The percentage of districts that require elementary schools to teach physical education increased, to 93 percent last year from 83 percent in 2000.
But just 4 percent of elementary schools, 8 percent of middle schools and 2 percent of high schools provided physical education each school day, as is recommended by the disease control agency. One-fifth of schools did not require physical education at all.
Although the researchers found that the proportion of schools selling bottled water grew, to 46 percent from 30 percent, they also said three-fourths of high schools sold soft drinks and that 61 percent sold potato chips and other high-fat snacks.
“What we’re seeing is that the nation’s schools really are making progress in addressing the obesity crisis and teenage tobacco use,” said Howell Wechsler, the director of the division of adolescent and school health at the disease agency and an author of the study. “But large numbers of schools are still not implementing recommended policies. We need all the nation’s schools to have environments that make it easy for children to make healthy choices.”
In some instances, Mr. Wechsler said, states set policies that districts and schools do not immediately embrace, particularly when mandating physical activity.
“It takes a while for the policies to go down,” he said. “Local school districts just haven’t been able to figure out how to make time for physical education in the school day.”
The overall picture, however, suggests a nationwide response by school administrators and elected officials to concerns about children’s weight and inactivity.
A recent national survey determined that 17 percent of children from 2 to 19 could be classified as overweight. The prevalence of overweight children for all age groups is nearly double that of a decade ago.
In 2004, Congress passed a law requiring each school district to develop a “wellness policy” to promote the students’ health by setting goals for nutrition education and physical activity. Those policies are just now taking effect, and some school administrators predict that the next survey will show more marked improvements. Some schools have set out to place health education on a par with academics. In Los Angeles County, Sepulveda Middle School has banned soft drinks and eliminated unhealthy snacks from the school store. Salad, fruit and yogurt are always available in the cafeteria, said Patricia J. Pelletier, the principal.
Nearly an hour of physical education is required daily, the school offers after-hours training in distance running, and it has started a class on healthy cooking for parents.
“If kids are healthy and have healthy lifestyles, they’re going to be better students,” Ms. Pelletier said. “They’re going to be in school, and they’re going to be connected with the teachers in a better way.”
Dr. David K. Appel, director of the Montefiore School Health Program, which provides health services to 15 schools in the Bronx, said the improvements noted in the study “show that we are now in the early stages of a comprehensive societal response to what could be the greatest health challenge the U.S. has ever faced, which is pervasive childhood obesity.”
Dr. Appel said much more needed to be done, particularly in educating families and gaining the support of marketers of fast food and soft drinks.
The survey found that nearly two-thirds of schools prohibited tobacco use in all locations, including at off-campus functions, up from 46 percent in 2000. Another finding was that the proportion of states that require middle schools to teach human sexuality grew, to 59 percent from 46 percent.
The report found a variety of indications of healthier cooking in school cafeterias. Fifty-five percent reported that they had removed the skin from poultry before cooking, up from 40 percent, and 46 percent now use low-fat cheeses, up from 31 percent. But 12 percent of elementary schools, 19 percent of middle schools and 24 percent of high schools offer students brand-name fast food from businesses like Pizza Hut and Taco Bell.