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桜美林大学

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National Institutes of Biomedical Innovation,
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国立研究開発法人 医薬基盤・健康・栄養研究所
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Tokyo Medical University
東京医科大学

Juntendo University
順天堂大学

The 2016 Japan Report Card on Physical
Activity for Children and Youth
Details of Method and Results
Table of Contents
Objective of the 2016 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 Levels ・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・ 6２ Organized Sport Participation ・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・ 8
３ Active Play・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・ 9
４ Active Transportation ・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・ 10
５ Sedentary Behaviours・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・ 11
６ Physical Fitness ・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・ 13
７ Weight Status ・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・ 14

Settings and Influences on Physical Activity and Health
8 Family and Peer Influence ・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・ 16
9 School ・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・ 17
10 Community and the Built Environment ・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・ 19
11 Government Strategies and Investments ・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・ 19
Next Steps ・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・ 20
The Cover of the 2016 Japan Report Card・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・ 20
Acknowledgements・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・ 20
References・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・ 21

3

Objective of the 2016 Japan Report Card on
Physical Activity for Children and YouthPublic health surveillance of physical fitness in children and youth in Japan using school-measures ofphysical fitness-has been based on the Physical Fitness Test of the Ministry of Education, Culture, Sports,
Science and Technology (MEXT) since 1964, when the 18th Summer Olympic Games were held in Tokyo.
This annual surveillance is performed to evaluate physical fitness and exercise, life and eating habits acrossthe life course, from Japanese children to the elderly. In 2013, MEXT issued a report comparing physicalfitness in children and adolescents from the 1980s to the present. Results indicated that physical fitness
and motor skill levels obtained in 2014 were lower than results in the 1980s (MEXT 2013). Also, obesity
is increasing and physical activity is decreasing around the world (OECD 2014, Hallal et al. 2014). With
the mission to improve physical activity in children and youth, The Active Healthy Kids Global Alliance wasestablished in 2014. The Active Healthy Kids Global Alliance is a network of researchers, health professionals
and stakeholders who are working together to advance physical activity in children and youth from aroundthe world.
Western countries have been publishing the Report Card on Physical Activity for Children and Youth toconsolidate existing evidence; identify research gaps; facilitate international comparisons; encourage moreevidence-informed physical activity and health policies; improve surveillance of physical activity of children.
However, there is a deficit of evidence-from outside western countries, including Japan. The relationshipbetween physical activity and environmental factors in Japan may be different from those in Westerncountries. For example, in Japanese children, moderate-to-vigorous physical activity (MVPA) was significantly
related to the safety and the availability of greenery in neighborhoods (Tanaka C. et al. 2011). Moreover,thinness, rather than excess weight, is associated with decreased light, moderate, and high intensity physicalactivity (Tanaka C. & Tanaka S. 2013). The Report Card can clarify the physical activity environment in Japanand place it in an international context, which will be benefit to Japan and to other nations.
The 2016 Japan Report Card on Physical Activity for Children and Youth can provide critical and upto-date evidence and information in order to support and advocate for physical activity and the health ofJapanese children and adolescents. The Japan report card can be used in a number of ways: for example,
a. Governments: 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, to educate students, anduse it to - inform research or knowledge exchange grant applications.
c. Teachers, coaches, public health promoters, recreation professionals and community development
leaders: could use it to inform work with children, adolescents, their families and community members.
d. Provincial or municipal organizations: could use it as a tool to inform planning, research, grant writing andcapacity building.
The Report Cards on Physical Activity for Children and Youth from Canada and 14 other countries
published in 2014 presented a promising approach to achieving a more robust physical activity surveillanceand evidence-based physical activity promotion strategies in Japan (Barnes J.D. et al. 2012, Colley R.C. et
al. 2012, Reilly J.J. et al. 2014, Tremblay M.S. et al. 2014). In 2020 Japan will host the Tokyo Olympic andParalympic Games. A joint UK Government and Mayor of London report showed that 1.4 million more people
are playing sport once a week since London won the bid in 2005, as one of the legacies from the London
2012 Olympic and Paralympic Games (Government of the United Kingdom and Mayor of London, 2013).
Similarly, the Japan report card can reveal the sporting legacy created by the Games, and may have a lasting
impact on not only children and adolescents but also on the country and its residents, in the near future.
The Long Form Japan Report Card 2016 explains how the report grades were derived, which data sourceswere used to derive the grades, and 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 Japanesechildren and youth were summarized 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 15 countries on 5 continents
using 9 common indicators (Overall Physical Activity Levels, Organized Sport Participation, Active Play,
Active Transportation, Sedentary Behaviour, 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 first Japan Report Card 2016 assigns grades to 11 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 2016
Japan Report Card on Physical Activity for Children and Youth
Indicator

