The 2022 Japan Report Card on Physical
Activity for Children and Youth
Details of Method and Results
Table of Contents
Objective of the 2022 Japan Report Card on Physical Activity for Children and Youth・・・・・4
Methodology・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・5
Summary of Report Card Indicators & Grades・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・5

Physical Activity, Health Behaviours and Outcomes
１ Overall Physical Activity

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２ Organized Sport Participation ・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・ 9
３ Active Play・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・ 10
４ Active

Transportation ・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・ 11

５ Sedentary

Behaviours・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・ 12

６ Physical Fitness ・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・ 13
７ Weight Status ・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・ 14
8 Sleep ・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・ 16

Settings and Influences on Physical Activity and Health
9 Family and Peer Influence ・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・ 17
10 School ・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・ 18
11 Community and the Built

Environment・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・ ・・・・・・・・・・・・・・ 19

12 Government ・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・ 20

Next Steps ・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・21
Acknowledgements・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・21
References・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・21

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Objective of the 2022 Japan Report Card on
Physical Activity for Children and Youth
Levels of overall daily physical activity established during childhood can track into adulthood as well as
influence health status at the time (Telama et al. 2009; Poitras et al. 2016). Two Previous studies have reinforced
global public health concerns related to physical inactivity in children and adolescents. The proportion of 11to17-year-olds among 16,000 surveyed children and adolescents in 146 countries doing fewer than 60 minutesof moderate-to-vigorous physical activity (MVPA) per day was about 81% (Guthold et al. 2020). There is also a
global increase in the number of children and adolescents who are overweight and obesity among children andadolescents is also rising (NCD Risk Factor Collaboration 2020). With the mission to improve physical activity inchildren and youth, The Active Healthy Kids Global Alliance was established in 2014. The Active Healthy Kids
Global Alliance is a network of researchers, health professionals, and stakeholders who are working together toadvance physical activity in children and youth from around the world. The published Report Card on Physical
Activity for Children and Youth (Report Card) grades the current status of physical activity in children andadolescents and the status of surveillance systems and variables (such as family and peer influences) using acommon set of indicators and framework. The first international comparative study was conducted in 2014 by
15 countries, followed by a second study by 38 countries including Japan in 2016 (Tremblay et al. 2014;2016). A
third study by 49 counties was conducted in 2018 (Aubert et al. 2018). The Report Card can clarify the physicalactivity environment in Japan and place it in an international context, which will benefit Japan and other nations.
The 2022 Japan Report Card on Physical Activity for Children and Youth can provide critical and up-to-dateevidence and information to support and advocate for physical activity and the health of Japanese children andadolescents. The Japan report card can be used in several ways: for example,aGovernments: could use the report to develop policy and to inform scientific and health investment
strategies or decisions.

b

Researchers/academics: could use the report to identify gaps in the evidence, educate students, and use
it to inform research or knowledge exchange grant applications.

cTeachers, coaches, public health promoters, recreation professionals, and community development
leaders: could use it to inform work with children, adolescents, their families, and community members.

dProvincial or municipal organizations: could use it as a tool to inform planning, research, grant writing
and, capacity building.

The Long Form Japan Report Card 2022 explains how the report grades were derived, which data sources wereused to derive the grades, which data sources were considered for the report card but were not used for grading,
and why. Links to all data sources are also provided. Results of studies of Japanese children and youth weresummarized for some indicators, allowing the report to illustrate global gaps, and to detect problems particular
to Japan.

4

Methodology
The Report Card on Physical Activity for Children and Youth is published in 57 countries on 5 continents using
10 common indicators (Overall Physical Activity Levels, Organized Sport Participation, Active Play, Active
Transportation, Sedentary Behaviour, Physical fitness, Family and Peer Influence, School, Community and the
Built Environment, and Government Strategies and Investments). The report card is the most comprehensive
assessment of child and youth physical activity.
This third Japan Report Card 2022 assigns grades to 10 indicators grouped into 2 categories (see below).
Nationally representative Japanese data were used where possible, as this is a national report card.
The card grades are determined by the percentage of Japanese children and adolescents meeting the benchmark foreach indicator.
We are succeeding with a large majority of children and adolescents (81-100%)
We are succeeding with well over half of children and adolescents (61-80%)
We are succeeding with about half of our children and adolescents (41-60%)
We are succeeding with less than half children and adolescents (21-40%)
We are succeeding with very few children and adolescents (0-20%)
Incomplete data combined with lack of an evidence-based recommendation.

The grades illustrate the state of physical activity in Japanese children and adolescents. The report card
can be utilized as information to support policy development in physical activity for children and adolescents,
families, schools, local communities, and the country as a whole.

Summary of Report Card Indicators & Grades
Table1. Grades According to Physical Activity Indicator in the 2022
Japan Report Card on Physical Activity for Children and Youth

5

Comparison of grades between the second
edition (2018) and the third edition (2022) of theJapan Report Card
We compared the grades between the second edition (2018) and the third edition (2022) of the Japan
Report Card as follows:

In the third edition (2022), two grades (indicators) improved, eight grades stayed the same, and one grade
dropped. Overall PA which was graded INC in the second edition (2018), was graded in the third edition(2022) (Sasakawa sports foundation). The grade for Community and the Built Environment was examinedusing the number of local governments which were trying to provide the environment where residents couldndndeasily be active in Health Japan 21 (2 stage), increased from 30 prefectures in the 2 edition (2018) to 34rdprefectures in the 3 edition (2022) (Ministry of Health, Labour and Welfare). To grade physical fitness thesecond edition (2018) used the maximum speed of the shuttle run based on the international benchmark of
Global Matrix 3.0, whereas, in the third edition (2022), muscle power, muscular strength, and muscular
endurance were used based on the international benchmark of Global Matrix 4.0 as well as the number oflaps of the shuttle run (Tomkinson et al. 2018).

6

Physical Activity,
Health Behaviours and Outcomes

1Overall Physical Activity

Sixty-three % of 13- to 15-year-olds accumulated at least 60 minutes of moderate- to vigorous-intensity
physical activity per day on at least 4 days a week according to the WHO Health Behaviour in School-agedChildren (HBSC) Japanese version (HBSC-J) (Tanaka et al. 2017; 2021). The HBSC-J was part of the 2019 SSF(Sasakawa Sports Foundation) National Sports-Life Survey.

