State policies mandating physical education and recess associated with increase in overall in-school physical activity among children

"Children spend the majority of their waking hours in school, thus schools are important locations to focus obesity prevention activities, such as increasing physical activity opportunities," the authors write as background information in the article. "The national recommendation for school physical education [PE] -- endorsed by the National Association of Sports and Physical Education (NASPE) and the American Heart Association -- is that elementary school students be offered at least 150 minutes/week of PE. However, fewer than 20 percent of third grade students in the United States were offered this amount during the 2007-2008 school year."

Sandy J. Slater, Ph.D., and colleagues with the University of Illinois at Chicago, examined the association between state and local school district-level policies requiring or recommending minimum requirements for in-school physical activity and the odds that elementary schools within those states and districts meet the levels of physical activity recommended, with an emphasis on physical education and recess. The authors collected data on existing state PE and recess-related laws and collected data at the local school level through mail-back surveys that included questions on the number of days per week and number of minutes for which PE class was scheduled during a typical week for a third grade student. The study sample included 47 states, 690 districts and 1,761 schools, during the 2006-2007 through 2008-2009 school years.

The authors found that approximately 70 percent of schools included in the analysis offered at least 20 minutes of daily recess, and 17.9 percent offered 150 minutes/week of physical education. The majority of states (83 percent) offered no daily recess law and less than half offered some kind of law addressing the recommended 150 minutes/week of physical education. The authors found that the odds of schools meeting the NASPE recommendation for physical activity increased if they were located in states or school districts having a law requiring 150 minutes/week of physical education.

Schools in states with policies encouraging daily recess had higher odds of having 20 minutes of recess daily, however district policies were not significantly associated with school-level recess practices. The authors also found that adequate physical education time was inversely associated with recess, with schools offering at least 150 minutes/week of physical education being 50 percent less likely to meet recommendations on recess time. Additionally, schools with students of predominantly white race/ethnicity were more likely than all other racial/ethnic groups to have daily recess, and schools with the highest number of students receiving free or reduced-cost lunch were less likely to have 20 minutes of recess daily.

"Our results show that mandating only increased physical education or recess time does not result in more overall physical activity as schools and/or districts appear to compensate for any increased physical activity in one area by decreasing other physical activity opportunities," the authors conclude. "By mandating physical education or recess, policy makers can effectively increase school-based physical activity opportunities for youth."

Editorial: Promoting the Health of Our Youth

In an accompanying editorial, Kristine Madsen, M.D., M.P.H., of the University of California, San Francisco writes, "as a result of the current focus on reversing the obesity epidemic, the benefits of increased physical activity are becoming more widely discussed. What is not discussed is that lack of physical activity may be a far greater public health problem than obesity."

Dr. Madsen notes that one of the barriers to the adoption of laws and policies to increase school-day physical activity is funding. However, she also notes that, "there is an underused funding solution that would promote children's nutrition and at the same time provide needed resources to support adoption of exemplary nutrition and physical activity standards and programs: the taxation of highly sweetened beverages and nutrient-poor junk food."

"One concerning finding from the Slater et al study is that recess and PE can compete with each other for time in the school day; schools that offered more time in recess offered less time in PE, and vice versa," writes Dr. Madsen. "While schools appear to use PE and recess somewhat interchangeably, PE and recess make unique and separate contributions."

"The solution is not limited to the local, state or national level, but rather, the solution rests with decision makers at each level," Dr. Madsen writes. "We must work together to advocate for our nation's greatest resource -- our youth."