ORIGINAL ARTICLE Physical fitness of normal, stunted and overweight children 6–13 years in Oaxaca, Mexico RM Malina 1,2 , ME Pen ˜a Reyes 3 , SK Tan 4 and BB Little 5 1 Department of Kinesiology and Health Education, University of Texas at Austin, Austin, TX, USA; 2 Department of Kinesiology, Tarleton State University, Stephenville, TX, USA; 3 Escuela Nacional de Antropologia e Historia, Instituto Nacional de Antropologia e Historia, Mexico, DF, USA; 4 Fifth Ray Integrated Activities Pte Ltd, Singapore, Singapore and 5 Departments of Mathematics, Physics, and Engineering, and Academic Affairs, Tarleton State University, Stephenville, TX, USA Background/Objective: The objective of this study is to compare the growth and physical fitness of normal, stunted and overweight/obese (owt/ob) Oaxaca children 6–13 years. Subjects/Methods: This study was a cross-sectional, included 688 school children (grades 1–3, 4–6), aged 6–13 years, from an indigenous rural community (n ¼ 361) and colonia popular (n ¼ 327) in Oaxaca, southern Mexico. Measurements: Anthropometry—weight, height, sitting height, limb circumferences, skinfolds. Derived—body mass index, sitting height/ height ratio, leg and step lengths, limb muscle areas, sum of skinfolds. Physical fitness—sit and reach, sit-ups, distance run, grip strength, standing long jump, 35 yard dash. Physical activity—steps to and from school, household chores, sports participation. Analysis: Normal—not stunted, not owt/ob; stunted—not owt/ob; and owt/ob—not stunted were compared with multivariate analysis of covariance controlling for age. Two children were stunted and owt/ob, and were excluded. Results: Age-adjusted means for body size, muscularity, adiposity and grip strength showed a gradient, owt/ob4normal4 stunted in both sexes and grade levels (Po0.001). Relative position of stunted and owt/ob children was reversed for strength per unit mass. Stunted and normal children ran a greater distance than owt/ob children (Po0.05). Normal, stunted and owt/ob children did not differ consistently in other fitness items and indicators of activity and inactivity. Conclusion: Size, muscularity, fatness and strength differed significantly, owt/ob4normal4stunted, but owt/ob children had less strength per unit mass and poorer endurance. Normal and stunted children did not differ consistently in fitness. Physical activity and television time did not differ among the three groups. European Journal of Clinical Nutrition (2011) 65, 826–834; doi:10.1038/ejcn.2011.44; published online 30 March 2011 Keywords: undernutrition; stunting; endurance; strength; flexibility; physical activity Introduction A shift from high prevalence of chronic undernutrition and associated infectious/diarrheal diseases to high prevalence of chronic diseases associated with dietary change and reduced physical activity and increased overweight/obesity (owt/ob) is characteristic of the nutritional transition (Popkin, 1994). It is suggested that overweight is more common among stunted children in several countries in the transition (Popkin et al., 1996; Hoffman et al., 2000). Concurrent stunting and owt/ob were about twice as common in indigenous compared with non-indigenous preschool children in Mexico (Fernald and Neufeld, 2007), but was not common in indigenous school age children in Chihuahua and Oaxaca in 2007 (Pen ˜a Reyes et al., 2009, 2010). Nevertheless, growth stunting often persists while overweight and/or obesity increase in Latin American and other countries experiencing the nutritional transition (Rivera et al., 2004). Growth stunting is an outcome of linear growth retarda- tion associated with chronic undernutrition during the preschool years. Children undernourished early in life are smaller, have reduced muscle mass and are deficient in muscular strength and aerobic fitness compared with better nourished peers (Malina et al., 1991, 2004; Benefice, 1998). Chronic undernutrition is also associated with reduced Received 6 August 2010; revised 15 November 2010; accepted 24 February 2011; published online 30 March 2011 Correspondence: Professor RM Malina, 10735 FM 2668, Bay City, TX 77414. E-mail: rmalina@1skyconnect.net European Journal of Clinical Nutrition (2011) 65, 826–834 & 2011 Macmillan Publishers Limited All rights reserved 0954-3007/11 www.nature.com/ejcn