The results of the nationwide survey

and the MVPA (min/day) objectively assessed using
accelerometers was similar for both elementary school students
The official national physical activity guidelines for each age(ρ = 0.39, p = .002) and junior high school students (ρ = 0.32, pgroup are as follows:< .001). However, there was no significant correlation for fourth
graders (ρ = -0.021, p = .901) (Unpublished data).
For 3–6-year-old preschool children: The official
national physical activity guideline was proposed by
・In the third edition, the results of the HBSC-J from the 2019
MEXT. Youjiki Undou Shishin (2012)
SSF (Sasakawa Sports Foundation) National Sports-Life Survey
The guideline reads
essential for preschool
were used to grade overall physical activity.
children to have various kinds of fun play more than・In 2001, the SSF carried out a national survey every 4 years to
60min/day, every day!”. The guideline addresses only
understand the current status of participation in sports among
duration, not intensity.
teenagers. The survey has been continuously conducted every
two years since 2011. The SSF has also carried out a national
For mainly primary school children: The Japan Sports
survey of 4-9 years olds every two years since 2009. The 2019
Association guideline (Active Child 60min) for
survey targeted 4-11- and 12–21-year-olds living in cities,
preschool and primary school children (2010)
towns, and villages across Japan, and was conducted using a
The guideline reads “Let′s move at least 60min/day,stratified two-stage random sampling method, with samples
every day, move using your body in daily life, physicaldrawn according to the size of the population per age group,
education, and sports”. Moreover, the guideline is not
and questionnaires administered by the visiting-dwelling
evidence-based and uses primarily international notmethod.
Japanese research. The guideline is based oninternational physical activity guidelines.
・According to the Japan Sports Agency (2018) survey, 7.2% of
5th-grade boys and 13.2% of girls engaged in exercise for lessthan 60 min/week outside of physical education classes. In the・The indicator ‘Overall Physical Activity’ could not be graded,second year of junior high school 6.9% of boys and 19.8% of
because evidence-based data for physical activity weregirls. In the daily PA of Japanese primary school children, thelacking in the second edition Japan Report Card in 2018. Thus,
percentage of locomotive and non-locomotive physical activity
firstly, we examined global trends in the evaluation
is about 50% each as assessed by accelerometry based on 15methodology of physical activity questionnaires for children
second epochs (Tanaka et al. 2016). Thus, total exercise timeand adolescents as used in 38 countries in their Report Cards
alone cannot reflect the overall physical activity of children.
in 2016 and we found that the Health Behaviour in Schoolaged Children (HBSC) questionnaire by the World HealthOrganization (WHO) was used most frequently among the 38
countries (12 countries, 31.6%) (Kidokoro et al. 2018).

80%

・ Second, we developed a Japanese version of the HBSC
questionnaire (HBSC-J), which assesses daily overall physicalactivity. HBSC surveys have been conducted with 11-, 13- and15-year-olds. Therefore, we examined the validity of thequestionnaire using accelerometers as a criterion forJapanese fifth-grade elementary school students (10-11 years
old) (Tanaka et al. 2017). The HBSC-J asks for the number ofdays in the last seven days when students were physically
active for at least a total of 60 minutes per day. The results
showed a moderate correlation (ρ = 0.34, p = 0.004) between
the number of days of MVPA at least 60 minutes/day(days/week) by the HBSC-J and MVPA (min/day) objectively
assessed using accelerometers. In comparison with the resultsof systematic reviews of questionnaire validity reported inother countries, a similar relationship was found (Chinapaw
et al. 2010).

69%
56%

60%

40%

20%

0%
Boys（13-15 year olds）

Girls (12-15 years old)・Third, the validity study of the HBSC-J using accelerometers
was examined by expanding the target age range to include
Figure 1. Percentage of students who met at least 60 min of
fifth and sixth graders in primary school and first and thirdmoderate- to vigorous-intensity physical activity per day
graders in junior high school (Tanaka et al. 2021). The results
on at least 4 days a week.
showed that the correlation between the number of days of
MVPA of at least 60 minutes/day (days/week) by the HBSC-J

7

mean step counts were almost 11000steps/day inprimary school students, almost 9000steps/day in juniorhigh school students, and almost 8000steps/day in highschool students (Fukushima et al. 2016). The step counts
decrease with age and are lower in girls than in boys
(Figure 2).

Main findings of previous studies in Japanesechildren and adolescents・ The Tokyo Metropolitan Board and Education Survey collected
pedometer data for 6–17-year-olds in Tokyo in 2011 and found that

How to improve the grade of the Japan
report card1)How to improve the monitoring system of theJapan report card

attached on the hip. A physical activity investigation in a
Tokyo metropolitan area for students was performed
using a pants pocket-type pedometer (Yamasa, EX-200).
We compared Kenz Lifecorder as the criterion device
with the Yamasa EX-200 for primary school children(Tanaka et al. 2019). The average difference was -7.9%.
The correlation between the Kenz Lifecorder and the
Yamasa EX-200 was strong (r = 0.812).

・As above, the official national physical activity guideline (Youjiki
Undou Shishin, 2012) for 3–5-year-olds in Japan was proposed by
MEXT. The guideline reads “It is essential for preschool children
to have various kinds of fun play for more than 60min/ day, every
day! The guideline addresses only duration, not intensity.
・ The Japan Sports Association guideline (Active Child 60min) forpreschool and primary school children (2010) is not evidencebased and uses primarily international, not Japanese research. An
official national physical activity guideline for children andadolescents between 6 and 17 years old based on Japanese
research similar to the one for preschool children is necessary.
・The SSF survey data (2019) was a random sample, but with a small
number of participants. An extensive investigation is needed.
・ A regular monitoring system is needed to evaluate the present
state of daily physical activity including regional and seasonal
differences.
・ In some countries methods to objectively measure daily physicalactivity (e.g. accelerometers) are used in public health surveillance.
The evaluation of qualitative data for daily physical activity withquestionnaires and quantitative data with pedometers or
accelerometers is needed in Japan. Moreover, an examination of
the validity of the questionnaires is needed. The official national
physical activity guideline (Youjiki Undou Shishin, 2012) for 3-5
years old in Japan suggested questionnaires and pedometers as
the method of evaluation of physical activity in preschool children.
A strong and significant correlation was observed between
minutes of MVPA and step counts (r=0.832) (Tanaka C. & Tanaka
S., 2009), although the correlation coefficient between minutes ofhigher intensity activities and step counts was slightly lower(r=0.604).
・A future survey of daily physical activity that collects data on boththe amount of time per day spent in physical activity andintensity is needed.
・The Youjiki Undou Shishin (2012) points out that the step counts
depend on the type of pedometer.
・Pedometers that can be placed in the child’s pants pocket havebecome available and are more convenient than those・For preschool children, the correlation between Kenz
Lifecorder EX and Omron Active style Pro was strong(r=0.825); the average difference between these two
pedometers was -27.7% (Tanaka et al. 2022). The
correlations between the Kenz Lifecorder EX and the
Yamax SW-200 or the Yamasa EX-200 were moderate(r=0.657) or strong (r=0.817); the average differences
between pedometers were −17.3% and −15.6%,
respectively. Correlations between the Omron Active
style Pro and the Yamax SW-200 or YAMASA EX-200
were moderate (r=0.688) or strong (r=0.880); theaverage differences between pedometers were +28.7%
and +8.6%, respectively.
・The choice of a pedometer is a substantial impact on step
counts for children.

