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Educating the Student Body
Many different types of physical activity—including aerobic activity, 
resistance training, yoga, dance, flexibility training, walking programs, 
and body building—have been shown to improve mood and other mental 
health indicators. The evidence is strongest for aerobic physical activ-
ity, particularly for reduction of anxiety symptoms and stress (Peluso 
and Guerra de Andrade, 2005; Dishman et al., 2006; Martikainen et al., 
2013), because more of these studies have been conducted (Peluso and 
Guerra de Andrade, 2005). One meta-analysis of RCTs concluded that 
physical activity interventions focused exclusively on circuit training had 
the greatest effect on mental health indicators, followed closely by inter-
ventions that included various types of physical activity (Ahn and Fedewa, 
2011). Among studies other than RCTs, only participation in sports had 
a significant impact on mental health (Ahn and Fedewa, 2011). The few 
studies that investigated the impact of vigorous- versus lower-intensity 
physical activity (Larun et al., 2006; Biddle and Asare, 2011) found no 
difference, suggesting that perhaps all levels of physical activity may be 
helpful. Among adults, studies have consistently shown beneficial effects of 
both aerobic exercise and resistance training. Ahn and Fedewa (2011) con-
cluded that both moderate and intense physical activity have a significant 
impact on mental health, although when just RCTs were considered, only 
intense physical activity was significant (Ahn and Fedewa, 2011). While 
physical activity carries few risks for mental health, it is important to note 
that excessive physical activity or specialization too early in certain types 
of competitive physical activity has been associated with negative mental 
health outcomes and therefore should be avoided (Peluso and Guerra de 
Andrade, 2005; Hallal et al., 2006). Furthermore, to reach all children, 
including those that may be at highest risk for inactivity, obesity, and men-
tal health problems, physical activity programming needs to be nonthreat-
ening and geared toward creating a positive experience for children of all 
skill and fitness levels (Amis et al., 2012).
Various types of physical activity programming have been shown to 
have a positive influence on mental health outcomes. Higher levels of atten-
dance and participation in physical education are inversely associated with 
feelings of sadness and risk of considering suicide (Brosnahan et al., 2004). 
Classroom physical activity is associated with reduced use of medication for 
attention deficit hyperactivity disorder (Katz et al., 2010). And participa-
tion in recess is associated with better student classroom behavior, better 
focus, and less fidgeting (Pellegrini et al., 1995; Jarrett et al., 1998; Barros 
et al., 2009).
Strong evidence supports the short-term benefits of physical activity for 
mental health. Acute effects can be observed after just one episode and can 
last from a few hours to up to 1 day after. Body building may have a simi-
lar effect, which begins a few hours after the end of the exercise. The ideal 

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Educating the Student Body: Taking Physical Activity and Physical Education to School
Relationship to Growth, Development, and Health
 
135
length and duration of physical activity for improving mental health remain 
unclear, however. Regular exercise is associated with improved mood, but 
results are inconsistent for the association between mood and medium- or 
long-term exercise (Dua and Hargreaves, 1992; Slaven and Lee, 1997; 
Dimeo et al., 2001; Dunn et al., 2001; Kritz-Silverstein et al., 2001; Sexton 
et al., 2001; Leppamaki et al., 2002; Peluso and Guerra de Andrade, 2005). 
Studies often do not specify the frequency and duration of physical activ-
ity episodes; among those that do, interventions ranged from 6 weeks to 
2 years in duration. In their meta-analysis, Ahn and Fedewa (2011) found 
that, comparing interventions entailing a total of more than 33 hours, 
20-33 hours, and less than 20 hours, the longer programs were more effec-
tive. Overall, the lack of reporting and the variable length and duration of 
reported interventions make it difficult to draw conclusions regarding dose 
(Ahn and Fedewa, 2011).
In addition to more structured opportunities, naturally occurring 
physical activity outside of school time is associated with fewer depres-
sive symptoms among adolescents (Penedo and Dahn, 2005). RCTs have 
demonstrated that physical activity involving entire classrooms of stu-
dents is effective in alleviating negative mental health outcomes (Ahn and 
Fedewa, 2011). Non-RCT studies have shown individualized approaches 
to be most effective and small-group approaches to be effective to a more 
limited extent (Ahn and Fedewa, 2011). Interventions have been shown 
to be effective in improving mental health when delivered by classroom 
teachers, physical education specialists, or researchers but may be most 
effective when conducted with a physical education specialist (Ahn and 
Fedewa, 2011). Many physical activity interventions include elements of 
social interaction and support; however, studies to date have been unable to 
distinguish whether the physical activity itself or these other factors account 
for the observed effects on mental health (Hasselstrom et al., 2002; Hallal 
et al., 2006). Finally, a few trials (Larun et al., 2006; Biddle and Asare, 
2011) have compared the effects of physical activity and psychosocial inter-
ventions, finding that physical activity may be equally effective but may not 
provide any added benefit.