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Vigorous-intensity physical activity:
Physical exertion that leads 
to sweating and heavy breathing, such as running, basketball, soc-
cer, and swimming laps; usually performed at or above an intensity 
of 6.0 times resting metabolic rate.
bACkGROUND AND STUDY CONTExT
Since before the early 1900s, schools have had a role in providing 
health care for youth (IOM, 1997). From the single school nurse perform-
ing inspections and injury treatment to the provision of screening, health 
education, and immunizations to today’s school-based health centers, 
schools have been important in providing health services to children. 
Throughout the history of school-based health care, access to children for 
large portions of the day has made schools practical and effective in pro-
viding these services (IOM, 1997). With the emergence of obesity as a key 
health threat for youth, schools are yet again being called on to take a lead 
role in the health of students. 

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Educating the Student Body: Taking Physical Activity and Physical Education to School
Introduction
 
19
As noted above, physical activity is an essential component of proxi-
mal and distal health indicators in youth (see Chapter 3). Recent efforts 
have led to an evidence-based guideline for physical activity in youth of 
at least 60 minutes per day, 7 days per week (Strong et al., 2005; Physical 
Activity Guidelines Advisory Committee, 2008) (see Box 1-1). Most of 
the 60 minutes per day should be spent in vigorous- or moderate-intensity 
activities. Further, vigorous physical activities, bone-strengthening activi-
ties, and muscle-strengthening activities should be included at least 3 days 
each week. Such activities should offer variety, be enjoyable, and be age 
appropriate.
Schools have long provided opportunities for physical activity to 
children and adolescents, most notably through physical education. Early 
school-based physical education efforts in the 19th century focused largely