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American Journal of Lifestyle Medicine
1
Relationships of Physical
Activity to Brain Health and
the Academic Performance
of Schoolchildren
François Trudeau, PhD, FACSM,
and Roy J. Shephard, MD [Lond], PhD, DPE, DLl
DOI: 10.1177/1559827609351133. Manuscript received September 7, 2007; revised April 2, 2009; accepted April 3, 2009. From the Department of Physical Activity
Sciences, Université du Québec à Trois-Rivières, Trois-Rivières, Canada, and Faculty of Physical and Health Education, Department of Public Health Sciences, Faculty of
Medicine, University of Toronto, Canada. Address correspondence to François Trudeau, PhD, FACSM, Département des sciences de l’activité physique, Université du Québec
à Trois-Rivières, 3351 boul des Forges, CP 500, Trois-Rivières (Québec), Canada G9A 5H7; e-mail: francois.trudeau@uqtr.ca.
For reprints and permission queries visit SAGE’s Web site, http://www.sagepub.com/journalsPermissions.nav.
Copyright © The Author(s)
vol. x • no. x
Abstract: This review examines possi-
ble relationships between academic per-
formance and participation in sports,
physical education, and other forms
of physical activity. Recent fundamen-
tal research has reignited interest in the
effects of physical activity on cognitive
processes. Experimental studies of poten-
tial mediating variables point to physio-
logical influences such as greater arousal
and an increased secretion of neurotro-
phins and psychosocial influences such as
increased self-esteem and connectedness
to schools. In the specific case of sports,
experimental studies are limited to dem-
onstrations of greater attention and acute
gains of mental performance immedi-
ately following such activity. Several quasi-
experimental studies of other types of
physical activity have been completed,
mainly in primary school students;
these have found no decrease in aca-
demic performance despite a curtail-
ing of the time allocated to the teaching
of academic subjects. Indeed, in some
cases, experimental students under-
taking more physical activity have out-
performed control students. Many
investigators have looked at cross-
sectional associations between par-
ticipation in sport or other forms of
physical activity and academic perfor-
mance. Despite difficulties in allowing
for confounding variables, particu-
larly socioeconomic status, the overall
conclusion has been of a weak positive
association. From the practical point
of view, it can be concluded that the
physical activity needed for healthy
child development can be incorporated
into the school curriculum without det-
riment to academic achievement.
Keywords: children; learning; physical
activity; physical education
T
he topic assigned for this invited
review is physical activity par-
ticipation and cognitive perfor-
mance. Research results from the early
2000s, largely echoed in the media, sug-
gest a positive impact of regular physi-
cal activity on learning and memory at
all ages. It seems fairly well accepted
that such activity is associated with the
maintenance of cognitive functions and
brain health in older adults.
1
Leisure time
physical activity has even been shown to
offer some protection against Alzheimer
disease.
2,3
Furthermore, the Nun study
demonstrates the importance of early
stimulation of brain structures to cog-
nitive function in later life.
4
It has been
suggested that early stimulation increases
the reserves of brain function, as char-
acterized by both the number of neu-
rons and the extent of their interconnec-
tions. There is also growing evidence
that physical activity can make an impor-
tant contribution to this increase of brain
reserve.
Physical activity is here defined as
all form of movement associated with
an increase of energy expenditure. It
includes spontaneous physical activ-
ity and organized noncompetitive forms
of physical activity including exercise,
physical education classes, and sport. In
Europe, the term sport was once used to
describe all forms of vigorous physical
activity,
5
but we have followed the rec-
ommendation of an international consen-
sus conference
6
and restrict this term to
physical activities performed individually
or in teams and involving some form of
competition.
AMERICAN JOURNAL OF LIFESTYLE MEDICINE OnlineFirst, published on November 6, 2009 as doi:10.1177/1559827609351133
2
American Journal of Lifestyle Medicine XXX • XXX XXXX
Academic achievement has com-
monly been assessed by the student’s
grade point average or standing in pro-
vincial, statewide, or national examina-
tions, although occasional studies have
accepted subjective assessments of learn-
ing or self-reports of students or teach-
ers. One assumption commonly made
in reviewing findings has been that var-
ious forms of physical activity provide a
similar stimulus to the learning process;
however, this seems unlikely to be the
case. A second assumption underlying
most investigations has been that athletes
and sedentary students receive compara-
ble instruction, although this again seems
inherently unlikely. In the school sys-
tem, the introduction of a physical activ-
ity program for a particular class may
allow the academic teachers who are
involved a greater amount of free time
to prepare their courses. At the univer-
sity level, athletes often receive substan-
tial scholarship support and additional
academic coaching, both of which help
them to achieve good grades. If reli-
ance is placed on classroom assessments
of scholastic performance, findings may
be biased further by the attitudes of aca-
demic teachers toward the sports pro-
gram
7
and (particularly at the university
level) by the special pleading of coaches
for the upward adjustment of marginal
grades assigned to athletes in their care.
7
Finally, the direction of any associations
has usually been assumed from physical
activity to academic excellence, although
directionality cannot be inferred from
correlational studies, and there are sev-
eral potential factors influencing associ-
ations. Students who strive for academic
achievement are often regarded as
“uncool” or “nerds.” Thus, a desire for
academic excellence can sometimes moti-
vate a student to vigorous sports partici-
pation. Sir Roger Bannister once told one
of us that the reason he became involved
in sport was so that his fellow students
would allow him opportunity to study.
