Did your daughter work up a sweat playing basketball in gym class today or did she spend half the class hanging out on the bleachers? Most likely, physical education is not even part of her daily schedule.

A new review from Canada supports programs pushing more — and more active — physical education, both in gym class and throughout the school day.

“We have an issue of children not being physically active according to guidelines, that childhood overweight and obesity is increasing and that these habits track into adulthood and lead to cardiac disease,” said Maureen Dobbins, Ph.D., associate professor at the School of Nursing at McMaster University in Ontario, and lead author of the new systematic review of studies.

Along those lines, proposed legislation aims to increase the quality and quantity of physical education in U.S. schools.

“Schools have the responsibility of providing good physical education but parents may think locales are doing a lot more than what’s actually going on,” said Russell Pate, Ph.D., a spokesperson for the American Heart Association (AHA).

“Prevailing guidelines are that children should be active an hour a day, so 30 minutes should be in school,” he said. Instead, “a typical child gets about half the recommended physical activity dose in school — 15 minutes.”

“Activity levels are decreasing,” Pate said. “We’re in an obesity epidemic, with type 2 diabetes and cardiac risk factors at unacceptable levels in our children. At the same time, school PE programs are being eroded. This is a very unfortunate intersection.”

The new review appears in the latest issue of The Cochrane Library, a publication of The Cochrane Collaboration, an international organization that evaluates medical research. Systematic reviews like this one draw evidence-based conclusions about medical practice after considering both the content and quality of existing medical trials on a topic.

Dobbins and a team of researchers looked at 26 studies of school-based “multifaceted interventions focused on changing multiple risk behaviors associated with adult-onset cardiovascular disease…including physical activity, nutrition and smoking.”

Successful interventions led to modest increases in physical activity and aerobic fitness, as well as decreased TV viewing and blood cholesterol levels in school-age children.

In general, programs did not change physical activity rates outside of school or affect body mass index (BMI).

Gym teachers appear to be the best choice to run these programs: “Interventions that involved someone with specialized training in physical education had more positive outcomes then, say, a home room teacher or general education teacher,” Dobbins said.

Parents also are a big part of the fitness picture, and many programs sought to increase their involvement.

Programs tried to increase physical activity and health education beyond the realm of PE class, to encompass the entire curriculum; for example, by incorporating discussions on healthy eating and physical activity in science class. Other programs carried over into school cafeterias, which provided healthier food choices.

Dobbins said the review’s take-home message “is rethinking the school day so that there are more opportunities throughout the day for kids to be active.”

There was pushback by non-physical education staff, Dobbins said. “There was some reaction from teachers that there is already a full curriculum and finding the time and resources to also focus on physical activity and healthy eating can be difficult.”

This does not surprise AHA’s Pate: “Time and resources are huge issues. There are only so many hours in a school day, so many dollars in a school budget. Part of the issue is priorities. As a society we have to ask ourselves, what is most important for our children?”

All reviewed studies included a control group of school or schools that did not receive the intervention. Most studies took place in urban areas, with the majority in the United States, but also in Europe, Australia and Russia.

Elementary schools received the most attention, with programs ranging from five weeks to six ears. The study with the longest follow-up period found no initial improvement, but did see delayed effects.

In that study, “they intervened with these kids when they were very young,” Dobbins said. “Eleven years later, the researchers compared participants who did and did not have the intervention. As young adults, those who had received the intervention in childhood are now more physically active.”

The AHA supports passage of the Fitness Integrated with Teaching Kids (FIT Kids) Act, intended to amend No Child Left Behind with changes to improve physical and health education, including reporting requirements for schools, districts and states. “This legislation would bring a much higher level of scrutiny to the nation’s physical education program,” Pate said.

Dobbins M, et al. School-based physical activity programs for promoting physical activity and fitness in children and adolescents aged 6-18 (Review). Cochrane Database of Systematic Reviews 2009, Issue 1.

The Cochrane Collaboration is an international nonprofit, independent organization that produces and disseminates systematic reviews of health care interventions and promotes the search for evidence in the form of clinical trials and other studies of interventions.

Source: Health Behavior News Service