GradesPhysical Activity, Health Behaviours and Outcomes
1. Overall Physical Activity Levels ・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・INC
2. Organized Sport Participation ・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・ C
3. Active Play・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・INC
4. Active Transportation・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・ B
5. Sedentary Behaviours・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・ C
6. Physical Fitness ・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・ C
7. Weight Status ・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・ A
Settings and Influences on Physical Activity and Health
8. Family and Peer Influence ・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・ D
9. School ・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・ B
10. Community and the Built Environment ・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・ D
11. Government Strategies and Investments・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・ B

5Physical Activity,
Health Behaviours and Outcomes

1Overall Physical Activity Levels

There are no representative Japanese data for physical activity in under 15-year-olds. The National Healthand Nutrition Examination Survey reported step counts for 15-19 year olds. In males, the data showed amarked decrease for several years. On the other hand, the trend in females generally continues to be flat.
However, data haven’t been reported since 2012.

The results of the nationwide survey

problem is that in Japan an official national physicalactivity guideline does not exist for adolescents.
・The gathering of more nationally representative physicalactivity data for those under 18 years old is needed.
・Development of the Japan 2016 Report Card has also
confirmed that there are currently no objectively or
subjectively measured Japanese daily physical activity
surveillance data for younger children, a major gap inpublic health surveillance in Japan.
・According to the MEXT (2010) survey, 10.5% of 5th
grade boys and 24.2% of girls engaged in exercise forless than 60 min/week outside of physical education
classes. In the second year of junior high school 9.3% ofboys and 31.1% of girls engaged in exercise outside ofschool except for physical education class for less than
60 min/week. The great majority (90%) of children andadolescents who exercised for less than 60 min/week
didn’t belong to a sports club.

The official national physical activity guidelines for each age
group are as follows.
For 3-5 years olds: the official national physicalactivity guideline was proposed by MEXT. Youjiki
Undou Shishin (2012)
The guideline reads “It’s essential for preschool
children to have various kinds of fun play more than
60min/day, everyday!”. The guideline addresses only
duration not intensity.
For 6-17 years olds: The Japan Sports Association
guideline (Active Child 60min) for preschool andprimary school children (2010)
The guideline reads “Let’s move at least 60min/day,every day, move using your body in daily life, physicaleducation and sports”. Moreover, the guideline is
not evidence based and uses primarily international
not Japanese research. The guideline is based oninternational physical activity guidelines.

Main findings of previous studies inJapanese children and adolescents

・The indicator ‘Overall Physical Activity’ could not be
graded, because evidence-based data for the behaviour
were lacking in Japan. The National Health and Nutrition
Examination Survey reported step counts for 15-19 year
olds (Arunesu200S，AS-200). In males, the data showeda marked decrease over the past few years in 2010, withmean values of 7458 steps/day for girls and 7872 steps/
day for boys (Cabinet Office, 2013). On the other hand,
trend data in females generally continues to be flat, withno obvious recent secular trends. However, step countdata haven’t been reported by the National Health andNutrition Examination Survey since 2012. An additional・ The Tokyo Metropolitan Board and Education Survey
collected pedometer data for 6-17 year olds in Tokyoin 2011 and found that mean step counts were almost
11000steps/day in primary school students, almost
9000steps/day in junior high school students and almost
8000steps/day in high school students (The Tokyo
Metropolitan Board and Education 2012). The step
counts decrease with age and are lower in girls than inboys (Figure 1).
・ There are consistent patterns among many previous
studies in Japan that found daily step counts are higher
on weekdays than on weekends, and are higher in

15000

Step counts（step counts/day）

12733

12878

10775

12804

10699

12736

10549

10000

12347

10121

9670

Boys

12242

Girls

10539
9134

10072
9209
8624

8435
7433

8443 8320 8346

7885

8341 8108

5000

0

6

7

8

9

10

11

12

13

14

15

16

17

Age (year)

