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6 AUTHORS, INCLUDING:
Raquel Burrows
Paulina Correa-Burrows
University of Chile
University of Chile
12 PUBLICATIONS 16 CITATIONS
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Daniza Ivanovic
University of Santiago, Chile
81 PUBLICATIONS 384 CITATIONS
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Burrows (rburrows@inta.uchile.cl) is with the Dept of Nutritional Epidemiology and Genetics, Institute of Nutrition and Food Technology (University
of Chile), Santiago, Chile. Correa-Burrows is with the Dept of Nutritional
Epidemiology and Genetics, Institute of Nutrition and Food Technology,
University of Chile, Santiago, Chile, since late 2013. Orellana is with the
Dept of Statistics, Institute of Nutrition and Food Technology, University
of Chile, Santiago, Chile. Almagi and Lizana are with the Laboratory of
Biology, Pontifical Catholic University of Valparaso, Valparaso, Chile.
Ivanovic is with the Dept of Human Nutrition, Institute of Nutrition and
Food Technology (University of Chile), Santiago, Chile.
1600
Methods
Study Population and Sample Selection
The target population, 187,860 children (39% of Chilean school
population), included all school-age children enrolled in 5th (N
= 91,663) and 9th (N = 96,197) grade in the Chiles Metropolitan
Region (MR) in 2010 and who took the SIMCE test at the end of
the year 2009. They attended public, partially-subsidized and private
schools from urban areas.
The sampling frame of this study corresponds to the educational
establishments from the urban area of MR. The sampling system
was performed in 2 stages. In the first stage, 33 educational establishments accounting for 2.61% of the total urban school population (N = 1262) were randomly selected by proportional allocation
according to the stratification by type of school and the levels of
achievement in the SIMCE 2009 established by the Ministry of
Education (high, intermediate and low). In a second stage, in each
of the 33 schools all students enrolled in both grades and taking
SIMCE Tests
Academic performance (AP) was assessed through the SIMCE
test, which has national coverage in Chile and is administered by
the Ministry of Education. The aim of this testing is to improve the
quality and equality of the educational process in the different areas
covered by the national curriculum. Scores range between 0 and
400.17 To carry out this analysis, we transformed the test raw values
into z-scores, and then we estimated a composite z-score, including
Language, Mathematics and Science results, and taking out Social
Science as this one only tests mid school students.
Anthropometric Measurements
Standardized procedures were used to measure weight to the closest
0.1 Kg, using a Seca scale, and height to the closest 0.1 cm, using
a Holtain stadiometer. All the instruments were verified before
measuring each subject.18 BMI (Kg/m2) and Height for age were
evaluated and z-scores were obtained according to CDC/NCH/USA
references.19 Nutritional status was defined as follows: Underweight
(z-score < 1 SD), Normal weight (z-score from 1 SD to 1 SD),
Overweight (z-score from +1 SD to < 2 SD) and Obesity (z-score
2 SD).
Scheduled Exercise
Scheduled exercise was measured accounting for the number of
weekly hours devoted to (1) school-based physical education and
(2) sport extracurricular activities that occur outside of the regular
school day, either school or nonschool organized. That is, our
research focused on regularly scheduled physical activity.
To measure scheduled exercise, we used a questionnaire which
was validated using accelerometry-based activity monitors.20 This
questionnaire was administered by a researcher to all students at the
time they attended the anthropometric examination. Ninth graders
answered by themselves, whereas 5th graders answered with their
parents help. In spite of this, the questions and response categories
were identical in both groups.
School Performance
School performance was measure using the criteria of the Chilean
Ministry of Education. Schools are divided into 3 groups (good
academic standing, satisfactory, and unsatisfactory) according to the
overall performance achieved by their students in the SIMCE tests.17
Statistical Analysis
Data were processed using Stata for Windows 10.1 (Lakeway Drive
College Station, TX, US). Statistical analysis included Chi2 for
categorical variables, and variance analysis and Bonferroni test for
comparison of means. Logistic regressions were used to assess the
relationship between the allocation of time to scheduled exercise
(exposure) and individual academic performance (outcome).
Two models were considered, using SIMCE composite z-score
50th percentile and 75th percentile as dependent variables,
respectively. In both models, the primary explanatory variable was
the allocation of weekly hours to scheduled exercise. Models were
adjusted for potential confounders, including sex, because male
students traditionally show better performance in the standardized
tests administered in Chile; SES, because income level and parents educational and occupational status are closely linked to the
students academic outcomes;13,14 and school performance, because
the school sets important parameters of the students learning experience (eg, preparation of teachers or availability of resources),22,23
and because strong differentials in the quality of education exist
between Chilean schools with different administrative structures.