Furthermore, those who are intrinsic high
achievers or strongly motivated by their
parents may excel in both their academic
work and in sport. Such issues are diffi-
cult to disentangle other than by experi-
mental or quasi-experimental studies. The
present review will focus primarily on the
practical issue of whether participation
in physical activity influences academic
achievement. This question is still the
subject of heated debate among schools,
universities, school boards, and parent-
teacher associations. If teaching time is
diverted from academic work to sport,
will learning suffer? And given an expo-
nential increase in the volume of knowl-
edge to be transmitted, should sport
programs be curtailed to allow a greater
amount of time to be allocated to aca-
demic instruction?
Several previous reviews have exam-
ined the broader question of relation-
ships between physical activity and
academic achievement in the context of
state schools.
8-15
A meta-analysis of 44
studies, both experimental and cross-
sectional, found an average effect size of
0.32, significantly greater than zero,
13
for
an enhancement of cognition.
The present review looks at published
quasi-experimental and cross-sectional
studies of the problem, considering also
experimental investigations of poten-
tial mediating mechanisms. We have
excluded most studies on the relation-
ship between physical fitness and cog-
nition because a recent meta-analytic
review concluded that physical fitness
was not significantly associated with cog-
nitive performance.
16
In any event, most
studies linking physical fitness and cog-
nition have been cross-sectional, with
inherent problems of selection (biological
or socioeconomical). Limitations of space
have also precluded discussion of such
special cases as individuals with hyperac-
tive disorders
17
or learning disabilities.
18,19
Method
Databases searched for the purpose
of this review included MEDLINE (1966
to 2008), PsychINFO (1974 to 2008),
Google Scholar, ERIC, Ovid HealthSTAR
(1950-2008), and SPORTDiscus (1993-
2008), as well as the extensive personal
databases of both authors. The reference
lists of the articles identified and “find
similar articles” computer linkages were
also consulted when available. A number
of other experimental studies possibly
relevant to this issue have been excluded
from consideration because they are
available only as microfiche summaries
of doctoral theses rather than peer-
reviewed reports.
The successful academic records of
British public schools (where each week-
day afternoon is devoted uniquely to
sport) have long suggested that a sub-
stantial commitment to athletic endeavor
is not necessarily a handicap to learn-
ing for most of the students concerned.
Formal evidence of a possible connection
between sports participation and intel-
lectual achievement has been of research
interest since a review by Davis and
Cooper
20
claimed a positive association
between the 2 variables. Nevertheless, it
is difficult to isolate the effects of phys-
ical activity from the academic support
enjoyed by athletes
7
and the attitudes of
academic teachers toward the sports pro-
gram.
7
Moreover, considerable caution is
needed in equating physical activity with
organized sports programs. The latter gen-
erally have a greater impact on the individ-
ual’s social status and self-esteem
21
; time
demands are often much greater (due
to both extensive training and the travel
There is . . . growing evidence that
physical activity can make an
important contribution to this
increase of brain reserve.
There is . . . growing evidence that
American Journal of Lifestyle Medicinevol. X • no. X
3
associated with competition), and the
learning process may be helped by schol-
arships and special coaching
22
or cur-
tailed by major injuries. Potential indices
of academic outcome used in this review
include not only grade point averages
and student or teacher assessments but
also such accepted classroom determi-
nants of academic performance as assess-
ments of concentration, class behavior,
and school engagement.
The most prolific source of citations
relevant to these various topics was
the database “SPORTDiscus full text”;
this yielded 407 entries for a combina-
tion of the terms Sports and Academic
Achievement. However, when the arti-
cles were reviewed, many entries were
for popular rather than peer-reviewed
scientific publications (Table 1). In
contrast, entry of the term Academic
Achievement into Ovid HealthSTAR
yielded only 10 articles that were linked
to Sports Participation, 7 linked to
Physical Education or Physical Education
and Training, and 14 linked to Physical
Activity. Both of the present authors eval-
uated all potentially relevant articles for
possible inclusion in this review. Effect
size was measured using Cohen’s d (stan-
dardized mean difference), calculated for
quasi-experimental studies with a pooled
standard deviation.
Experimental Studies
Experimental studies undertaken in
both animals and humans provide addi-
tional evidence of the influence of phys-
ical activity on cognitive development.
Investigations have focused on both
physiological and learning/developmental
mechanisms. Physiological concerns have
included changes in the cerebral circu-
lation, levels of arousal, concentrations
of neurotransmitters and neurotrophins,
structural changes in the central ner-
vous system, and resulting long-term hip-
pocampal potentiation (LTP). Studies of
learning and developmental mechanisms
have examined the carryover of physical
skills and understanding of spatial rela-
tionships into academic learning.
13,23
Cerebral circulation. Most forms of phys-
ical activity lead to a substantial increase
of systemic blood pressure, and because
there is little vasomotor control of the
cerebral circulation, the overall perfu-
sion of the brain typically increases by
14% to 25% during a bout of endurance
exercise.
24
In a healthy subject, the total
cerebral blood flow exceeds the meta-
bolic demands of the brain.
25
Some of
the activity-induced increase in blood
flow is directed to motor areas, but there
may also be increased perfusion of other
parts of the cortex. In a longer term per-
spective, regular physical activity may
further augment cerebral blood flow by
reducing the viscosity of the blood.
