This study investigated the longitudinal relationship between self-reported physical activity and national examination results among adolescents in an upper-middle-income country. This study engaged in a secondary data analysis derived from a closed prospective cohort consisting of 579 students, who were recruited at the age of 13 in 2012 and followed up at ages 15 (2014) and 17 (2016) as part of the Malaysian Health and Adolescents Longitudinal Research Team (MyHeART) study, which was conducted across three states in Peninsula Malaysia. Physical activity levels were evaluated using the Physical Activity Questionnaire, and outcomes were assessed based on the National-Based Examinations at ages 15 (Form 3, Year 9) and 17 (Form 5, Year 11) in Malaysia. A multivariate ordinal regression employing complex sample analysis was applied to ascertain the relationship between physical activity and national examination results. In Form 3 (Year 9), those physically active performed better in Malay Language, English Language, Mathematics and Science. Those physically active in Form 5 (Year 11), performed better in Modern Mathematics, Chemistry, and Principles of Accounting. Longitudinally, there was an increase in the overall percentage of those who were overweight and obese and an increase in those with suboptimal dietary and iron intake. This study has shown that those physically active students fared better in several subjects in the national-based examinations. Suitable physical activity intervention should be tailored accordingly to support adolescents' optimum achievement in academia.
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