How can we get school children physically active? ~ Sigmund A Anderssen, PhD

Regular physical activity in school has the potential of improving health outcomes in children and youth, including overweight and obesity. Recent research shed light upon the opportunities and challenges of implementing physical activity interventions in schoolchildren.

Regular physical activity is necessary for normal growth and the development of cardio-respiratory endurance, muscle strength, flexibility, motor skills and agility.  In addition, regular physical activity has an impact on a range of health outcomes in children and youth 1 including overweight and obesity. Children are seen as a critical target group for public health efforts to prevent overweight and obesity.

Photo by Kris Krug. Used with permission. All rights reserved. Source: flickr

Photo by Kris Krug. Used with permission. All rights reserved. Source: flickr

Grydeland et al recently reported the effect of a 20-month school-based intervention on body composition outcomes 2. The intervention succeeded in increasing the overall physical activity among the participants and in particular among girls and low-active participants. Furthermore, the study demonstrated beneficial effects on BMI in girls.

These results on body composition outcomes are promising. However, no intervention effects were seen among boys or among participants of parents with lower levels of education. There appear to be some reasons why the impact was not better and did not reach boys.  Among them were that low cost and applicability in the public school system had high priority in the study by Grydeland, and the intervention components were primarily delivered through the school teachers and dependent on their devotion.

Even with ambitious goals for what activities the children should engage in, the impact depends on what the children actually do.  Just like when patients take their medications it works, if they do not, the treatment does not work. The challenge is to implement physical activity with strong enough impact.

From the literature 3-6 we know:

  • Children become less physically active as they approach adolescence and adulthood
  • Girls are generally less active than boys
  • Children that are physically active during childhood and adolescence are more likely to be physically active as adults
  • Learning different types of physical activities in childhood may help you dare join in activities later in life
  • Mandatory physical activity in school is not prioritized
  • There is no evidence that added physical activity to school curriculum by taking time from other subjects hinder academic performance

The school represents the only available arena where all children, irrespective of social background, can be reached continuously over a long period of time. Therefore we should urge the decision makers to prioritize physical activity at school and ensure that the PE teachers have enough competence. However, if this is just lip service and halfhearted whitewashing, the likely outcome is an increase in social inequalities rather than a reduction in them.

For more information on sports medicine and the younger athlete, turn to Chapter 42 in Clinical Sports Medicine.

Sigmund A Anderssen is Professor in Physical Activity and Health, and Department Head of Sports Medicine at the Norwegian School of Sport Sciences. His main research areas are physical fitness and physical activity surveillance and physical activity in relation to risk factors for diabetes and cardiovascular disease in both children and adults.


  1. Strong WB, Malina RM, Blimkie CJ et al. Evidence based physical activity for school-age youth. J Pediatr 2005; 146:732-37.
  2. Grydeland M, Bjelland M, Anderssen SA, Klepp KI, Bergh IH, Andersen LF, Ommundsen Y, Lien N. Effects of a 20-month cluster randomised controlled school-based intervention trial on BMI of school-aged boys and girls: the HEIA study. Br J Sports Med. 2013 Apr 27. [Epub ahead of print]
  3. Kolle E, Steene-Johannessen J, Andersen LB, Anderssen SA. Objective measures of physical activity level and directly measured aerobic fitness in a population based sample of Norwegian 9- and 15-year olds. Scand J Med Sci Sports. 2010 Feb;20(1):e41-7. doi: 10.1111/j.1600-0838.2009.00892.x.
  4. Telama R, Yang X, Viikari J, et al. Physical activity from childhood to adulthood. A 21-year tracking study.  Am J Prev Med 2005;28:267–73.
  5. Ahamed Y, Macdonald H, Reed K, Naylor PJ, Liu-Ambrose T, McKay H. School-based physical activity does not compromise children’s academic performance. Med Sci Sports Exerc. 2007 39:371-6.
  6. François Trudeau F, Shephard RJ. Physical education, school physical activity, school sports and academic performance. Int J Behav Nutr Phys Act. 2008; 5: 10.

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