Longitudinal Associations between Physical Activity and Educational Outcomes
Full text
Longi udinal Associa ions be ween Physical
Ac i i y and Educa ional Ou comes
JAANA T. KARI
1,2
, JAAKKO PEHKONEN
2
, NINA HUTRI-KA
¨HO
¨NEN
3
, OLLI T. RAITAKARI
4,5
,
and TUIJA H. TAMMELIN
1
1
LIKES Resea ch Cen e o Physical Ac i i y and Heal h, Jy a¨skyla¨, FINLAND;
2
Jy a¨skyla¨ Uni e si y School o Business and
Economics, Jy a¨skyla¨, FINLAND;
3
Depa men o Pedia ics, Uni e si y o Tampe e and Tampe e Uni e si y Hospi al,
Tampe e, FINLAND;
4
Resea ch Cen e o Applied and P e en i e Ca dio ascula Medicine, Uni e si y o Tu ku, Tu ku,
FINLAND; and
5
Depa men o Clinical Physiology and Nuclea Medicine, Tu ku Uni e si y Hospi al, Tu ku, FINLAND
ABSTRACT
KARI, J. T., J. PEHKONEN, N. HUTRI-KA
¨HO
¨NEN, O. T. RAITAKARI, and T. H. TAMMELIN. Longi udinal Associa ions be ween
Physical Ac i i y and Educa ional Ou comes. Med. Sci. Spo s Exe c., Vol. 49, No. 11, pp. 2158–2166, 2017. Pu pose: This longi udinal
s udy examined he ole o leisu e- ime physical ac i i y in academic achie emen a he end o compulso y basic educa ion and
educa ional a ainmen in adul hood. Me hods: The da a we e d awn om he ongoing longi udinal Ca dio ascula Risk in Young Finns
S udy, which was combined wi h egis e -based da a om S a is ics Finland. The s udy consis ed o child en who we e 12 y (n= 1723,
49% boys) and 15 y (n= 2445, 48% boys) o age a he ime when physical ac i i y was measu ed. The child en we e ollowed up un il
2010, when hei mean age was 40 y . Physical ac i i y was sel - epo ed and included se e al measu emen s: o e all leisu e- ime
physical ac i i y ou side school hou s, pa icipa ion in spo s club aining sessions, and pa icipa ion in spo s compe i ions. Indi iduals_
educa ional ou comes we e measu ed wi h he sel - epo ed g ade poin a e age a age 15 y and egis e -based in o ma ion on he yea s
o comple ed pos compulso y educa ion in adul hood. O dina y leas squa es models and he ins umen al a iable app oach we e used o
analyze he ela ionship be ween physical ac i i y and educa ional ou comes. Resul s: Physical ac i i y in adolescence was posi i ely
associa ed wi h educa ional ou comes. Bo h he physical ac i i y le el a age 15 y and an inc ease in he physical ac i i y le el be ween
he ages o 12 and 15 y we e posi i ely ela ed o he g ade poin a e age a age 15 y and he yea s o pos compulso y educa ion in
adul hood. The esul s we e obus o he inclusion o se e al indi idual and amily backg ound ac o s, including heal h endowmen s,
amily income, and pa en s_educa ion. Conclusion: The esul s p o ide e idence ha physical ac i i y in adolescence may no only
p edic academic success du ing compulso y basic educa ion bu also boos educa ional ou comes la e in li e. Key Wo ds: ACADEMIC
ACHIEVEMENT, EDUCATIONAL ATTAINMENT, PHYSICAL ACTIVITY, REGISTER-BASED DATA
Pos compulso y educa ion is one o he mos impo an
in es men s in human capi al (4). Besides he s ong
co ela ion be ween academic achie emen and la e
educa ional a ainmen , p e ious s udies ha e shown ha a
highe le el o educa ion is posi i ely associa ed wi h heal h
ou comes (8,12,28), employabili y (22), ea nings (4,7), and
economic g ow h (14).
Apa om he well-known heal h bene i s o physical ac-
i i y (18,20,25,39,40), p e ious s udies ha e linked physical
ac i i y wi h posi i e e u ns in e ms o academic achie e-
men (11,16,17,31,33) and educa ional a ainmen (3,19,23).
Fo example, S e ens e al. (33) ound ha physical ac i i y
had a posi i e associa ion wi h ma hema ics and eading
achie emen among boys and gi ls, whe eas Fox e al. (11)
epo ed ha physical ac i i y and spo s eam pa icipa ion
we e posi i ely associa ed wi h g ade poin a e age (GPA).
Acco ding o Long and Caudill (19), a hle es who a ended
EPIDEMIOLOGY
Add ess o co espondence: Jaana T. Ka i, M.Sc. (Econ), LIKES Re-
sea ch Cen e o Physical Ac i i y and Heal h, Rau pohjanka u 8, 40700
Jy a¨skyla¨, Finland; E-mail: jaana.ka[email p o ec ed].
Submi ed o publica ion Feb ua y 2017.
Accep ed o publica ion June 2017.
Supplemen al digi al con en is a ailable o his a icle. Di ec URL ci a-
ions appea in he p in ed ex and a e p o ided in he HTML and PDF
e sions o his a icle on he jou nal_s Web si e (www.acsm-msse.o g).
0195-9131/17/4911-2158/0
MEDICINE & SCIENCE IN SPORTS & EXERCISE
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Copy igh Ó2017 The Au ho (s). Published by Wol e s Kluwe Heal h, Inc.
on behal o he Ame ican College o Spo s Medicine. This is an open-
access a icle dis ibu ed unde he e ms o he C ea i e Commons A ibu ion-
Non Comme cial-No De i a i es License 4.0 (CCBY-NC-ND), whe e i is
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DOI: 10.1249/MSS.0000000000001351
2158
colleges and uni e si ies had highe g adua ion a es han
nona hle es, whe eas Ba on e al. (3) ound ha a hle ic pa -
icipa ion was associa ed wi h a highe pos seconda y le el o
educa ion. Simila ly, P ei e and Co neliQen (23) showed ha
nonp o essional physical ac i i y du ing childhood and you h
inc eased he p obabili y o a aining a highe school deg ee.
