Differences Between Health- and Skill-Related Physical Fitness Profiles of Kenyan Children from Urban and Rural Areas: The Kenya-LINX Project

Physical fitness is a key indicator of children's health, yet amidst rising inactivity and obesity, data on Kenyan children are scarce. This study assessed health- and skill-related fitness differences between rural and urban Kenyan children while examining demographic influences. Cardiorespiratory fitness (CRF), BMI, strength, flexibility, speed, agility, and coordination were assessed in 1131 children aged 11.07 ± 0.9 years (52.7% girls) recruited using stratified cluster random sampling. Significant rural-urban disparities were observed. In urban areas, 16.6% were overweight and 2.8% obese, compared to 4% and 0.6% in rural areas (<i>p</i> < 0.001). Conversely, 44.5% of the rural cohort were underweight versus 13.7% urban cohort (<i>p</i> < 0.001). Multivariable regression revealed that rural children demonstrated superior CRF (β = -4.68 laps, <i>p</i> < 0.001) and lower back flexibility (β = -2.77 cm, <i>p</i> < 0.001), while urban children excelled in speed and coordination (β = 3.68 bounces, <i>p</i> < 0.001) and grip strength (β = 2.16 kg, <i>p</i> < 0.001). Boys outperformed girls in explosive leg power (β = -6.75 cm, <i>p</i> < 0.001) and CRF (β = -6.92 laps, <i>p</i> < 0.001). These findings highlight fitness inequities among Kenyan children, emphasising the need for equitable, targeted, and inclusive physical activity opportunities.