Abstract

PURPOSE: To examine the associations between participation in Physical Education (PE) classes and objective measures of physical activity (PA) and sedentary behavior (SB) in children from 12 countries at different levels of human and socioeconomic development. METHODS: This multinational, cross-sectional study included 5874 children aged 9-11 years from sites in Australia, Brazil, Canada, China, Colombia, Finland, India, Kenya, Portugal, South Africa, the United Kingdom, and the United States. PA and SB were measured over 7 consecutive days using a waist-worn accelerometer. Participation in PE classes was determined by questionnaire. Multilevel modeling analyses were used to account for the hierarchical nature of the data. RESULTS: PE classes were not attended by 6.6% of the total sample, and in low- and middle-income countries this prevalence was higher than in high-income countries (8.4% vs. 4.7%, respectively, p<0.01). After adjusting for age, sex, parental education, and BMI z-score, results showed that children from low- and middle-income countries who participated in PE classes at least once a week were more likely to meet the moderate-to-vigorous physical activity (MVPA) recommendations (male - OR: 1.80; 95%CI: 1.17- 2.77; female - OR: 2.17; 95%CI: 1.44-3.27), to spend more time at different PA intensities, and to have shorter SB time (male - OR: 1.61; 95%CI: 1.01-2.60; female - OR: 2.20; 95%CI: 1.38-3.50) than those who did not attend PE classes. In high-income countries, boys that participated in PE classes were more likely to meet the recommendations for PA (OR: 2.20; 95%CI: 1.29-3.76) and to have shorter SB time (OR: 2.42; 95%CI: 1.22-4.81). For girls in high-income countries, attending PE classes increased the likelihood of spending more time in MVPA, especially if they attended three or more classes per week (OR: 2.42; 95%CI: 1.22-4.80). CONCLUSION: Attending PE classes is associated with a higher level of PA and lower level of SB in children from countries at various levels of human and socioeconomic development. PE classes should be compulsory in all countries as an important contributor to healthy movement behaviors of children.

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