Figure 1 Mean values of daily step counts in boys and girls in the Tokyo metropolitan area.
(This graph was taken from a survey of step counts among children in the Tokyo Metropolitan area by the Tokyo Metropolitan Board of Education.)6women than in men (Adachi et al. 2007，2008，Shiomi
et al. 2008, Sasayama et al. 2009，Tanaka C. ＆ Tanaka S.
2009ab，Mitsui et al. 2010, Sasayama ＆ Adachi 2011，
Tokyo Metropolitan Board Education 2011，Hanawa
2011, Nakae et al. 2013，Mishima et al. 2013, Ishii et al.
2015, Tanaka C. et al. 2015).
・ Daily step counts under free-living conditions differedamong pedometers depending on which type of
pedometer was used. The average differences can beat least 20% (Tanaka S. et al. 2012). Figure 2 shows
daily step counts which were measured by the Kenz
Lifecorder (Suzuken Corp., Nagoya, Japan) in previous
studies of Japanese children and adolescents（Adachi etal. 2008, Sasayama et al. 2009，Tanaka C. ＆ Tanaka S.
2009，Sasayama ＆ Adachi 2011). According to TudorLocke et al. (2008) categories, the results for primaryschool children are categorized as Gold or Silver.

counts and in girls 9343±2020 step/counts) than inurban areas (Kyoto city: in boys 19775±5277step/counts
and in girls 12128±2306 step/counts) children (n = 227,
11–12 years old) (Itoi et al. 2012).
・ From 1999 (n=125) to 2009 (n= 108), step counts on
weekdays in girls decreased considerably (20832 vs.
12237 steps per day in boys; ns and 16087 vs. 10748
steps per day in girls) (Itoi et al. 2015).
・ Among 379 Japanese primary school boys and girls
aged 9.3±1.6 years in Tokyo, Kanagawa and Kyoto, theage at which children started walking without assistance
was inversely correlated with the time spent in MVPA(r=−0.24). A younger age at which children started walking
unassisted was significantly associated with increased
time spent in MVPA. There was no evidence of an
association between birth weight and MVPA (Aoyama et
al. in press).
・ Among 216 4th grade (9-10 years) elementary school
children (105 boys and 111 girls), body fat in boys as
measured by the bioelectrical impedance method wassignificantly correlated with sleeping, exercise, television
watching periods, and step counts. For girls, BMI, relative
body weight and body fat were significantly correlatedwith sleeping and exercise periods, as well as the steps
counts but not with the amount of time spent watching
television (Munakata et al. 2010).
・ Among 300 Japanese adolescents aged 12-14 years
in Tokyo, for boys, accumulating more than 80.7 min/day of MVPA as evaluated by the Lifecorder (SuzukenCo.) may reduce the probability of low fitness. For girls,
accumulating only 8.4 min/day of vigorous physicalactivity could reduce the likelihood of exhibiting low
fitness (Kidokoro et al. 2016a).
・ The factors associated with achieving physical activity
guidelines in 293 Japanese adolescents (140 boys:
13.2 ± 0.6 years old and 153 girls: 13.2 ± 0.6 years
old) in Tokyo were investigated. Based on MVPA using
the Kenz Lifecorder EX, the participants were classified
as “Active” (≧60 min/day of MVPA) or “Inactive” (<60min/day of MVPA). After-school sports activities werepositively associated with the probability of being
Active for both sexes. In addition, body fat in girls was
negatively associated with a reduced likelihood of being
Active. Those in the Inactive group had significantly lower
physical activity levels than those in the Active groupon both the activities in regular curriculum time and in
extra curriculum time. In addition, for girls, there was asignificant interaction effect between domains activities
in curriculum time vs. in extra curriculum time and afterschool sport activities, suggesting that obtaining higher
physical activity levels on extra-curricular activities might
be difficult for those who do not belong to any afterschool sport classes. Anthropometry, age, screen time,mental health, sleep status, and breakfast status were
not associated with achieving physical activity guidelines(Kidokoro et al. 2016b).
・ Among 98 Japanese elementary school boys (at baseline:
8.9 ± 1.8 years) and 111 elementary school girls (atbaseline: 9.1 ± 1.8 years), daily MVPA was significantly
higher during the summer vacation than during theschool year for both boys and girls.
Moreover, the decrease in non-ambulatory
MVPA in boys was significantly lower inthose who participated in sports comparedto those who did not (Tanaka C. et al.
2016).