Al hough he ela ionship be ween physical ac i i y and
educa ional ou comes has been es ablished, some o he esea ch
indings a e mixed and sugges he exis ence o unmeasu ed
he e ogenei y, selec ion issues, and he po en ial endogenei y
o physical ac i i y (3,10,26,34). Addi ionally, a ecen sys-
ema ic e iew by Donnelly e al. (9) indica ed ha much o he
p e ious esea ch explo ed he ela ionship be ween physical
ac i i y and academic achie emen only h ough c oss-
sec ional s udies. The e o e, li le is known abou he longi-
udinal consequences o leisu e- ime physical ac i i y du ing
adolescence o academic achie emen and subsequen edu-
ca ional a ainmen among he same indi iduals.
The pu pose o he p esen s udy was o examine whe he
physical ac i i y in adolescence is associa ed wi h academic
achie emen a he end o compulso y basic educa ion and
wi h pos compulso y educa ion la e in li e. The s udy aug-
men ed he p e ious li e a u e in h ee ways: Fi s , we in-
es iga ed whe he he physical ac i i y le el a age 15 y o
a change in he physical ac i i y le el be ween he ages o
12 and 15 y a e associa ed wi h he GPA a age 15 y and
he yea s o pos compulso y educa ion in adul hood. Sec-
ond, we examined he ole o pa icipa ion in o ganized
spo s in academic achie emen and educa ional a ainmen .
Thi d, we used an ins umen al a iable (IV) app oach o
deal wi h he po en ial endogenei y o physical ac i i y,
omi ed a iable bias, and measu emen e o . We hypo he-
sized ha a highe physical ac i i y le el and an inc ease in
he physical ac i i y le el in adolescence a e associa ed wi h
highe educa ional ou comes.
METHODS
S udy popula ion. The da a we e d awn om he on-
going longi udinal Ca dio ascula Risk in Young Finns S udy
(YFS), which was launched in 1980, when 3596 indi iduals
age 3, 6, 9, 12, 15, and 18 y pa icipa ed in he baseline
s udy. The pa icipan s we e andomly chosen boys (51%)
and gi ls (49%) om i e Finnish uni e si y ci ies wi h
medical schools (Helsinki, Tu ku, Tampe e, Oulu, and Kuopio)
and hei u al su oundings. Since 1980, se en ollow-up
phases (1983, 1986, 1989, 1992, 2001, 2007, and 2011) ha e
been conduc ed. The examina ions ha e included comp e-
hensi e da a collec ion using blood es s, physical measu e-
men s, and ques ionnai es (24).
To ob ain egis e -based in o ma ion on educa ional a ain-
men , he YFS da a we e linked wi h he egis e -based Finnish
Longi udinal Employe –Employee Da a (FLEED) om S a-
is ics Finland. Finnish Longi udinal Employe –Employee
Da a is an annual panel ha includes in o ma ion on
indi iduals_educa ional a ainmen ob ained di ec ly om he
comp ehensi e adminis a i e egis e s main ained by S a is-
ics Finland. Regis e -based in o ma ion on amily backg ound
ac o s, including amily income and pa en s_educa ion,
was ob ained om he Longi udinal Popula ion Census
(LPC) o S a is ics Finland om 1980. To a oid p oblems
c ea ed by e o s in eco d linkages (27), FLEED and LPC
da a we e combined wi h he YFS da a based on he unique
pe sonal iden i ie s.
The p esen s udy consis ed o indi iduals who we e age
12 o 15 y when he in o ma ion abou physical ac i i y was
collec ed; ha is, he sample consis ed o 2445 indi iduals
(48% boys) who we e bo n be ween 1965 and 1977. The e-
a e , he indi iduals we e ollowed un il 2010, when he
pa icipan s_mean age was 40 y . Depending on he model
speci ica ion, he sample size a ied om 1126 o 1628.
Da a p o ec ion issues we e aken in o accoun as speci ied
in cu en Finnish legisla ion. Mo eo e , he esea ch p o ocol
o he YFS was app o ed by he e hics commi ees o he i e
uni e si ies (Helsinki, Tu ku, Tampe e, Oulu, and Kuopio),
and each pa icipan p o ided w i en in o med consen be o e
pa icipa ing in he s udy.
Sel - epo ed physical ac i i y. Leisu e- ime physi-
cal ac i i y a he ages o 12 and 15 y was measu ed wi h a
sel - epo ed ques ionnai e. The pa icipan s we e asked he
ollowing ques ions: ‘‘How o en do you engage in leisu e-
ime physical ac i i y o a leas hal an hou pe session?,’’
‘‘How much a e you b ea h- aking and swea ing when you
engage in physical ac i i y and spo s?,’’ ‘‘How many imes
a week do you usually engage in aining sessions o a spo s
club?,’’ ‘‘Wha do you usually do in you leisu e ime?,’’ and
‘‘Do you pa icipa e in egional- o na ional-le el spo s
compe i ions?.’’ The esponse al e na i es we e coded om 1
o 3—excep pa icipa ion in spo s compe i ions, which was
coded as 1 o 2—and he ea e summed o o m a physical
ac i i y index (PAI) wi h sco es anging om 5 o 14
(Table, Supplemen al Digi al Con en 1, The o iginal sco ing
and ecoding o PAI; 37, h p://links.lww.com/MSS/A969).
Educa ional ou comes. Two measu es we e used o
illus a e indi iduals_educa ional ou comes: sel - epo ed
GPA a age 15 y and yea s o comple ed pos compulso y
educa ion. The in o ma ion on GPA was p o ided by he
YFS; he a iable e e ed o a nume ical assessmen on a
scale o 4 o 10, whe e 4 deno es ailed, and 10 deno es
excellen . In o ma ion on pos compulso y educa ional a -
ainmen was p o ided by he egis e -based FLEED. Using
o icial es ima es om S a is ics Finland o comple ing a
speci ic deg ee, he yea s o educa ion we e o mula ed by
ans o ming he highes ob ained deg ee in 2010 in o yea s
o educa ion.
S a is ical analyses. The analysis was based on o di-
na y leas squa es (OLS) models s a i ied by sex. The models
used he GPA a age 15 y and he yea s o comple ed edu-
ca ion as he dependen a iables and he PAI a age 15 y
as an explana o y a iable. All models we e adjus ed by bi h
coho and bi h mon h, which we e p ede e mined a iables (2).