26
In
an elderly person, in whom cerebrovas-
cular atherosclerosis is threatening the
adequacy of cerebral perfusion, these
changes may result in some improvement
of brain function. Even when at rest,
trained humans and animals show an
increased cerebral blood volume, with an
increase of angiogenesis in the primary
motor cortex
27
and the dentate gyrus.
28
The latter is the most plastic region of
the adult hippocampus, an area of the
brain responsible for learning and mem-
ory consolidation. However, such mecha-
nisms seem unlikely to modify cognition
in children and adolescents, in whom the
cerebral circulation is generally in good
condition, and there is little evidence that
brain oxygenation or substrate utiliza-
tion is compromised, at least until effort
approaches exhaustion.
29
Nevertheless,
during fatiguing exercise, the cerebral
uptake of oxygen relative to carbohy-
drate (glucose and lactate) drops from 6
to less than 3.
30
The high daily energy expenditures
demanded in many sports and physical
activities requires a high overall intake of
nutrients. Micronutrient deficiencies suf-
ficient to limit the cognitive development
of the average child nevertheless remain
unlikely except in impoverished seg-
ments of the population and in catego-
ries of athletes who engage in rigorous
dieting in attempts to “make weight” or
enhance slimness.
31
Arousal. Participation in physical activ-
ity generally increases an individual’s
immediate arousal through an increase
of neural activity in the reticular for-
mation of the brain, although the long-
term impact is less well established. A
moderate increase of arousal is likely
to increase attention and thus facilitate
learning, but excessive arousal may be
detrimental to the learning process.
32
In
the extramural context, sport is likely to
offer greater mental stimulation than the
common alternative of passive television
watching.
33
Other types of physical activ-
ity and some mental pursuits can increase
arousal, but on the other hand, repeti-
tive movements such as walking or mod-
erate jogging have a calming effect,
34
a
view substantiated by electroencephalog-
raphy (EEG) studies.
35
Relaxing forms of
physical activity may be helpful in coun-
tering the stress of examination time, thus
Table 1.
Search Results on Various Research Engines
PubMed
a
SPORTDiscus PsychINFO Google Scholar Ovid HealthSTAR
Physical activity academic achievement 101 45 24 201 000 14
Sport academic achievement 131 407 159 71 500 10
Physical activity cognitive health 101 5 4 397 000
a
After using Related Articles links.
4
American Journal of Lifestyle Medicine XXX • XXX XXXX
bettering a student’s academic grade.
36
In young children, any form of physical
activity may be helpful; thus, one recent
experimental study of students in grades
2 to 4 found an immediate increase of
concentration in response to 15 minutes
of stretching and walking.
37
Electroencephalography. A simple
Fitnessgram of preadolescent children
demonstrated an association between a
high fitness score and shorter latencies of
P3, an evoked response potential asso-
ciated with attention processes and the
capacity of the working memory during
stimulus discrimination.
38
This interesting
observation needs verifying by a longitu-
dinal study to isolate potential selection
effects; furthermore, such EEG features
could reflect a high intrinsic level of
physical fitness rather than an underlying
difference in habitual physical activity.
Concentrations of neurotransmitters.
Physical activity increases transfer of the
serotonin precursor tryptophan across
the blood-brain barrier. The resulting
increase in cerebral serotonin has an
immediate calming effect. Whether this
facilitates or hampers learning depends
on the child’s initial level of arousal.
Two studies have reported negative cor-
relations between plasma serotonin lev-
els and vocabulary scores, particularly in
autistic children,
39,40
although there have
been no studies looking at serotonin lev-
els within the cerebrospinal fluid.
Neurotrophins and LTP. Much of the
recent experimental research on physi-
cal activity and cognition has centered on
the hippocampus. LTP is an essential pro-
cess in the consolidation of memory and
is characterized by an increase of synap-
tic efficacy.
41
Physical activity seems to
facilitate LTP
42
through several short-term
and longer term mechanisms: improved
synaptic transmission, increased con-
centrations of neurotrophins, protection
against the adverse effects of free radi-
cals, and increased neurogenesis.
In rats, improved synaptic transmission
after voluntary running has been demon-
strated as associated with a faster learn-
ing of maze pathways.
43-45
These gains
have been associated with increased
expression of brain-derived neurotrophic
factor (BDNF).
46
The hippocampal glu-
tamate receptors of aged rats were unaf-
fected by exercise,
47
suggesting that
postreceptor mechanisms are responsible
for the stronger LTP seen in active ani-
mals. However, this remains to be con-
firmed by studies of the hippocampus in
younger animals.
BDNF not only promotes neural growth
but also protects neurons from oxida-
tive damage. Several animal studies have
shown increases of BDNF and other
growth factors, including insulin-like growth
factor (IGF-1), nerve growth factor, and
fibroblast growth factor 2 (FGF-2), in
response to exercise.
48
Concentrations
of BDNF mRNA have increased in pyra-
midal cells of the CA1, CA4, CA3, and
dentate gyrus of exercised rats,
49-51
and
conversely, BDNF mRNA levels have
been reduced by exercise deprivation.
52
In young human adults, plasma levels
of BDNF have risen with acute bouts of
exercise,
53
particularly if the intensity was
at or above the ventilatory threshold.
54
Stroop test scores have also improved in
response to physical activity, although
such gains were not correlated with
increases in plasma BDNF.
54
IGF-1 is also neuroprotective. Subcuta-
neous administration of an IGF-1 antibody
to animals reverses the neuroprotec-
tion against domoic acid–induced inju-
ries. Conversely, IGF-1 injection has a
neuroprotective effect in sedentary rats.
