| Sumario: | Highlights: What are the main findings? This research highlights a sex-specific pattern in body composition changes in middle school students over two years: the percentage of FM decreased significantly in males while increasing significantly in females. Moreover, unlike females, males improved their cardiorespiratory fitness and showed an increase in muscle mass. Regarding flexibility, while females remained stable, a decrease was observed in males. The analysis revealed a significant positive correlation between changes in MVPA and PA enjoyment for the whole sample; more specifically, the correlation was significant for males and not for females. What are the implications of the main findings? In order to consider the fundamental biological sex distinctions and developmental differences, PE programs may need to be modulated, adapted and personalized to better address the sex-specific developmental needs of students. Because enjoyment is a key driver of physical activity and a protective factor against sport dropout—especially among girls aged 11–13—the observed increases in MPA and MVPA underline the important role of school PE in fostering active habits among both boys and girls. Background: This two-year longitudinal study examined sex-specific changes and interrelations among body composition, physical fitness, physical activity (PA) enjoyment and PA levels during early adolescence. Methods: A cohort of 266 Italian middle school students (boys: n = 139; girls: n = 127) was assessed at two time points across two consecutive school years using anthropometry, field-based fitness tests, the Physical Activity Enjoyment Scale Questionnaire (Italian version) and a PA frequency questionnaire. Repeated-measures ANOVAs were used to explore time and time × sex effects, and correlations between change scores were calculated to explore associations between variables. Results: BMI increased in both sexes, while fat mass decreased in boys and increased in girls. Boys showed greater gains in cardiorespiratory fitness and muscular strength, whereas girls maintained better flexibility. Moderate PA and overall moderate-to-vigorous PA (MVPA) increased over time, with stronger positive associations between changes in PA enjoyment and MVPA in boys. Conclusion: These findings describe sex-specific patterns in physical fitness, body composition, and physical activity during early adolescence, and may help inform future research on sex-sensitive, individualized physical education approaches.
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