Be o e unning, he OLS models, he co ela ion coe icien s
PHYSICAL ACTIVITY AND EDUCATIONAL OUTCOMES Medicine & Science in Spo s & Exe cise
d
2159
EPIDEMIOLOGY
we e calcula ed o illus a e he uncondi ional connec ions
be ween adolescen physical ac i i y and educa ional ou -
comes (Table, Supplemen al Digi al Con en 2, Co ela ion
coe icien s, h p://links.lww.com/MSS/A970).
The baseline models we e ex ended in he ollowing ways.
Fi s , o educe he possibili y ha physical ac i i y e lec s
omi ed a iables wi hou ha ing an independen e ec on
educa ional ou comes, he models we e augmen ed wi h se e al
co a ia es: 1) indi iduals_ch onic condi ions and body a in
1980 (32); 2) amily backg ound ac o s in 1980, including
egis e -based amily income, egis e -based pa en s_edu-
ca ion, and amily size; and 3) indi idual_s p io academic
achie emen measu ed wi h he sel - epo ed GPA a he
age o 12 y (see Table, Supplemen al Digi al Con en 3,
Desc ip i e s a is ics wi h co a ia es, o addi ional de ails,
h p://links.lww.com/MSS/A971).
Typically, du ing childhood and you h, pa icipa ion in
spo s dec eases wi h age (15,21). An open ques ion is whe he
his change is ela ed o academic achie emen and educa-
ional a ainmen . To ind an answe , he associa ion be ween
educa ional ou comes and he change in he physical ac i i y
le el be ween ages 12 and 15 y was examined. Addi ionally,
wo bina y a iables we e o mula ed, which equals 1, i he
physical ac i i y le el inc eased o dec eased be ween he wo
ime poin s, and 0 o he wise.
Almos hal o he Finnish child en age 7–18 y epo
pa icipa ion in spo s club ac i i ies a leas once a week
(36). To examine whe he pa icipa ion in spo s club ain-
ing sessions o pa icipa ion in spo s compe i ions ha e an
independen ole in educa ional ou comes, he o iginal PAI
was di ided in o h ee pa s: 1) a a iable ha indica ed
pa icipa ion in spo s club aining sessions (1, pa icipa es in
spo s club aining sessions; 0, does no pa icipa e in spo s
club aining sessions), 2) a a iable ha indica ed pa ici-
pa ion in spo s compe i ions (1, pa icipa es in na ional- o
egional-le el spo s compe i ions; 0, does no pa icipa e in
spo s compe i ions), and 3) he o iginal PAI sub ac ed om
he pa icipa ion in spo s club aining sessions and pa ici-
pa ion in spo s compe i ions a iables. The o iginal PAI was
eplaced wi h hese h ee new a iables in he equa ion, and
he same co a ia es we e used as in he baseline OLS models.
To alle ia e he possible endogenei y o physical ac i i y,
omi ed a iable bias, and measu emen e o , an IV ap-
p oach was used. The app oach equi es ins umen s ha a e
co ela ed wi h he included endogenous eg esso and
unco ela ed wi h he e o e m o he explana o y equa ion
(2,35). The e o e, he selec ed ins umen s should a ec edu-
ca ional ou comes only h ough hei e ec s on physical ac-
i i y (5). Following P ei e and Co neliQen (23), Rees and
Sabia (26), and Eide and Ronan (10), we used he indi idual_s
body heigh as an ins umen . Following a ecen s udy by
Cabane e al. (6) in which pa en al a is ic ac i i ies we e used
as an ins umen o examine he ole o playing music o spo s
du ing adolescence in educa ion and heal h ou comes, we also
included pa en s_physical ac i i y de ails as an ins umen . As
sugges ed by Cabane e al. (6), pa en al a is ic ac i i ies a e a
s ong p edic o o an adolescen _s pa icipa ion in music and
a e unlikely o in luence he ou come di ec ly. Because he IV
es ima es can di e sys ema ically om he a ge pa ame e i
he sample size is small (2), he IV analysis was conduc ed
using a pooled sample o women and men, and he models
we e adjus ed by sex, bi h coho , and bi h mon h.
RESULTS
Baseline esul s. Rega dless o he used measu es o
physical ac i i y and spo s pa icipa ion, a he ages o 12
and 15 y , boys had highe alues han gi ls (PG0.001;
Table 1). The a e age PAI was app oxima ely one uni highe
among boys compa ed wi h gi ls. Rela i e o gi ls, boys mo e
TABLE 1. Sample cha ac e is ics.
All Women Men
nMean (SD) nMean (SD) nMean (SD) P
a
Physical ac i i y in adolescence
PAI a 12 y ( ange, 5–14 y )
b
1723 9.57 (1.80) 886 9.06 (1.63) 837 10.11 (1.82) PG0.001
PAI a 15 y ( ange, 5–14 y ) 2445 8.97 (1.97) 1271 8.61 (1.77) 1174 9.37 (2.10) PG0.001
$PAI a 12–15 y
c
1723 j0.52 (1.84) 886 j0.36 (1.80) 837 j0.70 (1.88) PG0.001
+$PAI a 12–15 y
d
1723 0.28 (0.45) 886 0.31 (0.46) 837 0.23 (0.42) PG0.001
j$PAI a 12–15 y
e
1723 0.50 (0.50) 886 0.46 (0.50) 837 0.53 (0.50) PG0.004
Pa icipa ion in spo s club aining a 15 y
2445 0.28 (0.45) 1271 0.24 (0.43) 1174 0.32 (0.47) PG0.001
Pa icipa ion in spo s compe i ions a 15 y
g
1854 0.24 (0.43) 981 0.19 (0.39) 873 0.30 (0.46) PG0.001
Academic achie emen a he age o 15
GPA a 15 y
h
( ange 4–10) 1941 7.82 (0.93) 1022 8.08 (0.88) 919 7.53 (0.90) PG0.001
Educa ional a ainmen a he age o 33–45
Yea s o educa ion
i
2445 13.53 (2.88) 1271 13.88 (2.82) 1174 13.23 (2.86) PG0.001
a
P alues o sex di e ences ( - es ).
b
PAI (minimum 5 o maximum, 14) a he age o 12 and 15 y is a summa y o i e a iables ha illus a e he equency and in ensi y o leisu e- ime physical ac i i y, equency o pa icipa ion
in spo s clubs aining sessions, pa icipa ion in spo s compe i ions, and he mos common ac i i y du ing leisu e ime.
c
$PAI a 12–15 y illus a es he change in physical ac i i y le el (PAI) be ween he ages o 12 and 15 y .
d
+$PAI a 12–15 y is a bina y a iable ha ge s alue 1 i he indi idual has inc eased his o he physical ac i i y le el be ween he ages o 12 and 15 y , and 0 o he wise.
e
j$PAI a 12–15 y is a bina y a iable ha ge s alue 1 i he indi idual has dec eased his o he physical ac i i y le el be ween he ages o 12 and 15 y , and 0 o he wise.
