Association between regularly performed physical activity and academic performance in female adolescents from middle to high school
Article information
Abstract
Regular participation in regularly performed physical activity (PA) is recommended for proper development of rapidly changing physical and psychological status of adolescents. Despite the importance of proper PA, various prioritizing factors in adolescents’ daily lives such as competitive academic performance deter regular participation. This study has been conducted to analyze impact of PA on academic performance (grades) for middle to high school female adolescents. 20th Korea Youth Risk Behavior Survey data with 8 factors were utilized for the study. 25,668 female adolescents across six grade levels (M1, M2, M3, H1, H2, H3) were grouped to sedentary (SG: 2 or fewer days/wk) and physically active (PG: 3 or more days/wk) groups based on their weekly PA days and compared. Also, each incremented day of PA (0- through 7-day PA) was further compared. Although SG and PG showed mixed results, incremented PA days showed either significantly better academic performances or no difference. Significant poor academic performances were shown for 7-day PA compared to 0-day PA for M2 (2.88±1.19 vs. 3.25±1.17), M3 (2.84±1.20 vs. 3.23±1.23), H3 (3.02±1.08 vs. 3.51±1.09). Although body mass index (BMI) of each grade level was within normal range for all PA groups, significantly increased BMI was shown in SG groups. Moreover, perceived effort on weight control (effort) was shown for all 7-day PA groups compared to all 0-day PA groups. In conclusion, regularly performed PA may positively influence or have no effect on academic performance. However, excessive PA aimed at weight control may have a negative impact.
INTRODUCTION
Adolescence is a critical stage of human development, characterized by swift psychological and biological transformations (Bélanger et al., 2015; Jee, 2023; Silva et al., 2022; van Sluijs et al., 2021). This period may be the most crucial for human health, both now, in adulthood, and for the well-being of the next generation (Jee, 2023; van Sluijs et al., 2021). Regular physical activity (PA) is essential for the healthy growth of adolescents. Additionally, engaging in PA during this stage has been linked to positive physical and mental health across various stages of life (Batista et al., 2019; Bélanger et al., 2015; Silva et al., 2022).
Low levels of PA have been negatively linked to both physical and mental health in adolescents, which can carry over into adulthood. Research on adolescents has shown a positive link between regularly performed PA and improvements in bone strength, cardiorespiratory fitness, blood pressure, lipid profile, and insulin sensitivity (Farooq et al., 2020; Rodriguez-Ayllon et al., 2019; Zou et al., 2023). Although regularly performed PA is recommended for healthy development of both mind and body, studies have shown that the amount of PA tends to decrease with age in adolescents across various countries (Farooq et al., 2018; Janz et al., 2014).
Many experts advocate PA at a young age, as developing an exercise habit is a key factor in maintaining PA and preventing comorbidities associated with a sedentary lifestyle in adulthood (Batista et al., 2019; Bélanger et al., 2015; Silva et al., 2022). Despite the importance of sufficient amount of PA, adolescents perform insufficient amount of PA in many countries including Korea (Aubert et al., 2022; Ferrari et al., 2020; Jee, 2023; Oh et al., 2019). To encourage PA in adulthood, it is crucial to understand PA patterns during various stages of growth.
A decrease in PA among Korean male adolescents has been previously reported (Jee, 2023). Due to the importance of preparing for higher education, it is often that Korean adolescents and guardians do not prioritize PA over education (Lee and Yi, 2016). However, through previous study that participating in moderate amount of PA do not correlate with low academic participation in adolescent males (Jee, 2023). Moreover, male adolescents with comparatively better academic performance performed recommended amount of moderate amount of PA (Jee, 2023). Building on previous studies of male adolescents, the relationship between PA habits and academic performance has not been elucidated for female adolescents. Elucidating this relationship may promote the proper practice of health-promoting PA without hindering academic performance.
Given the distinct physiological, social, and psychological characteristics of female adolescents, it is crucial to analyze their PA patterns, academic performance, and related confounding factors. Therefore, this study was prepared to observe the changes in the amount of regularly performed PA of middle and high school female adolescents in Korea. This study also observed academic performance, body mass index (BMI), efforts for weight control, and mental health state (stress and loneliness) in relationship to PA for each grade.
MATERIALS AND METHODS
This study used data from the 20th Korea Youth Risk Behavior Survey (KYRBS), a nationwide survey that provides a detailed overview of the health status of Korean youth (Korea Disease Control and Prevention Agency, 2024). The survey addressed various factors such as nutrition, mental health, and sedentary and PA habits. The main goal of the KYRBS is to collect crucial data for developing and evaluating health promotion programs aimed at youth in Korea.
