Physical fitness and academic performance in middle school students

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1 Acta Pædiatrica ISSN REGULAR ARTICLE Physical fitness and academic performance in middle school students Ronald W Bass Dale D Brown, Kelly R Laurson, Margaret M Coleman Illinois State University, School of Kinesiology and Recreation, Bloomington, IL, USA Keywords Academic achievement, Aerobic capacity, Middle school, Neurocognitive, Physical fitness Correspondence Ronald W Bass, Bloomington Junior High School, 901 N. Colton, Bloomington, IL 61701, USA. Tel: ext. 223 Fax: Received 15 January 2013; revised 21 March 2013; accepted 24 April DOI: /apa ABSTRACT Aim: The purpose of this study was to determine whether physical fitness is linked to academic success in middle school students. Methods: The FITNESSGRAM test battery assessed students (n = 838) in the five components of health-related fitness. The Illinois Standardized Achievement Test (ISAT) was used to assess academic achievement in reading and math. Results: The largest correlations were seen for aerobic fitness and muscular endurance (ranging from 0.12 to 0.27, all p < 0.05). Boys in the Healthy Fitness Zone (HFZ) for aerobic fitness or muscular endurance were times more likely to pass their math or reading exams. Girls in the HFZ for aerobic fitness were approximately 2 4 times as likely to meet or exceed reading and math test standards. Conclusion: Aerobic capacity and muscular endurance seem to positively affect academic achievement in middle school students. INTRODUCTION Concerns for the overall health, physical fitness, well being and academic achievement of children are at an all time high. Obesity in children has risen, although it appears to be stabilizing, and physical fitness scores have declined (1 3). Academic achievement scores are falling as well as marks for health and well being (1 5). However, these parameters are often treated as although they are unrelated. Recent research is beginning to establish the link between physical and cognitive variables with data showing that physical activity (PA) is not merely coincidentally related to cognitive function (6 13). The ability of the brain to adapt, adjust and respond to a new situation, environment or stress is referred to as brain plasticity (6,12) which may be impacted by chronic PA (14). In addition to the role exercise plays in effecting brain plasticity, PA is important for cognitive development, mood state, memory, learning and concentration (6,12,14 16). With evidence of exercise effecting cognition, there have been a small number of studies that have shown a relationship between physical fitness and academic achievement (8,10,11,13,17). As a result of these recent findings, the need for increased PA in children and adolescents may be critical for the reversal of current disease trends and also for the improvement of academic achievement. Even with the current trends in childhood obesity and the evidence of the benefits of exercise, only a minute number of states in the United States mandate physical education (PE) for all school children Kindergarten-12th (K-12 grade, ages 5-18) (18). Perhaps the most significant opportunity for K-12 students to engage in meaningful PA is in a quality PE programme. Instead, recommendations continue for the reduction or elimination of PE, so that more time and focus can be placed on other academic areas. Two main factors contribute to calls for reduction in PE programmes. One is an increased emphasis placed on schools to perform well on standardized academic achievement tests, forcing schools to direct resources to the classroom to better academic test scores. Second is the reduction in economic resources available to schools. Research indicates that time engaged in PA, thus taking away classroom time, does not hamper academics (5,7,8,17,19). This points to the importance of physical fitness to the learning process, resulting in better academic achievement test scores (7,8,10,11,13). As a result, academic achievement may improve because of increased quality PE and PA programmes. Of the small number of studies that have been completed on PA and academic achievement, only a few have examined the relationship between obesity, standardized fitness assessments and academic achievement scores. However, those studies were of limited sample size for the age groups included with rather incomplete data sets thereby limiting the strength of the conclusions and Key notes This study examines the relationship between physical fitness and academic achievement in middle school students. In this study, logistic regression and correlation were used to compare academic achievement test data with physical fitness test data. Aerobic capacity and muscular endurance seem to positively affect academic achievement in middle school students Foundation Acta Pædiatrica. Published by John Wiley & Sons Ltd , pp