These observations suggest that exercise-
induced increases of IGF-1 may contrib-
ute to the enhanced neurogenesis seen in
trained animals.
55
Fibroblast growth fac-
tor (FGF), sometimes known as epidermal
growth factor, is another important vari-
able. Voluntary wheel exercise augments
FGF-2 mRNA expression in the hippocam-
pus.
56
FGF-2 mimics the exercise-induced
stimulation of angiogenesis seen in the
cerebellar cortex and the hippocampus,
57
whereas motor learning augments
synaptogenesis in the same areas.
58
FGF-2 administration also enhances LTP in
hippocampal CA1 pyramidal cells
59
and in
the granular cells of the dentate gyrus.
60,61
The concentration of other antioxidants
is increased in the brain of trained ani-
mals, further protecting the hippocam-
pal cells from damage.
62
Radak et al
63
studied the acute effects of 2 hours of
exercise on previously immobile ani-
mals. Oxidative damage to macromole-
cules was prevented through an increase
of glutathione synthetase activity and a
reduction in the deleterious efflux of glu-
tamate induced by immobilization. Acute
exercise also normalized memory func-
tions, as measured by orientation time to
novelty and passive avoidance.
In humans, regular physical activity
increases protection against reactive spe-
cies, more than counterbalancing the
increased production of oxidative spe-
cies during effort, and this could pro-
tect the brain against functional loss.
63
However, such a process would benefit
mainly elderly individuals, in whom cog-
nitive function was already showing signs
of deterioration. Histological studies have
confirmed an increase of neurogenesis in
mice following chronic exercise.
45,64
Although these mechanisms have the
potential to enhance learning and mem-
ory, to our knowledge, they have yet to
be demonstrated in younger animals at a
stage of development corresponding to
school-age children. However, it is con-
ceivable that the changes observed in
adult animals could assume even greater
importance in the more plastic brains of
young children.
Quasi-experimental and
Longitudinal Studies
Our literature search did not identify any
randomized controlled trials exam ining
the impact of sport or physical activity
interventions on academic performance.
We were not surprised because such
studies are impractical in most school
and university settings. However, a
number of quasi-experimental trials have
been completed (Table 2). All involved
relatively young (primary school)
children; some of the interventions
included sports, but none isolated the
specific effects of sports from participation
in other forms of physical activity.
The first such investigation was under-
taken in Vanves, a suburb of Paris
(France). The subjects were a small
group of children in their final year of
American Journal of Lifestyle Medicinevol. X • no. X
5
primary school. The authors claimed that
despite a 26% reduction in the time allo-
cated to academic work, students who
spent mornings in the classroom and
afternoons undertaking a variety of phys-
ical activities (gymnastics, swimming,
training, sports and outdoor pursuits, to
a total of 15 hours per week) had a better
academic performance than control
students who were given only 2
hours of athletic activity per week.
65,66
Unfortunately, available information is
limited, and details of the study were
never published in peer-reviewed journals.
A second and more sophisticated quasi-
experimental study was conducted
between 1970 and 1977 in Trois-Rivières
(Québec, Canada). It involved a very sub-
stantial sample of primary schoolchildren
(n = 546), and the findings were docu-
mented extensively in peer-reviewed
journals. One issue examined over the
6-year study was the impact of an hour
per day of vigorous, professionally
Table 2.
Quasi-experimental Studies of the Influence of Sport, Physical Education, or Physical Activity on Academic Achievement
Author
Sample
Milieu
Intervention
Outcome
Measure
Response
Effect Size
(Cohen’s d)
Fourestier
65
Vanves
(Paris)
Children in
final year
of primary
school, n = ?
Various sports
and other
activities, 13
h/wk increase
for 1 y
Overall academic
performance
Enhanced in
experimental group
No data available
Shephard
et al
67
Trois
Rivières,
Québec
546 children
in grades 1
through 6
5 h of specialist
physical
education per
week for 6 y
Teacher ratings,
Standard
Provincial
examination,
WISC tests
Enhanced teacher
ratings, math
but not English
improved in
provincial exams,
3%-4% gain on
WISC
French language:
0.22*
a
Mathematics:
0.75
English language:
0.80
a
Sallis et al
70
California 655 children in
grades 5 and 6
27-42 min
additional
physical
education per
week for 2 y
Metropolitan
achievement
tests
Nonsignificant trend
to gains in English,
arithmetic, and
behavior
Reading: 0.44
Dwyer
et al
71
South
Australia
500 10-y-old
students
75 min/d of
endurance
training
Scores for
reading and
arithmetic
Nonsignificant trend
to gains in English
and arithmetic at
2-y follow-up
Arithmetic: 1.21
Behavior: 5.66
Ahamed
et al
73
British
Columbia
287 9- to 11-
y-old primary
students
Added 47 min/
wk of varied
activities for
16 mo
Canadian
Achievement Test
(CAT-3)
Slight trend to
improved scores
CAT-3: 0.79 boys
and girls
Girls: 1.17
Boys: 0.84
Coe et al
74
Western
Michigan,
United
States
214 grade 6
students
Nominal 55
min/d (actual
19 min/d)
physical
education for 1
semester
Classroom
assessments
and nationally
standardized
achievement
scores
Change in academic
performance only
in subgroup who
exercised vigorously
For vigorous
physical activity
exceeding
Healthy People
2010 guidelines:
0.47
Abbreviation: WISC, Weschler Intelligence Scale for Children.
a
In favor of the control group.