The Korea Disease Control and Prevention Agency (KDCA) administers this anonymous online questionnaire to middle and high school students between April and June. A nationwide selection process was first conducted to select 800 sample middle and high schools. Cluster sampling with two-stage stratification was conducted randomly, with schools as the primary sampling unit and classes as the secondary unit. In total, 117 strata were considered, categorized by 39 local districts (including metropolitan areas, cities, towns, etc.) and three school levels (middle school, general high school, and specialized high school).
A teacher overseeing the survey directed a sample class to a computer room with internet access, where each student was randomly assigned a computer. The survey process took approximately 45 to 50 minutes. After completion, the teacher recorded the number of participating and non-participating students, and this information was submitted online during the survey. These data were then used to calculate the survey’s weighting.
The KYRBS included 106 questions and 109 indicators, collected between June and July of 2024. The questions and indicators related to 10 categories were preselected through public suggestions and a committee selection process prior to the survey. These 10 categories pertained to adolescents’ health: smoking, drinking, obesity, nutrition, injury and safety awareness, mental health, oral health, disease, socioeconomic status, and PA.
A complex sampling method, incorporating stratification, clustering, and multilevel sampling, was used to ensure a representative sample of Korean adolescents. Each sample was assigned a weight to accurately reflect the Korean adolescent population. To minimize bias, a composite sample design was applied, and values were calculated using weighted averages.
The survey was conducted with 54,653 students from 799 schools, out of an initially expected 400 middle schools and 400 high schools. The participation rate, based on the number of students, was 94.9%. The subject count reflects the number of students absent on the day of the survey. Students with long-term absenteeism, special needs that prevented independent participation, and reading disabilities were excluded from the study.
The Korea Youth Risk Behavior Survey was conducted after receiving thorough review and approval from the Medical Research Ethics Review Committee of the Korea Center for Disease Control and Prevention. The KYRBS has been conducted in compliance with the Enforcement Regulations of the Bioethics and Safety Act of Korea, without approval from the Institutional Review Board since 2015 (Korea Disease Control and Prevention Agency, 2024).
This review evaluated the survey’s scales and methodology to ensure ethical considerations for all participants. Prior to data collection, consent was obtained from all participants. For this study, 8 factors (grades, height, weight, frequency of PA, academic performance, loneliness, stress, and effects for weight control) were selected for analysis, focusing on variables related to PA, sedentary behavior, and mental health.
Measures
The study measurement protocol was prepared according to previous study (Jee, 2023). Initially, the subjects were grouped by gender and only adolescent female subjects were selected. Female subjects were further divided by grade level for comparison: M1 (first year of middle school), M2 (second year of middle school), M3 (third year of middle school), H1 (first year of high school), H2 (second year of high school), and H3 (third year of high school). These groups were then compared based on the amount of regularly performed PA, resulting in two categories: sedentary group (SG) and PA group (PG).
The frequency of PA was analyzed using various questionnaires. First, the perceived frequency of regular PA was assessed with the question: “Over the past 7 days, on how many days did you engage in more than 60 min of PA (regardless of type) that increased your heart rate or made you short of breath?” The response options were: (1) none in the past 7 days, (2) 1 day per week, (3) 2 days per week, (4) 3 days per week, (5) 4 days per week, (6) 5 days per week, (7) 6 days per week, and (8) 7 days per week. The subjects who engaged in PA for 2 days or fewer were categorized in the SG, while those who performed PA for 3 or more days were categorized in the PG. Moreover, the subjects were grouped into either 0-, 1-, 2-, 3-, 4-, 5-, 6-, or 7-day groups depending on the frequency of PA for further analysis.
The degree of perceived academic performance (grades) was assessed with the question: “In the last 12 months, how would you rate your academic performance?” The response options were: (1) high, (2) middle-high, (3) middle, (4) low-middle, and (5) low.
The degree of perceived loneliness (loneliness) was assessed with the question: “In the last 12 months, how often did you feel lonely?” The response options were: (1) not at all, (2) almost never, (3) sometimes, (4) often, (5) always.
The degree of perceived stress (stress) was assessed with the question: “How much stress do you usually feel?” The response options were: (1) always, (2) often, (3) sometimes, (4) almost never, (5) not at all.
Lastly, perceived effort on weight control was assessed with the question: “Did you try to control weight in the past 30 days?” The response options were: (1) I have not made any significant efforts to control my weight in the past 30 days, (2) I have made efforts to lose weight in the past 30 days, (3) I have made efforts to gain weight in the past 30 days, (4) I have made efforts to maintain my current weight in the past 30 days.