2 Bass et al. Physical fitness and academic performance recommendations. Additional research is needed to examine each component of physical fitness and its effect on academic achievement in middle school students. By understanding which fitness component/s effect academic achievement allows educators to understand the importance of PE and PA programmes in support of academics but also the components of physical fitness for schools to focus on as there resources may be limited. The purpose of this study was to examine the relationship between obesity, physical fitness and academic achievement scores in a large sample of middle school students. Unique to this study is the large sample size and the numerous variables that were collected. Specifically by including five health-related components of fitness, the aim was to examine the relationship between various dimensions of fitness and academic achievement to determine whether certain individual components of fitness were more strongly related to academics than others. METHODS Participants were students from a public middle school (grades 6 8) in central Illinois. Approximately 1200 students were enrolled in the school at the time of the study. Only students completing all of the required assessments were included in the final data set. Students that were missing demographic information, physical fitness or academic test results, and those that had physician-directed PE waivers were excluded from the study. Therefore, the available sample size for the study was 838. Race/ethnicity information could not be attained for individual students; however, the district reported the school-level background of the students to be White people 59.5%; Black people 23.2%; Hispanic 7.8%; Multiracial/ethnic 6.9%; Asian/ Pacific Islander 2.4%; and Native American 0.3%. Participation in the National School Lunch Programme, providing free or reduced lunch to economically disadvantaged students, was used as an indicator for socio-economic status (SES). At the time of data collection, the school district reported a school-level 50.0% low-income rate. Given the type of research and that the data associated with this project were secondary, de-identified data were used by the Institutional Review Board which approved this investigation and declared the study to be exempt from the usual requirement of obtaining written informed consent and ascent forms for subject participation. Additionally, approval was granted by the administration of the involved school with the protocols and procedures following the guidelines set forth in the policies for the school regarding the use of student data from approved research projects. FITNESSGRAM physical fitness test battery In this particular district, PE participation was required five days per week, except for those students receiving medical waivers. All PE classes were taught by full-time certified PE teachers (n = 6), averaging 19 years of experience. Students enrolled in PE were assessed twice a year using the FITNESSGRAM assessment battery with a pretest conducted in October and a post-test in March. The March test results were used for data analysis. The fitness tests were conducted over the course of six class periods. All tests were administered and overseen by the PE staff who have been trained in FITNESSGRAM (20) and have been administrating these tests as a group for 8 years. The tests were demonstrated, so students could practice and familiarize themselves with the test prior to the date of the assessment. Teachers and peers provided the participants with encouragement throughout the tests. FITNESSGRAM is a criterion-referenced test battery endorsed by the American College of Sports Medicine (21) that has been found to be both valid and reliable in assessing the five main components of physical fitness (body composition, aerobic capacity, muscular strength, muscular endurance and flexibility) when conducted by trained physical educators (20). The FITNESSGRAM ageand sex-specific testing standards categorize youth into groups as needs improvement (failing to meet criterion standard) or Healthy Fitness Zone (HFZ; meeting or exceeding criterion standard) (21). The Progressive Aerobic Capacity Endurance Run (PACER) was used to assess aerobic capacity. Muscular strength and muscular endurance were assessed using the push-up test and one-minute curl-up test, respectively. The back-saver sit and reach was used as an assessment