Abstract

Background: The aim of the current study was to examine the association between physical education classes (PE) and health outcomes. Materials and Methods: A systematic review was carried out with studies identified in seven databases. The eligibility criteria included an observational design, objective or self-reported measure of PE exposure (i.e., participation or frequency in classes) and any health outcome. The synthesis of data was performed by clustering studies according to the direction of association between PE classes and each outcome, classified as beneficial, no effect, inconclusive, or harmful. Results: A total of 6,102 studies were screened, of which 99 were included, with 2,717,508 participants and 22 groups of outcomes. The results revealed a beneficial effect of PE on physical activity (74%), mental health (69%), physical fitness (80%), sports practice (80%), self-rated health (75%) and smoking (60% of studies). No effect was found for the association between PE and alcohol consumption. Inconclusive results emerged from studies that analyzed body fat indicators, sedentary behavior, academic achievement, and the other 12 outcomes. Conclusions: PE as offered in schools, provides health benefits regarding physical activity, mental health, physical fitness, sports practice, self-rated health, and smoking, in addition to the pedagogical aims of the discipline.

Keywords

Health behavior, Lesson, School, Students,

References

  1. Araujo, R.H., Werneck, A.O., Christofaro, D.G., Silva, D.R., Participation in physical education classes and social isolation among adolescents: A harmonized analysis with 266,156 participants from 69 countries. Mental Health and Physical Activity, 26, (2024), 100583.
  2. Bacil, E., Rech, C., Hino, A. (2013). Padrões de atividade física em escolares de Ponta Grossa, Paraná. Revista Brasileira de Atividade Física & Saúde, 18(2), 177-177.
  3. Bacil, E.D.A., Rech, C.R., Hino, A.A.F., de Campos, W. (2016). Overweight in adolescents: moderating role of gender and mother’s education level. Revista Brasileira em Promocao da Saude, 29(4), 515.
  4. Bandeira, A.D.S., Ravagnani, F.C.D.P., Barbosa Filho, V.C., de Oliveira, V.J.M., de Camargo, E. M., Tenório, M.C.M., Sandreschi, P.F. , Santos, P.C.D., Ramires, V.V., Hallal, P.C., Silva, K.S. (2022). Mapping recommended strategies to promote active and healthy lifestyles through physical education classes: a scoping review. International Journal of Behavioral Nutrition and Physical Activity, 19(1), 36.
  5. Barbosa Filho, V.C., de Campos, W., Bozza, R., Lopes, A.D.S. (2012). The prevalence and correlates of behavioral risk factors for cardiovascular health among Southern Brazil adolescents: a cross-sectional study, BMC Pediatrics, 12 (2012) 130.
  6. Barros, S., Barros, M., Hardman, C., Júnior, A. S., Nascimento, J., Brito, A., & Nahas, M. (2013). Aulas de Educação Física e indicadores de violência em adolescentes. Revista Brasileira de Atividade Física & Saúde, 18(5), 566-566.
  7. Bednar, S., Rouse, K. (2020). The effect of physical education on children's body weight and human capital: new evidence from the ECLS‐K: 2011. Health economics, 29(4), 393-405.
  8. Bergmann, G.G., Bergmann, M.L.D.A., Marques, A.C., Hallal, P.C. Prevalência e fatores associados à inatividade física entre adolescentes da rede pública de ensino de Uruguaiana, Rio Grande do Sul, Brasil. Cadernos de Saude Publica, 29, (2013) 2217-2229.
  9. Bergmann, G.G., dos Santos Pinheiro, E., Mello, J.B., Graup, S. (2020). Associação entre diferentes domínios da atividade física ea dor lombar inespecífica em adolescentes. Motricidade, 16(3), 245-254.
  10. Bezerra, J., Lopes, A.D.S., Del Duca, G.F., Barbosa Filho, V.C., Barros, M.V.G.D. Leisure-time physical activity and associated factors among adolescents of Pernambuco, Brazil: from 2006 to 2011. Revista Brasileira de Cineantropometria & Desempenho Humano, 18, (2016) 114-126.
  11. Brosnahan, J., Steffen, L.M., Lytle, L., Patterson, J., Boostrom, A. The relation between physical activity and mental health among Hispanic and non-Hispanic white adolescents. Archives of pediatrics & adolescent medicine, 158(8), (2004) 818-823.