Statistical analysis
In accordance with the analytical guidelines of the KDCA, all analyses were conducted using IBM SPSS ver. 26.0 (IBM Co., Armonk, NY, USA) with the raw data from the 20th Youth Health Behavior Survey, applying a significance level of P<0.05 for hypothesis testing. To ensure the national samples were properly represented, complex sample weights were applied.
To analyze the differences in the BMI, grade, effort, loneliness, and stress between the SG and the PG for each grade (M1, M2, M3, H1, H2, and H3), one-way analysis of variance was used as the primary statistical analysis, with a significance level of 0.05 for the F-test. Post hoc tests were conducted using Bonferroni analysis at a significance level of 0.05. The analysis was further conducted by comparing days of PA (0-, 1-, 2-, 3-, 4-, 5-, 6-, and 7-day groups) in comparison to the grade, loneliness, effort, and stress.
RESULTS
To observe the patterns of PA in adolescents, the subjects were divided into the SG (<3 days/wk) and PG (3 or more days per week) based on the days of PA performed more than 60 min a day and days per week. BMI was calculated with perceived height and weight of the subjects.
BMI of SG and PG were 19.53±3.18 kg/m2 and 19.89± 3.12 kg/m2 for M1 (P<0.01), 20.16±3.05 kg/m2 and 20.36± 3.03 kg/m2 for M2 (P=0.02), 20.38±3.08 kg/m2 and 20.75± 3.16 kg/m2 for M3 (P<0.01), 20.16±3.08 kg/m2 and 21.57± 3.16 kg/m2 for H1 (P<0.01), 21.11±3.20 kg/m2 and 21.61± 3.24 kg/m2 for H2 (P<0.01), and 21.59±3.55 kg/m2 and 21.88± 3.47 kg/m2 for H3 (P<0.05), respectively.
The rate of first year in middle school (M1) who did not participate in regular PA (less than 2 days per week) (SG) was 60.6% (1,738) and those who did participate in PA (PG) were 39.4% (1,159). However, female adolescents who did not participate in regular PA decreased as the grade increased. In M2, the rates were 64.9% (1,055) and 35.1% (570), in M3, the rates were 69.2% (982) and 30.8% (437), in H1, the rates were 81.5% (2,923) and 18.5% (664), in H2, the rates were 81.7% (2,817) and 18.3% (631), and in H3, the rates were 82.2% (2,649) and 17.8% (573) for SG and PG, respectively.
The academic performance or grades were compared between SG and PG by the grade levels of M1, M2, M3, H1, H2, and H3 as shown on Table 1. Frequency of PA was further divided into the number of PA days (0-, 1-, 2-, 3-, 4-, 5-, 6-, and 7-day groups) and compared with the grades in Tables 2 and 3. The grades were significantly lower (better) for the 3-, 4-, and 5-day groups in comparison to the 0-day group for M1. The grades were significantly lower for the 7-day group in comparison to the 0-day group and for the 0-, 1-, 2-, -3, and 4-day groups in comparison to the 7-day group for M2. The grades were significantly lower for the 1-, 2-, 3-, 4-, and 5-day groups in comparison to the 7-day group for M3. Moreover, the grades were significantly higher (worse) for the 7-day group in comparison to the 0-day group and significantly lower for 0-, 1-, and 2-day groups for H3.
Comparisons of academic performance between sedentary and physically active female adolescents
Comparisons of academic performance of middle school female adolescents by incremented physical activity
Comparisons of academic performance of high school female adolescents by incremented physical activity
The subjects who participated in daily (7-day group) PA showed significantly greater efforts to control weight (effort) across all grades compared to other groups: M1 (1.82±0.98 vs. 2.23±1.08, P<0.01), M2 (1.75±0.94 vs. 2.13±1.06, P<0.01), M3 (1.76± 0.93 vs. 2.15±1.01, P<0.01), H1 (1.67±0.87 vs. 2.01±1.02, P<0.01), H2 (1.64±0.84 vs. 2.04±0.83, P<0.01), H3 (1.62± 0.88 vs. 2.03±0.86, P<0.01).
Other factors, such as Loneliness or Stress levels, did not show significant differences between the groups.
DISCUSSION
The amount and type of PA engaged in during youth are crucial for lifelong physical and mental health. However, preparing for higher education has been prioritized over regularly performed PA in many countries including Korea (Farooq et al., 2018; Jee, 2023). However, regular PA and poor academic performance have not been correlated. Moreover, previous studies indicate either a positive influence or no deterrent effect of PA on academic performance (García-Hermoso et al., 2021; Haverkamp et al., 2020; Jee, 2023). To elucidate this relationship, the present study the relationship between regularly performed PA and academic performance.
