Physical Activity for Youth All Year Long

Q: What are the benefits of physical activity for youth during the school year? What are ways to encourage more physical activity, rather than less, during the summer months?

A: No matter the time of year, regular physical activity is encouraged! As with adults, the benefits of physical activity for kids are numerous, including improved cardiorespiratory and muscular fitness, improved bone health, improved cardiovascular and metabolic biomarkers, and favorable body composition (¹⁹). The Physical Activity Guidelines for Americans recommends 60 minutes per day of moderate or vigorous aerobic activity (3 days per week, vigorous activity should be included); muscle-strengthening activities and bone-strengthening activities should be included within the 60 minutes of physical activity on at least 3 days per week (¹⁹). Unfortunately, a recent report concluded less than half of youth are achieving recommended amounts of daily physical activity (¹⁴). For more information on physical activity recommendations and the impact on health, see “Kids and Physical Activity — Who, What, Why, and How” in the September/October 2014 issue of ACSM’s Health & Fitness Journal^® (⁵).

PHYSICAL ACTIVITY, COGNITIVE FUNCTION, AND ACADEMIC PERFORMANCE

Looking beyond the many health and fitness benefits of physical activity, ACSM examined the impact of physical activity on cognition and academic performance in a 2016 position stand: “Physical Activity, Fitness, Cognitive Function, and Academic Achievement in Children: A Systematic Review” (⁸). After reviewing available research, some limitations related to study designs were noted, as were considerations related to timing of physical activity to various measurements, limited information on participants, and lack of adjustment for socioeconomic status, among others. This is still an emerging area with many questions yet to be explored. For example, what is (are) the mechanism(s) by which physical activity impacts cognitive performance? Knowledge of mechanism(s) would lead to better understanding of the optimal recommendation (i.e., exercise mode, duration, frequency, intensity). Another consideration is the manner in which to infuse physical activity (e.g., activity breaks, active lessons). Within the current knowledge base, the reviewers found evidence to support positive associations among physical activity, fitness, cognition, and academic achievement; physical activity was found to have a positive influence on cognition and brain structure and function (⁸). For additional details, the position stand is a valuable resource; selected findings are noted in Box 1.

BOX 1. ACSM Position Stand: Physical Activity, Fitness, Cognitive Function, and Academic Achievement

Consider the following examples of findings (see the position stand (⁸) for the entire review):

• Cross-sectional studies (these look at groups at a given time) have generally reported positive relationships between physical activity or aerobic fitness and cognitive performance; scoring within the Healthy Fitness Zone on the FITNESSGRAM has been associated with scoring higher on academic achievement tests.
• Longitudinal studies (these types of studies follow individuals for a time) are limited in number but do support an association between higher fitness and better cognitive performance across time; longitudinal studies also have noted an association between fitness and academic achievement.
• Acute physical activity studies have not produced consistent results, although overall, a beneficial relationship between physical activity and cognition has been noted (and no evidence of a negative impact was found); immediate effects of physically active lessons in the classroom mostly have been positive (e.g., improved on-task behavior), although differences have been found related to performance in given academic areas; only two studies examined the impact of classroom physical activity breaks, and neither demonstrated a difference from classrooms who did not include activity breaks.
• Physical education and academic achievement were not found to be associated with one another in the limited number of studies included in this review. Additional studies need to be conducted that address current limitations (e.g., lack of control for socioeconomic status, relying on self-report, study designs).

The wide-ranging benefits of physical activity for youth are supported in the conclusions of the 2016 Copenhagen Consensus Conference, which focused on youth and physical activity (⁴). The consensus statement includes items related to the value of cardiovascular and muscular fitness for youth and the importance of exercise on health promotion and cardiovascular risk factor reduction. In addition, physical activity is noted to benefit brain structure, brain function, and cognition as well as to promote scholastic performance. Given the many benefits, the researchers highlight the need for inclusion and consideration of social, cultural, physical, and demographic characteristics when developing opportunities for physical activity (⁴).

PHYSICAL ACTIVITY PROMOTION IN YOUTH

The Copenhagen Consensus Statement encouraged whole-school approaches and environments that are conducive to physical activity — including parks and playgrounds (⁴). Various aspects impact use including proximity, safety, and access (¹⁴). Access to parks has been found to vary in the United States. For youth in rural or more isolated areas, less than 37% have access to a park; however, in urban areas, access is greater (64%) (⁹). Suggestions to help address lack of access include sharing facilities with schools and use of green or open spaces for activity (⁹).