Pa icipa ion in spo s club aining sessions a he age o 15 is a bina y a iable ha ge s alue 1 i an indi idual pa icipa es in o ganized spo s clubs aining sessions, and 0 o he wise.
g
Pa icipa ion in spo s compe i ions a he age o 15 is a bina y a iable ha ge s alue 1 i an indi idual pa icipa es in na ional- o egional-le el spo s compe i ions, and 0 o he wise.
The sample size a ies because in he 1992 ollow-up pa icipa ion in spo s compe i ions was no asked.
h
GPA a he age o 15 y e e s o a sel - epo ed nume ical assessmen on a scale o 4–10, whe e 4 is ailed and 10 is excellen .
i
Regis e -based in o ma ion on educa ional a ainmen in adul hood based on he yea s o comple ed educa ion.
h p://www.acsm-msse.o g2160 O icial Jou nal o he Ame ican College o Spo s Medicine
EPIDEMIOLOGY
commonly pa icipa ed in spo s club aining sessions and
spo s compe i ions a he age o 15 (PG0.001; Table 1).
Be ween he ages o 12 and 15 y , howe e , boys_physical
ac i i y le els dec eased mo e han hose o gi ls (PG0.001;
Table 1). In e ms o educa ional ou comes, he GPA a
age 15 y was app oxima ely 0.6 uni s highe among gi ls
compa ed wi h boys (PG0.001; Table 1). Simila ly, he
le el o pos compulso y educa ion was highe among women
han men; ha is, women had app oxima ely 0.7 mo e yea s
o educa ion hanmendu ing he ollow-uppe iod(PG
0.001; Table 1).
The baseline OLS es ima es (Table 2, column 1) sug-
ges ed ha a highe PAI a age 15 y was associa ed wi h a
highe GPA a age 15 y and a highe le el o educa ion in
la e li e. Among women, a one-uni inc ease in he PAI was
ela ed o a 0.11 uni inc ease in GPA and 0.17 addi ional
yea s o educa ion (Table 2, column 1). Among men, he
coe icien s we e 0.06 o GPA and 0.17 o yea s o edu-
ca ion. As a ough es ima e, a he end o compulso y basic
educa ion, child en wi h he highes physical ac i i y le el
(PAI = 14 a he age o 15 y ) had a GPA ha was app oxi-
ma ely 1.0 uni highe among gi ls and 0.5 uni highe among
boys compa ed wi h hose wi h he lowes physical ac i i y
le el (PAI = 5 a he age o 15 y ). In e ms o educa ional
a ainmen , he mos physically ac i e gi ls and boys (PAI =
14 a he age o 15 y ) had app oxima ely 1.5 mo e yea s o
educa ion in adul hood compa ed wi h hei leas physically
ac i e coun e pa s (PAI = 5 a he age o 15 y ).
Robus ness checks. Among men, he inclusion o a
comp ehensi e se o po en ial con ounding ac o s (Table 2,
columns 2–4) kep he physical ac i i y es ima e s a is ically
signi ican bu dec eased he poin es ima es. In he ex ended
model (Table 2, column 4), a one-uni inc ease in he PAI
was ela ed o a 0.03 uni inc ease in GPA and 0.09
addi ional yea s o educa ion. Among women, when he
models we e adjus ed by indi iduals_p io academic
achie emen (Table 2, column 4), in he case o educa ional
a ainmen , he associa ion emained posi i e bu became
s a is ically insigni ican . The coe icien o GPA, howe e ,
emained s a is ically signi ican , indica ing a posi i e asso-
cia ion be ween physical ac i i y and academic achie emen .
The R
2
o he ex ended models (Table 2, column 4) a ied
om 0.28 o 0.67. In he case o GPA, app oxima ely 70% o
he a iance was accoun ed by he model, whe eas he pe -
cen age o educa ional a ainmen was app oxima ely 30%.
The esul s om he baseline OLS models we e quali a-
i ely and quan i a i ely simila o women and men. The e o e,
om Table 3 onwa d, he esul s a e p esen ed o women and
men combined and he models we e adjus ed by sex. In line
wi h he baseline OLS esul s, change in he physical ac i i y
le el in adolescence ($PAI a 12–15 y ) was posi i ely asso-
cia ed wi h academic achie emen a age 15 y and educa ional
a ainmen in la e li e (Table 3, panel 1). When he models
we e adjus ed by indi idual cha ac e is ics, amily back-
g ound ac o s, and p io academic achie emen (Table 3,
panel 1, columns 2–4), he poin es ima e dec eased by hal
while emaining posi i e and s a is ically signi ican . In he
ex ended models, he co esponding coe icien s we e ap-
p oxima ely 0.05 (academic achie emen ) and 0.09 (edu-
ca ional a ainmen ). When ocusing on hose whose physical
ac i i y le els inc eased be ween he ages o 12 and 15 y
(+$PAI a 12–15 y ), he esul s implied a posi i e associa-
ion be ween he a iables (Table 3, panel 2). Fo academic
achie emen , he poin es ima es o physical ac i i y we e
app oxima ely 0.3 (Table 3, panel 2, column 1) and 0.16 in he
ex ended model (Table 3, panel 2, column 4). Fo educa ional
a ainmen , he co esponding poin es ima es we e app oxi-
ma ely 0.7 (Table 3, panel 2, column 1) and 0.3 (Table 3,
TABLE 2. OLS es ima es o he ela ionship be ween physical ac i i y le el a he age o 15 y , academic achie emen a he age o 15 y , and educa ional a ainmen in adul hood.
