This large, rigorously conducted cluster RCT in 10-year-old children supports the notion that there is still inadequate evidence to conclude that increased physical activity in school enhances academic achievement in all children. Still, combining physical activity and learning seems a viable model to stimulate learning in those academically weakest schoolchildren.

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Cross-sectional data have suggested an inverse relation between physical activity and cardiometabolic risk factors that is independent of sedentary time. However, little is known about which subcomponent of physical activity may predict cardiometabolic risk factors in youths. We examined the independent prospective associations between objectively measured sedentary time and subcomponents of physical activity with individual and clustered cardiometabolic risk factors in healthy children aged 10 y. We included 700 children (49.1% males; 50.9% females) in which sedentary time and physical activity were measured with the use of accelerometry. Systolic blood pressure, waist circumference (WC), and fasting blood sample (total cholesterol, high-density lipoprotein cholesterol, triglycerides, glucose, fasting insulin) were measured with the use of standard clinical methods and analyzed individually and as a clustered cardiometabolic risk score standardized by age and sex ( score). Exposure and outcome variables were measured at baseline and at follow-up 7 mo later. Sedentary time was not associated with any of the individual cardiometabolic risk factors or clustered cardiometabolic risk in prospective analyses. Moderate physical activity at baseline predicted lower concentrations of triglycerides ( = 0.021) and homeostatic model assessment for insulin resistance ( = 0.027) at follow-up independent of sex, socioeconomic status, Tanner stage, monitor wear time, or WC. Moderate-to-vigorous physical activity ( = 0.043) and vigorous physical activity ( = 0.028) predicted clustered cardiometabolic risk at follow-up, but these associations were attenuated after adjusting for WC. Physical activity, but not sedentary time, is prospectively associated with cardiometabolic risk in healthy children. Public health strategies aimed at improving children's cardiometabolic profile should strive for increasing physical activity of at least moderate intensity rather than reducing sedentary time. This trial was registered at clinicaltrials.gov as NCT02132494.