  12. Carlson, S.A., Fulton, J.E., Lee, S.M., Maynard, L.M., Brown, D.R., Kohl III, H.W., Dietz, W. H. (2008). Physical education and academic achievement in elementary school: data from the early childhood longitudinal study. American journal of public health, 98(4), 721-727.
  13. Cawley, J., Frisvold, D., Meyerhoefer, C. (2013). The impact of physical education on obesity among elementary school children. Journal of Health Economics, 32(4), 743-755.
  14. Cawley, J., Meyerhoefer, C., Newhouse, D. (2007). The impact of state physical education requirements on youth physical activity and overweight. Health economics, 16(12), 1287-1301.
  15. Ceschini, F.L., Andrade, D.R., Oliveira, L.C., Araújo Júnior, J.F., Matsudo, V.K. (2009). Prevalence of physical inactivity and associated factors among high school students from state's public schools. Jornal de pediatria, 85, 301-306.
  16. Cheah, Y.K., Lim, H.K., Kee, C.C. (2018). Demographic and lifestyle determinants of time spent in physical activity among Malaysian adolescents. International Journal of Pediatrics and Adolescent Medicine, 5(2), 49-54.
  17. Chen, H.J., Wang, Y. (2013). Influence of school beverage environment on the association of beverage consumption with physical education participation among US adolescents. American journal of public health, 103(11), e63-e70.
  18. Coledam, D.H.C., Ferraiol, P.F. (2017). Engagement in physical education classes and health among young people: does sports practice matter? A cross-sectional study. Sao Paulo Medical Journal, 135, 548-555.
  19. Coledam, D.H.C., Ferraiol, P.F., Dos-Santos, J.W., Oliveira, A.R.D. (2016). Fatores associados à aptidão cardiorrespiratória de escolares. Revista Brasileira de Medicina do Esporte, 22(1), 21-26.
  20. Coledam, D.H.C., Ferraiol, P.F., Greca, J.P.D.A., Teixeira, M., Oliveira, A.R.D. (2018). Physical education classes and health outcomes in Brazilian students. Revista Paulista de Pediatria, 36, 192-198.
  21. Coledam, D.H.C., Ferraiol, P.F., Pires Junior, R., dos-Santos, J.W., Oliveira, A.R.D. (2014). Prática esportiva e participação nas aulas de educação física: fatores associados em estudantes de Londrina, Paraná, Brasil. Cadernos de Saúde Pública, 30, 533-545.
  22. Coledam, D.H.C., Ferraiol, P.F., Pires Júnior, R., Ribeiro, E.A.G., Ferreira, M.A.C., Oliveira, A.R. D. (2014). Agreement between two cutoff points for physical activity and associated factors in young individuals. Revista Paulista de Pediatria, 32, 215-222.
  23. Dills, A.K., Morgan, H.N., Rotthoff, K.W. (2011). Recess, physical education, and elementary school student outcomes. Economics of Education Review, 30(5), 889-900.
  24. Dunn, M.S. (2014). Association between physical activity and substance use behaviors among high school students participating in the 2009 Youth Risk Behavior Survey. Psychological reports, 114(3), 675-685.
  25. Ekblom-Bak, E., Ekblom, Ö., Andersson, G., Wallin, P., & Ekblom, B. (2018). Physical education and leisure-time physical activity in youth are both important for adulthood activity, physical performance, and health.Journal of Physical Activity and Health, 15(9), 661-670.
  26. El-Ammari, A., El Kazdouh, H., Bouftini, S., El Fakir, S., El Achhab, Y. (2017). Level and potential social-ecological factors associated with physical inactivity and sedentary behavior among Moroccan school-age adolescents: a cross-sectional study. Environmental health and preventive medicine, 22, 47.
  27. Esteban-Cornejo, I., Martinez-Gomez, D., Garcia-Cervantes, L., Ortega, F.B., Delgado-Alfonso, A., Castro-Piñero, J., & Veiga, O. L. (2017). Objectively measured physical activity during physical education and school recess and their associations with academic performance in youth: The UP&DOWN study. Journal of Physical Activity and Health, 14(4), 275-282.
  28. Farias Júnior, J.C.D., Lopes, A.D.S., Mota, J., Hallal, P.C. (2012). Physical activity practice and associated factors in adolescents in Northeastern Brazil. Revista de Saúde Pública, 46, 505-515.
