Taking a Whole-of-School ApproachRecommendation 1: District and school administrators,teachers, and parents should advocate for and create awhole-of-school approach to physical activity that fostersand provides access in the school environment to at least60 minutes per day of vigorous or moderate-intensityphysical activity more than half (> 50 percent) of whichshould be accomplished during regular school hours.• School districts should provide high-qualitycurricular physical education during which thestudents should spend at least half (> 50 per-cent) of the class-time engaged in vigorous ormoderate-intensity physical activity. All elemen-tary school students should spend an averageof 30 minutes per day and all middle and highschool students an average of 45 minutes perday in physical education class. To allow for flex-ibility in curriculum scheduling, this recommen-dation is equivalent to 150 minutes per week forelementary school students and 225 minutes perweek for middle and high school students.• Students should engage in additional vigorous ormoderate-intensity physical activity throughout theschool day through recess, dedicated classroomphysical activity time, and other opportunities.• Additional opportunities for physical activitybefore and after school hours, including butnot limited to active transport, before- andafter-school programming, and intramural andextramural sports, should be made accessible toall students.RationaleBecause the vast majority of youth are in schools for manyhours, because schools have important infrastructure andare critical to the education and health of children andadolescents, and because physical activity promotes healthand learning, it follows that physical activity should be apriority for all schools, particularly if there is an opportu-nity to improve academic achievement.Potential ActionsFor state legislatures and state departments of education,potential actions include• Adopting and/or strengthening physical edu-cation and recess policies so they align withexisting national recommendations for both totalnumber of weekly minutes of physical education,as well as requiring students to spend at leasthalf (> 50 percent) of the class-time doing vigor-ous or moderate-intensity physical activity.• Adopting and/or strengthening before- andafter-school program policies so they align withnational recommendations on physical activitystandards.• Adopting school siting policies that encourageschools to be located within residential neighbor-hoods.• Working with national and state-level parent-teacher organizations to mobilize and createengagement in this effort.For school districts and schools, potential actions include• Continuing to strengthen policies by requiringtime for physical education and recess that alignswith the national recommendations.RECOMMENDATIONS MAY 2013For more information visit www.iom.edu/studentbodyEducating theStudent BodyTaking Physical Activity andPhysical Education to SchoolThe committee’s recommendations for strengthening and improving programs and policies forphysical activity and physical education in the school environment—including before, during, and afterschool—were based on guiding principles. The principles included recognizing the benefits of instillinglifelong physical activity habits in children; the value of using systems thinking; the recognition ofcurrent disparities in opportunities and the need to achieve equity in physical activity and physicaleducation; the importance of considering all types of school environments; the need to considerthe diversity of students as recommendations are developed; the importance of practicality ofimplementation and accounting for the challenges and barriers that stakeholders face; and the need tobase recommendations on the best available scientific evidence and promising approaches.
2• Increasing the amount of time youth spend inphysical activity through brief classroom breaksor incorporating physical activity directly intoacademic sessions.• Offering intramural sports and physical activityclubs before or after school and helping suchprograms be accessible to all students.• Adopting joint or shared use agreements allow-ing school facilities to be used for physical activ-ity programs during nonschool hours.• Identifying key champions in schools to lead efforts.• Working with parent groups and parent-teacherassociations to create a demand for physicalactivity and mobilize this effort.For municipalities, local governments, and urban planners,potential actions include• Considering renovating schools already locatedin existing neighborhoods rather than buildingnew schools away from where students live.• Incorporating traffic calming (e.g., reduced speedlimits, speed humps or tables, sidewalks withbuffers, medians) and traffic control (markedcrosswalks, traffic lights with pedestrian signals)strategies into community planning to ensuresafe active travel routes for students.• Adopting school policies that encourage schoolsto be located within residential neighborhoods.Considering Physical Activity in AllSchool-Related Policy DecisionsRecommendation 2: Federal and state governments,school systems at all levels (state, district, and local), citygovernments and city planners, and parent-teacher organi-zations should systematically consider access to and provi-sion of physical activity in all policy decisions related to theschool environment as a contributing factor to improvingacademic performance, health, and development for allchildren.RationaleMany examples exist of effective and promising strategiesfor increasing vigorous and moderate-intensity physicalactivity in schools. The most thorough, yet often mostdifficult to implement, are multi-component interventionsbased on a systems approach that encompass both schooland community strategies.Potential ActionsFor states, school districts, schools, and school wellnesscommittees, potential actions include• Designating individuals or committees specifical-ly responsible for physical activity–related oppor-tunities and programs. An emphasis on physicalactivity is important and new enough that theseindividuals should not also be responsible forworthy but already well-established health-related behaviors such as nutrition or drug abuse.