Association between body mass index, muscle-to-fat ratio, and handgrip strength-to-BMI ratio with physical fitness in children from North Macedonia.

Background: this cross-sectional study, conducted on a convenience sample of 2197 Macedonian primary school children, aimed to examine how certain anthropometric indices (body mass index (BMI), muscle-fat ratio (MFR), hand grip strength-BMI ratio) are related to the physical fitness of individuals.

Methods: the sample was split into two groups based on gender: 1096 boys and 1101 girls (average age 8.1 ± 1.