Physical education classes and leisure-time sedentary behavior: An analysis including adolescents from 73 countries

Introduction: Curricular physical education (PE) is a school-based opportunity to influence movement behaviors. Previous evidence suggests that a higher weekly frequency of PE classes is related to a higher physical activity level in children and adolescents; however, the relationship between the frequency of PE classes and sedentary time is still nuclear. This study aimed to verify the association between the weekly frequency of physical education (PE) classes and leisure sitting time among adolescents. Methods: We analyzed cross-sectional data from 73 countries using data from the Global School-based Student Health Survey (283,233 adolescents between 11 and 18 years of age). Leisure sitting time and weekly frequency of PE classes were self-reported. Sex, age, and food insecurity were used as covariates and the analyses were stratified by world regions and country income level. Poisson regression models (random-effects meta-analysis) were used for the main analyses. Results: In comparison with 1 PE class per week (reference group), those with no PE classes presented a lower prevalence of ≥3h/d of leisure sitting time (PR [95%CI] = 0.94 [0.91; 0.98]). On the other hand, adolescents with 2 days (PR [95%CI] = 1.06 [1.02; 1.26]), 3-4 days (PR [95%CI] = 1.17 [1.12; 1.22]), and 5 days (PR [95%CI] = 1.08 [1.04; 1.11]) of PE classes presented a higher likelihood of ≥3h/d of leisure sitting time. No clear differences were observed for the different world regions and country income levels. Conclusions: We conclude that a higher weekly frequency of PE classes is associated with increased leisure sitting time among adolescents worldwide. Although longitudinal studies are needed, we advise the importance of rethinking the role of PE as a critical predictor of health-related behaviors over the life course.