting bias.

Objective: Snacking has been related to increased prevalence of overweight among school-age children in cross-sectional studies. It is uncertain, however, whether snacking influences the development of adiposity over time., Design: We examined whether adherence to a snacking dietary pattern was associated with greater increases in children's BMI, subscapular:triceps skinfold thickness ratio and waist circumference over a median 2·5-year follow-up. Dietary patterns were identified through principal component analysis of an FFQ administered at recruitment in 2006. Anthropometric follow-up was conducted annually. Linear mixed-effects models were used to estimate rates of change in each indicator according to quartiles of adherence to the snacking pattern. We also examined change in BMI, subscapular:triceps skinfold thickness ratio and waist circumference in relation to intake of the food items in the snacking pattern., Subjects: Children (n 961) 5-12 years of age., Setting: Public schools in Bogotá, Colombia., Results: After adjustment for age, sex, total energy intake and socio-economic status, children in the highest quartile of adherence to the snacking pattern had a 0·09 kg/m2 per year higher BMI gain than children in the lowest quartile (P trend = 0·05). A similar association was observed for mean change in subscapular:triceps skinfold thickness ratio (highest v. lowest quartile difference = 0·012/year; P = 0·03). Of the food items in the snacking pattern, soda intake was positively and significantly associated with change in BMI (P trend = 0·01) and waist circumference (P trend = 0·04) in multivariable analysis., Conclusions: Our results indicate that snacking and soda intake are associated with development of adiposity in school-age children.

Poor physical fitness is associated with increased health-related risks in children. The association of nutritional status indicators and physical fitness in children residing in developing countries is not well characterised. We conducted a cross-sectional study among 1945 children of age 5-12 years in Bogotá, Colombia, to assess whether anthropometric and micronutrient status indicators were associated with performance in the shuttle run and standing long jump tests. Stunted children scored significantly lower in the run (0·4 s; P = 0·0002) and jump (6 cm; boys only; P = 0·003) tests than non-stunted children, after adjustment for age and other factors. Children who were thin, overweight or obese ran slower than normal-weight children (P < 0·01). Lower jump scores were associated with overweight or obesity and greater arm fat area in boys only (P < 0·0001). Girls with low ferritin concentrations ran 0·6 s slower than girls with normal ferritin concentrations (P = 0·02). Erythrocyte folate concentrations were linearly related to higher run (P < 0·0001) and long jump scores (P = 0·0001). Boys with marginal or low vitamin B12 status had 4 cm lower long jump scores than children with normal status (P = 0·01). Suboptimal anthropometric and micronutrient status are related to poorer performance in fitness tests. The effects of improving nutritional status on physical fitness of children warrant investigation.