Variable selection for the logistic regression models was also guided
by the bivariate analyses. A P-value of < 0.05 denoted statistical
significance.
Results
In our sample, 79.2% of students reported less than 2 hours of
weekly scheduled exercise, while 10.6% and 10.2% reported 2
to 4 hours and more than 4 hours of weekly scheduled exercise,
respectively. Table 1 contains the descriptive statistics of the sample.
Mean values of chronological age, performance in Language,
Mathematics and Science tests, and composite performance in the
3 tests significantly increase at higher allocation of time to weekly
scheduled exercise (P < .000). The proportion of physically active
subjects was significantly higher among males (14%), 9th graders
(18%), students attending schools with good academic standing
(15.4%), and high-SES students (16%).
The proportion of school-age children above selected thresholds
of academic performance in the SIMCE (composite Language,
Mathematics and Science) significantly increased (P < .001) at
higher allocation of time to weekly scheduled exercise, as shown
in Figure 1.
Table 2 provides the results of the bivariate analysis which
was used to identify explanatory variables of individual academic
achievement. There was a significant association between performance thresholds in the SIMCE and sex (P < .01), socioeconomic
level, school performance, and allocation of time to weekly scheduled exercise (P < .001). No significant differences were found for
nutritional status and grade over the control groups.
Table 3 shows the results of logistic regressions modeling the
association between individual academic performance and scheduled exercise in school-age children, after controlling for sex, SES
and school performance in the SIMCE. Devoting more than 4 hours/
week to scheduled exercise significantly increased (P < .01) the odds
Table 1 General Characteristics of the Sample by Allocation of Time to Weekly Scheduled Exercise (n = 1271)
< 2 h (A) (n = 1007)
24 h (B) (n = 134)
P-valuec
Bonferroni
adjustment
12.9 2.3***BC
14.7 1.9
15.3 1.5
0.000
ABB
Sex
Male
Female
500 (75.1)
507 (83.8)
75 (11.3)
59 (9.8)
91 (13.7)
39 (6.5)
0.000d
Anthropometrics
BMI (z-score)
Height (z-score)
0.97 1.1
0.02 1.0
0.92 1.0
0.13 0.9
0.76 1.0
0.13 0.9
0.080
0.153
0.16 0.9**B***C
0.13 1.0***BC
0.19 1.0**B***C
0.17 1.0**B***C
0.16 1.0
0.12 1.0
0.15 1.0
0.20 1.1
0.41 0.8
0.40 0.9
0.42 0.9
0.29 0.9
0.000
0.000
0.000
0.000
Socioeconomic status
High
Middle
Low
133 (69.3)
373 (77.4)
509 (83.9)
29 (15.1)
52 (10.8)
53 (8.9)
30 (15.6)
57 (11.8)
43 (7.2)
0.000d
Grade
5th
9th
598 (91.8)
409 (66.0)
35 (5.4)
99 (16.0)
18 (2.8)
112 (18.0)
0.000d
School performance
Good
Satisfactory
Unsatisfactory
421 (72.2)
318 (83.5)
268 (87.3)
72 (12.4)
32 (8.4)
30 (9.8)
90 (15.4)
31 (8.1)
9 (2.9)
0.000 d
Age
Mean age
Academic performance
SIMCE (z-score)
Language (z-score)
Mathematics (z-score)
Science (z-score)
ABC
ABB
ABC
ABC
Mean SD.
(%).
c One-way ANOVA test, except as indicated.
d Chi2 (Pearson).
a
b Number
Figure 1 Percentage of students above performance thresholds in the National System for the Assessment of Educational Quality 2009 (combined
Language, Mathematics and Science) by allocation of time to weekly scheduled exercise.