1) How to improve the daily physicalactivity level in children and adolescents・ A strategy to improve physical activity on weekends, during
summer vacation, and in girls is especially important.
・ It is important that the public realizes that improvements indaily physical activity in children and adolescents can havea positive influence on many aspects of children’s lives
such as appropriate body weight management, improved
physical fitness like aerobic power, better outlook on life,
greater academic achievements, and so on.
・ As noted below, increased participation in exercise andsports, increased time spent in active play, greater use of
public transportation and active transportation, a decrease
in sedentary behaviour, an improvement in the family
environment in which children are raised, and theestablishment of a system of sports facilities, such as
sidewalks and bicycle tracks are all needed.

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2 Organized Sport Participation
Participation in organized sport was reported for 63 % of 6-to 17-year-olds by the Report of Survey on PhysicalStrength and Athletic Performance of Japan Sports Agency (2020).

How to improve the grade of the Japan
report card

The results of the nationwide survey
・ A national physical fitness survey has been conducted by
MEXT every year since 1964 to evaluate the physical fitness andmotor skills of Japanese citizens. The survey data is usedadministratively and as supporting data for evaluating andcreating teaching methods for physical education and sports.
For children and adolescents, the participants in the survey
were public primary, junior high school, and high school
students (6-18 years old) of both genders in 47 prefectures. The
survey is conducted from May to July and samples 1000
children or adolescents in every age group. An exhaustive
survey has been conducted in grade 5 in primary school (10year-olds) and the second year in junior high school (13-yearolds) from 2007. This is a national representative survey
・ For the 2020 JSA survey, all prefectures were requested to
conduct the survey with the understanding that the survey
period could be extended or the possibility of conducting thesurvey could be determined according to the circumstances ofeach region (2021). The impact of COVID-19 infection was
taken into account and the extension of the survey period andthe possibility of conducting the survey could be determinedaccording to the situation in each region. However, as many
prefectures were unable to conduct the survey and sufficient
data could not be collected, we decided to report the results as
reference values. For this reason, the results of the 2019 survey
were used in the third report card.

１)How to improve the monitoring system of the Japan
report card
・The Japanese government does not currently issue
recommendations for organized sports participation inchildren and adolescents.
・ In future Japan Report Cards, grades for children andadolescents between the ages of 6 and 17 will be evaluatedusing the JSA survey.
・ A regular monitoring system that includes regional andseasonal differences is needed to evaluate the present stateof participation in organized sports for children under theage of 5.

２) How to improve participation in organized
sports by children and adolescents・ According to the above surveys and previous studies, thepercentage of organized sports participation in boys’ andgirls’ preschool children (SSF, 2019) was low. On the other
hand, there is a polarization of organized sports
participation in students (JSA, 2020). Thus, a strategy toincrease the percentage of children who participate inorganized sports is especially important. Moreover, thepercentages of participation by girls were lower than inboys in all age groups. Thus, to provide an environment thatallows girls to participate in organized sports the100%
introduction of seasonal systems and/or multisport systems
87%
is needed. Examples of these include various types of
Boys
Girls
exercise and sports clubs, the improvement of facilities (e.g.
80%fostering comprehensive sport clubs, sports groups, NPOs:
69%
Nonprofit Organizations) and the maintaining and67%
63%
promoting of children’s and adolescents’ health facilities,a system that allows girls to participate in sports with60%
friends and in their local communities, and facilities that let
46%
girls improve their competitive ability.
44%
・ It is important to encourage children and adolescents who
40%
do not participate in exercise and sports clubs to take partin organized sports. On the other hand, the moreadolescents played sports, the more likely they were to have20%
and develop sports-related pain and injuries (Kamada et al.
2016). Thus, the duration and intensity of the sports activity
have to be closely monitored by teachers, coaches, parents,and so on. Furthermore, while improving athletic0%
Primary school students
Junior high school students
High school students
performance, it is also important to maintain the lifelong(6-12 years old)
(12-15 years old)
(15-18 years old)
health of the children and adolescents involved in sports.
・ In 2018, the Japan Sports Agency formulated the
Figure 3. Percentage of 6 to 18 years old boys and"Comprehensive Guidelines for Athletic Club Activities",
which sets out specific policies for athletic club activities atgirls participating in organized sport.
junior high schools, including the establishment of at least
two rest days per week and off-season, as well as aminimum of two hours of activity on weekdays and threehours on weekends.
Main findings of previous studies in・Inorder to reduce teachers' busy workload, including
Japanese children and adolescentsworking on weekends to supervise sports club activities,
・ Obviously, the physical fitness of children and adolescents whoweekend club activities at junior high schools will bebelonged to sports clubs was higher than that of children andgradually transferred to community sports clubs from 2023.
adolescents who did not belong to sports clubs (JSA, 2020).
Thus, the trends in the sports participation rate in Japan as
・ Participation in organized sport was reported for 36.3 % of 4-to 5a result of the changes in the system, will need to be
year-olds (For boys 38.8%; For girls 33.7%) by the SSF Survey (2019).
monitored closely.

9

3 Active Play
There are no representative Japanese data for active and outdoor play. There are no Japanese government
recommendations for active and outdoor play.

2)How to improve active play time inchildren and adolescentsThe results of the nationwide survey
・There are no Japanese government recommendations for
active and outdoor play.
・ According to the survey by the SSF, the types of active playin children (4-9yr) were 4.7±3.7 types a year for boys and 5.5±3.9
types a year for girls, respectively. The number of different typesof active play increased until the age of 7 for boys and until theage of 8 for girls (SSF, 2015).