Academic Achie emen a he Age o 15 y , GPA
Educa ional A ainmen a he Age o 33–45 y ,
Yea s o Educa ion
12341234
Panel 1: women
PAI a 15 y
a
0.108*** 0.108*** 0.083*** 0.048*** 0.174*** 0.174*** 0.103** 0.028
(0.019) (0.019) (0.018) (0.011) (0.050) (0.050) (0.048) (0.043)
N661 661 661 661 850 850 850 850
R
2
0.11 0.11 0.19 0.67 0.05 0.06 0.13 0.28
Panel 2: men
PAI a 15 y 0.060*** 0.062*** 0.054*** 0.032** 0.166*** 0.162** 0.139** 0.092*
(0.018) (0.018) (0.017) (0.010) (0.051) (0.052) (0.049) (0.043)
N586 586 586 586 778 778 778 778
R
2
0.05 0.05 0.19 0.66 0.05 0.05 0.16 0.32
Con ol a iables
Bi h coho and bi h mon h
b
xxxxxxxx
Indi idual cha ac e is ics
c
xxx xxx
Family backg ound
d
xx xx
GPA a 12 y
e
xx
Robus s anda d e o s a e in pa en heses. The le el o s a is ical signi icance: ***P G0.001, **P G0.01, *P G0.05.
a
PAI (minimum, 5 o maximum, 14) a he age o 15 y is a summa y o i e a iables ha illus a e he equency and in ensi y o leisu e- ime physical ac i i y, equency o pa icipa ion
in spo s clubs aining sessions, pa icipa ion in spo s compe i ions, and he mos common ac i i y du ing leisu e ime.
b
All models include con ols o coho (1–5) and bi h mon h. The coho dummies illus a e he yea o bi h: coho 1, bo n in 1977; coho 2, bo n in 1974; coho 3, bo n in 1971;
coho 4, bo n in 1968; and coho 5, bo n in 1965.
c
Indi idual cha ac e is ics: summa y o an indi idual_s ch onic condi ions and body a .
d
Family backg ound ac o s: amily income, pa en s_educa ion, amily size.
e
GPA a he age o 12 y e e s o a sel - epo ed nume ical assessmen on a scale o 4–10 (4 is ailing and 10 is excellen ).
PHYSICAL ACTIVITY AND EDUCATIONAL OUTCOMES Medicine & Science in Spo s & Exe cise
d
2161
EPIDEMIOLOGY
panel 2, column 4). Fo hose, whose physical ac i i y le els
dec eased be ween he ages o 12 and 15 y (j$PAI a 12–
15 y ), he associa ions we e nega i e in all model speci i-
ca ions (Table 3, panel 2, columns 1–4).
The models ha examined whe he pa icipa ion in o ga-
nized spo s a age 15 y is ela ed o educa ional ou comes
a e epo ed in Table 4. In he case o academic achie emen
(Table 4, le -hand side), he associa ion was posi i e o all
measu es o physical ac i i y: o e all physical ac i i y le el,
pa icipa ion in spo s club aining sessions, and pa icipa ion
in spo s compe i ions. The inclusion o a comp ehensi e se
o po en ial con ounding ac o s (Table 4, le -hand side,
columns 2–4) kep he es ima es s a is ically signi ican . In
he case o educa ional a ainmen (Table 4, igh -hand side),
howe e , no such clea ela ion was obse ed. In he baseline
model (Table 4, igh -hand side, column 1), he associa ion
depended on he measu emen ype o physical ac i i y. Mo e
p ecisely, pa icipa ion in spo s club aining sessions was
posi i ely ela ed o educa ional a ainmen (Table 4, igh -
hand side, panel 1, column 1), whe eas he associa ion be ween
pa icipa ion in spo s compe i ions and educa ional a ainmen
was s a is ically insigni ican (Table 4, igh -hand side, panel 2,
column 1). In he ex ended model (Table 4, igh -hand side,
column 4), ega dless o he measu es o physical ac i i y, he
poin es ima es became s a is ically insigni ican .
The IV esul s a e epo ed in Table 5. Rega dless o he
ins umen , he IV es ima es we e posi i e and s a is ically
signi ican , sugges ing ha adolescen physical ac i i y is pos-
i i ely ela ed o educa ional ou comes. When he indi idual_s
body heigh was used as an ins umen (Table 5, columns 2),
he Fs a is ics a ied om 4.67 o 6.23, indica ing ha body
heigh is only weakly co ela ed wi h physical ac i i y. The e-
o e, he IV es ima o may be biased owa d he OLS es ima o ,
and he esul s should be ea ed wi h cau ion. In he case o
pa en s_physical ac i i y (Table 5, columns 3–4), he F alues
a ied om 26.85 o 70.19, indica ing ha pa en s_physical
ac i i y is highly co ela ed wi h hei child en_s physical ac i -
i y. In gene al, he IV es ima es we e g ea e han he co e-
sponding OLS es ima es sugges ing an e en s onge associa ion
be ween physical ac i i y and educa ional ou comes.
DISCUSSION
Summa y o he esul s. Using da a om a popula ion-
based ollow-up s udy om you h o adul hood combined
wi h egis e -based in o ma ion on pos compulso y educa ion,
TABLE 3. Changes in physical ac i i y le els be ween ages o 12 and 15 y in associa ion wi h academic achie emen a he age o 15 y and educa ional a ainmen in adul hood.
