An article in the Observer this weekend highlighted anxieties within cabinet over plans to reduce funding for sports in schools. The Observer reported that Andrew Lansley, the health secretary, is concerned about the effects this cut to funding might have on obesity levels and the health of school children.
Investigating the effect school sport programmes have on obesity and health is difficult for a number of reasons, not least the fact that to achieve any sort of change in the first place you have to alter behaviour through a structured intervention which is no simple task. However, there is evidence from a well-designed trial in Switzerland that shows levels of body fat and physical fitness can be improved through classroom and home based activities(1).
The researchers conducted a cluster-randomised trial, where the classes, not individual children, were randomised to a combination of interventions designed to increase the levels of physical activity and reduce body fat. All classes in the study continued the normal programme of physical activity in schools: three physical education lessons per week given by their usual teachers – compulsory by law in Switzerland. The classes randomised to the intervention additionally had: two extra physical activity classes per week (given by specially trained teachers); short activity breaks during each lesson; and physical activity homework to carry out each day. My favourite example of a homework task was brushing your teeth whilst standing on one leg – a good way to liven up that normally dull event before bedtime.
The study ran for one school year and just fewer than 500 children were included in the trial which involved 28 classes (note the small class sizes). The authors took a lot of effort to ensure the outcomes they wanted to examine were carefully measured using validated methods so we can have confidence that they measured what they intended. They also measured physical activity both at home and at school, a nice touch as this meant they attempted to gauge how much their intervention worked outside of the school when children were at home without the influence of teachers and classmates.
At the end of the study the researchers found evidence for a change in three of their four main outcomes in the intervention group: body fat was reduced, aerobic fitness had improved, and physical activity had increased. They did not find any evidence for a change in quality of life between the two groups which was the fourth outcome they looked at.
One of the strengths of this study is that it showed a reasonably simple set of interventions in school children, can reduce body fat and increase fitness and physical activity. However, it was carried out in Switzerland, so would it work in England? Well, there’s no big reason to think why not. The interventions were well described in the study, so it shouldn’t be too difficult to replicate. One concern might be that the study was limited to schools with a proportion of ethnic minorities between 10-30% of pupils. This could potentially be a concern if this trial was replicated in areas like London where levels might be higher, however, I can’t really imagine this to be a huge issue if appropriate considerations were taken into account. A bigger concern might be raised over how easily these additional activities could be carried out – the size of the classes in the study are smaller than in England and the interventions were all performed outside by specially trained teachers.
The activities in this study aren’t representative of what currently happens in English schools, however, it shows that sports and physical activity can have positive health benefits on children. Rolling this scheme out in the UK would cost money and would require appropriate facilities, specially trained teachers and appropriate class sizes. To me it seems like common sense that children should be given every opportunity to undertake physical activity in schools, and this study provides some evidence that such things can improve physical fitness and reduce body fat in children. Cutting the budget for sport in schools can only make activities like the ones in this trial more difficult to carry out and will ultimately just add to the growing problem of obesity in school children.
1. Kriemler S, Zahner L, Schindler C, Meyer U, Hartmann T, Hebestreit H, et al. Effect of school based physical activity programme (KISS) on fitness and adiposity in primary schoolchildren: cluster randomised controlled trial. BMJ. 2010 2;340(feb23 1):c785-c785.