Main findings of previous studies in Japanesechildren and adolescents・ According to the survey by the SSF, types of active play inpreschool children was 2.4±2.0 types a year for boys and
3.0±2.0 types a year for girls, in the first and second grade inprimary school was 3.0±2.3 types a year for boys and 3.4±2.4
types a year for girls, in the third and fourth grade in primaryschool was 2.7±2.4 types a year for boys and 3.3±2.3 types a
year for girls, in the fifth and sixth grade in primary school was
2.1±2.3 types a year for boys and 2.6±2.4 types a year for girls,
respectively.

・ Further study/research is needed because, as the above
surveys and previous studies show, there are few studies ofactive play, although some previous studies have used
questionnaires for preschools and primary schools.
・ An increase in active play environments that allow for safe
active play with diversified physical contents (e.g.
Comprehensive
sportsclubs,NPOs),
greater
communication with friends and the local community
about activities, as noted below, and the establishment ofa safe environment for active play for children andadolescents, are all needed.
・ Further study is needed on the types of play, the quality andquantity of indoor and outdoor play, the clarification of thestate of active play, and the effect of play on the health ofchildren and adolescents.

How to improve the grade of the Japan
report card1)How to improve the monitoring system of theJapan report card
・ Recommendations for active play in children and adolescentsneed to be established by the Japanese government.
・ A regular monitoring system is needed to evaluate the present
state of active play including regional and seasonal differences.

10

4 Active transportation
The National Survey on Physical Fitness, Athletic Performance and Exercise Habits of the Japan Sports
Agency (2017) reported that 89 % of 10-to 11-year-olds and 82 % of 13-to 14-year-olds regularly commuted
actively (walking or cycling) to school.

The results of the nationwide survey
・ The Japan Sports Agency database was used to estimate
the prevalence of active transportation to school for the
purposes of grading in this report card, as it provided recent
and nationally representative data. The details are shown in thesection on organized sports participation as above.
・ According to a survey by MEXT (2008), 95% of elementary school
children (11 years old) and 69% of junior high school students(14 years old) regularly commuted to school on foot. Time spentwalking to school was 17.0 minutes for 11-year-old boys and17.7 minutes for 11-year-old girls and 16.9 minutes for 14year-old boys and 18.4 minutes for 14-year-old girls on average,
respectively.

％
100
90

89

85

80

80

60

40

20

0
Boys
Girls
Boys
Girls
(10-11 years old) (10-11 years old) (13-14 years old) (13-14 years old)

Figure 4. Percentage of students who regularly
commuted actively (walking and cycling) to school.

Main findings of previous studies in Japanesechildren and adolescents・ The SFF Survey (2019) reported that 22.8 % of 4-to 6-yearolds, 95.6 % of 6-to 11-year-olds, and 76.2 % of 15-to 18year-olds regularly commuted actively (walking or cycling)
to school.

How to improve the grade of the Japan reportcard１) How to improve the monitoring system of the Japan
report card
・ There are no Japanese government recommendations for active
transportation.
・ A future survey of active transportation outside of walking or
cycling to school such as active transportation for shopping,after-school lessons, etc. is needed.
・ A regular monitoring system of national repetitive data is needed
to evaluate the present state of active transportation by children
and adolescents to school including regional and seasonal
differences.
２) How to improve active transportation in children andadolescents・ It is important that the public realizes that active
transportation to school in children and adolescents canhave a positive influence on many aspects of children’s
lives such as high physical activity levels before class,appropriate body weight management, and so on.
・ As noted below, the establishment of an environment
conducive to physical activity, such as sidewalks and bicycle
tracks, neighborhood safety, etc. are all needed.
・ A future survey of active transportation and its effect on thehealth of children and adolescents is needed.

115Sedentary Behaviours
The National Survey on Physical Fitness, Athletic Performance and Exercise Habits of the Japan Sports Agency(2017) reported that 49 % of 10-to 11-year-olds and 38 % of 13-to 14-year-olds spent less than 2 hours per
day watching TV and/or DVDs, using portable electronic devices having game functions.

The results of the nationwide survey
・ The Japanese government does not currently issue
recommendations for sedentary behaviour in children
and adolescents. In other countries, sedentary behaviour
guidelines are devised separately from physical activity
guidelines. These state that school-age children andadolescents should spend no more than 2 hours per day
on recreational screen time. There are no Japanese
government recommendations for sedentary behaviour.
・The JSA survey reported that 5th-grade primary schooland 2nd-grade junior high school students who watched
TV or used games/cell phones/smartphones for a longtime per day had lower physical fitness than the otherstudents. (JSA, 2018)%70

Weekday
59

60
50
40

Weekend

49
43

45

44

35

30
21

21

20

・The SFF (2019) reported that 73-79% of students in Japanese
junior high schools and high schools spent more than 2 hours
per day in recreational screen time watching TV, videos orDVDs, etc. For primary school students, a proxy reporting byparents was 35-45%.

How to improve the grade of the Japan reportcard１) How to improve the monitoring system of
the Japan report card
・ An official national sedentary behaviour guideline for children
and adolescents between 6 and 17 years old based onJapanese research is necessary.
・ A regular monitoring system is needed to evaluate thepresent state of daily sedentary behaviour including regionaland seasonal differences.
・ Objectively measured daily time in sedentary behaviour andbreaks of sitting position (e.g. accelerometers, posture)should be used in public health surveillance (Tanaka C. et al.
2014).
・ Under the GIGA School Initiative, the deployment of one
learning terminal per student in primary and junior highschools nationwide had been completed by the end of March
2021. Given this, it is necessary to also focus on screen timeoutside leisure time.

２) How to improve sedentary behaviour inchildren and adolescents

100Main findings of previous studies in Japanesechildren and adolescentsBoys(10-11 years old)Girls
(10-11 years old)Boys
(13-14 years old)Girls
(13-14 years old)

Figure 5. Percentage of students who spent less than
2 hours per day on screen time (watching TV
and/or DVDs, using portable electronic devices
having game functions).

・ Further study is needed, especially objective methods,
because the number of studies of sedentary behaviour are
few and there is a dearth of evidence of objectively
measured sitting time, although there are some previous
studies that used questionnaires.
・ It is important that the public realizes that decreasing
sedentary time in children and adolescents can have apositive influence on many aspects of children’s lives suchas appropriate body weight management, high physicalfitness like aerobic fitness, better mental health, and better
academic achievement, and so on (Tremblay et al. 2011).
・ It is important to establish rules for screen time during
leisure time with parents and guardians.

126Physical Fitness
We evaluated average percentiles for aged 9‒17 years achieved on some physical fitness indicators based on thenormative values published by Tomkinson et al. (2018). The average number of laps in the 20-m shuttle run ranged
from the 80th to 91st centiles; the average distance in the standing broad jump ranged from 70th to 83rd centiles;
the average grip strength ranged from 32nd to 48th centiles; the average number of sit-ups ranged from 63rd to85th centiles from the Report of the Survey on Physical Strength and Athletic Performance of the Japan Sports
Agency (2020).