of flexibility (results were averaged between the right and left legs). For body composition, two tests were used. Stature (metres) and mass (kilograms) were measured, and then, Body Mass Index (BMI) was calculated as body mass divided by stature squared. Additionally, body fat percentage was assessed using a Tanita bioelectrical impedance analyzer (TBF 300A, Arlington Heights, IL, USA). Academic performance The Illinois Standards Achievement Test (ISAT) was used to test students in the content areas of reading and math for all three grades. The ISAT is a required test and taken annually by public school students to serve as notification of performance and progress. The test was taken during the morning hours in the first two weeks of March, coinciding with the post-test fitness assessment. Each testing session consisted of 40-min intervals and questions included multiple choice and extended response in math and reading. Each content area was based on a scale ranging from 120 to 410, and students are categorized as exceeds standards, meeting standards, below standards or academic warning (22). With regard to data analysis, the physical fitness test results were the independent variables, and academic test results were the dependent variables. Descriptive statistics were calculated for girls, boys and all students combined. A one-way analysis of variance was used to examine differences in continuous scores for the fitness and academic scores between the sexes. Chi-square tests were used to identify significant differences between boys and girls with regard to meeting/not meeting the selected thresholds for physical fitness and academic tests. Pearson correlations 2013 Foundation Acta Pædiatrica. Published by John Wiley & Sons Ltd , pp

3 Physical fitness and academic performance Bass et al. (controlling for age) were used to analyse the relationship between the continuous fitness and academic test scores in boys and girls, separately. However, as both the fitness and academic tests have clearly defined cut points associated with them, logistic regression was utilized to indicate whether students in the various FITNESSGRAM HFZs were more or less likely to meet or exceed ISAT reading and math test standards than students who failed to attain the HFZ. Initially, univariate models were used to identify the crude odds ratio between fitness and academic success. Finally, an adjusted logistic model, controlling for age and SES, was used to determine the relative strength of the association between fitness and academic scores. All analyses were conducted separately for boys and girls using SPSS version 17 (SPSS Inc., Chicago, IL, USA). Alpha levels were set at p 0.05 to indicate statistically significant results. RESULTS Descriptive statistics are reported in Table 1. Of the 838 middle school students, 52.9% were female, and the mean age approximated 13 years. Overall, 47.1% of students participated in the federal free/reduced lunch programme, indicating a relatively diverse SES within the sample. Although not included in Table 1 the grade level, the sample represented 307 (36.6%), 254 (30.3%) and 277 (33.1%) students in 6th, 7th and 8th grades, respectively. The mean BMI was 21.2 (5.3) and 21.9 (5.2) for boys and girls, respectively. This corresponds to a BMI percentile of 63.0 (32.7) and 67.1 (29.0) for boys and girls, respectively. Table 2 shows the percentage of students meeting or exceeding the physical fitness test standards Table 1 Descriptive statistics Variable Boys (n = 395) Girls (n = 443) Total (n = 838) Age (years) 13.1 (0.9) 13.1 (1.0) 13.1 (1.0) Height (cm) (10.6) (7.5) (9.1) Weight (kg) 55.1 (17.8) 56.0 (15.5) 55.5 (16.6) Participate in free/ 43.8% 50.1% 47.1% reduced lunch programme (%) Body Mass Index 21.2 (5.3) 21.9 (5.2)* 21.5 (5.2) (kg/m 2 ) Body fat 16.7 (10.2) 26.3 (10.2)* 21.8 (11.2) percentage (%) Pacer laps 46.1 (23.9) 32.5 (17.0)* 38.9 (21.6) Curl-ups 59.1 (25.7) 49.2 (26.1)* 53.8 (26.4) Push-Ups 22.1 (14.6) 13.0 (8.5)* 17.3 (12.6) Sit and reach (cm) (3.0) 12.4 (3.2)* 11.6 (3.2) ISAT: Reading (26.2) (24.3)* (25.3) ISAT: Math (30.1) (28.6) (29.3) Values are mean (standard deviation) or percentages. Sit and reach = average of left and right legs; ISAT, Illinois Standards Achievement Test. *Significant difference between the sexes (p < 0.05). Table 2 Percentage of students meeting/exceeding physical fitness or academic standards Variable Boys (n = 395) Girls (n = 443) Total (n = 838) Physical fitness tests BMI 71.1% 75.4% 73.4% Body fat (%) 81.3% 72.9%* 76.8% Pacer laps 64.8% 79.7%* 72.7% Curl-ups 91.1% 90.3% 90.7% Push-ups 82.3% 72.9%* 77.3% Sit and reach 87.1% 85.1% 86.0% Academic tests ISAT: Reading 76.7% 