  29. Ferreira, V.R., Jardim, T.V., Póvoa, T.I.R., Viana, R.B., Sousa, A.L.L., Jardim, P.C.V. (2020). Physical inactivity during leisure and school time is associated with the presence of common mental disorders in adolescence. Revista de saude publica, 54, 128.
  30. Gomes, T.N., dos Santos, F.K., Zhu, W., Eisenmann, J., & Maia, J.A. (2014). Multilevel analyses of school and children's characteristics associated with physical activity. Journal of School Health, 84(10), 668-676.
  31. Gordon-Larsen, P., McMurray, R.G., Popkin, B.M., (2000). Determinants of adolescent physical activity and inactivity patterns. Pediatrics, 105, e83.
  32. Hardie Murphy, M., Rowe, D.A., Woods, C.B. (2017). Impact of physical activity domains on subsequent physical activity in youth: a 5-year longitudinal study. Journal of Sports Sciences, 35(3), 262-268.
  33. Hardman, C.M., Barros, S.S.H., Andrade, M.L.S.D.S., Nascimento, J.V.D., Nahas, M.V., Barros, M.V.G.D. (2013). Participação nas aulas de educação física e indicadores de atitudes relacionadas à atividade física em adolescentes. Revista Brasileira de Educação Física e Esporte, 27, 623-631.
  34. Henrique, R.S., Gomes, T.N., Tani, G., Maia, J.A. (2018). Association between body mass index and individual characteristics and the school context: a multilevel study with Portuguese children. Jornal de pediatria, 94(3), 313-319.
  35. Herman, K.M., Sabiston, C.M., Mathieu, M.E., Tremblay, A., Paradis, G. (2015). Correlates of sedentary behaviour in 8-to 10-year-old children at elevated risk for obesity. Applied Physiology, Nutrition, and Metabolism, 40(1), 10-19.
  36. Hobin, E.P., Leatherdale, S.T., Manske, S.R., Robertson-Wilson, J. (2010). A multilevel examination of school and student characteristics associated with moderate and high levels of physical activity among elementary school students (Ontario, Canada). Canadian Journal of Public Health, 101(6), 495-499.
  37. Jesus de, G.M., de Oliveira Araujo, R.H., Dias, L.A., Barros, A.K.C., dos Santos Araujo, L.D.M., de Assis, M.A.A. (2022). Attendance in physical education classes, sedentary behavior, and different forms of physical activity among schoolchildren: a cross-sectional study. BMC public health, 22(1), 1461.
  38. Jodkowska, M., Oblacińska, A., Dzielska, A., Nałęcz, H., & Fijałkowska, A. (2019). Behavioural factors as predictors of self-rated health among polish adolescent girls. Developmental period medicine, 23(2), 109.
  39. Khan, M.M.A., Karim, M., Islam, A.Z., Islam, M.R., Khan, H.T., Khalilullah, M.I. (2019). Prevalence of overweight and obesity among adolescents in Bangladesh: do eating habits and physical activity have a gender differential effect?. Journal of Biosocial Science, 51(6), 843-856.
  40. Kim, B., Lee, C.Y., Kim, H.S., Ko, I.S., Park, C.G., Kim, G.S. (2012). Ecological risk factors of childhood obesity in Korean elementary school students. Western journal of nursing research, 34(7), 952-972.
  41. Kim, S.Y., So, W.Y. (2012). The relationship between school performance and the number of physical education classes attended by Korean adolescent students. Journal of sports science & medicine, 11(2), 226.
  42. Knaus, M.C., Lechner, M., Reimers, A.K., (2020) For better or worse?, The effects of physical education on child development. Labour Economics, 67, 101904.
  43. Kremer, P., Elshaug, C., Leslie, E., Toumbourou, J.W., Patton, G.C., Williams, J. (2014). Physical activity, leisure-time screen use and depression among children and young adolescents. Journal of science and medicine in sport, 17(2), 183-187.
  44. Kwak, Y., Kim, H., Ahn, J.W. (2022). Health risk behaviors affecting internet usage in adolescents: evidence from the 2018 Korea youth risk behavior web-based survey. Iranian Journal of Public Health, 51(7), 1559-1567.
  45. Lima de, T.R., Silva, D.A.S. (2018). Prevalence of physical activity among adolescents in southern Brazil. Journal of bodywork and movement therapies, 22(1), 57-63.