The results of the nationwide survey
・ The Report of the Survey on Physical Strength andAthletic Performance of the JSA (2015) comprehensively
evaluated physical fitness by 5 gender- and age-specificranks (A-E). The ranks were based on the MEXT survey on
physical strength and athletic performance. Thus, theevaluation value is not robust, although it is useful incomparing past results.
・ According to the MEXT physical fitness survey (2014a),
conducted since 1964, the physical fitness level ofJapanese children and adolescents reached a peak during
the 1980s and then declined until around 2000. In the lastten years, physical fitness has flattened out, and shown agradual upwards tendency.
・ According to the MEXT survey (2014b), students who
participated in sports at school or in school sports clubs,
had greater physical fitness and longer total exercise time
per week than students who did not play or participate insports. Moreover, these students said they liked sports
and exercise and had better exercise skills including in
active play.
・ The MEXT survey (2014b) examined the relationshipbetween the percentage of 5th-grade girls ranked A+B on
comprehensively evaluated current physical fitness tests
and the types of active play the children engaged in when
they were in preschool. The percentage of these children
who answered that they participated in “different typesof activities “during preschool play was 42.8%. This washigher by 7.7% than those who answered “always thesame activities”, and was 23.1% higher than those whoreported that they did not engage in any active play. The
results are the same for boys.
・ According to the MEXT survey (2012) 80.5% of boys and64.5% of girls in primary school and 88.7% of boys and69.4% of girls in junior high school exercised on

Saturdays and Sundays. The physical fitness of students who
exercised on Saturdays and Sundays was higher than those
who didn’t exercise during weekends.
・ The MEXT survey (2010) also found that primary school
children who participated in sports events in their local
community had higher total physical fitness scores thosechildren who didn’t participate in sports.

How to improve the grade of theJapan report card
１) How to improve the monitoring system of
the Japan report card
・ In future Japan Report Cards, children in grades past the first
grade should be evaluated using the JSA survey.
・ In the future, a regular monitoring system is needed toevaluate the present state of physical fitness and fundamental
motor skills of under 5-year-old children including regionaland school differences.

２ )How to improve the physical fitness ofchildren and adolescents・ It is important that the public realizes that improving physicalfitness in children
and adolescents can have apositive influence on many
aspects of children’s lives
such as appropriate bodyweight management, bettermental health, and better
academic achievement, and soon.

13

7Weight Status
The School Health Survey data (2019) by the Ministry of Education, Culture, Sports, Science and Technology(MEXT) reported that 8.68 % of 6–17-year-old Japanese boys and girls were obese. Overall, however, thelevels are high compared to the 1980s. On the other hand, the percentage of underweight children was
2.33 %.

The results of the nationwide survey
・ The Annual Report of School Health Statistics Researchhas been continuously conducted every year since 1948
by MEXT to evaluate the growth and state of health inchildren and adolescents. The participants wererandomly selected by prefecture, school type, gender,
and age using a two-stage stratified random samplingfor every school in all age groups. The survey is anational representative survey.

Diet
The World Health Organization Guideline “Sodium
intake for adults and children” states “the recommended
maximum level of intake of 2 g/day sodium (5 g/day salt)
in adults should be adjusted downward based on theenergy requirements of children relative to those of
adults”. Therefore, the Dietary Reference Intakes forJapanese 2015 calculated the target values for each sex andage category by extrapolation from the value for adults
using the estimated energy requirements. As a result, thetarget values of intake were set as, 2.5g for boys aged 3 to
5 years, 2.9g for boys aged 6 to 7 years to 5.4g for boys
aged 15 to 17 years, and 2.5g for girls aged 3 to 5 years,
2.9g for girls aged 6 to 7 years to 5.9g for girls aged 15 to
17 years, respectively. However, the medians obtained by
the National Health and Nutrition Survey were about 1.5 to
2 times of the target values. Therefore, the mean values of
the target values based on the WHO Guideline and thecurrent mean intake were adopted as the tentative Dietary
Goal for preventing lifestyle-related diseases. It is thoughtthat such conditions should be improved.
As for calcium, current mean intakes are comparable withor slightly more than the estimated average requirementsin children aged 7 to 14 years, while they are obviously
lower than the estimated average requirements in children
aged 15 to 19 years. Mean intakes of iron were also lower
than the estimated average requirements in some sex andage categories. The tentative dietary goal for preventing
lifestyle-related diseases for the percentage of energy
intake from fat is set as 20 to 30 %. In contrast, according
to the National Health and Nutrition Survey in 2019
(Ministry of Health, Labour and Welfare, 2020), the mean
intakes for boys and girls aged 7 to 14 years were 29.5%
and 30.2%, those for boys aged 15 to 19 years were 29.8%
and 31.3%, those intake values are around upper boundaryof the tentative dietary goal for preventing lifestyle-relateddiseases.
According to the results of the National Health andNutrition Survey and the Dietary Reference Intakes forJapanese 2015, which are based on domestic andinternational evidence, there are no other nutrients that
especially need to be careful at present. Based on the
Dietary Reference Intakes for Japanese 2020, a similar
conclusion would be reached.
Thus, the nutrients which are at risk of deficiency arecalcium and iron. On the other hand, sodium intake, which
is important for the prevention of hypertension, was muchhigher, about 1.5 to 2 times of the dietary goal values forpreventing lifestyle-related diseases. Percentages ofenergy intake from fat are around the upper boundary of
the tentative dietary goals for preventing lifestyle-relateddiseases.

・ From 2020, due to the impact of the COVID-19, it was
decided to conduct the health check-ups, which areusually conducted between 1 April and 30 June, by theend of the relevant fiscal year (MEXT, 2021). Due to this,the survey period was extended to the end of the year.
For this reason, the results of the survey conducted in2019 (MEXT, 2020) were used in the third edition of thereport card.