85.3%* 81.3% ISAT: Math 85.6% 85.3% 85.4% Values represent percentage of students in FITNESSGRAM Healthy Fitness Zone (HFZ) or percentage of students meeting or exceeding Illinois Standards Achievement Test (ISAT) criterion. BMI, Body Mass Index. *Percentages between boys and girls are significantly different (p < 0.05). (FITNESSGRAM HFZ) and ISAT academic standards. In general, the majority of students met or exceeded standards for all tests. Approximately 65 91% of students tested met or exceeded the HFZ for physical fitness tests, and 77 86% met academic standards. However, more boys met the standards for per cent body fat and push-ups than girls. In contrast, a larger percentage of girls met the standards for the Pacer and reading tests. Results of correlational analysis are presented in Table 3, separated by sex. In general, correlations were low in strength for both boys and girls, indicating weak relationships between continuous physical fitness tests and academic results. In boys, correlations between body composition and academic tests ranged from 0.08 to In contrast, the same correlations were smaller and Table 3 Partial correlations between physical fitness and academic tests Fitness test Academic tests Reading Math Reading + Math Boys (n = 395) BMI Body fat (%) Pacer laps Curl-ups Push-ups Sit and reach Girls (n = 443) BMI Body fat (%) Pacer laps Curl-ups Push-ups Sit and reach Adjusted for age. BMI = Body Mass Index. Bolded correlations are statistically significant, p < Foundation Acta Pædiatrica. Published by John Wiley & Sons Ltd , pp

4 Bass et al. Physical fitness and academic performance non-significant for girls. The largest correlations (although still low in strength) were seen for aerobic fitness and muscular endurance (ranging from 0.12 to 0.27, all p < 0.05). Correlations between muscular strength and academic performance were nonsignificant for boys but significant and low in strength for girls. Correlations involving the sit-and-reach test for flexibility were all nonsignificant. The logistic regression models (both crude and adjusted) are located in Table 4, separated by sex. In general, the strongest associations were seen for aerobic fitness, muscular endurance and muscular strength. The crude (unadjusted) odds ratio indicated significant relationships between aerobic fitness and muscular endurance for boys, for both reading and math criterion. After adjustment for SES and age, boys in the HFZ for aerobic fitness or muscular endurance were times as likely to also be passing their math or reading tests as boys not in the HFZ. The odds ratio results were just over 2 (both crude and adjusted) for boys with regard to muscular strength and math, but not reading. Girls in the HFZ for aerobic fitness were approximately 2 4 times as likely to meet or exceed reading and math test standards. The crude odds ratios for girls in the HFZ for muscular strength and endurance were significant, but were weakened after adjustment for SES and age. In both boys and girls, neither tests of body composition or flexibility were found to be significant predictors in terms of reading or math test results. DISCUSSION The most important finding of the study was that specific aspects of physical fitness are associated with academic achievement in a large group of middle school students. Further, aerobic capacity has the strongest relationship to academic achievement. Odds ratio showed that students who were aerobically fit were 2 4 times more likely to pass their reading and math standardized tests than students who were not in the HFZ. Muscular strength and endurance were also found to be significantly related to academic success, but with lesser consistency than aerobic fitness. These associations persisted even after controlling for SES. This underscores the importance of programmes that promote physical fitness and activity, such as PE, as they may also play a significant role in critical academic areas. While it is a common belief with professionals in PE that students who are physically fit tend to perform better in school, little scientific data exist to support that contention (7,8,10,11,13). The results of this study are consistent with a collection of studies showing that aerobic capacity is related to academic achievement (6 8,10 14). For example, Castelli et al. (7) and Van Dusen et al. (11) examined the relationship between academic achievement and aerobic capacity. Both the current study and Castelli et al. found a significant positive correlation between math and reading ISAT scores and PACER scores, whereas Van Dusen et al. found a positive association between academic standardized tests and the PACER and curl