***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background Strategies for combating increasing childhood obesity is called for . School setting s have been pointed out as potentially effective setting s for prevention . The objective of this paper was to evaluate the effect of four additional Physical Education ( PE ) lessons/week in primary schools on body composition and weight status  in children aged 8–13 . Methods Children attending 2nd to 4th grade ( n = 632 ) in 10 public schools , 6 intervention and 4 control schools , participated in this longitudinal study during 2 school years . Outcome measures : Primary : Body Mass Index ( BMI ) and Total Body Fat percentage ( TBF% ) derived from Dual Energy X ray Absorptiometry ( DXA ) . Secondary : the moderating effect of overweight/obesity ( OW/OB ) and adiposity based on TBF% cut offs for gender . Results Intervention effect on BMI and TBF% ( BMI : β -0.14 , 95 % CI : -0.33 ; 0.04 , TBF% : β -0.08 , 95 % CI:-0.65;0.49 ) was shown insignificant . However , we found significant beneficial intervention effect on prevalence of OW/OB based on BMI ( OR 0.29 , 95 % CI : 0.11;0.72 ) . The intervention effect on adiposity based on TBF% cut offs was borderline significant ( OR 0.64 , 95 % CI:0 . 39 ; 1.05 ) . Conclusion Four additional PE lessons/week at school can significantly improve the prevalence of OW/OB in primary schoolchildren . Mean BMI and TBF% improved in intervention schools , but the difference with controls was not significant . The intervention had a larger effect in children who were OW/OB or adipose at baseline The aim was to study long-term effects on motor skills and school performance of increased physical education ( PE ) .  All pupils born 1990 - 1992 from one school were included in a longitudinal study over nine years . An intervention group ( n = 129 ) achieved daily PE ( 5 × 45 min/week ) and if needed one extra lesson of adapted motor training . The control group ( n = 91 )  had PE two lessons/week . Motor skills were evaluated by the Motor Skills Development as Ground for Learning observation checklist and school achievements by marks in Swedish , English , Mathematics , and PE and proportion of pupils who qualified for upper secondary school .  In school year 9 there were motor skills deficits in 7 % of pupils in the intervention group compared to 47 % in the control group ( P < 0.001 ) , 96 % of the pupils in the intervention group compared to 89 % in the control group ( P < 0.05 ) qualified for upper secondary school . The sum of evaluated marks was higher among boys in the intervention group than in the control group ( P < 0.05 ) . The sum of marks was also higher in pupils with no motor skills deficit than among pupils with motor skills deficits ( P < 0.01 ) , as was the proportion of pupils who qualified for upper secondary school ( 97 % vs 81 % , P < 0.001 ) . Daily PE and adapted motor skills training during the compulsory school years is a feasible way to improve not only motor skills but also school performance and the proportion of pupils who qualify for upper secondary school Current physical activity and fitness levels among adolescents are low , increasing the risk of chronic disease . Although the efficacy of high intensity interval training ( HIIT ) for improving metabolic health is now well established , it is not known if this type of activity can be effective to improve adolescent health . The primary aim of this study is to assess the effectiveness and feasibility of embedding HIIT into the school day . A 3-arm pilot r and omized controlled trial was conducted in one secondary school in Newcastle , Australia . Participants ( n = 65 ; mean age = 15.8(0.6 ) years ) were r and omized into one of three conditions : aerobic exercise program ( AEP ) ( n = 21 ) , resistance and aerobic exercise program ( RAP ) ( n = 22 ) and control ( n = 22 ) . The 8-week intervention consisted of three HIIT sessions per week ( 8–10 min/session ) , delivered during physical education ( PE ) lessons or at lunchtime . Assessment s were conducted at baseline and post-intervention to detect changes in cardiorespiratory fitness ( multi-stage shuttle-run ) , muscular fitness ( push-up , st and ing long jump tests ) , body composition ( Body Mass Index ( BMI ) , BMI -z scores , waist circumference ) and physical activity motivation ( question naire ) , by research ers blinded to treatment allocation . Intervention effects for outcomes were examined using linear mixed models , and Cohen 's d effect sizes were reported . Participants in the AEP and RAP groups had moderate intervention effects for waist circumference ( p = 0.024 ) , BMI -z ( p = 0.037 ) and BMI ( not significant ) in comparison to the control group . A small intervention effect was also evident for cardiorespiratory fitness in the RAP group ABSTRACT Aim of this study was to evaluate the effectiveness of two different 5-month physical education ( PE ) interventions conducted by a specialist PE teacher on primary school children ’s skill- and health-related outcomes . About 230 children were r and omly assigned to one of three intervention groups : experimental_1 group , experimental_2 group or control group ( school curriculum given by the generalist teacher ) . Pre- and post-intervention tests assessed pupils ’ fitness ( pacer , curl-up , push-up , trunk lift , sit and reach tests ) and gross motor coordination ( shifting platforms , balance beam , jumping laterally , hopping on one leg over an obstacle tests ) . Both experimental groups significantly improved some fitness and coordinative tests after the intervention period when compared with control group . However , no differential changes on coordinative development were observed between the 2 experimental groups . Results of this study demonstrated that children benefitted from a well-structured PE intervention conducted and supervised by a specialist PE teacher improving their motor skills and fitness Abstract This study aims to evaluate the effectiveness of two school-based physical education ( PE ) programmes ( exercise-based and games-based ) compared with traditional PE , on health- and skill-related physical fitness components in children in Tirana , Albania . Participants were 378 first- grade ( 6.8 years ) and 389 fourth- grade ( 9.8 years ) children attending four r and omly selected schools in Tirana . Twenty-four school classes within these schools were r and omly selected ( stratified by school and school grade ) to participate as exercise group ( EG ) , games group ( GG ) and control group ( CG ) . Both EG and GG intervention programmes were taught by professional PE teachers using station/circuit teaching framework while CG referred to traditional PE school lessons by a general teacher . All programmes ran in parallel and lasted 5 months , having the same frequency ( twice weekly ) and duration ( 45 min ) . Heart rate ( HR ) monitoring showed that intensity during PE lessons was significantly higher in the intervention groups compared with control ( P < 0.001 ) . Both PE exercise- and games programmes  significantly improved several health- and skill-related fitness indicators compared with traditional PE lessons ( e.g. gross motor skill summary score : 9.4 ( 95 % CI 7.9 ; 10.9 ) for exercise vs. control and 6.5 ( 95 % CI 5.1 ; 8.1 ) for games vs. control , cardiorespiratory fitness : 2.0 ml O2 · min−1 · kg−1 ( 95 % CI 1.5 ; 2.4 ) for exercise vs. control and 1.4 ml O2 · min−1 · kg−1 ( 95 % CI 1.0 ; 1.8 ) for games vs. control ) . Furthermore , compared to games-based PE , exercise-based PE showed more positive changes in some gross motor coordination skills outcomes , coordination skills outcomes and cardiorespiratory fitness . The results from this study show that exercise- and games-based PE represents a useful strategy for improving health- and skill-related physical fitness in Albanian elementary school children . In addition , the study shows that exercise-based PE was more  effective than games-based PE in improving gross motor function and cardiorespiratory fitness BACKGROUND Although adolescence is a time when physical activity levels decline , few interventions have targeted high school-aged girls in the school setting . OBJECTIVE To evaluate the effects of a life skills-oriented physical activity intervention for increasing overall physical activity in high school-aged girls . DESIGN R and omized controlled trial . SETTING Baltimore magnet high school . PARTICIPANTS A total of 221 ninth- grade girls , 83.0 % of whom were African American . Intervention Participants were r and omized to an 8-month physical intervention conducted in physical education class or to a st and ard physical education class ( control ) . MAIN OUTCOME MEASURES Self-reported estimated daily energy expenditure ( physical activity ) , self-reported sedentary activities ( television viewing and computer or Internet use ) , cardiorespiratory fitness , and selected cardiovascular disease risk factors . RESULTS Intervention classes spent 46.9 % of physical education class time in moderate to vigorous