  46. Lima De, T.R., Silva, D.A.S. (2019). Association between sports practice and physical education classes and lifestyle among adolescents. Human Movement, 20(3), 48-55.
  47. Littman, A.J., Doody, D.R., Biggs, M.L., Weiss, N.S., Starr, J.R., Schwartz, S.M. (2009). Physical activity in adolescence and testicular germ cell cancer risk. Cancer Causes & Control, 20, 1281-1290.
  48. Loucaides, C.A., Plotnikoff, R.C., Bercovitz, K. (2007). Differences in the correlates of physical activity between urban and rural Canadian youth. Journal of school health, 77(4), 164-170.
  49. Lowry, R., Lee, S. M., Fulton, J.E., Demissie, Z., Kann, L. (2013). Obesity and other correlates of physical activity and sedentary behaviors among US high school students. Journal of obesity, 2013(1), 276318.
  50. Lowry, R., Lee, S.M., Galuska, D.A., Fulton, J.E., Barrios, L.C., Kann, L. (2007). Physical activity-related injury and body mass index among US high school students. Journal of physical activity and health, 4(3), 325-342.
  51. Martins, J., Marques, A., Gouveia, É. R., Carvalho, F., Sarmento, H., Valeiro, M. G. (2022). Participation in physical education classes and health-related behaviours among adolescents from 67 countries. International journal of environmental research and public health, 19(2), 955.
  52. Martins, P.C., Lima, T.R.D., Silva, D.A.S. (2017). Association between different contexts of physical activity and abdominal obesity and excess weight in adolescents. Motriz: Revista de Educação Física, 23(spe2), e1017104.
  53. Myers, L., Strikmiller, P.K., Webber, L.S., Berenson, G.S., (1996). Physical and sedentary activity in school children grades 5-8: The Bogalusa heart study. Medicine and Science in Sports and Exercise, 28, 852–859.
  54. Naiman, D.I., Leatherdale, S.T., Gotay, C., Mâsse, L.C. (2015). School factors associated with the provision of physical education and levels of physical activity among elementary school students in Ontario. Canadian Journal of Public Health, 106, e290-e296.
  55. National Heart, Lung, and Blood Institute, Study quality assessment tools: quality assessment tool for observational cohort and cross-sectional studies, (2013). Available at: https://www.nhlbi.nih.gov/health-topics/study-quality-assessment-tools
  56. Novaes, J.F.D., Lamounier, J.A., Franceschini, S.D.C.C., Priore, S.E. (2009). Fatores ambientais associados ao sobrepeso infantil. Revista de Nutrição, 22, 661-673.
  57. Nakamura, P.M., I.P. Teixeira, C.B. Papini, N.D. Lemos, M.E.S. Nazario, Kokubun, E. (2013). Physical education in schools, sport activity and total physical activity in adolescents. Revista Brasileira de Cineantropometria & Desempenho Humano, 15, 517-526.
  58. Page, M.J., McKenzie, J.E., Bossuyt, P.M., Boutron, I., Hoffmann, T.C., Mulrow, C.D., Shamseer, L., Tetzlaff, J.M., Akl, E.A., Brennan, S.E., Chou, R., Glanville, J., Grimshaw, J.M., Hróbjartsson, A., Lalu, M.M., Li, T., Loder, E.W., Wilson, E.M., McDonald, S., McGuinness, L.A., Stewart, L.A., Thomas, J., Tricco, A.C., Welch, V.A., Whiting, P., Moher, D. (2021) The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. Systematic Reviews, 10, 89.
  59. Palakshappa, D., Virudachalam, S., Oreskovic, N.M., Goodman, E. (2015). Adolescent physical education class participation as a predictor for adult physical activity. Childhood Obesity, 11(5), 616-623.
  60. Peltzer, K., Pengpid, S. (2015). Unintentional injuries and psychosocial correlates among in-school adolescents in Malaysia. International journal of environmental research and public health, 12(11), 14936-14947.
  61. Peltzer, K., Pengpid, S. (2016). Leisure time physical inactivity and sedentary behaviour and lifestyle correlates among students aged 13–15 in the association of Southeast Asian nations (ASEAN) member states, 2007–2013. International journal of environmental research and public health, 13(2), 217.
  62. Peralta, M., Santos, D.A., Henriques-Neto, D., Ferrari, G., Sarmento, H., Marques, A. (2020). Promoting health-related cardiorespiratory fitness in physical education: The role of class intensity and habitual physical activity. International Journal of Environmental Research and Public Health, 17(18), 6852.