up tests. A study conducted by Chomitz et al. (8) examined the relationship between physical fitness as measured in the five domains of fitness. These tests were then compared to the Massachusetts Comprehensive Assessment System (MCAS) in the areas of Math and English in fourth-, sixth-, seventh- and eighth-grade students. Logistic regression revealed that for every fitness test passed, the odds of passing the English portion of the MCAS increased by 24%. Although all three of the mentioned studies found similar results, this study examined each component of fitness to determine which component(s) Table 4 Odds of academic success in students meeting physical fitness criterion standards Logistic model Odds of academic success in reading Odds of academic success in math Fitness test Crude Adjusted Crude Adjusted Boys (n = 395) BMI 1.10 (0.66, 1.84) 1.09 (0.64, 1.85) 0.96 (0.51, 1.78) 0.91 (0.48, 1.73) Body fat (%) 1.07 (0.59, 1.94) 0.96 (0.52, 1.79) 1.04 (0.51, 2.13) 0.92 (0.44, 1.92) Pacer laps 3.04 (1.88, 4.91) 3.15 (1.90, 5.21) 2.76 (1.56, 4.89) 2.81 (1.56, 5.07) Curl-ups 3.15 (1.55, 6.41) 2.56 (1.22, 5.38) 3.13 (1.44, 6.81) 2.56 (1.14, 5.72) Push-ups 1.67 (0.94, 2.95) 1.58 (0.87, 2.87) 2.29 (1.21, 4.33) 2.21 (1.14, 4.27) Sit and reach 1.02 (0.51, 2.03) 0.92 (0.45, 1.91) 2.04 (0.99, 4.20) 2.00 (0.95, 4.22) Girls (n = 443) BMI 1.10 (0.60, 2.01) 0.85 (0.45, 1.58) 1.00 (0.54, 1.84) 0.76 (0.40, 1.45) Body fat (%) 1.24 (0.70, 2.19) 0.98 (0.54, 1.79) 1.13 (0.63, 2.03) 0.84 (0.46, 1.56) Pacer laps 3.01 (1.17, 5.30) 2.08 (1.10, 3.93) 4.19 (2.39, 7.33) 2.58 (1.39, 4.78) Curl-ups 1.90, (0.89, 4.08) 1.25 (0.56, 2.79) 2.53 (1.23, 5.24) 1.56 (0.72, 3.37) Push-ups 1.24 (0.70, 2.19) 0.96 (0.52, 1.76) 1.86 (1.07, 3.23) 1.43 (0.80, 2.56) Sit and reach 1.20 (0.59, 2.43) 0.90 (0.43, 1.87) 1.35 (0.68, 2.71) 1.04 (0.51, 2.15) Values are point estimates (95% confidence limits). Adjusted model controlling for socio-economic status and age. BMI, Body Mass Index. Bolded odds ratios are statistically significant, p < Foundation Acta Pædiatrica. Published by John Wiley & Sons Ltd , pp

5 Physical fitness and academic performance Bass et al. had the strongest relationship with meeting academic achievement standards. In this study, tests of muscular endurance showed a significant relationship with academic achievement with an odds ratio of approximately 2.5 in boys, but results were not as strong for girls. In contrast, most other studies have found muscular endurance to be unrelated to academics (1,7) with the exception of Van Dusen et al. The Castelli et al. study did not find a significant relationship between muscular endurance and academic achievement possibly due to the differential in age of participants between that study and the present study. In this study, the significant relationship between muscular endurance and academic achievement may be due to some similarities between the PACER test and the curl-up test. The PACER and curl-up tests are the longest in duration and may cause the most discomfort for students performing the test. Additionally, results of the logistic regression did not show a significant relationship between body composition and academic achievement. Castelli et al. found a negative correlation between body composition and academic achievement with stronger associations than were found herein. This may be due to the different maturation levels between the subjects. As students begin adolescence, major discrepancies occur in physical maturation from subject to subject, thus altering the consistency of the results in BMI. Several mechanisms may explain why aerobic capacity and muscular endurance are linked with academic achievement. Physiologically, there are three neurocognitive mechanisms to examine which may explain how chronic aerobic exercise affects brain plasticity. First, balancing neurotransmitters optimizes the mind to improve attention, alertness and motivation; second, it encourages nerve cells to bind together; and lastly, it spawns the development of new nerve cells from stem cells in the hippocampus of the brain, also known as neurogenesis (12,14,23 25). Neurocognitive factors may also include increased blood flow back to the brain following exercise which may enhance brain function. With this increased blood flow back to the brain, there is evidence of an increase in the serotonin precursor tryptophan across the blood brain barrier which has a calming effect on children allowing them to focus on academics (26,27). Third, fitness is positively associated with attention and working memory neuroelectric activity, response speed and cognitive processing speed (16). These neurocognitive factors of fitness seem to