Physical Activity as a Key Factor in Elevated BMI Among Children with Developmental Coordination Disorder: A Cross-Sectional Analysis

<b>Background/Objectives</b>: Developmental Coordination Disorder (DCD) affects approximately 5% of children globally and is characterized by motor difficulties that can negatively impact physical activity levels and increase the risk of obesity. Understanding the behavioral and physiological profiles of children with DCD is essential for early intervention. This cross-sectional study compared physical activity, dietary habits, and obesity indicators between children with DCD and their typically developing (TD) peers. <b>Methods</b>: A total of 243 children (134 boys, 109 girls) aged 6.65 to 11.65 years (M = 9.50, SD = 1.38) from two mainstream schools in the Chartered Community of Navarre, Spain, participated in the study. Children with conditions that could explain poor motor development were excluded based on DSM-5 Criterion D. Motor competence was evaluated using the FUNMOVES (n = 243) and MABC-2 tools (n = 49). Physical activity was assessed using the Physical Activity Questionnaire for Children (PAQ-C), dietary habits with the Krece Plus questionnaire, and obesity indicators through bioimpedance analysis (Body Mass Index and body fat percentage). Regression analyses were adjusted for age and sex. <b>Results</b>: Children classified with probable DCD (pDCD) using FUNMOVES showed significantly higher BMI (95% CI: 0.96 to 4.30 kg/m²) and body fat percentage (95% CI: 3.99 to 10.24%) than TD peers. Differences in physical activity were not statistically significant between DCD and TD (95% CI: -0.68 to 0.01. No significant differences were found in dietary quality. When assessing motor development with MABC-2, the results followed similar trends but lacked statistical significance. <b>Conclusions</b>: Children with DCD are at increased risk of overweight and obesity, primarily due to lower physical activity rather than dietary differences. Early identification and targeted interventions are essential to promote healthier lifestyles in this population.