1602
Table 2 Association Between Performance Thresholds in the National System for the
Assessment of Educational Quality 2009 (Combined Language, Mathematics, and Science)
and Sociodemographic and Health Characteristics
SIMCE z-score 50th percentile
Overall
753
59.0
265
24.9
Sex
Male
Female
419
334
62.9
54.7
163
102
29.3
20.1
P = .001
P = .003a
Grade
5th grade
9th grade
373
380
51.1
60.9
141
124
P = .170
Nutritional statusb
Underweight
Normal
Overweight
Obesity
10
448
176
119
P = .643
58.8
62.0
55.2
54.6
3
166
58
38
P = .097
Socioeconomic level
High
Middle
Low
147
309
297
76.2
63.7
49.6
452
184
117
80
115
70
77.0
48.2
38.0
104
95
550
206
47
12
39.9
15.3
5.0
P < .001
80.0
70.9
54.6
P < .001
47.9
27.1
14.8
P < .001
P < .001
Scheduled exercise
>4 hours/week
24 hours/week
<2 hours/week
23.1
27.4
21.9
21.1
P = .195
P < .001
School performance
Good
Satisfactory
Unsatisfactory
25.5
24.3
49
35
181
49.5
32.7
21.2
P < .001
Discussion
Main Conclusions
The results of this study confirm the direct and significant association between regular exercise and academic outcomes achieved by
school-age students. Those reporting less than 2 hours of weekly
scheduled exercise had significantly lower performance in Language, Mathematics and Science, than those reporting more than 4
hours. Similarly, students allocating more than 4 hours to weekly
scheduled exercise were 2.1 times more likely to fall into the group
with the highest academic performance (composite z-score 75th
percentile).
It is also important to recognize the influence of sex, socioeconomic factors as well as the availability of resources and facilities.13,14,2426 Academic performance measured by SIMCE and PSU
(University Selection Test, a standardized test for college admission)
has been traditionally higher in males and among students attending
private schools.17,27 In our sample, 29% of male fell into the group
with composite z-score 75th percentile in comparison with 20%
1604Burrows et al
OR [95% CI]
OR [95% CI]
> 4 hours/week
2.27 [1.413.64]**
2.09 [1.313.31]**
24 hours/week
1.82 [1.202.77]**
1.39 [0.862.24]
Male
1.24 [0.971.59]
1.51 [1.102.06]*
High SES
1.43 [0.942.17]
2.48 [1.593.86]***
Mid SES
Good performance (school)
Satisfactory performance (school)
Observations
Likelihood ratio
(Chi2)
Hosmer-Lemeshow
Correctly classified (%)
1.08 [0.821.42]
1.21 [0.831.75]
4.59 [3.306.38]***
8.97 [4.7816.8]***
1.44 [1.061.97]*
3.37 [1.746.53]***
1271
1271
187.86***
180.17***
6.88 P = .549
9.94 P = .270
67.3
76.7
Abbreviations: SIMCE, System for the Assessment of Educational Quality; OR 95% CI, Odd Ratio 95% Confidence Interval.
* P < .05; ** P < .01; *** P < .001.
of females (P < .01). Likewise, 48% of High SES student fell into
that group compared with 15% of low SES students (P < .001). In
our models, when controlling for sex and socioeconomic status, the
effect of scheduled exercise remained significant.
Our findings are consistent with the results obtained by previous studies examining the link between academic outcomes and
regular physical activity.79 Among American students aged 11
to 18 (n = 4,746), it was observed a positive association between
physical activity involvement and academic achievement. In girls,
both, allocation of time to weekly moderate- to vigorous- intensity
physical activity and participation on sport teams were significantly
associated with higher academic performance, but in males only
the participation on sport teams was independently associated.
In that sample, less than 25% of the students reported less than
2.5 hours/week of scheduled exercise.28 Other study performed
in 3rd to 11th grade students from Texas (n = 254,000), fitness
measured by 6 independent test was strongly related to academic
performance measured by standardized academic test (TAKS).16
Likewise, in 9th grade students from Sweden (n = 232; 16 0.4
years old), academic achievement was associated with vigorous
activity in girls but association with fitness was insignificant. In
boys, only fitness was significantly associated while association
with intensity of physical activity was insignificant.29 Finally, in
a cross-sectional study involving 2127 children attending 4th to
8th grade from northeastern US, fitness achievement measured by
5 independent tests was significantly and positively associated to
the results obtained in Mathematics and English standardized tests,
after controlling for nutritional status, ethnicity, gender, grade and
socioeconomic status.15
Some studies suggest that a certain threshold of intensity or
a minimum weekly exercise time are required to produce positive
effects on academic performance.28,30 Others conclude that academic
achievement is positively linked to cardiovascular fitness, suggesting
that fitness may mediate the association between physical activity
and cognitive performance.16,29,31 Several research studies stress
the need for a better understanding of the explanatory mechanisms
involved in these relations as well as the need to assess the dose-
response relation between physical activity and academic performance. However, we should keep in mind that the main goals of
promoting physical activity are to improve the populations health
and to prevent and control chronic diseases. Improving academic
outcomes might be considered a positive external effect. On the
other hand, interpretations of dose-response relationships would
be extremely complex because of the variety of factors affecting
individuals academic performance.