Main findings of previous studies inJapanese children and adolescents・ Thirty years of cross-sectional and longitudinal changes
in the prevalence of obesity from 1978 to 2007 in
Japanese children and adolescents between 5 and 17
years of age, were investigated using the annual
reports of the School Health Survey published by the
MEXT. Cross-sectional analysis of 5-, 8-, 11-, 14-, and17-year- olds showed that the prevalence of obesity
has gradually decreased since the early 2000s, with thehighest prevalence in the late 1990s to early 2000s,
except for in 17-year-old boys. Longitudinal studies
showed that the critical periods for developing obesity
were in early childhood (between 5 and 6 years of age)and the high school period in boys, and mainly in earlychildhood in girls (Yoshinaga et al. 2010).
％
12.00

10.93

Underweight

9.92

10.00

Obese

8.59
7.91

8.00

7.71

7.00

6.00
3.46

4.00
2.57
2.00

0.00

1.49

1.52

Boys
(6-12 years old)Girls
(6-12 years old)Boys
(12-15 years old)

2.96
1.99

Girls
(12-15 years old)Boys
(15-18 years old)Girls
(15-18 years old)

Figure 6. Prevalence of obesity and underweight in children
and adolescents.

14

How to improve the grade of the Japan reportcard1）How to improve the monitoring system of
the Japan report card
・ In future Japan Report Cards, grades will be evaluatedusing the survey of the School Health Survey data and the
National Health and Nutrition Examination Survey.
・ A regular monitoring system that includes regional
differences is needed to evaluate the present state ofobesity, being overweight, and thinness in children under
4 years old.

2) How to reduce obesity rates and thinness inchildren and adolescents・ According to the above surveys and previous studies, thestate of care at home and lifestyles in preschool children
seems to have a great influence on children andadolescents being obese or overweight later in life.
Therefore, providing parents and grandparents with accessto information on how to care for their children is needed.
・ It is important that the public realizes that improvements
in daily physical activity, physical fitness, and fundamental
motor ability and decreasing sedentary behaviour inchildren and adolescents can have a positive influence on
many aspects of children’s weight status such as obesity,
overweight, and thinness, in addition to understanding
approaches for improvement.
・The Basic Act on Shokuiku (Food and Nutrition Education)(Act No. 63 of June 17, 2005)
The Roles of Guardians and Education-Related Persons in
Shokuiku for Children: Article 5 When providing shokuiku(food and nutrition education), to actively participate inactivities regarding the promotion of shokuiku for children,
parents and other guardians of children must be aware thateach household plays an important role in shokuiku, andpersons that provide child education, childcare or the likemust be conscious of the importance of shokuiku in childeducation, childcare or the like. The Hands-On Activities
Regarding Food and Nutrition and Performing Activities toPromote Shokuiku: Article 6 Shokuiku (food and nutrition
education) must be provided with the principle that thecitizens will deepen their understanding of food andnutrition by carrying out
various hands-on activities
concerning food and nutrition
from production to
consumption or other stages in the food supply chain andby spontaneously performing activities
to promote
shokuiku, taking advantage of every opportunity they canfind at places such as households,
schools, childcare
centers, and local communities.

15

8 Sleep
The National Survey on Physical Fitness, Athletic Performance and Exercise Habits of the Japan Sports Agency (2019)
reported that 24 % of 14- to 15-year-olds met the National Sleep Foundation’s sleep time duration recommendations(Hirshkowitz et al. (2015) recommended that teenagers spend 8 to 10 hours asleep per day).

The results of the nationwide survey
・ The Japanese government does not currently issue
recommendations for sleep in children and adolescents.
・In international sleep guidelines, the recommendation forages 5 to 13 is 9 to 11 hours of sleep per night. However,in the JSA survey (2019), sleep duration for the fifth-gradestudents (10–11-year-olds) was measured as less than 6hours, between 6 and 8 hours, and more than 8 hours, so
the prevalence of international guidelines could not be
examined.
・The JSA (2019) reported that the percentage of fifth-gradestudents who slept less than 8 hours a night decreased byabout 15 % (boys: 32.0% vs. 46.2%; girls: 27.5% vs. 44.3%)
for both sexes in 2019 compared to 2008. For eighthgrade students, the percentage of students who slept lessthan 8 hours decreased by about 10 % (boys: 71.6% vs.
83.2%; girls: 77.4% vs. 89.2%) for both sexes. In eighth
grade, the percentage of both boys and girls who slept
less than 8 hours decreased by about 10 % (boys: 71.6%
vs. 83.2%; girls: 77.4% vs. 89.2%).

Main findings of previous studies inJapanese children and adolescents・According to the SSF (2019), 4-5 year-olds slept 9.6 ± 0.7
hours on weekdays, 9.8 ± 0.8 hours on weekends, and 9.7 ±0.7 hours per week. Primary school students spent 9.0 ± 0.7
hours, 9.4 ± 0.9 hours, and 9.1 ± 0.6 hours, respectively.
Junior high school students spent 7.7±0.9 hours, 8.5±1.3
hours, and 7.9±0.9 hours, respectively. High school students
spent 6.9 ± 1.0 hours, 8.1 ± 1.6 hours, and 7.2 ± 1.0 hours,
respectively. Thus, the difference between hours of sleep on
weekdays and weekends was small for young children, but
about one hour less for junior high school and high school
students. Therefore, it may be necessary to pay attention to
sleep duration on weekdays.

How to improve the grade of the Japan
report card1）How to improve the monitoring system of
the Japan report card

・The JSA (2019) reported that the 8-9 hours’ sleep group
had the highest physical fitness among 10-11-year-olds,
while the 7-8 hours’ sleep group had the highest
physical fitness among 13-14-year-olds.

・ In future Japan Report Cards, grades will be evaluatedusing the survey of the JSA survey.
・ In the future, a regular monitoring system is needed toevaluate the present state of sleep of children andadolescents including regional and seasonal differences.

%
30.02) How to reduce obesity rates and thinness inchildren and adolescents

26.4

25.0

・It is important that the public realizes that improving sleep
in children and adolescents can have a positive influenceon many aspects of children’s lives such as appropriate
body weight management, better mental health, andbetter academic achievement, and so on.

21.5

20.0
15.0
10.0
5.0
0.0
Boys (13-14 years old)

Girls (13-14 years old)

Figure 7. Percentage of students who met the sleep
time duration recommendations.

16Settings and Influences on Physical
Activity and Health

9 Family and Peer Influence

In fifth-grade Japanese primary school students, the reported percentage of participation in sport orexercise with a guardian once or more per week was 31% (2015). Fifty-seven % of 10-to 11-year-olds and
48 % of 13-to 14-year-olds reported that their guardians encourage them often or sometimes to exercise or
do sports (2018). The National Health and Nutrition Survey (2020) reported that daily step counts were 7,226
in adults aged 20 to 64 years old. The prevalence of healthy weight in Japanese adults was 64.5 %.
Participation in sport twice or more a week, 30 minutes or more per time over 1 year was reported by 20 %.