  63. Pérez, A., Reininger, B.M., Aguirre Flores, M.I., Sanderson, M., Roberts, R.E. (2006). Physical activity and overweight among adolescents on the Texas-Mexico border. Revista panamericana de salud pública, 19, 244-252.
  64. Perez, C.E. (2003). Children who become active. Health Reports, 14, 17-28.
  65. Perry, C.K., Saelens, B.E., Thompson, B. (2011). Intrapersonal, behavioral and environmental factors associated with meeting recommended physical activity among rural Latino youth. Pediatric Exercise Science, 23(4), 521-536.
  66. Pimentel, J., Hardman, C.M., Júnior, R.S.W., Santos, S.J., da Silva Brito, A.L., Lima, R.A., de Barros, M.V.G. (2013). Associação entre prática de atividade física e indicadores de comportamento sexual de risco em adolescentes. Revista Brasileira de Atividade Física & Saúde, 18(4), 493-493.
  67. Pinto, A.D.A., Oppong Asante, K., Puga Barbosa, R.M.D.S., Nahas, M.V., Dias, D.T., Pelegrini, A. (2021). Association between loneliness, physical activity, and participation in physical education among adolescents in Amazonas, Brazil. Journal of health psychology, 26(5), 650-658.
  68. Prazeres Filho, A., Mendonça, G., Neto, J.M.S., Tassitano, R.M., Silva, A.B.P., de Farias Júnior, J. C. (2019). Attendance in Physical Education classes and associated factors among high school students.Revista Brasileira de Atividade Física & Saúde, 24, 1-10.
  69. Puia, A., Leucuta, D.C. (2017). Childrens lifestyle behaviors in relation to anthropometric indices: a family practice study. Clujul Medical, 90(4), 385.
  70. Quennerstedt, M. (2019). Healthying physical education-on the possibility of learning health. Physical Education and Sport Pedagogy, 24(1), 1-15.
  71. Reis, L.N., Reuter, C.P., Burns, R.D., Martins, C.M.L., Mota, J., Gaya, A.C.A., Silveira, J.F.C., Gaya. A.R., Effects of a physical education intervention on children’s physical activity and fitness: the PROFIT pilot study. BMC Pediatrics, 24, (2024) 78.
  72. Rezende de, L.F.M., Azeredo, C.M., Canella, D.S., Claro, R.M., de Castro, I.R.R., Levy, R.B., Luiz, O.D.C. (2014). Sociodemographic and behavioral factors associated with physical activity in Brazilian adolescents. BMC Public Health, 14, 1-11.
  73. Rocliffe, P., Adamakis, M., O´keefe B.T., Walsh, L., Bannon, A., Garcia-Gonzalez, L., Chambers, F., Stylianou, M., Sherwin, I., Mannix-McNamara, P., MacDonncha, C., (2024) The impact of typical school provision of physical education, physical activity and sports on adolescent mental health and wellbeing: A systematic literature review. Adolescent Research Review, 9(2), 339-364.
  74. Rocha da, R. Z., da Silva Ribeiro, F., Romig, I.D.K., de Oliveira Arrieira, H., da Cunha, G.D.O. K., Gaya, A.R., Pinheiro, E.D.S., Bergmann, G.G. (2025). Effects of Implementing 15-Minute Physical Exercise Sessions During Physical Education Classes on Physical Fitness and Anthropometric Indicators in Rural Adolescents. Journal of Physical Activity and Health, 1(aop), 1-11.
  75. Ruedl, G., Greier, K., Kirschner, W., Kopp, M. (2016). Factors associated with motor performance among overweight and nonoverweight Tyrolean primary school children. Wiener klinische Wochenschrift, 128, 14-19.
  76. Ryu, S., Loprinzi, P., Kim, H., & Kang, M. (2020). Temporal trends in the association between participation in physical education and physical activity among US high school students, 2011–2017. International journal of environmental research and public health, 17(7), 2357.
  77. Sabia, J.J., Nguyen, T.T., Rosenberg, O., High school physical education requirements and youth body weight: New evidence from the YRBS. Health Economics, 26(10), (2017) 1291-1306.
  78. Santos Silva dos, R.J., Silva, D.A.S., Oliveira, A.C. (2014). Low physical activity levels and associated factors in Brazilian adolescents from public high schools. Journal of physical activity and health, 11(7), 1438-1445.