Step counts (step counts/day)

20000

15000

10000

5000

Boys
Girls

0

4

6

8

10

12

14

16

18

Age (year)

Figure 2 Daily step counts as taken by the Kenz Lifecorder in previous
studies of Japanese children and adolescents of both genders.
(Adachi et al. 2008, Sasayama et al. 2009，Tanaka C. ＆ Tanaka S. 2009，Sasayama ＆ Adachi 2011)

・ Among sixty adolescents aged 12-15 years, the physicalactivity level (PAL) using the doubly labelled water
method were 1.97±0.31 in subjects who exercised, and
1.85±0.27 in subjects who did not exercise(IshikawaTakata et al. 2013).
・ PAL by the doubly labelled water method was 1.64 ±0.17 in girls (n=10, 10.9± 0.3 years old) and 1.60 ± 0.19
in boys (n=20, 10.6 ± 0.5 years old) in Chiba prefecture,
respectively (Nakae et al. 2013).
・ The changes in physical activity levels were evaluatedwith the Activity Style Pro (HJA-350IT, Omron Healthcare,
Kyoto, Japan) among children and adolescents living in
the area affected by the 2011 earthquake and tsunami
for 3 years immediately following the disaster. Mediandaily step counts for children and adolescents weresignificantly different on both weekdays and weekends
over the 3 years. The median daily step counts taken
by children of both genders on weekdays and those ofgirls on weekends at period IV (n=365, 3 years after
the earthquake/tsunami) were significantly lower thanthose at period I (n=434, 6 months after the earthquake/tsunami). In addition, the median daily step counts ofadolescents on weekdays among girls and weekends
among boys at period IV were significantly lower thanthose at period I (Okazaki et al. 2015).
・ Among 195 Japanese preschool boys and girls aged
5.7±0.6 years in Kanto region, the children’s cognitive
appraisals of themselves as being good at exercise or as
liking exercise were not related with MVPA on weekdays
or weekends (Ono H. et al. in press).
・ The number of steps per day were significantly lower inrural areas (Tohoku region: in boys 12128±2306 step/7

quantitative data with pedometers or accelerometers isneeded in Japan. Moreover, an examination of the validityof the questionnaires is needed. The official national
physical activity guideline (Youjiki Undou Shishin, 2012)
in 3-5 years old in Japan suggests questionnaires andpedometers as the method of evaluation of physicalactivity in preschool children. A strong and significant
correlation was observed between minutes of MVPA andstep counts (r=0.832)(Tanaka C.& Tanaka S., 2009a),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 both the amount of time per a day spent inphysical activity and intensity is needed.

How to improve the grade of the Japan
report card

1) How to improve the monitoring system of the Japan
report card
・ International and national physical activity guidelines forchildren over 5 years old to adults are 60 min per day ormore of MVPA. However, 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’s essential for preschool children tohave various kinds of fun play for more than 60min/
day, everyday!. The guideline addresses only duration
not intensity. Moreover, the guideline is only basedon research by MEXT (2007-2009) which found thatpreschool children who spent a longer time playing
outdoors than their peers, as reported by their parents,
had higher levels of physical fitness. The survey also
found that over 40% of children played outside for lessthan 1 hour/day (MEXT, 2011).
・ On the other hand, the Japan Sports Association
guideline (Active Child 60min) for preschool and primaryschool children(2010) is not evidence based and uses
primarily international, not Japanese research. The
guideline is based on international physical activity
guidelines (Start active, stay active, Canadian Society
for Exercise Physiology, Australian Governments). An
official national physical activity guideline for children
and adolescents between 6 and 17 years old based onJapanese research similar to the one for primary school
children is necessary.
・ A regular monitoring system is needed to evaluate thepresent state of daily physical activity including regionaland seasonal differences.
・ In some countries methods to objectively measure
daily physical activity (e.g. accelerometers) are used inpublic health surveillance. The evaluation of qualitative
data for daily physical activity with questionnaires and2) How to improve the daily physical activity level inchildren and adolescents・ A strategy to improve physical activity on weekends,
summer vacation and in girls is especially important.
・ It is important that the public realizes that improvements
in daily physical activity in children and adolescents canhave a 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 soon.
・ As noted below, increased participation in exercise andsports, increased time spent in active play, greater useof public transportation and active transportation, adecrease in sedentary behaviour, an improvement in thefamily environment in which children are raised, and theestablishment of a system of sports facilities, such as
sidewalks and bicycle tracks are all needed.

2 Organized Sport Participation

Participation in sport was reported for 27-92% of 6- to 17-year-olds by the Report of Survey on PhysicalStrength and Athletic Performance of Japan Sports Agency (JSA) (2015). The prevalence at 4-5 years
old was reported at 29% in 2015 according to the Sasakawa sports foundation (SSF) National Sports-Life
Survey of Children.