influence cognitive and academic success which may contribute to the results of this study. The results of this study show that a majority of the students were fit in each of the five components of fitness. As students are deemed fit, they may be more likely to be healthy. If students are healthy, they have the potential to learn efficiently as their most innate needs are being met. It has been documented that good health may contribute to academic achievement in a positive manner (8). Fitness may enhance students concentration and arousal which in turn betters their behaviour (8,15,19,23). Better behaviour by students may result in less distractions and increased instruction time for the classroom teacher; thus, learning has more of an opportunity to take place. In addition to better concentration, exercise has been linked to mental health (28 30). An increase in self-esteem can also be seen in those who habitually exercise (30). Regular exercise can lower stress, anxiety and depression, all of which can influence academic success (23,26,29). Lastly, student motivation and determination could have been a factor in the results of this study. It could be said that students who were highly motivated and determined in academics could show the same motivation and determination in the fitness assessments. Students who show the least motivation may give up as soon as the test becomes difficult. Future studies in this area may want to include a motivational assessment in addition to the academic and fitness assessments. Teacher attitudes and student attitudes are both potential explanations for the relationship between fitness and academic achievement (15,19). In the school used for this particular study, PE is well respected and supported by the administration and the faculty. This attitude may then be carried over to the student body causing them to work harder and enjoy PE. There are limitations and strengths of the current research that merit consideration. First, this was a crosssectional study, and causation cannot be established. Further, the sample consisted of a single middle school, and one should use caution when making generalizations to students across the K-12 spectrum; however, other empirical evidence does exist with similar results at differing grade levels (6 8,17,26). A lack of specific race/ethnicity adjustments are a limitation of this study. Race/ethnicity data were provided at the school level but not from the individual participants of this study. As opposed to gathering data in a laboratory by one researcher, the fitness data collection occurred in the field and was completed by six different physical educators. Each educator had training and experience in administering the FITNESSGRAM test battery; however, there may be some differences on how the data were collected which may or may not have been biased. This study was carried out in a setting in which the author feels strengthens this study due to the collaborative effort of school personnel, providing unique authenticity to the findings. Physical educators collected data within the parameters of a normal school day. This would indicate that other physical educators could also replicate this study and advocate for quality PE in their schools. Other strengths of the study include the use of multiple indicators of physical fitness and academic achievement, the large sample, inclusion of important covariates such as SES and age and the analysis incorporated the frequently used FITNESSGRAM HFZ. In conclusion, this study showed a significant relationship exists between certain domains of physical fitness and academic achievement. In times of economic stress, schools may be more likely to reduce funding to programmes that focus on physical fitness and PA (such as PE, sports and after school activity programmes) while preserving funding for more traditional areas of academics. However, this Foundation Acta Pædiatrica. Published by John Wiley & Sons Ltd , pp

6 Bass et al. Physical fitness and academic performance approach may be counterproductive. Additionally, while the cardiovascular and metabolic health benefits of physical fitness have long been recognized, this research underscores the importance of physical fitness and activity for parents, researchers and policy makers in regard to cognitive function. References 1. Tomporowski PD, Davis CL, Miller PH, Naglieri JA. Exercise and children s intelligence, cognition, and academic achievement. Educ Psychol Rev 2008; 20: US Department of Health and Human Services. Washington (DC): US Department of Health and Human Services; [cited 2004]. Available at: (accessed on November 1, 2009). 