Academic Achie emen a he Age o 15 y , GPA
Educa ional A ainmen a he Age o 33–45 y ,
Yea s o Educa ion
12341234
Panel 1: change in physical ac i i y le el
$PAI a 12–15 y
a
0.099*** 0.099*** 0.080*** 0.050*** 0.209*** 0.208*** 0.148*** 0.088*
(0.015) (0.015) (0.014) (0.009) (0.042) (0.042) (0.040) (0.036)
PAI a 12 y
b
0.064*** 0.064*** 0.052*** 0.032*** 0.103* 0.101* 0.073 0.022
(0.016) (0.016) (0.016) (0.009) (0.016) (0.047) (0.045) (0.040)
N1191 1191 1191 1191 1556 1556 1556 1556
R
2
0.17 0.17 0.26 0.70 0.06 0.06 0.16 0.31
Panel 2: inc ease in physical ac i i y le el
+$PAI a 12–15 y
c
0.297*** 0.297*** 0.229*** 0.156*** 0.678*** 0.675*** 0.474** 0.326*
(0.059) (0.059) (0.055) (0.034) (0.167) (0.167) (0.156) (0.141)
PAI a 12 y 0.037* 0.037* 0.030* 0.019* 0.055 0.054 0.039 0.005
(0.016) (0.016) (0.015) (0.009) (0.044) (0.044) (0.042) (0.038)
N1191 1191 1191 1191 1556 1556 1556 1556
R
2
0.15 0.17 0.25 0.70 0.06 0.06 0.16 0.31
Panel 3: dec ease in physical ac i i y le el
j$PAI a 12–15 y
d
j0.263*** j0.264*** j0.201*** j0.123*** j0.696*** j0.696*** j0.537*** j0.362**
(0.053) (0.053) (0.051) (0.032) (0.149) (0.149) (0.142) (0.130)
PAI a 12 y 0.044** 0.044** 0.035* 0.021* 0.073 0.072 0.055 0.015
(0.016) (0.016) (0.015) (0.009) (0.044) (0.045) (0.042) (0.038)
N1191 1191 1191 1191 1556 1556 1556 1556
R
2
0.15 0.15 0.25 0.70 0.06 0.07 0.16 0.31
Con ol a iables
Bi h coho and bi h mon h
e
xxxxxxxx
Sex xxxxxxxx
Indi idual cha ac e is ics
xxx xxx
Family backg ound
g
xx xx
GPA a 12y
h
xx
Robus s anda d e o s a e in pa en heses. The le el o s a is ical signi icance: ***P G0.001, **P G0.01, *P G0.05.
a
$PAI a 12–15 y illus a es he change in physical ac i i y le el (PAI) be ween he ages o 12 and 15 y .
b
PAI (minimum, 5 o maximum, 14) a he age o 12 y is a summa y o i e a iables ha illus a e he equency and in ensi y o leisu e- ime physical ac i i y, equency o pa icipa ion
in spo s clubs aining sessions, pa icipa ion in spo s compe i ions, and he mos common ac i i y du ing leisu e ime.
c
+$PAI a 12–15 y is a bina y a iable, which ge s alue 1 i he physical ac i i y le el inc eases, and 0 o he wise.
d
j$PAI a 12–15 y is a bina y a iable, which ge s alue 1 i he physical ac i i y le el dec eases, and 0 o he wise.
e
All models include con ols o coho (1–5) and bi h mon h. The coho dummies illus a e he yea o bi h: coho 1, bo n in 1977; coho 2, bo n in 1974; coho 3, bo n in 1971;
coho 4, bo n in 1968; and coho 5, bo n in 1965.
Indi idual cha ac e is ics: summa y o an indi idual_s ch onic condi ions and body a .
g
Family backg ound ac o s: amily income, pa en s_educa ion, amily size.
h
GPA a he age o 12 e e s o a sel - epo ed nume ical assessmen on a scale o 4–10 (4 is ailing and 10 is excellen ).
h p://www.acsm-msse.o g2162 O icial Jou nal o he Ame ican College o Spo s Medicine
EPIDEMIOLOGY
he aim o his s udy was o examine whe he adolescen
physical ac i i y is associa ed wi h academic achie emen a
he end o compulso y basic educa ion and wi h educa ional
a ainmen la e in li e. The esul s p o ided e idence ha
physical ac i i y in adolescence was posi i ely associa ed wi h
educa ional ou comes: The physical ac i i y le el a age 15 y
and an inc ease in he physical ac i i y le el be ween he ages
o 12 and 15 y we e posi i ely ela ed o GPA a age 15 y and
yea s o subsequen educa ion in adul hood. The esul s we e
obus o he inclusion o addi ional co a ia es, including in-
di idual and amily backg ound ac o s.
Physical ac i i y and educa ional ou comes. Ou
indings a e consis en wi h p e ious li e a u e showing ha
physical ac i i y is posi i ely ela ed o academic achie e-
men (11,16,17,31,33) and educa ional a ainmen (3,19,23).
Howe e , he ques ions conce ning physical ac i i y ha e been
s udy speci ic, and he e o e, a compa ison o he esul s would
no be s aigh o wa d. Mo eo e , o ou knowledge, he longi-
udinal associa ions be ween you h physical ac i i y and edu-
ca ional ou comes a e a less s udied. In e ms o ca dio ascula
i ness, Swedish s udy demons a ed ha he change in ca dio-
ascula i ness be ween he ages o 15 and 18 y p edic s cog-
ni i e pe o mance a age 18 y , and ha ca dio ascula i ness
a age 18 y p edic s highe subsequen educa ion (1).
The possible sel -selec ion in o physical ac i i ies is an
issue ha has o be discussed while in e p e ing he esul s.
As S e enson (34) sugges s, subs an ial sel -selec ion in o
physical ac i i ies may exis , and wi hou adequa e co a ia es,
he impac o physical ac i i y on educa ional ou comes can
be upwa dly biased. Fu he mo e, indi iduals_academic
achie emen and educa ional a ainmen can be highly co e-
la ed wi h hei pa en s_educa ion le el and socioeconomic
s a us. Thus, he baseline OLS models we e augmen ed wi h
indi iduals_ch onic condi ions, body a , p io academic
TABLE 5. IV es ima es o he ela ionship be ween PAI a he age o 15 y and educa ional ou comes.
Academic Achie emen a he Age o 15 y , GPA Educa ional A ainmen a he Age o 33–45 y , Yea s o Educa ion
123 4 123 4
PAI a 15 y 0.081*** (0.013) 0.966* (0.476) 0.285*** (0.063) 0.277*** (0.061) 0.169*** (0.036) 2.501* (1.086) 0.850*** (0.192) 0.833*** (0.186)
Fi s -s age F — 4.67 52.06 26.85 — 6.23 70.19 36.07
N1247 1247 1247 1247 1628 1628 1628 1628
Robus s anda d e o s a e in pa en heses. The le el o s a is ical signi icance: ***P G0.001, *P G0.05.
All models include con ols o coho (1–5), bi h mon h and sex. The coho dummies illus a e he yea o bi h: Coho 1 = bo n in 1977, Coho 2 = bo n in 1974, Coho 3 = bo n in
1971, Coho 4 = bo n in 1968, and Coho 5 = bo n in 1965.
1, Baseline OLS.
Ins umen s used:
2, Heigh .
3, Physical ac i i y, a he .
4, Physical ac i i y, a he and mo he .
