One out of five adults around the world is physically inactive. Physical inactivity was more prevalent among wealthier and urban countries, and among women and elderly individuals.

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Among girls, higher amounts of physical education may be associated with an academic benefit. Physical education did not appear to negatively affect academic achievement in elementary school students. Concerns about adverse effects on achievement may not be legitimate reasons to limit physical education programs.

Fitness was strongly and significantly related to academic performance. Cardiovascular fitness showed a dose-response association with academic performance independent of other socio-demographic and fitness variables. The association appears to peak in late middle to early high school. We recommend that policymakers consider physical education (PE) mandates in middle high school, school administrators consider increasing PE time, and PE practitioners emphasize cardiovascular fitness.