Association of Recess Provision With Elementary School-Aged Children's Physical Activity, Adiposity, and Cardiorespiratory and Muscular Fitness.

To identify associations between amount of school recess provision and children's physical activity (PA), weight status, adiposity, cardiorespiratory endurance, muscular strength, and muscular endurance. Data from 6- to 11-year-old participants (n = 499) in the 2012 National Youth Fitness Survey were analyzed. Parents/guardians reported children's PA levels and recess provision, categorized as no/minimal (9.0%), low (26.1%), medium (46.0%), or high (18.9%). Children wore a wrist-worn accelerometer for 7 days and completed anthropometric measurements. Fitness was assessed using grip strength and treadmill, pull-up, and plank tests. Cross-sectional linear and logistic regression compared outcomes across levels of recess provision adjusting for the survey's complex sampling design. Children with high provision of recess were 2.31 times more likely to meet PA guidelines according to parent report than those with no/minimal recess. Accelerometer-measured PA followed a more U-shaped pattern, wherein PA was higher in children with high, compared to low, recess provision but comparable to those with no/minimal recess provision. There were no associations with weight status, adiposity, or fitness. Current recess recommendations (20 min·d-1) may be insufficient as 30 minutes per day of recess was associated with a 2-fold greater likelihood of achieving recommended PA levels. Additional research on recess quantity and quality is needed.