Physical Activity Across the Curriculum (A+PAAC)

Abstract

Improving academic achievement (AA) and reducing the rates of obesity in elementary school students are both of considerable interest. Increased physical activity (PA) during academic instruction time in school offers a potential intervention to address both issues. However, it is unclear if classroom based PA interventions also impact cognitive performance (CP) and how this relates to AA. PURPOSE: To describe current findings from an adequately powered, cluster randomized classroom-based PA intervention. METHODS: 17 elementary schools were cluster randomized to A+PAAC (n=9) or control (n=8) for a 3-year trial. In A+PAAC classroom teachers were trained to deliver academic instruction through PA. The primary outcome measure was AA measured by the Weschler Individual Achievement Test-III, which was administered at baseline and was repeated during the spring of each year. Potential mediators of any association between A+PAAC and AA were examined on the same schedule and included changes in CP, cardiovascular fitness, PA, BMI, and blood chemistry. RESULTS: A random sample of students in each school, stratified by gender and grade (A+PAAC = 370, Control = 317), were selected for outcome assessments from those who provided consent/assent. Findings suggest that higher-fit children produce shorter reaction times (RT) and superior accuracy, in addition to more accurate target detection and discrimination performance when working memory and attention demands are increased. HDL cholesterol also has an independent, negative association with RT, and children without risk factors for metabolic syndrome exhibit better inhibitory control and increased cognitive flexibility than at-risk children. Mediation analysis indicates that PA exerts an influence on mathematics achievement through its relation to fitness. There are also findings to suggest that breakfast consumption, specifically one containing whole grains, aids in AA independent of fitness. CONCLUSION: This trial shows promising findings that suggest PA and fitness have a positive relationship with AA and CP in elementary aged children. Future findings will help establish if classroom based PA can produce changes in AA and CP as well as evaluate the highlights and pitfalls of large longitudinal trial research. Funding source: NIH DK85317.