Kahan David, McKenzie Thomas L
San Diego State University, School of Exercise and Nutritional Sciences, 5500 Campanile Drive, San Diego, CA 92182-7251, United States.
San Diego State University, School of Exercise and Nutritional Sciences, 5500 Campanile Drive, San Diego, CA 92182-7251, United States.
Prev Med. 2017 Feb;95:82-88. doi: 10.1016/j.ypmed.2016.12.008. Epub 2016 Dec 13.
Schools are salient locations for addressing the high prevalence of overweight and obesity. Most US states require some physical education (PE) and the energy expended during PE has potential to positively affect energy balance. We previously used 2012 data to examine state policies for PE to calculate estimated student energy expenditure (EEE) under potential (i.e., recommendations followed) and existing conditions. Since then, data have been updated on both state policies and the conduct of PE. Based on updated data, we used PE frequency, duration, and intensity, student mass, and class size to calculate EEE for the delivery of PE under (a) national professional recommendations, (b) 2016 state policies, and (c) school-reported conditions. Although increased from four years ago, only 22 states currently have policies mandating specific PE minutes. EEE over 10years shows the enormous impact PE could have on energy balance. For the average recommended-size PE class, resultant annual EEE based on professional recommendations for min/week far exceeded those based on average state (n=22) policy for min/week by 44.5% for elementary, 62.7% for middle, and 59.5% for high schools. Since 2012 more states adopted policies for PE minutes than dropped them, however, EEE over 10years showed a net loss of 1200kcal/student. With no overall recent improvements in state PE policy and professional recommendations currently not being met, PE remains an underutilized public health resource for EEE. Strong policies, coupled with enhanced accountability of PE teachers and administrators, are needed to ensure PE exists in schools.
学校是解决超重和肥胖高患病率问题的重要场所。美国大多数州都要求开设一定的体育课程（PE），且体育课程期间消耗的能量有可能对能量平衡产生积极影响。我们之前利用2012年的数据来研究体育课程的州政策，以计算在潜在（即遵循建议）和现有条件下学生的估计能量消耗（EEE）。从那时起，州政策和体育课程实施情况的数据都已更新。基于更新后的数据，我们利用体育课程的频率、时长、强度、学生体重和班级规模来计算在以下三种情况下体育课程实施的EEE：（a）国家专业建议；（b）2016年州政策；（c）学校报告的情况。尽管比四年前有所增加，但目前只有22个州制定了规定特定体育课程分钟数的政策。10年的EEE显示了体育课程对能量平衡可能产生的巨大影响。对于平均推荐规模的体育课，基于每周分钟数的专业建议得出的年度EEE，小学阶段比基于州平均政策（n = 22）每周分钟数得出的结果高出44.5%，初中阶段高出62.7%，高中阶段高出59.5%。自2012年以来，采用体育课程分钟数政策的州比取消此类政策的州更多，然而，10年的EEE显示每名学生净损失1200千卡。由于近期州体育课程政策没有整体改善，且目前未达到专业建议要求，体育课程在用于EEE方面仍然是一种未得到充分利用的公共卫生资源。需要强有力的政策，再加上加强体育教师和管理人员的问责制，以确保学校开设体育课程。
