Presented to the Childhood Obesity WorkGroup at the Capitol in St. Paul

1. “…love of repose (rest) will lead, in its progress, to a suspension
of healthy exercise, a relaxation of mind, an indifference to
everything around you, and finally to a debility of body, and
hebetude (dullness) of mind.” Thomas Jefferson

2. Obesity Trends* Among U.S. Adults
BRFSS, 1985 (CDC)
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14%

3. Obesity Trends* Among U.S. Adults
BRFSS, 1986
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14%

4. Obesity Trends* Among U.S. Adults
BRFSS, 1987
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14%

5. Obesity Trends* Among U.S. Adults
BRFSS, 1988
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14%

6. Obesity Trends* Among U.S. Adults
BRFSS, 1989
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14%

7. Obesity Trends* Among U.S. Adults
BRFSS, 1990
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14%

8. Obesity Trends* Among U.S. Adults
BRFSS, 1991
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19%

9. Obesity Trends* Among U.S. Adults
BRFSS, 1992
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19%

10. Obesity Trends* Among U.S. Adults
BRFSS, 1993
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19%

11. Obesity Trends* Among U.S. Adults
BRFSS, 1994
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19%

12. Obesity Trends* Among U.S. Adults
BRFSS, 1995
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19%

13. Obesity Trends* Among U.S. Adults
BRFSS, 1996
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19%

14. Obesity Trends* Among U.S. Adults
BRFSS, 1997
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% ≥20%

15. Obesity Trends* Among U.S. Adults
BRFSS, 1998
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% ≥20%

16. Obesity Trends* Among U.S. Adults
BRFSS, 1999
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% ≥20%

17. Obesity Trends* Among U.S. Adults
BRFSS, 2000
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% ≥20%

18. Obesity Trends* Among U.S. Adults
BRFSS, 2001
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% 20%–24% ≥25%

19. Obesity Trends* Among U.S. Adults
BRFSS, 2002
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% 20%–24% ≥25%

20. Obesity Trends* Among U.S. Adults
BRFSS, 2003
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% 20%–24% ≥25%

21. Obesity Trends* Among U.S. Adults
BRFSS, 2004
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% 20%–24% ≥25%

22. Obesity Trends* Among U.S. Adults
BRFSS, 2005
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

23. Obesity Trends* Among U.S. Adults
BRFSS, 2006
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

24. Obesity Trends* Among U.S. Adults
BRFSS, 2007
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

25. Obesity Trends* Among U.S. Adults
BRFSS, 2008
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

26. Obesity Trends* Among U.S. Adults
BRFSS, 2009
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

27. Obesity Trends* Among U.S. Adults
BRFSS, 2010
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

28. Obesity epidemic in children and adolescents

29. THE OBESITY PROBLEM
Become Overweight/Obese Adults:
-27% of overweight 1-5 year olds
-43% of overweight 3-9 year olds,
-86% of overweight 10-13 year olds [American Journal of Public Health]
-By age 11 obesity is considered persistent
The Problems it Causes for Learners
Attendance
-Overweight MS students had 25% more absences and 39% more days tardy to school relative to
overweight students. Shore, et al.. “Decreased Scholastic Achievement in Overweight Middle School Students.” Obesity. 16 (2008): 1535-1538.
-Obesity associated with higher absenteeism in elementary students. Geier et al Obesity (2007) 15, 2157–2161;
Study of 1069 Philadelphia inner city 4th – 6th graders
Academic Achievement
-BMI inversely related to academic achievement
-Hillman & Castelli @ University of Illinois (2007) Journal of Sport & Exercise Psychology, 2007, 29, 239-252
Study of 259 3rd & 5th graders found higher BMI associated with lower standardized test scores
-Byrd et al (2007) The Impact of Physical Activity and Obesity on Academic Achievement Among Elementary Students
BMI of students affected the students’ performance in both reading and mathematics achievement.
-Faulkner et al (2001) 22% of obese boys and 16% of obese girls report being held back or repeating a grade
Behavior
-BMI inversely related to behavioral incidents
-Overweight kids are three times more likely more likely to have behavior problems (2003) Lumeng et al.
U of Michigan study or 755 8-11 yr olds as part of the National Longitudinal Survey of Youth using the Behavior Problems
Index
-Overweight and Obese students are more likely to be the target of bullying (2003) Ian Janssen, PhD

30. Toddler Obesity Lowers IQ
4 yr olds with early onset obesity have a 28 point lower IQ than their normal weight siblings