activity compared with 30.5 % of time for control classes ( P<.001 ) . There were no significant between-treatment group differences for mean daily energy expenditure ( P = .93 ) , moderate-intensity energy expenditure ( P = .77 ) , or hard to very hard energy expenditure ( P = .69 ) . The proportion of participants who spent 3 or more hours viewing television during school days declined from 22.3 % to 17.0 % in the intervention group , but remained at 26.7 % for the control group ( P = .03 ) . Both groups improved their cardiorespiratory fitness ( P<.001 ) . CONCLUSION A life skills-oriented physical education curriculum may need to be combined with other approaches to increase the magnitude of effects on physical activity behavior in predominantly African American high school-aged girls The POWER PE study was an 8-mo , r and omized , controlled , school-based exercise intervention design ed to apply known principles of effective bone loading to practical opportunities to improve life-long musculoskeletal outcomes . A total of 99 adolescents ( 46 boys and 53 girls ) with a mean age of 13.8 + /- 0.4 yr ( peri- to postpubertal ) volunteered to participate . Intervention subjects performed 10 min of jumping activity in place of regular physical education ( PE ) warm up . Control subjects performed usual PE warm-up activities .  Bone mass ( DXA and QUS ) was assessed at baseline and follow-up along with anthropometry , maturity , muscle power , and estimates of physical activity and dietary calcium . Geometric properties ( such as femoral neck [ FN ] moment of inertia ) were calculated from DXA measures . Boys in the intervention group experienced improvements in calcaneal broadb and ultrasound attenuation ( BUA ) ( + 5.0 % ) and fat mass ( -10.5 % ) , whereas controls did not ( + 1.4 % and -0.8 % , respectively ) . Girls in the intervention group improved FN BMC ( + 13.9 % ) and lumbar spine ( LS ) BMAD ( + 5.2 % ) more than controls ( + 4.9 % and + 1.5 % , respectively ) . Between-group comparisons of change showed intervention effects only for whole body ( WB ) BMC ( + 10.6 % versus + 6.3 % ) for boys . Boys in the intervention group gained more lean tissue mass , trochanter ( TR ) BMC , LS BMC , and WB BMC and lost more fat mass than girls in the intervention group ( p < 0.05 ) . Ten minutes of jumping activity twice a week for 8 mo during adolescence seems to improve bone accrual in a sex-specific manner . Boys increased WB bone mass and BUA , and reduced fat mass , whereas girls improved bone mass at the hip and spine BACKGROUND Physical activity is important for weight control and good health ; however , activity levels decline in the adolescent years , particularly in girls . DESIGN Group r and omized controlled trial . SETTING / PARTICIPANTS Middle school girls with English-speaking skills and no conditions to prevent participation in physical activity in 36 schools in six geographically diverse areas of the United States . R and om , cross-sectional sample s were drawn within schools : 6th grade rs in 2003 ( n=1721 ) and 8th grade rs in 2005 ( n=3504 ) and 2006 ( n=3502 ) . INTERVENTION A 2-year study -directed intervention ( fall 2003 to spring 2005 ) targeted schools , community agencies , and girls  to increase opportunities , support , and incentives for increased physical activity . Components included programs linking schools and community agencies , physical education , health education , and social marketing . A third-year intervention used school and community personnel to direct intervention activities . MAIN OUTCOME MEASURES The primary outcome , daily MET-weighted minutes of moderate-to-vigorous physical activity ( MET-weighted MVPA ) , was assessed using accelerometry . Percent body fat was assessed using anthropometry . RESULTS After the staff-directed intervention ( pre-stated primary outcome ) , there were no differences ( mean= -0.4 , 95 % CI= -8.2 to 7.4 ) in adjusted MET-weighted MVPA between 8th- grade girls in schools assigned to intervention or control . Following the Program Champion-directed intervention , girls in intervention schools were more physically active than girls in control schools ( mean difference 10.9 MET-weighted minutes of MVPA , 95 % CI=0.52 - 21.2 ) . This difference is about 1.6 minutes 
    Output:
    
Conclusions and Relevance The findings suggest that quality -based PE interventions are associated with small increases in both student health-related physical fitness components and FMSs regardless of frequency or duration of PE lessons .