6
American Journal of Lifestyle Medicine XXX • XXX XXXX
taught physical education on overall aca-
demic performance
67
; the control group,
formed from immediately preceding and
succeeding classes at the same schools,
were instructed by the same teachers but
received only the standard program of 40
minutes per week physical education from
their homeroom teachers. Despite a 14%
loss of time for academic instruction, the
overall school performance of the experi-
mental group, as assessed by the classroom
teachers, improved significantly relative to
the controls. In the early stages of the pro-
gram, the experimental students also dem-
onstrated an accelerated development of
various psychomotor skills, such as the
appreciation of body size, perception of the
vertical, and finger recognition, but in the
later years of primary school, the control
students made good their disadvantage.
68
Weschler Intelligence Scale for Children
scores showed small (3%-4%) but statisti-
cally significant advantages for the exper-
imental students on both verbal and
nonverbal items. In standardized provin-
cial examinations, experimental students
attained higher scores in mathematics
(23.8 ± 7.9 vs 18.5 ± 6.1) but lower scores
in English (22.1 ± 6.1 vs 27.4 ± 6.8),
despite the fact that mathematics instruc-
tion was reduced by 33 minutes per
week, but the time for English instruction
was unchanged.
69
Scores for French lan-
guage were comparable for experimental
and control classes, but score of overall
intelligence was rated substantially lower
in the experimental students (40.8 ± 10.3
vs 62.6 ± 14.0).
In California, a 2-year quasi-
experimental study followed 759 chil-
dren through the fifth and sixth grades.
70
Subgroups of children were taught the
Sports, Play and Active Recreation for Kids
curriculum by a professional physical
educator (n = 178) or a trained home-
room teacher (n = 312), whereas a third
group continued in the normal program
(n = 165). The impact of the 2 interven-
tions on the amount of school-based
physical activity was relatively small; the
3 categories of students received, respec-
tively, 80, 65, and 38 minutes per week
of physical education. Metropolitan
achievement scores were compared at
the conclusion of the study. Students in
the specialist teacher group were supe-
rior to controls with respect to reading
but inferior on English language. Students
in the trained teacher group fared rather
better, being superior to the controls on
language, reading, and the basic test bat-
tery. The authors concluded simply that
there was no negative effect on aca-
demic achievement when more time was
devoted to physical education.
In South Australia, a 500-student
randomized control trial added 1.25
hours per day of endurance training to
the curriculum of 10-year-old primary
school students for a 14-week period.
71
Control groups received either a skills
program or normal physical education.
Arithmetic and reading scores were not
adversely affected in the experimental
classes, although academic instruction
was reduced by 45 to 60 minutes per
day; indeed, a 2-year follow-up of
216 continuing participants showed
statistically nonsignificant trends for better
arithmetic and reading grades relative to
their peers, as well as beneficial effects on
teachers’ ratings of classroom behavior.
72
In British Columbia, a study of 287
nine- to 11-year-old primary school
students
73
added an average of 47
minutes per week of various physical
activities to the normal curriculum,
where physical education was judged
as inadequate (139 ± 62 in experimental
students vs 92 ± 45 minutes in control
students, P < .001). The experimental
program was delivered by suitably
briefed homeroom teachers. Despite
a 47-min/wk reduction in time for
academic learning, performance as
measured by the computer-scored
Canadian Achievement Test remained
essentially unchanged; there was a slight
trend toward enhanced performance
in the intervention schools (from 1595
to 1672 units) but unchanged scores in
control schools (1678 to 1689 units).
A crossover trial was carried out on
214 sixth-grade US students.
74
Academic
grades were compared between a curric-
ulum in which students spent 55 nominal
minutes per day on physical education
(an actual 19 minutes of moderate or vig-
orous activity) and an alternative program
in which a similar amount of time was
allocated to arts or computer sciences.
Students in the 2 programs performed
equally well in mathematics, sciences,
and English, as well as on a national
standardized test.
74
A post hoc cross-
sectional analysis showed that students
who reported engaging in additional
periods of vigorous physical activity on
their own initiative had substantially
superior academic scores. Although the
authors lacked information to control this
additional data for socioeconomic status,
they suggested that greater benefit might
have been observed if the intervention
for the remaining experimental students
had been more intensive.
A recent prospective study on 1411
French middle-school schoolchildren
suggested a graded effect between
the amount of extracurricular sport
involvement and self-declared academic
performance.
75
Students reported
academic grade point average (GPA)
outcomes of 12.9/20, 12.4, and 12.0 if
they reported regular, occasional, or
no extracurricular sport practice. This
difference was maintained throughout the
4-year follow-up.
75
A controlled study from Israel looked
at the responses of 92 preschool and
266 first-grade children to a program of
movement education; relative to controls,
the experimental children showed better
balance and throwing abilities, together
with greater reading skills and arithmetic
readiness scores.
76
Finally, a small-scale study of 9 pairs
of monozygotic twins found that after 6
months of treadmill running (20 minutes
per day at an intensity above the anaer-
obic threshold), the correctness of scores
and decision time were improved relative
to 8 control students of the same age.
77
Several other projects with an exper-
imental design have been excluded
because the subjects had some form of
learning disorder. Finally, we may note a
few reports that looked only at immediate,
short-term responses to additional physical
activity.