31. Quality PE Provides REDUCES Obesity
• Participation in PE and other physical activity
reduces the chances that adolescents will be
overweight as young adults.
– “Each weekday that adolescents participated in
physical education decreased the odds of being an
overweight adult by 5%, with participation in all 5
weekdays of physical education decreasing the odds
by 28%.”
Source: Menschik, D., et. al. “Adolescent Physical Activities as Predictors of Young Adult Weight.” Arch Pediatr
Adolesc Med. 2008;162(1):29-33. http://archpedi.ama-
assn.org/cgi/content/full/162/1/29?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&fulltext=menschik
&searchid=1&FIRSTINDEX=0&resourcetype=HWCIT

32. Physical Education Reduces the Risk
of Overweight and Obesity
• Participation in PE reduces the chances that adolescents
will become overweight adults.
– “Each weekday that adolescents participated
in physical education decreased the odds of
being an overweight adult by 5%, with
participation in all 5 weekdays of physical
education decreasing the odds by 28%.”
Source: Menschik, D., et. al. “Adolescent Physical Activities as Predictors of Young Adult Weight.” Arch Pediatr Adolesc
Med. 2008;162(1):29-33. http://archpedi.ama-
assn.org/cgi/content/full/162/1/29?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&fulltext=menschik&searchid=1&FIRSTI
NDEX=0&resourcetype=HWCIT

33. Physical education key to improving health
in low-income adolescents
Kristine A. Madsen, MD, MPH (2009) Released jointly by UCSF and UC Berkeley Archives of Pediatrics & Adolescent Medicine” Nov 2009
Findings
• Regular participation in PE class is significantly
associated with greater cardiovascular fitness
and lower body mass index.
“We took an incredibly comprehensive look at all of the opportunities kids have
throughout their day to engage in physical activity and determined which are the
most strongly linked to fitness and weight status.”
“ PE was by far the most significant predictor of
students’ fitness and was the only variable
associated with improved weight status.”
Engaging in at least 20 minutes of exercise during PE class was significantly
associated with both shorter mile times and lower body mass index scores.
Furthermore, as the students’ reported levels of enjoyment of PE increased, their
mile times decreased.

34. Lifestyle of Our Kids (LOOK) Study
Professor Dick Telford Australian National University Medical School American Journal Public Health Sept 2011
PE Class a Smart Move
Study: 850 8 yr old Australian schoolchildren were followed over a four year period. The
study compared children who participated in traditional daily sport activities with those who
received specialist education in general fitness skills such as coordination, balance and
strength
Results:
Reduction of Body Fat in the PE Group
The study found that pupils in the physical education classes lost an average of 0.25kg of body
fat over two years (considered significant for 8- to 10-year-olds)
Increase in Standardized Test Scores in PE Group
Improved their NAPLAN scores by 10 points more than those who participated in sports only

35. Daily Physical Education and Physical Activity Reduces
Obesity and Overweight
University of Texas Elementary School, Austin TX FOX News Report (Nov 14, 2011)
UT Elementary’s Healthy Families Initiative:
-150 minutes (minimum) of weekly physical activity
-Individualized wellness plans based on students’ needs
-RTI (Response to Intervention) model applied to student health
-Monthly Family Nights
-Student Garden that yields produce for lunch program
Results:
After three years: Obesity and overweight dropped from 62% to 48% (a reduction of 23%)
Each year the reduction has been an even 5%
Goal:
Student body @ 5%

36. NYC Vital Signs
A Special Report from the New York City Health Department and the New York City
Department of Education – June 2009 Volume 8, No. 1
Childhood Obesity is a Serious Concern in New York City
Higher Levels of Fitness Associated with Better Academic Performance
STUDY:
The New York City DOHMH and DOE reviewed academic and fitness records of the 600,000
public school students in grades K-8 who participated in the NYC FITNESSGRAM program during
the 2007-2008 school year.
FINDINGS:
21% obese and 18% overweight (national average: 17% and 14%)
Obese and overweight students are less physically fit:
Healthy weight students score in the 56 percentile for fitness
Overweight students score in the 49th percentile
Obese students score in the 40th percentile
Academic test scores increased with higher NYC FITNESSGRAM scores across all racial
and ethnic groups
Students’ academic test scores increase with physical fitness scores across all weight
categories