• Specifying objectives for vigorous and moderate-intensity physical activity during all segments ofthe school day (e.g., physical education, recess,classroom, transportation to and from school,before- and after-school programs).• Work with leading professional organizationsacross disciplines to emphasize the importanceof physical activity and encourage them to em-bed this priority into their national recommenda-tions or position statements.Designating Physical Education as aCore SubjectRecommendation 3: Because physical education is foun-dational for lifelong health and learning, the Department ofEducation (DOE) should designate physical education as acore subject.RationalePhysical education in school is the only sure opportunityfor all school-aged children to access health-enhancingphysical activity and the only school subject area thatprovides education to ensure that students develop knowl-edge, skill, and motivation to engage in health-enhancingphysical activity for life.Potential ActionsFor the DOE and federal and state public health agencies,potential actions include• Finding innovative application of physical educa-tion as a core subject in sample states or districtsto highlight and measure outcomes.For non-governmental organizations, potential actionsinclude• Developing advocacy materials and planning dis-semination of these materials to key stakeholders.Monitoring Physical Education andOpportunities for Physical Activity inSchoolRecommendation 4: Education and public health agenciesat all government levels (federal, state, and local) shoulddevelop and systematically deploy data systems to monitorpolicies and behaviors pertaining to physical activity andphysical education in the school setting, so as to provide afoundation for policy and program planning, development,implementation, and assessment.RationaleAside from a few good one-time surveys of physical activityduring physical education classes, remarkably little informa-tion is available on the physical activity behaviors of stu-dents during school hours or school-related activities. Even
3Providing Preservice Training andProfessional Development forTeachersRecommendation 5: Colleges and universities and con-tinuing education programs should provide preservicetraining and ongoing professional development opportuni-ties for K-12 classroom and physical education teachersto enable them to embrace and promote physical activityacross the curriculum.RationaleTeaching physical education effectively and safely requiresspecific knowledge about physical/mental development,body composition (morphology) and functions (physiol-ogy and biomechanics), and motor skill development andacquisition.Potential ActionsFor the DOE and local school districts, potential actionsinclude• Identifying exemplary training programs andhighlighting them as best practices.• Establishing requirements for competencies inphysical education and physical activity for pre-service and continuing education for all teachersand school administrators.Ensuring Equity in Access to PhysicalActivity and Physical EducationsRecommendation 6: Federal, state, district, and localeducation administrators should ensure that programs andpolicies at all levels address existing disparities in physicalactivity and that all students at all schools have equal ac-cess to appropriate facilities and opportunities for physicalactivity and quality physical education.RationaleAll children should engage in physical education and meetthe recommendation of at least 60 minutes per day ofvigorous or moderate-intensity physical activity regardlessof their region, school attended, grade level, or individualcharacteristics.Potential ActionsFor the DOE, state departments of education, and schoolboards, potential actions include• Conducting an inventory of facilities includingthe type, condition, safety, and availability andopportunities for physical activity across schoolsand districts to give insight on where improve-ments can be made to address disparities.the best public health monitoring systems do not obtainthis information.Potential ActionsFor the DOE and the Department of Health and HumanServices, potential actions include• Collaborating to ensure the availability andpublication of information about school physicalactivity–and physical education–related policiesand students’ physical activity behaviors.• Facilitating collaboration among state and districtdepartments of education and state and localhealth departments to obtain and publicize suchinformation.For federal agencies, specifically the Centers for DiseaseControl and Prevention (CDC), potential actions include• Continuing to improve the Youth Risk FactorBehavior Surveillance System (YRBSS) and Na-tional Health and Nutrition Examination Survey(NHANES) systems to capture more completelystudent school-related physical activity behaviors.• Developing tools suitable for use by schools andschool districts for monitoring students’ physicalactivity behaviors throughout the school day.• Providing training for state and local health de-partments and state and district school systemsas they endeavor to improve the monitoring ofschool-related physical activity behaviors andstudent achievement.For local school districts and schools in coordination withlocal health departments, state departments of education,and state departments of public health, potential actionsinclude• Regularly assessing student achievement ofphysical education standards and the physical ac-tivity behaviors of students during all segmentsof the school day.• Developing systems to collect and publicize theinformation collected by the local schools.• Augmenting existing monitoring systems for stu-dents’ physical fitness to include school-relatedphysical activity behaviors and student achieve-ment.• Utilizing current systems of collecting educa-tional information within schools and districts tomonitor the quality of physical education and theusual dose of physical activity for students duringschool hours, going to and from school, and atschool-related functions. Involving teachers indeveloping the most efficient ways to collect andprovide data needed for monitoring.• Involving wellness committee members andparents in the monitoring of opportunities forstudents to be physically active during physicaleducation, recess, classroom activities, travelingto and from school, and at school-related eventsbefore and after school.