In Chile, the compulsory time devoted to physical exercise in
both Elementary and High schools is 1.5 hours/week. In 20022004,
60% of public schools students had less than 2 hours/week of regular exercise, while 70% of private schools students had more than
3 hours/week, according to the results obtained from a sample of
1700 school-age children from urban Santiago attending 8th and
9th grade.32 In the overall sample, 52% of students devoted less than
2 hours to weekly scheduled exercise. Since then, the proportion
with such allocation of time has remarkably increased (79.2%). Our
results show that devoting more hours to physical education is not
harmful in terms of academic performance. Likewise, the available
evidence suggests that increasing the allocation of time to Language,
Mathematics or Science at expense of physical education does not
entail better academic outcomes,79 while the effects on students
health are clearly negative.15 In spite of this, Chilean parents, education officials and school authorities still believe that improving
students performance requires shifting hours and resources away
from physical education toward time on academics.
References
1. Penedo F, Dahn J. Exercise and well-being: a review of mental and
physical health benefits associated with physical activity. Curr Opin
Psychiatry. 2005;18(2):189193. PubMed doi:10.1097/00001504200503000-00013
2. Murphy M, Blair S, Murtagh E. Accumulated versus continuous
exercise for health benefit: a review of empirical studies. Sports Med.
2009;39(1):2943. PubMed doi:10.2165/00007256-20093901000003
3. Hillman C, Erickson K, Kramer A. Be smart, exercise your heart: exercise effects on brain and cognition. Nat Rev Neurosci. 2008;9(1):58
65. PubMed doi:10.1038/nrn2298
4. Andersen B, Harro M, Sardinha B, et al. Physical activity and clustered
cardiovascular risk in children: a cross-sectional study (The European
Youth Heart Study). Lancet. 2006;368:299304. PubMed doi:10.1016/
S0140-6736(06)69075-2
5. Byberg L, Melhus H, Gedeborg R, et al. Total mortality after changes in
leisure time physical activity in 50 year old men: 35 year follow-up of
population based cohort. BMJ. 2009;338:b688. PubMed doi:10.1136/
bmj.b688
6. Hashim H, Freddy G, Rosmatunisah A. Relationships between negative
affect and academic achievement among secondary school students:
the mediating effects of habituated exercise. J Phys Act Health.
2012;9(7):10121019. PubMed
7. Trudeau F, Shephard R. Physical education, school physical activity,
school sports and academic performance. Int J Behav Nutr Phys Activ.
2008; 5:10. doi:10.1186/14795868-5-10
1606Burrows et al
26. Schneider M. Do school facilities affect academic outcomes? Washington, DC: National Clearinghouse for Educational Facilities; 2002.
27. Datos estadsticos del proceso de admisin a las universidades chilenas del consejo de rectores y aplicacin de la Prueba de Seleccin
Universitaria. Departamento de Evaluacin, Medicin y Registro
Educacional, Universidad de Chile. Retrieved from: http://www.
demre.cl/estadisticas.htm. Accessed February 20th, 2013.
28. Fox CK, Barr-Anderson D, Neumark-Sztainer D, Wall M. Physical
activity and sports team participation: association with academic
outcomes in middle school and high school students. J Sch Health.
2010;80(1):3137. PubMed doi:10.1111/j.1746-1561.2009.00454.x
29. Kwak L, Kremers S, Bergman P, Ruiz J, Rizzo N, Sjstrm M. Association between physical, fitness and academic achievement. J Pediatr.
2009;155:914918. PubMed doi:10.1016/j.jpeds.2009.06.019
30. Coe D, Pivarnick J, Womack C, Reeves M, Malina R. Effects of physical education and activity levels on academic achievement in children.
Med Sci Sports Exerc. 2006;38:15151519. PubMed doi:10.1249/01.
mss.0000227537.13175.1b
31. Etnier J, Nowell P, Landers D, Bibley B. A meta-regression to examine
the relationship between aerobic fitness and cognitive performance.
Brain Res Brain Res Rev. 2006;52:119130. PubMed doi:10.1016/j.
brainresrev.2006.01.002
32. Burrows R, Daz E, Sciaraffia V, Gattas V, Montoya A, Lera L. Dietary
intake and physical activity in school age children. Rev Med Chil.
2008;136:5363. PubMed doi:10.4067/S0034-98872008000100007