Associations between three school-based measures of health: is BMI enough?

School-based body mass index (BMI) notification programs are often used to raise parental awareness of childhood overweight and obesity, but how BMI results are associated with physical fitness and diet is less clear. This study examined the relationship between BMI, fitness, and diet quality in a diverse sample of urban schoolchildren (n = 122) utilizing a school-based cardiorespiratory fitness test and a food frequency questionnaire. Fifty-two percent of children were overweight/obese. Fit children were more likely to be normal weight than unfit children (p < .001). Weight status was not associated with adherence to any specific dietary guidelines; however, greater overall adherence to the recommendations was associated with normal weight (p < .05). These findings suggest a potential benefit may be gained by combining BMI reports with results of in-school fitness testing and basic information on how children's diets compare to recommendations.