78
For example, students showed
an immediate increase of concentration
following 15 minutes of stretching and
walking,
37
and improved computational
skills were seen immediately after 20 to 40
minutes of walking in the afternoon (but
American Journal of Lifestyle Medicinevol. X • no. X
7
not in the morning).
79
Although not qua-
si-experimental, a recent American inves-
tigation of data from the Early Childhood
Longitudinal Study indicated that, in girls,
the group undertaking more physical edu-
cation in kindergarten (ie, from 70 to 300
minutes weekly) had better scores for
mathematics and reading during their sub-
sequent primary school years (although no
such effects were found in boys).
80
Cross-sectional Studies
Many cross-sectional studies have
looked for possible relationships
between academic achievement and
sport or other forms of physical activity.
Unfortunately, such studies cannot indi-
cate the direction of any associations that
may be observed, and they are of inter-
est only insofar as potential sources of
bias can be controlled. One of the most
important covariates is the student’s
socioeconomic status; this is a strong pre-
dictor of both academic achievement
81
and participation in various forms of
physical activity.
82-84
Early reports commonly noted a
positive univariate association between
academic achievement and sport
participation, physical activity, or result-
ing fitness.
10,17,22
For instance, the “sit and
reach” scores of primary school students
showed a positive correlation with stan-
dard academic achievement scores,
85
and
in women entering university, scores
on a physical fitness index were associ-
ated with their academic data.
86
Against
these positive associations must be
set several reports of null or negative
associations.
10,87,88
Negative correlations
were noted between the time allocated
to sport and marks in English language
(r = –.29 to –.30) in a sample of 232
English adolescents aged 13 to 16 years.
89
Likewise, a study of grade 6 children
from New Brunswick (Canada) found a
weak inverse association between phys-
ical activity and academic achievement,
despite a positive relationship to self-
esteem.
90
Similarly, preadolescent boys
in Hong Kong had a positive association
between a high level of physical activity
and self-esteem, but academic achieve-
ment was unaffected.
91
Some cross-sectional studies have
attempted to allow for major confounders
by covariate analysis, examining data from
a single social stratum or using representa-
tive sampling. This may limit the general-
ity of findings because it is likely that the
influence of sport on academic achieve-
ment will differ with social class. Among
studies in which allowance was made for
covariates, the US National Longitudinal
Study of Adolescent Health observed that
students who were physically active in
school were likely to achieve high grades.
After adjusting for socioeconomic status
and demographics, the grades of active
individuals remained 20% higher for math-
ematics and 21% higher for English.
92
In a
similar vein, a British study found a pos-
itive association between sports partici-
pation and academic achievement after
controlling for socioeconomic status.
93
A
study involving 52 female and 37 male
high school seniors adopted the alterna-
tive tactic of evaluating only those of mid-
dle and upper-middle socioeconomic
status; again, the more active group had
a higher GPA.
94
An association between
perception of little or no involvement in
physical activity and perception of low
academic performance was reported in
a representative sample of US adoles
cents.
95
Another representative cross-
sectional survey studied 109 schools in
South Australia
8
(9000 schoolchildren aged
7 to 15 years). In most age and sex cate-
gories, linear regression analysis demon-
strated significant associations between
the school principals’ ratings of academic
achievement and physical activity both at
lunch time and over the entire previous
week. Correlations between simple field
tests of performance and academic rat-
ings were very weak (r = 0.08 to 0.19),
and they became nonsignificant when the
influences of motivation and obesity were
excluded by making an objective cycle
ergometer assessment of physical work
capacity per unit of lean mass. In support
of this negative conclusion, a survey of
117 Australian primary schools showed
that literacy and numeracy results were
unaffected by spending more time on
physical education.
96
Two studies from Hong Kong under-
lined the problems that can arise from
interactions between social class and
the response to sport. In a first analysis
of 4690 children aged 10 to 18 years,
responses to a prevalidated questionnaire
on sports and exercise participation
showed weak correlations with perceived
academic performance (r = .10 for the
whole sample, P < .01; r = .17, P < .01 for
girls; r = .06, nonsignificant for boys).
97
A second report
98
examined the same
issue in 1447 schoolchildren aged 13,
15, and 17 years, taking into account the
participants’ class banding, or scholastic
ability (40% low, 17% middle, 43% high).
For students in the high band, GPA was
positively linked to physical activity, but
for those in the low band, the relationship
was negative. A study from Iceland
99
likewise found that weak associations
of physical activity with self-reported
absenteeism (r = –.11) and school grades
(r = .09) were further diminished by
integrating confounders such as body
mass index, gender, parental education,
and family structure into the analysis.
Furthermore, academically gifted children
involved in sports did not display an
increase of grades in mathematics or in
verbal skills, possibly indica ting an effect
of the initial value (ie, those with lower
academic grades may benefit more than
higher academic achievers).
100
Specific studies of sports generally refer
to high school or university rather than
primary school. The competitive nature
of most sports introduces new problems,
and partly for this reason, the findings
are even more equivocal than for phys-
ical activity as a whole. Moreover, many
authors have failed to take account of
biases common to athletic and academic
endeavor.
101,102
Any interaction with aca-
demic status is likely influenced by the
type and status of the sport,
103
the gender
of the participant,
104,105
secular trends in
gender roles,
104
socioeconomic status,
104
ethnicity,
106
the level of competition, and
the location of the activity (intramural or
extracurricular).
107
The impact on aca-
demic scores may also vary with the dis-
cipline; thus, subjects such as English
may be more susceptible to the cultural
influence of sport participation than are
achievements in mathematics or scientific
subjects.
