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Cardiovascular disease outcomes A systematic review of 26 school-
based physical activity interventions documents good evidence that they 
exerted positive effects on blood cholesterol (as measured in 7 studies), but 
there was no evidence of effects on systolic (measured in 10 studies) and 
diastolic (measured in 9 studies) blood pressure (Dobbins et al., 2009). In 
the CATCH intervention, investigators observed no significant differences 
in blood pressure or cholesterol measures between control and treatment 
groups (Luepker et al., 1996).
Policies
Physical education policies, if adequately worded and incorporating 
mechanisms for monitoring compliance, have the potential to increase 
physical activity levels among school-age children across the nation. As 
discussed in Chapter 5, however, only a few state policies require a specific 
number of minutes of physical activity in physical education (or during 
school), the language in many of these policies is not strong enough, and 
monitoring for policy compliance is lacking (Carlson et al., 2013).

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Educating the Student Body: Taking Physical Activity and Physical Education to School
The Effectiveness of Physical Activity and Physical Education Policies and Programs
 
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Examining the impact of various physical activity opportunities dur-
ing the school day on daily physical activity among youth, Bassett and 
colleagues (2013, p. 110) conclude that “policies mandating daily physical 
education may have the greatest impact on physical activity of U.S. youth.” 
Further, a study based on a nationally representative sample of elemen-
tary schools found that schools located in states with a policy requiring 
150 minutes per week of physical education were 180 percent more likely 
to report having provided that many minutes per week of physical educa-
tion relative to schools in states with no policy on physical education time 
(Slater et al., 2012). This study also documented a significant association 
between school district–level policies related to physical education time and 
a higher likelihood of schools providing 150 minutes of physical education 
per week.
A commonly cited barrier to implementing physical education to the 
recommended extent is lack of time during the school day. There is some 
evidence for the effectiveness of unique scheduling options that can 
overcome this barrier (see Chapter 5).
Conclusion 
The body of evidence that has accumulated over the past two decades 
documents significant effects of school-based physical activity interventions 
on and associations of physical education policies with frequency and dura-
tion of physical activity, total activity, and levels of vigorous- or moderate-
intensity physical activity among children and adolescents (Luepker et 
al., 1996; Nader et al., 1999; Gordon-Larsen et al., 2000; Kahn et al., 
2002; Cawley et al., 2007; Barroso et al., 2009; Dobbins et al., 2009). 
Evidence concerning the associations between school-based physical activ-
ity interventions and BMI, overweight, and obesity is less clear, and these 
associations merit further investigation. Evidence is generally consistent 
that school-based physical activity interventions exert positive influences 
on fitness levels (Kahn et al., 2002; Dobbins et al., 2009) among students 
overall. However, there has been a paucity of research on the influence of 
compliance with physical education policy on students’ physical fitness 
levels (Sanchez-Vaznaugh et al., 2012) or whether this influence varies 
across race/ethnicity, gender, socioeconomic status, and locations. The lack 
of research in this area is due in part to the absence of data with which to 
study these questions. Data on the quality and quantity of physical activity 

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