TABLE 4. Pa icipa ion in spo s club aining sessions and pa icipa ion spo s compe i ions a 15 y in associa ion wi h academic achie emen a he age o 15 y and educa ional
a ainmen in adul hood.
Academic Achie emen a he Age o 15 y , GPA
Educa ional A ainmen a he Age o 33–45 y ,
Yea s o Educa ion
12341234
Panel 1: pa icipa ion in spo s club aining sessions
O e all physical
ac i i y a 15 y
a
0.078*** (0.024) 0.078*** (0.024) 0.067** (0.023) 0.052*** (0.014) 0.128 (0.075) 0.124 (0.075) 0.095 (0.072) 0.078 (0.065)
Pa icipa ion in spo s
club a 15 y
b
0.210*** (0.061) 0.210** (0.061) 0.155** (0.058) 0.088* (0.037) 0.445* (0.209) 0.452* (0.210) 0.265 (0.202) 0.116 (0.186)
N1126 1126 1126 1126 1168 1168 1168 1168
R
2
0.15 0.15 0.25 0.69 0.06 0.06 0.14 0.30
Panel 2: pa icipa ion in spo s compe i ions
O e all physical
ac i i y a 15 y
a
0.086*** (0.023) 0.086*** (0.023) 0.066** (0.022) 0.056*** (0.014) 0.161* (0.072) 0.158* (0.072) 0.101 (0.070) 0.089 (0.063)
Pa icipa ion in spo s
compe i ions a 15 y
c
0.186** (0.060) 0.185** (0.061) 0.186*** (0.057) 0.077* (0.036) 0.274 (0.202) 0.276 (0.203) 0.256 (0.196) 0.049 (0.181)
N1126 1126 1126 1126 1168 1168 1168 1168
R
2
0.15 0.15 0.25 0.69 0.06 0.06 0.14 0.30
Con ol a iables
Bi h coho and bi h mon h
d
x x x xxxxx
Sex x x x xxxxx
Indi idual cha ac e is ics
e
xx x xxx
Family backg ound
xx xx
GPA 12y
g
xx
Robus s anda d e o s a e in pa en heses. The le el o s a is ical signi icance: ***P G0.001, **P G0.01, *P G0.05.
a
The o iginal PAI sub ac ed om he pa icipa ion in spo s compe i ions and pa icipa ion in spo s club aining session a iables.
b
A a iable ha indica ed pa icipa ion in spo s club aining sessions (1, pa icipa es in spo club aining sessions; 0, does no pa icipa e in spo s club aining sessions).
c
A a iable ha indica ed pa icipa ion in spo s compe i ions (1, pa icipa es in na ional- o egional-le el spo s compe i ions; 0, does no pa icipa e in spo s compe i ions).
d
All models include con ols o coho (1–5) and bi h mon h. The coho dummies illus a e he yea o bi h: coho 1, bo n in 1977; coho 2, bo n in 1974; coho 3, bo n in 1971;
coho 4, bo n in 1968; and coho 5, bo n in 1965.
e
Indi idual cha ac e is ics: summa y o an indi idual_s ch onic condi ions and body a .
Family backg ound ac o s: amily income, pa en s_educa ion, amily size.
g
GPA a he age o 12 y e e s o a sel - epo ed nume ical assessmen on a scale o 4–10 (4 is ailing and 10 is excellen ).
PHYSICAL ACTIVITY AND EDUCATIONAL OUTCOMES Medicine & Science in Spo s & Exe cise
d
2163
EPIDEMIOLOGY
achie emen , pa en s_educa ion, amily size, and amily in-
come. In line wi h he indings o Ba on e al. (3), he esul s
suppo ed he iew ha di e ences ac oss indi iduals_abili-
ies, especially p io academic achie emen , pa ially explain
he co ela ion be ween physical ac i i y and educa ional ou -
comes: When he models we e adjus ed by indi iduals_p io
academic achie emen , in all model speci ica ions, he s eng h
o he associa ion dec eased. This esul implies ha he con-
nec ion be ween physical ac i i y and educa ion may be pa ly
a ibu ed o he highe GPA o physically ac i e adolescen s.
The e o e, i emains unclea whe he he educa ional bene i s
o adolescen physical ac i i y a e caused by pa icipa ion in
physical ac i i y ( ea men e ec ) o a e me ely ela ed o he
ypes o indi iduals who p e e o be physically ac i e du ing
hei leisu e- ime ( he selec ion e ec ).
Changes in physical ac i i y le el and educa-
ional ou comes. Pa icipa ion in spo s du ing childhood
and adolescence ypically dec eases wi h age (15,21). Acco ding
o Nade e al. (21), a he age o 9 y , almos all child en me
he ecommended 60 min o mode a e- o igo ous-in ensi y
physical ac i i y daily, whe eas a he age o 15 y , only 30%
achie ed he benchma k. A simila decline was seen in ou
da a. An open ques ion was whe he his change is ela ed o
academic achie emen and educa ional a ainmen . As an
answe , a posi i e associa ion be ween he change in physical
ac i i y le el and educa ional ou comes was ound. One no-
able ea u e in he esul s was ha in he case o academic
achie emen , he physical ac i i y le el a age 12 y as well as
he change in physical ac i i y be ween he ages o 12 and
15 y we e associa ed wi h highe GPA a age 15 y . Re-
ga ding educa ional a ainmen , howe e , only he change,
no he le el o physical ac i i y le el, seemed o ma e .
Mo e speci ically, an inc ease in he physical ac i i y le el
was associa ed wi h highe educa ional e u ns in adul hood,
whe eas he associa ion wi h espec o he dec ease in physical
ac i i y le el was nega i e. F om policy-pe spec i e, his ind-
ing could encou age de eloping p og ams and in e en ions
a ge ed o school-age child en aiming o os e child en_s
pa icipa ion in physical ac i i y. This could push he young
owa d mo e physically ac i e li es yles and imp o e hei
educa ional a ainmen in la e li e, p o iding bo h pe sonal
and socie al bene i s (4,8).
Pa icipa ion in o ganized spo s and educa ional
ou comes. The physical ac i i y a iable PAI used in he
s udy was a summa y o i e a iables. In addi ion o he
equency o weekly physical ac i i y, he PAI included in-
o ma ion abou he indi iduals_pa icipa ion in spo s club
aining sessions and pa icipa ion in spo s compe i ions (37).