When looking at school playgrounds, what type of environment invites physical activity? A recent study took a unique approach by consulting with the end users — elementary and secondary school children — rather than focusing on what adults anticipate children would enjoy (¹⁰). The EPIC-PA (The Environmental Perceptions Investigation of Children’s Physical Activity) Study included focus group discussions related to what features were desired in the school environment to encourage physical activity and map drawing to allow children to actively illustrate features they desired. Some desired features that emerged include adventure physical activity facilities (e.g., rock climbing walls, low-ropes courses, adventure flying fox (aka zip line)), animal physical activity program (e.g., dog walking, horse riding), natural environment features (e.g., hills, trees, water sources like a lake for kayaking and sailing), fitness/gym equipment (e.g., treadmill), recreational facilities (e.g., jumping pillows, mazes, obstacle courses, skate parks), and sporting facilities (e.g., multipurpose courts, running tracks, swimming pools, gymnastics) (¹⁰). In addition, the children identified the need to maintain facilities, to provide more physical education lessons, to develop policies for borrowing of equipment, to provide a range of teacher-directed activities, and to take excursions (i.e., going to places with other sport facilities) (¹⁰). Insights such as these are helpful in ensuring plans reflect what youth enjoy.

In addition to enjoyment, self-efficacy is essential to support participation in physical activity by youth (²²). Self-efficacy is the perception of ability to perform a given activity (²²). Researchers note that parents may play a role, although this could be positive or negative. For example, parents should avoid nagging or ordering kids to participate. Instead, support can be provided by being physically active with youth, watching youth engage in activity, or providing transportation so youth can be active (²²).

Along with self-efficacy, self-regulation and physical activity have been found to reinforce one another in an after-school program, Youth Fit 4 Life (³). Youth Fit 4 Life occurred 4 days per week and included a warm-up followed by 30 minutes of moderate-to-vigorous physical activity and then 10 minutes of either self-management/self-regulatory skill development or nutrition education (2 days per week for each). The program included developing skills to promote self-efficacy and overcoming barriers to healthy behaviors (i.e., physical activity, nutrition). Goals and progress toward goals were personal, rather than focused on competition with others. Over the 12 weeks of the program, there was a significant increase in out-of-school physical activity compared with a control group. Considering the target of at least 60 minutes per day (at least 300 minutes/week), the improvements were clear because 70.5% reached this level of activity by the end of the program compared with the baseline of 40.9% (³). The use of self-regulation was identified as a key factor.

Promoting total daily physical activity is a worthy goal. However, some have questioned if increasing activity during the school day with physical education might negatively impact activity at other times. One study of middle school-aged youth found more steps were taken on days when the students had physical education, and also that some students were more active after school on the days they had physical education (i.e., physical activity at school seemed to stimulate more activity over the day as a whole) (¹). This relationship was supported in a study looking at a wider age range (ages 6 to 19 years); higher school day physical activity was associated with higher overall daily physical activity (¹²). The youth did not compensate for the higher in-school activity by lowering activity outside of school (¹²). Thus, physical education is a part of the school day that can potentially contribute to the daily physical activity of youth.

Physical education is considered the foundation of the Comprehensive School Physical Activity Program (²⁰). With physical education as the foundation, other components include physical activity before, during, and after school; staff involvement; and family and community involvement (Figure 1). For more information, including a guide for schools as well as resources to support CSPAP, see http://www.cdc.gov/healthyschools/physicalactivity/cspap.htm.

Figure 1: Comprehensive school physical activity program (²⁰)

PHYSICAL ACTIVITY DURING THE SUMMER MONTHS AND BEYOND

With typically less structure than school days, summertime can easily turn into a period of limited activities and reduced physical activity. Taking that into consideration, weight gain over the summer is a concern. The Early Childhood Longitudinal Study, Kindergarten Class of 2010–11 (ECLS-K: 2011) examined overweight and obesity prevalence during the school year and summer vacation (²¹). Researchers followed participants from the fall of kindergarten in 2010 through the spring of second grade in 2013. The prevalence of overweight was approximately 23% and the prevalence of obesity was 9% at the beginning of kindergarten. During each summer, overweight and obesity prevalence increased on average 2 to 3 percentage points. Although overweight prevalence during the school year did not increase and obesity prevalence actually decreased, the decrease did not offset the growth seen during the summer (²¹). The results of this study highlight the importance of healthy behaviors, including keeping kids active, during the summertime.