3. US Department of Health and Human Services. Physical activity and health: a report of the Surgeon General. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion. 2004: Renter DS, Scott C, Kober N. From the Capital to the classroom: year 4 of no child left behind. 2006; Available at: (Accessed on November 1, 2009). 5. Sallis JF, Mckenzie TL. Physical education s role in public health. Res Q Exerc Sport 1991; 6: Aberg MI, Pedersen NL, Toren K, Svartengren M, B ackstrand B, Johnsson T, et al. Cardiovascular fitness is associated with cognition in young adulthood. Proc Natl Acad Sci U S A 2009; 106: Castelli DM, Hillman CH, Buck SM, Erwin H. Physical fitness and academic achievement in third-and-fifth grade students. J Sport Exerc Psychol 2007; 29: Chomitz VR, Slining MM, McGowan RJ, Mitchell SE, Dawson GF, Hacker KA. Is there a relationship between physical fitness and academic achievement? Positive results from the public school children in the northeastern United States. J Sch Health 2009; 79: Coe DM, Pivarnik JM, Womack CJ, Reeves MJ, Malina RM. Effect of physical education and activity levels on academic achievement in children. Med Sci Sports Exerc 2006; 38: Kwak L, Kremers SP, Bergman P, Ruiz JR, Rizzo NS, Sjostrom M. Associations between physical activity, fitness, and academic achievement. J Pediatr 2009; 155: e Van Dusen DP, Kelder SH, Kohl HW 3rd, Ranjit N, Perry CL. Associations of physical fitness and academic performance among schoolchildren. J Sch Health 2011; 81: Vaynman S, Ying Z, Gomez-Pinilla F. Hippocampal BDNF mediates the efficacy of exercise on synaptic plasticity and cognition. Eur J Neurosci 2004; 20: Wittberg RA, Northrup KL, Cottrell LA. Children s aerobic fitness and academic achievement: a longitudinal examination of students during their fifth and seventh grade years. Am J Public Health 2012; 102: Ferris LT, Williams JS, Shen CL. The effect of acute exercise on serum brain-derived neurotrophic factor levels and cognitive function. Med Sci Sports Exerc 2007; 39: Dwyer T, Sallis JF, Blizzard L, Lazarus R, Dean K. Relation of academic performance to physical activity and fitness in children. Pediatr Exerc Sci 2001; 13: Hillman CH, Castelli DM, Buck SM. Aerobic fitness and neurocognitive function in healthy preadolescent children. Med Sci Sports Exerc 2005; 27: California Department of Education (CDE). California physical fitness report test: report to the governor and legislation. Sacramento, CA: California Department of Education Standards and Assessment Division, 2001: National Association of Sport and Physical Education & American Heart Association. Shape of the nation report: Status of physical education in the USA. Reston, VA: National Association for Sport and Physical Education, 2010: Shepard RJ, Lavalle e H, Volle M, LaBarre R, Beaucage C. Academic skills and required physical education: the Trois Rivieres experience. CAPHER J Res Suppl 1994; 1: Morrow JR, Martin SB, Jackson AW. Reliability and validity of the FITNESSGRAM: Quality of teacher collected healthrelated fitness surveillance data. Res Q Exerc Sport 2010; 81 (Suppl 3): S Cooper Institute for Aerobics Research. FITNESSGRAM: Test administration manual. Human Kinetics: Champaign, 1999: Illinois State Board of Education. Springfield (IL): Illinois State Board of Education. Available at: (accessed on September 1, 2009). 23. Bluechardt M, Weiner J, Shepard RJ. Exercise programmes in the treatment of children with learning disabilities. Sports Med 2005; 19: Van Praag H, Kempermann G, Gage FH. Running increases cell proliferation and neurogenesis in the adult mouse dentate gyrus. Nat Neurosci 1999; 2: Van Praag H, Shubert T, Zhao C, Gage FH. Exercise enhances learning and hippocampal neurogenesis in aged mice. J Neurosci 2005; 25: Dwyer T, Coonan WE, Leitch DR, Hetzel BS, Baghurst PA. An investigation of the effects of daily physical activity on the health of primary school students in South Australia. Epidemiol Res Int 1983; 12: Herholz B, Buskies B, Rist M, Pawlick G, Hollman W, Heiss WD. Regional cerebral blood flow in man at rest and during exercise. JAMA Neurol 1987; 234: Berchtold NC, Chinn G, Chou M, Kesslak JP, Cotman CW. Exercise primes a molecular memory for brain-derived neurotrophic factor protein induction in the rat hippocampus. World J Neurosci 2005; 133: Ekeland E, Heian F, Hagan KB, Abbott JM, Nordheim L. Exercise to improve self-esteem in children and young people. Cochrane Libr 2009; 2009: Schendel J. Psychological differences between athletes and non-participants in athletics at three educational levels. Res Q Exerc Sport 1965; 36: Foundation Acta Pædiatrica. Published by John Wiley & Sons Ltd , pp

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