As p io analyses ha e shown, high school a hle ic pa ici-
pa ion, pa icipa ion in o ganized spo s, and pa icipa ion in
spo s compe i ions (23,26) a e ela ed o educa ional ou -
comes. Mo eo e , almos hal o Finnish child en and ado-
lescen s pa icipa e in o ganized spo s (36). The e o e, as a
obus ness check, we examined he ole o pa icipa ion in
spo s club aining sessions and spo s compe i ions in ed-
uca ional ou comes. In gene al, he esul s we e in line wi h
he baseline OLS esul s, sugges ing a posi i e associa ion
be ween physical ac i i y and educa ional ou comes. How-
e e , some ea u es equi ed a en ion. Fi s , i espec i e o
he di e en measu es o physical ac i i y, each physical
ac i i y a iable was posi i ely ela ed o academic achie e-
men . Second, in he case o educa ional a ainmen , no such
clea associa ion was obse ed. Ins ead, when he models
we e adjus ed by indi idual and amily backg ound ac o s,
he poin es ima e became s a is ically insigni ican . The e o e,
he esul s suppo he iew ha in he case o pos compul-
so y educa ion, wha ma e s is he o e all physical ac i i y
le el exp essed as he PAI, no he single measu es o o -
ganized spo s.
S eng hs and limi a ions. The linked da a and lon-
gi udinal se ing o he s udy con ibu e o and ex end he
p e ious li e a u e in ou impo an ways. Fi s , he longi-
udinal se ing allowed acking he same indi iduals_edu-
ca ional ou comes s a ing om compulso y basic educa ion
un il he end o pos compulso y g adua ion. Second, ins ead
o a single measu e o physical ac i i y, he s udy included ou
measu es o illus a e physical ac i i y: leisu e- ime physical
ac i i y le el a age 15 y , change in he physical ac i i y le el
be ween he ages o 12 and 15 y , pa icipa ion in spo s club
aining sessions, and pa icipa ion in spo s compe i ions.
Howe e , physical ac i i y de ails we e sel - epo ed; hus,
some measu emen e o may exis (29,30). Thi d, ins ead o
sel - epo ed in o ma ion on pos compulso y educa ion, his
s udy used he yea s o comple ed educa ion ob ained om
S a is ics Finland. This mi iga ed he possible measu emen
e o in he ou come a iable. Fou h, o alle ia e possible
endogenei y o physical ac i i y, omi ed a iable bias, and
measu emen e o , an IV app oach was used. Following
P ei e and Co neliQen (23), Rees and Sabia (26), and Eide
and Ronan (10), indi idual_s body heigh was used as an in-
s umen . The da a also allowed o ackle pa en s_physical
ac i i y de ails as an ins umen o explain a ia ions in hei
child en_s spo s pa icipa ion.
Fu u e di ec ions. The esul p o ided e idence ha
adolescen physical ac i i y is posi i ely ela ed o educa ional
ou comes du ing he li e cou se, bu he explana ion o his
associa ion is unclea . The e o e, u u e esea ch should ex-
plo e he po en ial mechanisms behind he indings o his
s udy. To unco e hese mechanisms, u u e s udies need in-
o ma i e da a se s co e ing, o example, heal h endow-
men s, cogni i e abili y, pe sonali y, and amily backg ound
ac o s (e.g., pa en al in ol emen in you h spo s, amily
suppo ). Addi ionally, mo e esea ch is needed o cla i y he
longi udinal ela ionship be ween physical ac i i y and edu-
ca ional ou comes. Fo now, we a e pe suaded o hink ha
he indings o his s udy a e gene alizable o o he de eloped
coun ies wi h simila physical ac i i y beha io as well as
educa ional a ainmen . Mo e speci ically, as in many o he
coun ies (13,38,39), he physical ac i i y le els a e low
among Finnish child en (36). Rega ding educa ional a -
ainmen , he c oss-coun y compa isons, e eal ha , in
e ms o educa ional le el, Finns age 25–64 y a e anked
h p://www.acsm-msse.o g2164 O icial Jou nal o he Ame ican College o Spo s Medicine
EPIDEMIOLOGY
se en h among OECD (The O ganiza ion o Economic
Co-ope a ion and De elopmen ) coun ies (22). To u he
inc ease unde s anding o his longi udinal associa ion be-
ween physical ac i i y and educa ional ou comes, i would
be aluable o eplica e his s udy wi h da a d awn om
o he coun ies han Finland.
CONCLUSIONS
Educa ional a ainmen has been used as a measu e o
he skills a ailable in he popula ion and he labo o ce
(4,22). Apa om he well-known heal h e ec s o physical
ac i i y (18,20,39), he posi i e associa ion ound in he p esen
s udy p o ides e idence ha adolescen physical ac i i y may
p edic be e lea ning ou comes s a ing om compulso y
basic educa ion and con inuing un il pos compulso y edu-
ca ion in adul hood.
This s udy was unded by he Finnish Minis y o Educa ion and
Cul u e, Juho Vainio Founda ion, Y jo¨ Jahnsson Founda ion (g an s
6648, 6914), he Academy o Finland (g an 273971), and OP G oup
Resea ch Founda ion. The YFS has been inancially suppo ed by he
Academy o Finland: g an s 134309 (Eye), 126925, 121584, 124282,
129378 (Sal e), 117797 (Gendi), and 41071 (Skidi), he Social Insu -
ance Ins i u ion o Finland, Kuopio, Tampe e and Tu ku Uni e si y
Hospi al Medical Funds, Juho Vainio Founda ion, Sig id Juselius
Founda ion, Paa o Nu mi Founda ion, Finnish Founda ion o Ca dio as-
cula Resea ch and Finnish Cul u al Founda ion, Tampe e Tube culosis
Founda ion and Emil Aal onen Founda ion.
The au ho s decla e no con lic s o in e es .
The esul s o he p esen s udy do no cons i u e endo semen by
he Ame ican College o Spo s Medicine.
The au ho s decla e ha he esul s o he s udy a e p esen ed
clea ly, hones ly, and wi hou ab ica ion, alsi ica ion, o inapp o-
p ia e da a manipula ion.
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h p://www.acsm-msse.o g2166 O icial Jou nal o he Ame ican College o Spo s Medicine
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