103
8
American Journal of Lifestyle Medicine XXX • XXX XXXX
Students engaged in extracurricular
sports generally have more interactions
with significant adults than their peers,
greater educational motivation, and a
greater level of satisfaction with their
educational experience, although this
does not always translate into a higher
GPA.
108-112
For example, involvement of
British Columbia students in school or
minor-league hockey was associated with
a low rate of absenteeism but no grade
point advantage.
113
In contrast, a study of
Maryland adolescents
114
found that partic-
ipation in extracurricular physical activ-
ities was associated with both higher
academic expectations and better actual
academic achievements. Sports partici-
pation by eighth-grade African American
students, likewise, was linked to a lesser
likelihood of inappropriate school behav-
ior and absenteeism and a greater desire
for university education.
115
Cooper et al
116
calculated that even after
allowing for confounding variables, extra-
curricular sports and physical activity
were predictors of academic achievement
in a sample of 2200 US high school stu-
dents. Likewise, after standardization for
socioeconomic status, sports participation
with parental presence was associated
with an adjusted relative risk of 1.232 of
better grades in English and mathematics
in a sample of 11 957 US adolescents.
117
Other investigators have reported either a
small positive association between sport
participation and General Certificate of
Education grades in mathematics and
English
118
or no effect.
112-120
It is commonly claimed that relative to
nonathletes, elite and varsity-level ath-
letes later experience greater success in
the labor market.
108,109,121-124
Some of these
studies have been plagued by technical
problems; for instance, in the investiga-
tion by Marsh and Kleitman,
122
two-
thirds of the subjects had missing data.
Furthermore, as with immediate academic
achievement, any apparent effect may be
mediated in part by external factors such
as maternal education and prior aca-
demic achievement,
125
racial group,
126
the
availability of scholarships, and the large
amounts of capital accumulated by top
athletes. Nevertheless, a multiple regres-
sion analysis by Carlson and associates
121
showed that after controlling for sex, eth-
nicity, socioeconomic status, and aca-
demic grades, 8 years after high school,
elite athletes were more likely to have
completed postgraduate education, to be
employed, and to have a high income.
Correlations With
Determinants of
Academic Performance
Another line of inquiry has been to
evaluate associations of physical activity
with possible determinants of academic
success such as motor coordination, body
image, psychosocial characteristics, and
overall classroom behavior.
Motor coordination. The concept of a
linkage between the development of
motor skills and learning dates back
to Piaget.
127
A study in Köln, Germany,
reported data from 12 intervention
(n = 668) and 5 control schools (n = 218).
The children were aged 6 to 7 years (3
months older in control schools because
the students were tested sequentially).
Overall, scores on a motor coordina-
tion test did not differ between inter-
vention and control students, but motor
coordination in the pooled sample was
positively associated with the rate and
accuracy of symbol processing.
128
This
was interpreted as supporting communa-
lity between cerebral learning and motor
control processes.
Body image. Sports programs have com-
monly contributed to an enhanced body
image.
129,130
The body image of the suc-
cessful athlete has traditionally meant
more to the status of boys than girls,
although this is changing. Conversely, the
body image of girls is particularly vulner-
able to obesity. A cross-sectional study
of third- and fifth-grade children found
a positive association between aero-
bic power and academic achievement.
131
Likewise, field measures of fitness were
associated with several measures of cogni-
tive function (Stroop test, digit span, digit
symbol test, and trail-making test) in a
sample of 203 German students aged 8 to
16 years.
132
However, perhaps because the
baseline level of physical activity is greater
in a developing society, these findings
were not duplicated in 212 rural South
African children aged 7 to 14 years.
133
Several authors have reported a negative
association between obesity and academic
achievement.
131,134,135
For example, a multi-
variate analysis of data for 11 192 kinder-
garten and first-grade children in the United
States showed a negative association
between obesity and academic achieve-
ment.
135
However, it is less clear that the
obesity would be reversed by a required
school program of sports or physical edu-
cation; such initiatives have generally had
little effect on body fat content, unless stu-
dents have been sent to a residential camp,
where diets can be rigidly controlled.
Psychosocial characteristics. It has been
hypothesized that the enhanced self-
concept,
136
social status,
137
and self-
esteem associated with improved motor
skills may increase a child’s desire to
learn.
138
The classic view has been that
self-esteem is a determinant of student
motivation, persistence, and academic
success.
139,140
Success in high-profile sports
is commonly associated with a greater
self-esteem.
22,117,141,142
The US National
Longitudinal Study of Adolescent Health
reported a positive association between
physical activity and several components
of mental health, including self-esteem,
emotive well-being, spirituality, and future
expectations.
91
Associations were particu-
larly marked if the sport or physical activ-
ity included parental involvement. Regular
participation in sports or physical activ-
ity has also been linked to greater school
satisfaction and connectedness,
143
with a
reduced dropout rate from school.
144
However, an increase in self-esteem has
not always translated into better academic
performance, and better academic per-
formance can itself result in an increase
of self-esteem.
145
For instance, a study
of almost all grade 6 students in New
Brunswick (n = 5856) found that after con-
trolling for socioeconomic circumstances,
sex, and the number of parents and sib-
lings, there was a weak positive associ-
ation between self-esteem (responses to
a 16-item self-description questionnaire)
and self-reported participation in sports
and physical activity in and out of school
but a weak negative relationship between
American Journal of Lifestyle Medicinevol. X • no. X
9
physical activity and classroom scores for
mathematics and reading.
