Policy Challenges in the Fight against Childhood Obesity: Low Adherence in San Diego Area Schools to the California Education Code Regulating Physical Education

Objective. Assess the adherence to the Physical Education (PE) requirements per California Education Code in San Diego area schools. Methods. Surveys were administered anonymously to children and adolescents capable of physical activity, visiting a specialty clinic at Rady Children's Hospital San Diego. The main questions asked were their gender, grade, PE classes per week, and time spent doing PE. Results. 324 surveys were filled, with 36 charter-school students not having to abide by state code excluded. We report on 288 students (59% females), mostly Hispanic (43%) or Caucasian (34%). In grades 1–6, 66.7% reported under the 200？min per 10 school days required by the PE code. Only 20.7% had daily PE. Average PE days/week was 2.6. In grades 7–12, 42.2% had reported under the 400？min per 10 school days required. Daily PE was noted in 47.8%. Average PE days/week was 3.4. Almost 17% had no PE, more so in the final two grades of high school (45.7%). Conclusions. There is low adherence to the California Physical Education mandate in the San Diego area, contributing to poor fitness and obesity. Lack of adequate PE is most evident in grades 1–6 and grades 11-12. Better resources, awareness, and enforcement are crucial. 1. Introduction The World Health Organization declared obesity a global epidemic associated with negative health outcomes in 1997 [1]. In over three decades of national surveys in the USA, from 1971 until 2000, the prevalence of children and adolescents who are obese has tripled [2, 3]. Recently though, the prevalence has stabilized except for those with a BMI 97 percentile [4], such that in 6–19-year olds in the 2007-2008 survey more than 1 in 6 were obese (18.7% with BMI 95%), and over 1 in 3 were overweight or obese (34.7% with BMI 85%) [4]. One of the most effective ways of battling obesity is through legislation or policies that enable changes in lifestyle, whether it impacts diet or exercise. For such policies to be effective, their implementation ought to be monitored and enforced. Promotion of routine physical activity in children from preschool age on may help prevent the development of overweight and obesity and associated comorbidities, and the role of schools in achieving that has been recognized and emphasized in guidelines to help battle obesity [5, 6]. As not all children live in safe neighborhoods or are allowed to play outside, schools offer a safe place to accomplish physical activity, delivered with guidance. Schools have historically promoted physical activity and healthy eating, and since over the past 2 decades more than