Schoolchildren are not getting enough physical activity during the school day, largely because few states require it, researchers reported.
In a cross-sectional analysis of nearly 1,800 schools in 47 states, only 6% of states required a daily recess period, according to Sandy Slater, PhD, and colleagues at the University of Illinois at Chicago.
And only 13% of states required that students get the recommended 150 minutes a week of physical education, Slater and colleagues reported online in Archives of Pediatrics & Adolescent Medicine.
Despite the lack of strong state policies, Slater and colleagues reported, 69.9% of the 1,761 schools in the sample reported daily 20-minute recess periods.
But just 17.9% reported offering at least 150 minutes a week of physical education, as recommended by the National Association for Sport and Physical Education and the American Heart Association.
And the two forms of activity – recess and physical education – appear to be inversely associated, Slater and colleagues found: schools that offered one were only half as likely to offer the other.
The findings come from a nationally representative survey of public schools that, in order to account for different grade compositions, all included a third grade.
Principals were asked about the school's physical education and recess policies, including what barriers prevented them from meeting recommendations. The researchers used legal databases to pin down state policies.
In a multivariate analysis, the odds of schools having 150 minutes a week of physical education rose if they were in states whose policies required it. The odds ratio was 2.8 with a 95% confidence interval from 1.3 to 5.7.
As well, the researchers reported, schools in states with laws encouraging daily recess were significantly more likely to offer 20 minutes of recess a day. The odds ratio was 1.8, with a 95% confidence interval from 1.2 to 2.8.
Interestingly, state laws
requiring daily recess were not associated with what happened in the schools, perhaps because only three states had such a law, Slater and colleagues reported.
The researchers also found evidence that schools are trading off the two types of physical activity:
- If a school offered daily recess, the odds ratio for also offering physical education was 0.5, with a 95% confidence interval from 0.4 to 0.6.
- And if a school offered at least 150 minutes a week of physical education, the odds ratio for daily recess was also 0.5, but with a slightly wider 95% confidence interval from 0.4 to 0.7.
Slater and colleagues cautioned that the analysis was a snapshot and doesn't address cause and effect. As well, they noted, there is a possibility of response bias because of the self-reported data from school principals.
The study also has no data on what sorts of physical activity actually take place during recess or physical education or on outcomes such as body mass index, they noted.
It's to be expected that strong state and local policies in favor of physical education and recess will be associated with schools actually offering both forms of activity, according to Kristine Madsen, MD, of the University of California San Francisco.
But an open question, she noted in an accompanying editorial, is why so few states have such policies, especially since there is growing evidence that "lack of physical activity may be a far greater public health problem than obesity."
She added that it is "concerning" that recess and physical education appear to compete with each other. "While schools appear to use (physical education) and recess somewhat interchangeably," she argued that they "make unique and separate contributions."
The study was supported by the Robert Wood Johnson Foundation and the National Institute on Child Health and Human Development. The journal said the authors made no disclosures.
The journal said Madsen made no disclosures.
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