Associations between Amount of Recess, Physical Activity, and Cardiometabolic Traits in U.S. Children

Abstract

Introduction/Purpose: In the United States, it is recommended that schools provide at least 20 min of daily recess, but the optimal amount for health benefits is unknown. We examined associations between amount of recess and health indicators using data from the National Health and Nutrition Examination Survey (NHANES; 2013–2016). Methods: For this cross-sectional analysis, parents/guardians of 6- to 11-yr-olds ( n = 738) reported recess provision which was classified as low (22.8%; approximately 10–15 min, 5 d·wk −1 ), medium (54.9%; approximately 16–30 min, 5 d·wk −1 ), or high (22.3%; approximately >30 min, 5 d·wk −1 ). Outcomes measured included parent/guardian-reported and accelerometer-measured physical activity (PA), blood pressure, cholesterol, grip strength, bone mineral content, weight status, percent body fat, vitamin D level, and C-reactive protein level. Linear and logistic regression compared outcomes by level of recess provision accounting for the NHANES complex survey design. Results: The odds of meeting PA guidelines according to parent/guardian reports were 1.70 and 2.05 times higher in those with medium and high (respectively) versus low recess provision. Accelerometer-measured weekday activity was highest in those with high recess provision, whereas weekend activity was highest in those with low recess provision (Cohen's d = 0.40–0.45). There were no other significant associations. Conclusion: At least 30 min of daily recess is associated with twofold greater odds of achieving recommended PA levels according to parent/guardian reports; accelerometer data suggest that this is through increased weekday activity. This finding suggests that current national recess recommendations are insufficient for PA promotion. More detailed data on the frequency and duration of recess are needed to quantify optimal provision more precisely.