90
Likewise, a
cross-sectional questionnaire study of 245
Finnish seventh- and ninth-grade adoles-
cents
146
found no significant correlations
between physical activity level and school
or educational problems, although there
was a weak association between partici-
pation in physical activity and the absence
of depressive mood (–0.20 and –0.26 for
girls and boys, respectively). One prob-
lem may be that sports and school work
are commonly related to differing psycho-
logical domains (perceived ability vs task
orientation).
147
Positive associations are
more likely to be observed if an effort is
made to create a context in which both
endeavors find common ground (ie, if a
school offers a setting where sports can be
modified to increase task orientation and
skills acquisition without decreasing the
element of pleasure). Even if sport partici-
pation has some positive influence on the
social adjustment of a child, this must be
tempered by observations suggesting that
other extracurricular activities are more
effective in this regard.
148
Classroom behavior. It seems self-evident
that a child who behaves well in the
classroom is more likely to learn. Thus,
considerable attention has been directed
to the influence of sports programs
on classroom behavior. If student
behavior is indeed improved by sport
participation, better teacher attitudes
toward the students concerned could
contribute to enhanced opportunities
for learning, as suggested in the quasi-
experimental studies from Vanves,
65
Trois-Rivières,
69
and Australia.
149
Improved teacher attitudes could also
provide a halo effect, with an increase in
the classroom marks assigned to students
in intervention groups.
A meta-analysis suggested that most
forms of physical activity prior to class sig-
nificantly reduced disruptive behavior in
disturbed students.
150
When emotionally or
behaviorally disturbed adolescents partic-
ipated in a program of jogging and foot-
ball, they also showed more appropriate
classroom behavior.
151
Gains are likely
less marked if students are initially well
adjusted. In the Trois-Rivières study, grades
assigned for classroom behavior were sim-
ilar in experimental and control groups,
except in the sixth grade, where the aver-
age class mark assigned for behavior was
better in experimental than in control stu-
dents.
152
Nevertheless, others have com-
mented on positive associations between
sport participation, classroom behavior,
149,153
and attitudes to learning.
154
In high school
students, self-identification as an athlete
rather than a jock is associated with fewer
reported acts of misconduct in class.
105
One
negative consideration is that participants
in high school and university team sports
seem more liable to become involved in
binge drinking.
121
Learning and developmental mecha-
nisms. An early hypothesis of the French
pediatrician Piaget was that the skills of
spatial organization required for sport
and other forms of active play would
carry over into an understanding of the
spatial relationships that comprise words
and mathematical relationships.
127,155,156
Several recent reports have given an
experimental basis to this line of inquiry,
particularly in elderly individuals. A pos-
itive effect of regular physical activity on
learning, memory, and retention of cog-
nitive function has been noted in elderly
subjects.
1,3,157-162
It remains difficult to rule
out a placebo effect from the added per-
sonal attention and social contacts expe-
rienced by experimental subjects, and the
influence of physical activity on the cogni-
tive health of younger subjects is less well
established. Nevertheless, several early
factor analyses have suggested a cluster-
ing of psychomotor training and cognitive
development in young children.
163-165
Conclusions
The overall conclusion from the studies
reviewed is that the introduction of sport
or physical education into the school cur-
riculum has no striking effect on GPA.
In some of the studies cited, the trans-
fer of teaching time from academic sub-
jects to physical activity was too small
to anticipate any great effect on learn-
ing. Nevertheless, when taken together,
the available data suggest that at least
in primary school students, the physical
activity needed to optimize the healthy
development of a child (an additional
60-90 minutes per day
166,167
) can be pro-
vided without jeopardizing academic per-
formance. In essence, active students
compensated for a reduction of academic
instruction time by greater efficiency
of the learning process.
69
This is by no
means a negative outcome. A study from
Virginia’s primary schools demonstrated
that if the time allocated to physical edu-
cation or the arts were to be reduced, as
suggested by some school boards, such a
change would not enhance performance
in subjects such as mathematics or read-
ing; increasing the time allocated to phys-
ical education is not detrimental to test
scores for academic subjects.
168
It is likely that findings would be simi-
lar if a modest amount of curricular time
was allocated to organized sport rather
than physical education, although this
remains to be tested in both intramu-
ral and extramural settings. The issue of
academic performance also needs to be
evaluated more fully in those older chil-
dren and university students, who com-
monly allocate much larger amounts of
time to sport and other physical pursuits.
In many developed countries, older stu-
dents commonly still have a large reserve
of discretionary time, as shown by exten-
sive television viewing.
169
However, in
other parts of the world, the discretionary
time of the older student may be severely
limited by several hours of nightly home-
work assignments or a need to contribute
to family income. Finally, much further
information is needed about the impact
of sports, physical education, and physi-
cal activity on the student’s ultimate suc-
cess in various types of careers and his
or her brain health later in life. One can-
not exclude the possibility that greater
neurogenesis (induced by exercise begun
early in life and continued over the life
span) may enhance cognitive function
later in life and offer protection against
the neuropathologies of old age. But
even if from the viewpoint of intellec-
tual function physical activity is no more
than an enrichment of the individual’s life
experience,
170
its numerous more general
health benefits warrant advocating an
active lifestyle at all ages.
AJLM
10
American Journal of Lifestyle Medicine XXX • XXX XXXX
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