Lower fitness levels, higher fat-to-lean mass ratios, and lower cardiorespiratory endurance are more likely to affect the body mass index of Saudi children and adolescents.

Background: Several studies suggest that health-related physical fitness may play a prominent role in preventing obesity in children and adolescents.

Objectives: The present study examined fitness levels using five components of health-related fitness in Saudi students aged 10-17 years (fat-to-lean mass ratio, cardiorespiratory endurance, upper body strength and endurance, abdominal muscle strength and endurance, and flexibility). Subsequently, the association between BMI and a health-related fitness index (HR-PFI) based on the five fitness components was investigated.