There were decreases in the amount of PA throughout the M1 to H3 grade levels ranged from −1.6% to −8.4% in this study. The decreasing trend in the PA level of male adolescents was similar observed in previous study, which ranged from −3.2% to −21.3% over 6 years of secondary school (Jee, 2023). Such continual decrease in the amount of PA by adolescents were reported by other previous studies (Farooq et al., 2020; Kandola et al., 2020).
The main factor, which is the academic performance (grades), showed mixed results. The academic performance or grade was significantly higher (worse performance) in SG than in PG in MG1 but significantly lower (better performance) in SG than in PG in MG2. As the grade level increased to high school, all PG groups (H1, H2, H3) showed significantly lower academic performance, as shown in Table 1.
To clarify the results, academic performance was compared for the number of PA days as shown in Tables 2 and 3. Interestingly, significantly lower academic performance was shown for 3-, 4-, and 5-day groups in M1. In M2, although no significant differences were shown between 1-day group and other groups, significantly higher (worse) academic performances were shown for 7-day group of PA for M2 and H3. Moreover, there were trends for increased (worse) academic performances for 7-day groups compared to other days across all grade levels. Such trends were also shown in M3.
The overall results show that participating in PA at least once a week has a positive effect on academic performance. However, participating in PA every day of the week may be associated with negative academic performance. The results showed a U-shaped curve, meaning that as the number of PA days increased, academic performance improved; however, this improvement declined as the number of PA days increased to 7 days a week. This trend was different from a previous study with similar age of male adolescents (Jee, 2023).
The difference may be due to the purpose of PA among female adolescents. Gender differences in body dissatisfaction begin to appear during the early teens and persist through to 18 years of age in girls. Moreover, adolescent girls experience various body and social changes during and after puberty, which can have a significant impact on their body image, often becoming more evident by late adolescence (Ganesan et al., 2018; Littleton and Ollendick, 2003). According to Meland et al., about 79% of girls were dissatisfied by their bodies, while only 44% boys were dissatisfied (Dixit et al., 2011; Meland et al., 2007).
When the SG and PG were compared for BMI, PG showed significantly greater BMI. However, the BMI for all groups was normal according to World Health Organization (WHO), where BMI is lower than 1 standard deviation above the WHO Growth Reference median (World Health Organization, 2024). The BMI results were also normal according to other standards, where the adolescent obesity is defined as a BMI above the 95th percentile based on the 2017 growth charts for children and adolescents (Korea Disease Control and Prevention Agency, 2017; Korean Society for the Study of Obesity, 2022). Despite the normal range of BMI in all groups, a slightly higher BMI may have influenced negative body dissatisfaction among some of the female adolescents and led to a greater frequency of PA (Ganesan et al., 2018; Xie et al., 2006).
All groups that participated in 7 days or daily PA showed significantly greater efforts to control weight in the past 30 days. Although significant differences were observed for other PA-day groups, mixed results were shown. This indicated that female adolescent who participate in daily PA had purpose of controlling weight instead of well-being or healthy lifestyle in comparison to other PA-day groups. Previous research reported that concerns about being overweight or obese have the potential to lead to health concerning behaviors such as excessive exercise (Niswah et al., 2021).
Nevertheless, renowned global organizations in PA and health, such as America College of Sports Medicine and WHO, recommend engaging in at least 60 min of PA every day of the week (Farooq et al., 2020; Van Hecke et al., 2016). Although performing PA every day has been shown to be related to poor academic performance in some cases, the purpose of losing weight, rather than promoting health, may have negatively influenced academic performance.
Overall, performing PA was either positively related to good academic performance or not associated with poor academic performance in many grade levels. Therefore, PA is recommended to maintain lifelong health without negatively affecting academic performance.
There were several limitations to this study. The first limitation was that not all influencing factors could be analyzed due to the limited number of variables. Various personal or social factors may have influenced PA and academic performance including genetic, environmental, dietary, socioeconomic, developmental, behavioral, nutritional, metabolic, biochemical, and hormonal influences, can affect the health and growth of adolescents. Second, adolescent academic performance and PA participation may be under or over-reported due to self-reporting biases, social stigma, or the emotional status associated with the topic. Third, this study used cross- sectional data rather than longitudinal data with the same subjects across each grade level. While general trends can be observed from cross-sectional analysis, there may be significant variations. In conclusion, this study observed a general trend of academic performance in relation to academic performance. Promoting PA in adolescents requires careful consideration of various factors to support their healthy development and long-term well-being. Therefore, more specifically designed, age- and gender-specific longitudinal comparisons are needed to elucidate the findings (Jee, 2023; Mousikou et al., 2023).
Notes
CONFLICT OF INTEREST
No potential conflict of interest relevant to this article was reported
ACKNOWLEDGMENTS
Funding for this paper was provided by Namseoul University.