37. Swedish Military Study
Cardiovascular fitness is associated with cognition
in young adulthood Aberg, Maria, A. I., et al.
PNAS (Proceedings of the National Academy of Sciences) December 8, 2009 vol. 106 no. 49 20906-20911 Edited by Fred H. Gage, The Salk
Institute for Biological Studies, San Diego, CA, and approved October 16, 2009
STUDY: Compared the relationships between cardiovascular fitness and intelligence.
Cohort study of all Swedish men born in 1950 through 1976 who were enlisted for military service at age 18
(N = 1,221,727). Of these, 268,496 were full-sibling pairs, 3,147 twin pairs, and 1,432 monozygotic twin pairs.
Grades, test scores, and information on physical fitness were analyzed at age 15 and 18 on all subjects.
RESULTS
1 - Cardiovascular fitness positively associated with intelligence
2 - Cardiovascular fitness changes between age 15yrs and 18 yrs
predicted cognitive performance at 18 yrs
Those with increased fitness between 15 and 18 y of age exhibited significantly higher global
intelligence scores than those with decreased fitness. Similar results were obtained for
logical, verbal, visuospatial, and technical scores.
3 - Cardiovascular fitness at age 18 yrs predicted higher socioeconomic
status and educational attainment later in life.

38. Cardiovascular Fitness Declines during the School Years
“Fitness levels declined with each passing grade level, corresponding with decreasing
emphasis on physical education in upper grades.” Texas Youth Fitness Study Findings
Positive correlation between physical activity and 7 categories of
cognitive performance – Sibley (2003)
-perceptual skills, IQ, achievement, verbal test scores, math test scores,
developmental level, academic readiness Pediatric Exercise Science
Exercise improves the rate of learning – Cotman
-rate of learning directly correlated to BDNF levels (BDNF produced by exercise)
Exercise increases executive function –
Exercise creates a better response to errors – Hillman
- “Flanker Test” results show a positive response to errors made
Exercise makes the body more adept in responding to mental
challenges - Dienstbier 1989
Exercise reduces stress – elevates mood
“Exercise is like a little Ritalin and a little Prozac.” Dr. John Ratey Harvard Medical school
Complex movement increases executive function

39. Fitness: the Key to Academic
Achievement
“Give about two of them [hours] every day to exercise; for health must
not be sacrificed to learning. A strong body makes the mind strong.”
Thomas Jefferson
California Dept. of Education Study (2001)
Direct Correlation between level of Fitness and SAT scores
STUDY: Approximately one million California school children had their Stanford
Achievement Test (SAT) scores compared with their Fitnessgram fitness scores
which are comprised of 6 components.
RESULTS: With each fitness test passed the level of academic
achievement also improved.
Delaine Eastin Superintendent of Public Instruction California Department of Education (CDE)
• SACRAMENTO, CA "This statewide study provides compelling evidence that the
physical well-being of students has a direct impact on their ability to achieve
academically," said Eastin. "We now have the proof we’ve been looking for: students
achieve best when they are physically fit. Thousands of years ago, the Greeks
understood the importance of improving spirit, mind, and body. The research
presented here validates their philosophic approach with scientific validation.”

40. 2001 Grade 5 SAT 9 and Physical Fitness Scores
• Higher academic achievement is
80 71 associated with higher levels of
SAT 9 Percentile
70
60 50
58 55 fitness in grade 5,7,9.
46
•
50 45
40
29
36 32
40 36 40
The relationship between
30
20
academic achievement and fitness
10 in grade 5,7,9 was greater in
0
1 2 3 4 5 6
mathematics than in reading,
Number of Fitness Standards Achieved particularly at high fitness levels.
Reading Mathematics
2001 Grade 7 SAT 9 and Physical Fitness Scores Grade 9 SAT 9 and Physical Fitness Scores
70 66 80
60 67
SAT 9 Percentile
SAT 9 Percentile
60 54 70 58
50 60
50 51
4144 50 43 45
40 3132 3436 35 38 37
2628 40 28 31
30 30 24
21
20 20
10 10
0 0
1 2 3 4 5 6 1 2 3 4 5 6
Number of Fitness Standards Achieved Number of Fitness Standards Achieved
Reading Mathematics Reading Mathematics

41. Texas Youth Fitness Study
• A Texas study shows similar positive results. The study
of 2.4 million Texas students in grades 3-12 during the
2007-2008 academic year compared level of physical
fitness to academic and related indicators.
“Significant associations were consistently found between
physical fitness and various indicators of academic
achievement, specifically:
• Academic Performance (TAKS) – Higher levels of fitness are
associated with better academic performance.
• School Attendance – Higher levels of fitness are associated with better
school attendance.
• School Incidents – Higher levels of fitness are associated with fewer
negative school incidents [including incidents involving drugs, alcohol,
violence and truancy].”
Source: Cooper Institute and the Texas Education Agency. March 2009. http://www.cooperinstitute.org/ourkidshealth/

