- Open Access
Important considerations when studying the impact of physical education on health in youth
© Cañadas et al.; licensee BioMed Central Ltd. 2014
- Received: 10 October 2013
- Accepted: 10 March 2014
- Published: 15 April 2014
Klakk et al. conducted an intervention study by increasing the frequency of physical education lessons in children aged 8 to 13 years, and they examined its effect on body fat during two school years. Physical education has potential to provide health in childhood and adolescence. For achieving these benefits, one of the most relevant aspects that need to be addressed during physical education classes is to provide students with high levels of physical activity. A well-recognized recommendation suggests that students should engage in moderate to vigorous physical activity for at least 50% of the time they spend in physical education classes. Therefore, it would be crucial to know what is happening during physical education classes before increasing their frequency. On the other hand, it seems that the main concern of health-related researchers is provide evidence on the impact of physical education on physical health outcomes (e.g. obesity), whereas other dimensions of health such as social, emotional, intellectual, and spiritual health are understudied. New evidence on the role of physical education on other health outcomes beyond physical health would also be important for the recognition of this curricular subject.
- Physical education
- Physical activity
By Heidi Klakk, Niels Wedderkopp and Lars Bo Andersen.
Thank you for the interest in our study – The CHAMPS study-DK.
The CHAMPS study-DK was an evaluation of a natural experiment, where a Danish municipality decided to establish sports schools with a tripling of physical education (PE) lessons, corresponding to six PE lessons per week. Given the nature of a natural experiment, the researchers had no influence or control of the content and intensity of the PE lessons besides the anticipation, that the teachers followed the age-related concept as taught to them in workshops during the first school year. The intention of introducing that concept was to enhance children’s joy of moving and their physical health, by improving their motor performance and fitness. Other researchers in the group currently prepare for publications on the effect on fitness, activity level and motor performance.
As put forward by Cañadas et al. it could be questioned whether substantial increase in the frequency of PE lessons without knowing/demanding an increase in intensity level would have the potential to actually lead to health benefits.
Preliminary analysis of physical activity (PA) levels (assessed with the GT3X Actigraph accelerometer) in schools and between schools in the CHAMPS study-DK show that PE lessons is the domain with the highest activity levels during the child’s school day. The intensity of PA in the PE lessons did not differ significantly between school types in our study, but tripling the duration of that domain – in a mandatory way – proved to be enough to have an impact on the children’s body composition expressed as prevalence and incidence of being overweight  and furthermore the level of cardio-vascular risk factors .
At neither intervention nor control schools the proportion of time spent in moderate-to-vigorous physical activity (MVPA) in PE lessons did not, with the chosen intensity and age related thresholds, exceed 50% as Cañadas et al. propose as an operational goal for PE lessons based on data from the CATCH study .
The observed health affects in the CHAMPS study-DK might to some extend be explained by a metabolic fitness effect despite intensity level and/or that the suggested operational goal (>50% of the time spent in MVPA) is not valid. In the CATCH study from 1996, PA levels were self-reported and/or observed. In a review on measurement issues, Ekelund et al.  conclude that there is low-to-moderate correlation (r =0.3-0.4) between self-reported and objectively measured PA levels and that intensity and duration might be overestimated by 72%. Furthermore Ekelund et al. stated that even with a more precise and objective measure of PA levels such as accelerometers, the proportion of children meeting a certain criteria (ie accumulation of >60 min of MVPA per day, or more than 50% of the time in PE spent in MVPA) vary considerably (from 1% to 100%). This variation is largely explained by the use of different intensity thresholds when defining MVPA . Consequently it seems, that defining sufficient proportions and intensity levels of PE lessons is still a scientific challenge, even when PA levels are objectively measured.
Our findings are supported by studies on health benefits of cycling as it has been shown that high frequency (twice a day) with even shorter bouts (10–15 minutes) of MVPA can have beneficial health effects in children with or without changing their cardiorespiratory fitness [11, 12].
In summary we therefore still put forward that, in the CHAMPS study-DK, a substantial increase in the frequency of PE lessons, regardless of knowing the intensity levels, did have a considerable and valuable public health effect in healthy children.
We do agree, that other aspects of children’s well-being are important as well, but was not the scope of this publication. The CHAMPS study-DK is an on-going cohort study (until now 6 years of follow up) and measurements of cognition, implementation and sustainment are planned for, but not yet completed.
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- The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1471-2431/14/75/prepub
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