The results of the nationwide survey
・ The original National Health and Nutrition Survey was
conducted in 1946. A total of 3648 households
participated in the 2014 survey.
・Physical Activity Guideline for Health Promotion 2013
established by the Ministry of Health, Labour andWelfare recommended that adults (20–64 years) should
engage in equivalent to 23 metabolic equivalents(MET)-h per week of moderate- to-vigorous-intensity
physical activity. Specifically, 60 minutes daily of walking
or other physical activity of equivalent or greater
intensity.
・Health Japan 21 (the second stage) sets the following
targets for 2022. 1) Increasing in the number of daily
steps: 9,000 steps for males and 8,500 steps for females
aged 20-64; 2) Increase in the percentage of people with
exercise habits: 36% for males and 33% for females aged
20-64; 3) Increase in the number of people who maintainhealthy body weight (decrease in obesity (Body massindex: BMI25 or higher) and thinness (BMI less than
18.5)): 28% for males aged 20-60 who are obese and 19%
for females aged 40-60 who are overweight, and 20% of
thin women in their 20s (2022). None of the indicators
have reached the target values at present.

%

40.0

35.8

35.0
30.0

27.0

25.0
20.0

with total exercise time under 60min/week, who weren’t
encouraged to participate in exercise or sports by family
members were at 33.8% (JSA, 2018). Adolescents with total
exercise time under 60 min/week who were encouraged toexercise or participate in sports by family members were at
8.3%. Adolescents with a total exercise time of over 420
min/week who weren’t encouraged to exercise or playsports by family members were at 48.4%. Adolescents with a
total exercise time of over 420min/ week who wereencouraged to exercise or play sports by family members
were at 77.5%. The encouragement of exercise or sport byfamily members was positively related to adolescents’
exercise time. There was a similar tendency in second-yearboys in junior high school (13-year-olds), and in the fifth-yearboys and girls in primary school (11-year-olds) (JSA, 2018).
・ According to the SSF's Sports Life Survey 2019 (2019), thepercentage of parents and first to sixth-grade students whoreported that they "often" or "sometimes" exercise or playsports with their families was 61% (63% of boys and 60% ofgirls). For young children, the percentage was 77% (76% ofboys and 78% of girls).

How to improve the grade of the Japan
report card

１) How to improve the monitoring system of
the Japan report card

・ In future Japan Report Cards, grades will be evaluated using
the survey of the National Health and Nutrition Survey, theJSA, and the SSF.
・ In the future, there is a need for a system to regularly
monitor the current status of children's exercise and sports
practices and support from parents or guardians.
・ A future national representative survey of the relationshipbetween participation in sports and family support inchildren and adolescents is needed.
・ Future research on the effect of health in children andadolescents by family and peer support is needed.

15.0２) How to improve family and peers’
influence on physical activity in children
and adolescents

10.0
5.0
0.0
Boys (10-11 years old)

Girls (10-12 years old)・ It is important to show the public in Japan to understandthat family and peer support can positively affect theamount of participation in exercise or sports by children
and adolescents.

Figure 8. Percentage of participation in sport or exercise
with a guardian once or more per week.

Main findings of previous studies inJapanese children and adolescents・ According to the national physical fitness survey by JSA,
second-year junior high school girls (13-14-year-olds)

17

10 School
The Japanese government sets primary school, junior high school, and high school curricula including the content ofphysical education (PE) classes and the number of PE classes provided. All schools have recess time in primary school,
junior high school, and high school. However, PE in primary schools isn’t taught by specialized course teachers who
have studied PE (only 5 % in primary schools). The MEXT produces guidelines for school infrastructure and equipment
for PE or active play in primary schools, junior high schools, and high schools, such as the area of the school playgroundand the existence of a gymnasium and relevant equipment according to education guidelines (eg, sports mat, horizontal
bars, hurdles, etc). Although health education classes past the 3rd grade use textbooks, there are no specialized physicaleducation textbooks for practical exercise and sports in Japanese primary schools.

The results of the nationwide survey
・ The MEXT sets educational curriculum guidelines forelementary schools, junior high schools, and highschools including the content of physical education
classes and the number of classes. The educational
curriculum guidelines for kindergartens are also set by
the MEXT. The guidelines for nursery schools andcenters for early childhood education and care are set
by the Ministry of Health, Labour and Welfare and the
Cabinet Office. Those guidelines require physicalactivity during childcare for young children.
・ The MEXT produces guidelines for school infrastructureand equipment for physical education or active play inkindergartens, primary schools, junior high schools, andhigh schools. The establishment of nursery schools andtheir facilities related to active play is regulated by the
Ministry of Health, Labour and Welfare.
・ Physical education in primary schools and active play innursery schools and kindergartens isn't carried out by
specialized course teachers who have studied physicaleducation. Also, in primary schools, physical education
classes are the only classes that don’t use textbooks.

Main findings of previous studies inJapanese children and adolescents・According to the MEXT survey, 77.3% of 10-11 year oldboys, 71.5% of 10-11-year-old girls, 70.6% of 13-14year-old boys, 59.8% of 13-14-year-old girls, answered
positively to whether they wanted to continue exercise
and sports after graduating from elementary school. The
percentage of boys is high than that of girls. The
percentages of junior high school students are lower
than that of primary school students.

How to improve the grade of the Japan
report card

１) How to improve the monitoring system of theJapan report card

・ In future Japan Report Cards, grades will be evaluated using the
educational curriculum guidelines by the MEXT, otherguidelines, and the Report of the Survey on Physical Strengthand Athletic Performance of the JSA.
・ We need to assess the actual situation of physical education
classes and activities across schools in a nationwide school
survey. In particular, it is important to examine the effects of theallocation of physical education teachers in elementary schools.

2)How to improve family and peers’ influenceon physical activity in children and adolescents・ Physical education in primary schools or active play in nurseryschools or kindergartens should be carried out by specialized
course teachers who have studied physical education.
・ Differences in gender and growth and development should beconsidered in physical education classes.
・ It is necessary to clarify the amount of physical activity inpreschool and school during physical activity and physicaleducation classes and outside of physical education classes.
・ The significance of physical activity and ways to promote
physical activity in the school, home, and community outsideof physical education classes should be widely disseminated,and opportunities for participation should be improved.
・It is necessary to conduct research on the amount of physicalactivity of Japanese children and adolescents during andoutside of physical education classes and its effect on theirhealth.
・In addition to the annual national survey on physical fitness,athletic ability, and exercise habits, a nationwide longitudinalsurvey on the quality of movement (skill), which is the basis ofchildren's athletic games and sports activities, is needed. It isalso desirable to conduct research to establish an evaluation
method as the basis for such a survey.

