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Preface
P
hysical activity is central to health, and its importance clearly extends 
beyond its role in achieving energy balance to prevent and treat 
obesity and overweight. Adequate daily physical activity improves cardio-
vascular health, metabolic health, brain and mental health, and musculo-
skeletal health—benefits that recent research shows are gained across the life 
span. Important emerging research has further focused on the association 
between physical activity in youth and academic achievement.
Clinical and public health guidelines indicate that youth need a mini-
mum of 60 minutes per day of vigorous- or moderate-intensity physical 
activity to optimize health and development. Because many youth spend 
a substantial amount of time in school, this report focuses specifically on 
the role schools can play in increasing physical activity among youth and 
providing opportunities to meet these guidelines. This role falls squarely 
within schools’ long-standing tradition of providing access to health-related 
services such as health screenings, nutrition programs, and immunizations. 
The assumption that school-based physical education can provide 
enough physical activity for children and adolescents has recently been 
challenged on a variety of fronts. First, the 60 minutes per day of physical 
activity that is health enhancing is nearly impossible to achieve through 
physical education, even with the highest-quality physical education cur-
riculum. Second, quality physical education must include time for teaching 
activities and lessons that may not be physically active. Third, political 
and economic pressures on education systems to improve standardized test 
scores have had the unintended consequence of reducing or eliminating 
physical education curricula and thus students’ opportunities for physical 

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Copyright © National Academy of Sciences. All rights reserved.
Educating the Student Body: Taking Physical Activity and Physical Education to School
x
 
Preface
activity. Therefore, the purpose of this report is to highlight the central 
need not only to provide quality physical education for all youth but also 
to implement other evidence-informed methods schools can use to help all 
children and adolescents attain a minimum of 60 minutes of vigorous- or 
moderate-intensity physical activity per day to improve health, develop-
ment, and academic performance. Many different constituents—including 
federal, state, district, and school administrators; teachers; parents; and 
all those interested in the health, development, and academic achievement 
of youth—must be reached with the message that such a whole-of-school 
approach to physical activity is needed.
Many people contributed to the successful completion of this project. 
First, the committee thanks Tina Kauh and the Robert Wood Johnson 
Foundation for supporting the study and the development of this report. 
The committee also wishes to thank participants in a public workshop held 
in September 2012 to gather expert opinion on this topic from leaders in 
the field: Michael Beets, Ph.D.; Becky Ciminillo; Don Disney, M.S., M.A.; 
Joseph Donnelly, Ed.D.; Erin Donoghue, M.Ed.; David Dzewaltowski, 
Ph.D.; Gillian Hotz, Ph.D.; Dolly Lambdin, Ed.D.; Melissa Maitin-
Shepard, M.P.P.; Noreen McDonald, Ph.D.; Thomas McKenzie, Ph.D.; Lisa 
Perry, M.Ed; Shellie Pfohl, M.S.; Abby Rose, M.Ed., M.A.; and Jennifer 
A. Weber, M.P.H., R.D. In addition, in December 2012, Katrina L. Butner, 
Ph.D., spoke with the committee during an open session, and we would like 
to thank her for her time.
I am most grateful to the volunteer expert committee members who so 
graciously gave time from their busy schedules to contribute to the comple-
tion of this task over such a short time period. The efforts of each member 
were extraordinary. Further, I appreciate the extensive consultative guidance 
from Terry T-K Huang, Ph.D., M.P.H., C.P.H., of the University of Nebraska 
Medical Center. Dr. Huang’s understanding of systems thinking helped 
shape the committee’s approach and this report in an innovative way.
This work could not have been completed without the outstanding 
support and guidance of the dedicated Institute of Medicine (IOM) staff, 
including Heather Del Valle Cook, study director; Lynn Parker, scholar; 
Emily Ann Miller, program officer; Sarah Ziegenhorn, research assistant; 
Allison Berger, senior program assistant; Sarah Sliwa, Christine Mirzayan 
Science and Technology Policy Fellow; and Linda Meyers, director of the 
IOM Food and Nutrition Board. Finally, the report greatly benefited from 
the copyediting skills of Rona Briere. I am grateful to each of these indi-
viduals for their patience and focus during the study process.
Harold W. Kohl III, Chair
Committee on Physical Activity and Physical 
Education in the School Environment

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Copyright © National Academy of Sciences. All rights reserved.
Educating the Student Body: Taking Physical Activity and Physical Education to School
xi
SUMMARY 1
1 INTRODUCTION 
15
Purpose of This Study, 16
Background and Study Context, 18
Study Approach, 21
Overview of the Report, 31
References, 32
2 STATUS AND TRENDS OF PHYSICAL ACTIVITY
BEHAVIORS AND RELATED SCHOOL POLICIES 
35
Physical Activity, 38
Status of Physical Activity Behaviors Among Youth, 38
Trends in Physical Activity Behaviors Among Youth, 63
State and Local Policies on School-Based Physical Activity, 69
Summary, 87
References, 89
3 PHYSICAL ACTIVITY AND PHYSICAL EDUCATION: 
RELATIONSHIP TO GROWTH, DEVELOPMENT, AND
HEALTH 97
Physical Health, 101
Psychosocial Health, 130
Mental Health, 132