School children and physical activity

A third of children in the UK are overweight or obese by the time they reach primary school. Many other countries are facing the same issue, with a tenfold increase in the worldwide prevalence of childhood obesity over the past four decades.

International guidelines recommend that young people aged five to 18 should do at least an hour of moderate to vigorous physical activity every day. But globally, eight out of ten adolescents fail to meet these guidelines. In particular, girls and children from disadvantaged socioeconomic backgrounds are less likely to be physically active.Governments worldwide are attempting to tackle the growing problem of obesity by increasing the amount of physical activity young people are doing on a daily basis. In the UK, for instance, the government’s Childhood Obesity Strategy focuses on helping pupils in schools to move more.

A typical school-based intervention may introduce activity breaks into daily class lessons or add a new physical education lesson through a specialised teacher. It could also include building new playground equipment or assigning physically active homework. In the UK, funding for such initiatives, specifically to finance physical activity in primary schools, has recently doubled to £320m. This is thanks to additional revenue generated from the Soft Drinks Industry Levy.

But while this all sounds well and good, robust evidence for the effectiveness of existing school-based physical activity programmes is lacking. It is also unclear whether all children – irrespective of socioeconomic status – benefit equally.

Recent research by the University of Cambridge, the findings of which were reported on in The Conversation, examined 17 international trials, shows that current efforts are not working as intended. When the results of these interventions were combined, there was no effect in increasing the amount of physical activity school children engaged in across the full day.

The study conducted a review examining previous research on school interventions that aim to improve physical activity. It looked at trials conducted in Europe, Australasia and North and South America. On average, 20 schools and over 450 children were included in each individual study. Physical activity was measured objectively using automatic electronic monitors to capture actual physical activity across the full day, instead of asking students or parents what they remembered doing, which can be highly inaccurate.

 The conclusion?

Overall, the interventions were ineffective in changing the amount of physical activity school children did across the day – compared to children in control schools. Breaking down the data, it showed no evidence of effectiveness among girls or boys, or for children from different socioeconomic backgrounds.

So despite the promise of schools being the ideal environment for influencing young people’s health behaviours, the available evidence suggests current efforts are failing.

One reason for the lack of effectiveness, for example, could be that the programmes may not have been implemented as intended in schools. The programmes often include many components and depend on a range of (already busy) school staff implementing them in a particular way. But to what extent this happens is very often unclear.

 And what of PE in the school curriculum?

 Physical Education (PE) is often viewed as a marginal subject within the curriculum. And many secondary schools actively reduce PE time to make way for what are deemed more “serious” or “important” subjects.

Research from the Youth Sport Trustshows that 38% of English secondary schools have cut timetabled PE for 14- to 16-year-olds. One of the main reasons for this is the increased pressure to produce exam results. Much of the time pupils would usually spend in PE lessons is now spent receiving extra tutoring on topics other than PE.

 PE is also praised for its contribution to improved psychological health, for helping to nurture social and moral development– as well as supporting cognitive and academic performance.

The spiralling downtrend of PE time in secondary schools is a major cause for concern and it would seem that PE is in urgent need of an overhaul. But while the future of PE may be uncertain, there are certainly many opportunities for cross-curricular links and integrative learning in PE. A recent project, for instance, explored the link between cyclingand wider conceptual learning. Similarly, another recent study explored the physical aspects of learning across all curriculum areas, simply through setting up a tent.

More work needs to be done to make sure the wider environments children spend time in are supportive for behaviour change – this includes their homes and local communities. So given that childhood obesity increases the risk of diseases including type 2 diabetes, heart disease and cancer in adulthood, and that together these diseases are estimated to cause around seven in ten deaths worldwide, this is something that needs to happen sooner rather than later.