18

11Community and the Built Environment
Health Japan 21 (second term) by the Ministry of Health, Labour and Welfare reported that the number of local
governments which addressed the need to improve the physical environment where residents can easily exercise and bephysically active stood at 72 % of prefectures (34/47 prefectures).

The results of the nationwide survey
・ The SSF survey reported that 48% of Japanese parents of
4-9-year-old children agreed they lived in neighborhoods
that allow children to engage in active outdoor play,
exercise, or organized sports, safely (SSF, 2015).

How to improve the grade of the Japan
report card
１) How to improve the monitoring system of
the Japan report card
・ In future Japan Report Cards, grades will be evaluatedusing the next phase of the Health Japan 21 (second)
plan by the Ministry of Health, Labour and Welfare andthe level of achievement of the survey results will bebased on this plan.

２) How to improve the community and thebuilt environment for physical activity inchildren and adolescents・ Improvements in sports facilities, playgrounds/parks, andsafe sidewalks and bicycle tracks are needed.
・ For preschool children, there are different environmental
attributes associated with daily MVPA among children
between Japan and other countries. Thus, further researchis needed for Japanese children over 6 years old.
・ Detailed data for community and built environment in Japanare needed.
・ Further research on the effect of the community and thebuilt environment on the health of Japanese children/
adolescents is needed.

19

12 Government
There are many relevant laws and ordinances such as The Basic Act on Sport, the Health Promotion
Law, the Basic Act on Food Education, and so on. There are also strategies and policies in place like the Sport Basic Planand Health Japan 21 (second term). Physical activity guidelines exist for preschool children, adults, and the elderly.
However, national physical activity guidelines for children and adolescents (6-17 years) have not been established.

enforcement.
・ It is necessary to establish guidelines for sport andexercise and physical activity for 6-18 years old children
and adolescents.
・ Regular and nationwide surveys for children's growthenvironment are needed.

The results of the nationwide survey
・ In Japan, the Sports Authority, an external organ of MEXT

and the Ministry of Health, Labour and Welfare, is
responsible for policies relating to sports, exercise, andphysical activity. MEXT has implemented the “National
Physical Fitness, Exercise Capacity, and Habits Survey”
every year, and the “Public Opinion Survey on PhysicalFitness and Sports” at a frequency of once every three tofour years. The Ministry of Health, Labour and Welfare has
investigated the number of steps and the proportion of
exercise habits every year through the National Healthand Nutrition Survey based on the Health Promotion Law.
However, children 6 years old to 18 years old are not the
subject of the survey. In addition, the Ministry of Health,Labour and Welfare has recently been surveying thenumber of prefectures that tackle urban development andenvironmental improvement to increase access to exercise.
・ Based on the results of the National Health and Nutrition
Survey and the evidence of many epidemiological studies
for exercise and physical activities, MEXT and the Ministryof Health, Labour and Welfare have respectively
established national physical activity guidelines forpreschool children and a physical activity guideline forhealth promotion (Active guide). These guidelines havebeen adopted as the basis for the planning of measuresfor each ministry and agency such as the Sport Basic Plan,
Health Japan 21 (second term), and Healthy Child 21(second term). However, national physical activity
guidelines for children and adolescents (6-17 years) have
not yet been established.
・ In addition, the Science Council of Japan, an externalbureau of the Cabinet Office, issued academic
recommendations for children in 2017, such as therecommendations "Toward the Sound Development ofChildren's Movements - Basic Movements are in Danger"and "Toward the Improvement of the Child Development
Environment in Japan - Issues and Recommendations for
the Child Development Community".
・ In local governments, the education, sports, and healthrelated departments are responsible for measures related
to physical activity and exercise. In recent years, there has
been an increase in local governments that address urban
development and health through initiatives by mayors or
governors. The Health Promotion Law obligates all
prefectures to formulate and initiate their health plans.
・ In addition to the above, there are relevant laws andinitiatives, such as the Health Promotion Law, the School
Lunch Program Act, the Community Health Act, theMaternal and Child Health Act, the School Health and the
Safety Act, Basic Act on Food Education, toto, and so on.

２) How to improve the participation levels
in organized sports in children andadolescents・ An official national physical activity guideline for children
and adolescents between 6 and 17 years old is necessary.
・ The understanding and practical use of the official
national physical activity guidelines (Youjiki Undou
Shishin, 2012) for 3–5-year-olds in Japan by preschool
teachers and parents should be examined. Also,
problems in the field of physical activity for 3–5-yearolds should be clarified and solved.
・ It is necessary to develop parks and the environment sothat every child can safely and actively engage inphysical activity.

How to improve the grade of the Japan
report card
１) How to improve the monitoring system of
the Japan report card
・ In future Japan Report Cards, grades will be evaluatedusing the relevant laws and ordinances, strategies andpolicies, physical activity guidelines, investments, and20

Next Steps

This is the third version of the Japan Report Card on Physical Activity for Children and Youth. We are planning to publish it
subsequently to monitor changes to each grade, in 2025. To do so, we need further funding and are seeking partnerships withindividuals or organizations who might consider providing financial or other support. The short and long forms of this report card
are available from our website (www.activekids.jp). An academic publication based on the 2022 Japan Report Card on Physical
Activity for Children and Youth was published in the Journal of Exercise Science & Fitness. Please contact the Active Healthy Kids
Japan Group (active.healthy.kids.japan@gmail.com) for further information.

Acknowledgements

This card was produced with a partnership between the Tokyo Kasei Gakuin University (Prof. Chiaki Tanaka), the Shimane University(Dr. Takafumi Abe), the Kagawa Nutrition University (Prof. Shigeho Tanaka), the National Institutes of Biomedical Innovation,
Health and Nutrition (Dr. Yoichi Hatamoto), the Waseda University (Prof. Motohiko Miyachi), the Tokyo Medical University (Prof.
Shigeru Inoue), and the University of Strathclyde (Prof. John J Reilly). The authors thank Prof. Minoru Takakura and M.S. Kenji Ueta
as the Stakeholder for their varied and substantial contributions to the 2022 Japan Report Card. The photo on the cover page ofthe third edition report card was provided by Mitoya Kodomoen (authorized centers for early childhood education and care) in
Unnan city, Shimane prefecture. This photo which playing outside in a familiar environment (rice field ridges) is an example of
how it can be a playground for kids everywhere.

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Tremblay MS. Systematic review of the relationships between
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