The Institute of Medicine serves as adviser to the nation to improve health.Established in 1970 under the charter of the National Academy of Sciences,the Institute of Medicine provides independent, objective, evidence-based adviceto policy makers, health professionals, the private sector, and the public.Copyright 2013 by the National Academy of Sciences. All rights reserved.500 Fifth Street, NWWashington, DC 20001TEL 202.334.2352FAX 202.334.1412www.iom.eduCommittee on Physical Activity and Physical Education in theSchool EnvironmentHarold W. Kohl, III (Chair)Professor, University ofTexas Health ScienceCenter-Houston, School ofPublic Health, Division ofEpidemiology, Human Geneticsand Environmental Sciences,Michael & Susan Dell Centerfor Healthy Living; Departmentof Kinesiology and HealthEducation, University of Texas,AustinDarla M. CastelliAssociate Professor,Department of Kinesiology andHealth Education, University ofTexas, AustinAng ChenProfessor, Department ofKinesiology, University of NorthCarolina, GreensboroAmy A. EylerAssistant Professor, GeorgeWarren Brown School of SocialWork, Program of PublicHealth, Washington University,St. Louis, MissouriScott GoingInterim Department Headand Professor, Departmentof Nutritional Sciences, andDirector, Center for PhysicalActivity and Nutrition,University of Arizona, TucsonJayne D. GreenbergDistrict Director, PhysicalEducation and Health Literacy,Miami-Dade County PublicSchools, Miami, FloridaCharles H. HillmanProfessor, Departments ofKinesiology and CommunityHealth, Psychology, andInternal Medicine; Affiliate ofthe Neuroscience Program,Division of Nutritional Sciences,and the Beckman Institutefor Advanced Science andTechnology, University ofIllinois, Urbana-ChampaignPhilip R. NaderProfessor Emeritus ofPediatrics, Department ofPediatrics, School of Medicine,University of California, SanDiegoKenneth PowellRetired Chief, Chronic Disease,Injury, and EnvironmentalEpidemiology Section,Division of Public Health,Georgia Department of HumanResources, AtlantaLeah E. RobinsonAssociate Professor,Department of Kinesiology,Auburn University, AlabamaEmma Sanchez-VaznaughAssistant Professor, HealthEducation Department, SanFrancisco State University,CaliforniaSandy SlaterResearch Assistant Professor,Institute for Health Researchand Policy, University of Illinois,ChicagoNicolas StettlerSenior Managing Scientist,Health Sciences Center forChemical Regulation and FoodSafety, Exponent, Washington,DCGail Woodward-LopezAssociate Director, Dr. RobertC. and Veronica Atkins Centerfor Weight and Health,University of California,BerkeleyStudy SponsorThe Robert Wood Johnson FoundationHeather Del Valle CookStudy DirectorLynn ParkerScholarEmily Ann MillerProgram Officer (until January2013)Sarah ZiegenhornResearch Assistant (fromJanuary 2013)Allison BergerSenior Program AssistantAnton L. BandyFinancial AssociateGeraldine KennedoAdministrative AssistantLinda D. MeyersDirector, Food and NutritionBoardStudy StaffFor local school districts, school wellness committees, andother relevant local entities, potential actions include• Thoroughly reviewing existing physical activityopportunities and reducing barriers to access forall students, including, but not limited to, creationand maintenance of physical facilities and safetyof their use.