42. Daily Physical Education and Physical Activity Changes
Fitness, Academics, and Behavior
Anthony Elementary in Leavenworth, Kansas Edutopia (Dec/Jan 2006)
In 2004 Anthony increased PE and PA from one to five days a week, revamped their school lunch
program, and added vitamins to the daily menu. Anthony had three remarkable changes in one year:
1. There was a 1300+% increase in those passing the fitness test.
2. They went from 10th in Reading and 9th in Math (in a district with 10
elementary schools) to 2nd in Reading and 1st in Math.
3. Office referrals for discipline were reduced from 438 to 18.
Anthony Elementary in Leavenworth, KS
In 2004 Anthony increased PE and PA from once to five days a week. They went from 10 th in Reading and 9th
in Math (in a district of 10 schools) to 2 nd in Reading and 1st in Math. Their disciplinary office referrals dropped
from 438 to 18. The number of students passing the Presidential Fitness Test increased by over 1300%.
Reading Assessment
YEAR UNSATISFACTORY ADVANCED EXEMPLARY
2002 25.9% 0% 7.4%
2003 25% 19.4% 8.3%
2004 11.1% 33.3% 18.5%
Math Assessment
YEAR UNSATISFACTORY ADVANCED EXEMPLARY
2002 40.5% 5.4% 2.7%
2003 27.3% 18.2% 3.0%
2004 0% 23.8% 47.6%

43. Daily Physical Education Transforms Schools
Naperville Central High school (Ill.)
Daily PE for all students
9th grade 3% overweight /obese vs (National Ave: 32%)
Graded on time in target heart rate zone
TIMMSS Test (Trends in International Mathematics and Science Study) Results:
Asian countries have nearly 50% of their students score in the top tier / US students – 7%
Naperville Central’s results:
Science: #1 in the world
Math: #6 in the world
Titusville Schools (Pennsylvania) SPARK p32
1999-2000:
Reading: Below state average on standardized tests
Math: Below state average
2000-01:
Lengthened school day
Reduced academic time to make room for daily PE
2000-2001 RESULTS:
Reading 17% above state average
Math 18% above state average
No middle school fights since the program began

44. Recommendations vs. Reality
NASPE & CDC Recommendations for PE
• Elementary School: 150 minutes per week
• Middle school & High School: 225 minutes per week
Reality
A recent CDC report found daily PE in only:
• 4% of elementary schools
• 8% of middle schools
• 2% percent of high schools
Physical activity in children is declining
- Fewer than 1 in 4 children get 20 minutes of vigorous physical activity per week
- Over one-third of adolescents aged 12 to 17 are physically active less than 3 out
of 7 days a week.
- Nearly 10% of students in grades 9-12 participate in no vigorous or moderate
physical activity on a weekly basis.
“Cutting off physical exercise – the very activity most likely to promote
cognitive performance – to do better on a test score is like trying to
gain weight by starving yourself.”
Dr. John Medina: Developmental molecular biologist / professor of bioengineering @ the University of Washington School of Medicine /
Director of the Brain Center for Applied Learning Research @ Seattle Pacific University

45. Exercise Makes the Brain Learning Ready
Brain after sitting quietly Brain after 20 minute walk
Average composite of 20 students brains taking the same test
Research/scan compliments of Dr. Chuck Hillman University of Illinois

46. Learning Readiness
THE EFFECT OF ACUTE TREADMILL WALKING ON COGNITIVE
CONTROL AND ACADEMIC ACHIEVEMENT IN PREADOLESCENT
CHILDREN Hillman et al 2009
Study:
20 normal functioning preadolescent children were tested after a 20 minute bout of moderate
(60% maxHR) treadmill walking and after a 20 minute sedentary period on brain activity (event-
related brain potential – ERP) and applied aspects of cognition (response accuracy and academic
achievement).
Results:
Participants scored a full grade level higher in reading
comprehension after PA than after a period of rest.
PA increased response accuracy and ERP levels.
“As demonstrated from previous literature, this study indicated that, after a 20 minute bout of PA,
children scored higher on multiple assessments of cognition and academic performance as
compared to a 20 minute rest period. Specifically, children performed significantly better in reading
comprehension, with participating children scoring approximately a full grade level higher in
reading comprehension after PA than after a period of rest.”