  79. Santos dos, S.J., Hardman, C.M., Barros, S.S.H., Santos, C.D.F.B.F., de Barros, M.V.G. (2015). Association between physical activity, participation in Physical Education classes, and social isolation in adolescents. Jornal de Pediatria (Versão Em Português), 91(6), 543-550.
  80. Santos, A.E., Araujo, R.H.O., Nascimento, V.M.S., Couto, J.O., Silva, R.J.S., Associations between specific physical activity domains and social isolation in 102,072 Brazilian adolescents: Data from the 2015 National School–Based Health Survey, Journal of Health Psychology, 26, (2021) 2626–2635.
  81. Santos, C., Bustamante, A., Hedeker, D., Vasconcelos, O., Garganta, R., Katzmarzyk, P.T., Maia, J. (2020). A multilevel analysis of gross motor coordination of children and adolescents living at different altitudes: the Peruvian Health and Optimist Growth Study. Annals of Human Biology, 47(4), 355-364.
  82. Santos, C., Bustamante, A., Hedeker, D., Vasconcelos, O., Garganta, R., Katzmarzyk, P.T., Maia, J. (2019). Correlates of overweight in children and adolescents living at different altitudes: the Peruvian health and optimist growth study. Journal of obesity, 2019(1), 2631713.
  83. Sawyer, S.M., Raniti, M., Aston, R. (2021). Making every school a health-promoting school. The Lancet Child & Adolescent Health, 5(8), 539-540.
  84. Sharma, B., Chavez, R.C., Nam, E.W. (2018). Prevalence and correlates of insufficient physical activity in school adolescents in Peru. Revista de saude publica, 52, 51.
  85. Shen, B., Physical Education and Academic Performance in Urban African American Girls. Urban Education, 52, (2017) 267–283.
  86. Silva Da, D.J., Barbosa, A.O., Barbosa Filho, V.C., de Farias Júnior, J.C. (2022). Is participation in physical education classes related to physical activity and sedentary behavior? A systematic review. Journal of Physical Activity and Health, 19(11), 786-808.
  87. Silva, D.A.S., Chaput, J., Katzmarzyk, P.T., Fogelholm, M., Gang, H., Maher, C., Olds, T., Onywera, V., Sarmiento, O.L., Standage, M., Tudor-locke, C., Trembley, M.S., (2018) Physical Education Classes, Physical Activity, and Sedentary Behavior in Children. Medicine and Science in Sports and Exercise, 50, 995–1004.
  88. Silva, D.A.S., Chaput, J.P., Tremblay, M.S. (2019). Participation frequency in physical education classes and physical activity and sitting time in Brazilian adolescents. PLoS one, 14(3), e0213785.
  89. Silva, J.K.T.D.N.F.D., Lins Filho, O.D.L., Gernmano-Soares, A.H., Ritti-Dias, R.M., Farah, B.Q. (2022). Association between frequency of physical education classes and heart rate variability in adolescents boys: a cross-sectional study. Journal of Physical Education, 33, e3322.
  90. Silva, K.S.D., Nahas, M.V., Peres, K.G., Lopes, A.D.S. (2009). Fatores associados à atividade física, comportamento sedentário e participação na Educação Física em estudantes do Ensino Médio em Santa Catarina, Brasil. Cadernos de Saúde Pública, 25, 2187-2200.
  91. Slemenda, C.W., Miller, J.Z., Hui, S.L., Reister, T.K., Johnston, C.C. (1991). Role of physical activity in the development of skeletal mass in children. Journal of bone and mineral research, 6(11), 1227-1233.
  92. So, W.Y., Sung, D.J., Swearingin, B., Baek, S.I., Rhi, S.Y., Webb, D., Fuller, T.M. (2011). Prevalence of obesity in Korean adolescents and its relationship with the weekly frequency of the physical education classes. Journal of sports science & medicine, 10(4), 679-684.
  93. Song, Y., Lee, E.Y., Jeon, J.Y., Song, Y., Lee, E.Y., Jeon, J.Y. (2021). Participation in physical education classes, psychological well-being, and sleep satisfaction among south Korean adolescents. Exercise Science, 30(4), 517-526.