As with weight, seasonal variations may impact children’s physical activity patterns. A study conducted in Australia found that children were significantly less active during the summer (warmest part of the year) compared with the winter (coldest part of the year), even when adjustments were made for meteorological variables (¹⁷). Less time was spent per day in moderate physical activity (5.0 minutes less) and moderate-to-vigorous physical activity (7.8 minutes less) during the summer. The main limitation to this study was that the accelerometers used to measure activity levels were not waterproof, and water-based activity might increase during the hot summer months but would not have been recorded (¹⁷).

To combat concerns related to increases in overweight and obesity and decreases in physical activity, finding ways to keep kids active during the summertime deserves attention. With children having more free time during the summer than the school year, they and their guardians have an opportunity to make intentional choices about how to use that time to achieve the recommended amount of physical activity.

Screen time is one area to consider (including television, video games, and computer). Children currently spend more than seven-and-a-half hours in front of a screen daily (¹⁵), whereas The American Academy of Pediatrics recommends that children spend no more than 1 hour a day with high-quality programming (²). The U.S. Centers for Disease Control and Prevention suggest the following to help control screen time (⁷):

• Know how much screen time all family members are getting and then set limits for the entire family.
• Do not use screen time as a reward or punishment.
• Turn commercial breaks into activity breaks when watching television (TV). Do jumping jacks, push-ups, or crunches or run in place during commercial breaks.
• Turn off the television during mealtimes.
• Put the TV and computer in common areas like the living room instead of individual bedrooms.

As imbedded in recommendations related to screen time, modeling positive behaviors related to physical activity can encourage children to be active. For example, build physical activity into family time, provide children with toys that encourage physical activity (i.e. balls, jump ropes), and encourage children to try new types of physical activity and be positive about the types of activities they enjoy (⁷). Some summertime activity ideas are found in Box 2.

BOX 2. Summertime Activity Ideas

Summertime activity options are numerous, including (^6,11,19):

• Explore your neighborhood by walking around the block
• Find forests or parks with trails to use for hiking and biking
• Use biking as a family activity and a means of active transportation
• Cool off on a hot summer day by swimming at a local pool or outdoor water source
• Walk the dog
• Jump rope on the driveway
• Play tag in the backyard

A helpful resource for any time of year is We Can! (Ways to Enhance Children’s Activity & Nutrition) (¹³). Along with providing information about healthy weight, eating right, and getting active, this Web site (http://www.nhlbi.nih.gov/health/educational/wecan/) provides a curriculum focused on leading healthier lifestyles that is designed specifically for families, youth, and children along with other tools and resources (¹³). For youth with disabilities, the I Can Do It, You Can Do It! program focuses on an individualized approach to promote physical activity and good nutrition; for more information see http://www.fitness.gov/participate-in-programs/i-can-do-it-you-can-do-it/(¹⁶).

BOX 3. What to Bring When Exercising Outdoors

Let’s Move provides suggestions on what to bring when exercising outdoors, including (¹¹):

• A backpack
• Water (enough for everyone)
• Healthy snacks (e.g., apple, baby carrots, nuts, unsweetened dried fruit, whole-grain pretzels or crackers)
• Sunscreen
• Hat and/or sunglasses
• Rain gear
• Extra layers

Summertime provides many outdoor activity options. Multiple studies support the idea that being outdoors is a significant predictor of physical activity, and one study found being outdoors to be the most powerful correlate of physical activity (¹⁸). For some tips on what to bring when exercising outdoors, see Box 3. Web site resources for finding locations for outdoor activities include:

• https://mapofplay.kaboom.org/ (search tool to find parks and playgrounds)
• http://www.discovertheforest.org/ (search tool to find local parks and forests)
• http://www.stateparks.com/index.html (search tool to find a nearby state park)

CONCLUSIONS

The benefits of physical activity for children are wide ranging, including promotion of fitness and health along with potential improvements in cognition and academic performance. To encourage physical activity requires attention to the environment (playgrounds, parks) as well as other individual factors including self-efficacy, self-regulation, and personalized goals. Summer is a time with great potential for expanded activity, and intentional planning can provide for many opportunities for enhanced, rather than decreased, physical activity.