Physical fitness profiles and behavioral correlates among preschoolers in a high-latitude cold region: a cross-sectional study in Heilongjiang, China

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Physical fitness during the preschool years is an important indicator of growth, motor development, and early health. However, evidence describing physical fitness profiles among preschool children in cold-climate regions remains limited, particularly regarding how body morphology, weight status, physical fitness performance, and parent-reported extracurricular participation patterns are related to composite physical fitness ratings. This study aimed to describe the body morphology and physical fitness profiles of preschool children in Heilongjiang Province, China, and to examine factors associated with failure to meet the physical fitness standard. This secondary cross-sectional analysis used data from the preschool section of the 2020 Heilongjiang Provincial National Fitness Surveillance dataset. A total of 1,315 children aged 3–6 years from Harbin, Shuangyashan, and Suihua were included. Anthropometric and physical fitness indicators were assessed using standardized surveillance procedures based on the Chinese National Physical Fitness Measurement Battery for Preschoolers (CNPFM-Pre). Weight status was classified using age- and sex-specific BMI criteria from the China Child Growth Standards for children under 7 years of age (WS/T 423—2022). Parent-reported questionnaire-derived covariates included structured sports participation, arts-related enrichment class participation, sleep duration, outdoor play duration, and parental education. Published 2020 national surveillance mean values were used as descriptive benchmarks. Factors associated with failure to meet the physical fitness standard were examined using a generalized estimating equation logistic model that accounted for kindergarten-level clustering. Preschool children in the Heilongjiang sample generally showed higher values for body morphology indicators than the published national surveillance averages. In contrast, physical fitness indicators showed more heterogeneous patterns, particularly in timed agility- and coordination-related tasks. In the primary GEE model, obesity was associated with higher odds of failure to meet the physical fitness standard compared with normal weight (OR = 3.54, 95% CI: 2.70–4.65, P < 0.001). Structured sports participation was associated with lower odds of failure to meet the standard (OR = 0.52, 95% CI: 0.34–0.80, P = 0.003), whereas arts-related enrichment class participation was associated with higher odds in the primary model (OR = 1.79, 95% CI: 1.20–2.65, P = 0.004). Sensitivity analyses using Firth-penalized logistic regression and additional adjustment for available family, early-life, and screen-related covariates yielded broadly consistent results for the main predictors; however, the association for arts-related enrichment class participation was attenuated after further adjustment for age group and municipality. In this secondary cross-sectional analysis of preschool surveillance data from Heilongjiang Province, physical fitness qualification status was associated with weight status and the structure of children’s extracurricular movement opportunities. Preschool physical fitness in cold-climate regions should be viewed as a functional and contextual profile that integrates weight status, movement-opportunity patterns, and movement-task demands. These findings support integrating weight-status monitoring with functional movement assessment and ensuring accessible, enjoyable, and developmentally appropriate opportunities for gross-motor activity in preschool fitness promotion.

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