  94. Sousa, T.F.D., Barbosa, A.R., Santos, S.F.D.S.D., Alvarenga, A.M., Fonseca, S.A., Nahas, M.V. (2016). Association between Physical Education program in school and the practice team sports during university. Revista Brasileira de Cineantropometria & Desempenho Humano, 18(2), 222-232.
  95. Southerland, J.L., Zheng, S., Dula, M., Cao, Y., Slawson, D.L. (2016). Relationship between physical activity and suicidal behaviors among 65,182 middle school students. Journal of physical activity and health, 13(8), 809-815.
  96. Tassitano, R.M., Barros, M.V., Tenório, M.C., Bezerra, J., Florindo, A.A., Reis, R.S. (2010). Enrollment in physical education is associated with health‐related behavior among high school students. Journal of School Health, 80(3), 126-133.
  97. Tassitano, R.M., Barros, M.V.G.D., Tenório, M.C.M., Bezerra, J., Hallal, P.C. (2009). Prevalência e fatores associados ao sobrepeso e à obesidade em adolescentes, estudantes de escolas de Ensino Médio de Pernambuco, Brasil. Cadernos de Saúde Pública, 25(12), 2639-2652.
  98. Tassitano, R.M., Dumith, S.C., Chica, D.A.G., Tenório, M.C.M. (2014). Agregamento dos quatro principais comportamentos de risco às doenças não transmissíveis entre adolescentes. Revista Brasileira de Epidemiologia, 17, 465-478.
  99. Tavares, G.H., Oliveira, D.P., Rodrigues, L.R., Mota, C.G., Sousa, T.F., Polo, M.C.E., Inatividade física no lazer durante a pandemia da COVID-19 em universitários de Minas Gerais. Revista Brasileira de Atividade Física e Saúde, 25, (2020) e0178.
  100. Tenório, M.C.M., Barros, M.V.G.D., Tassitano, R.M., Bezerra, J., Tenório, J.M., Hallal, P.C. (2010). Atividade física e comportamento sedentário em adolescentes estudantes do ensino médio. Revista brasileira de epidemiologia, 13, 105-117.
  101. Uddin, R., Salmon, J., Islam, S.M.S., Khan, A. (2020). Physical education class participation is associated with physical activity among adolescents in 65 countries. Scientific Reports, 10(1), 22128.
  102. Vancampfort, D., Damme, T.V., Firth, J., Smith, L., Stubbs, B., Rosenbaum, S., Hallgren, M., Hagemann, N., Koyanagi, A., (2019) Correlates of physical activity among 142,118 adolescents aged 12-15 years from 48 low- and middle-income countries, Preventive Medicine, 127, 105819.
  103. Veugelers, P.J., Fitzgerald, A.L. (2005). Prevalence of and risk factors for childhood overweight and obesity. Cmaj, 173(6), 607-613.
  104. Victo, E.R.D., Ferrari, G., Matsudo, V.K.R., Pires, C.A.M., Araújo, T.L., Katzmarzyk, P.T., Solé, D. (2020). Nutritional status, physical activity, sedentary behavior, diet, and lifestyle in childhood: an analysis of respiratory diseases in adolescence. Revista Paulista de Pediatria, 39, e2020007.
  105. Wang, L., Tang, Y., Luo, J. (2017). School and community physical activity characteristics and moderate-to-vigorous physical activity among Chinese school-aged children: a multilevel path model analysis. Journal of sport and health science, 6(4), 416-422.
  106. Wang, M., Zhong, J.M., Hu, R.Y., Gong, W.W., Yu, M. (2021). Sleep duration and behavioral correlates in middle and high school students: A cross-sectional study in Zhejiang province, China. Sleep Medicine, 79, 55-61.
  107. Wardle, J., Brodersen, N.H., Boniface, D. (2007). School-based physical activity and changes in adiposity. International journal of obesity, 31(9), 1464-1468.
  108. Werneck, A.O., Vancampfort, D., Oyeyemi, A.L., Stubbs, B., Silva, D.R. (2020). Joint association of ultra-processed food and sedentary behavior with anxiety-induced sleep disturbance among Brazilian adolescents. Journal of Affective Disorders, 266, 135-142.
  109. Zhan, X., Clark, C.C., Bao, R., Duncan, M., Hong, J.T., Chen, S.T. (2021). Association between physical education classes and physical activity among 187,386 adolescents aged 13–17 years from 50 lowand middle-income countries. Jornal de pediatria, 97, 571-578.