The results of the nationwide survey

・ In 2001, the SSF has carried out a national survey every
4years to understand the current status of participationin sports among teenagers. The survey has been
continuously conducted every two years since 2011.
The SSF has also carried out a national survey of 4-9
years olds every two years since 2009. Both surveys
are carried out using the household drop-off methodwith a questionnaire. The participants were randomly
selected boys and girls aged from four to nine and ten
to nineteen throughout the country using a two-stage
stratified random sampling for every 200 children oradolescents in all age groups. The usefulness of thesurvey of preschool children is limited by its small sample
size.

・ A national physical fitness survey has been conductedby MEXT every year since 1964 to evaluate the physicalfitness and motor skills of Japanese citizens. The survey
data is used administratively and as supporting data forevaluating and creating teaching methods for physicaleducation and sports. For children and adolescents, theparticipants in the survey were public primary, junior highschool and high school students (6-18 year old) of bothgenders in 47 prefectures. The survey is conducted from
May to July and samples 1000 children or adolescents
every age group. An exhaustive survey has been
conducted in grade 5 in primary school (10-year-olds)
and the second year in junior high school (13-year-olds)
from 2007. This is a national representative survey.

8Percentage of participating in organized sport (%)

report card
・ The Japanese government does not currently issue
recommendations for organized sport participation inchildren and adolescents.
・ In future Japan Report Cards, grades will be evaluatedusing the JSA survey.
・ In future Japan Report Cards, grades for children andadolescents from between the ages of 6 and 17 will be
evaluated using the JSA survey.
・ A regular monitoring system that includes regional andseasonal differences is needed to evaluate the present
state of participation in organized sports for children
under the age of 5.
２) How to improve participation in organized sports bychildren and adolescents・ According to the above surveys and previous studies,
the percentage of organized sports participation in boys’
and girls’ preschool children (SSF, 2015) was low. On theother hand, there is a bipolarization of organized sports
participation in students (JSA, 2015). 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 environmentthat allows girls to participate in organized sports theintroduction of seasonal systems and/or multisportsystems is needed. Examples of these include various
types of exercise and sports clubs, the improvementof facilities (e.g. fostering comprehensive sport clubs,
sports groups, NPOs: Nonprofit Organizations) and themaintaining and promoting of children’s and adolescents’
health facilities, a system that allows girls to participate
in sports with friends and in their local communities, andfacilities that let girls improve their competitive ability.
・ In preschool children there was no significant difference
in daily physical activity between those children who
participated in a sports club outside of preschool andthose who didn’t. On the other hand, physical fitness andfundamental movement skills correlated with participationin organized sports, regardless of age group. Moreover,in junior high school children, a similar relationshipbetween participation in sports clubs and higher
academic achievement was found. Thus, it is particularly
important to provide an environment that allows children
and adolescents who wish to do so, to participate inorganized sports. However, the more adolescents played
sports, the more likely they were to have and to develop
sports related pain and injuries.
Thus, the duration and intensityof the sports activity has to beclosely monitored by teachers,coaches, parents, and so on.

100
90
80
70
60
50
40
30
Boys

20

Girls

10
0

4-5

6-11
12-14
Age (year)

15-17

Figure 3 Percentage of 4 to 17 year old boys and girls participating in organized sport.
(This ﬁgure was drawn from the results of the JSA and SSF surveys in 2015)

Main findings of previous studies inJapanese children and adolescents・ Obviously, the physical fitness of children andadolescents who belonged to sports clubs was higherthat of children and adolescents who did not belong tosports clubs (MEXT, 2008).
・ Grip strength, 25 m run speed and total Z-score wereassociated with sports club participation out of school
in 191 Japanese 5 -6 year preschoolers in the Kanto
region(Tanaka C. et al. 2014).
・ There were no significant differences of time in MVPA
between children with and without out of school sports
club participation in 211 Japanese 5-6 year preschoolers
in the Kanto region(Tanaka C. et al. 2015).
・ Academic achievement was associated with participationin extracurricular sports in boys (n=330) or participationof extracurricular sports and cultural affairs in girls(n=297) for 14 year Japanese junior high school students
in Okayama prefecture (Sasayama et al. 2014). There
were weak correlations between time spent engaging in
exercise and academic achievement (boys: r=0.182, girls:
r=0.125).
・ The dose–response relationship between sports activity andmusculoskeletal pain among adolescents (n=2403) aged
12 to 18 years in Shimane prefecture was examined. The
prevalence of overall pain, defined as having pain recently atleast several times a week in at least one part of the body,was 27.4%. The risk ratio for developing pain at 1-year
follow-up per 1 h/wk increase in baseline sports activity was
1.03 (n=374) (Kamada et al. 2016).

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

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.

The results of the nationwide survey

active and outdoor play.
・ According to the survey by the SSF, types of active play・ There are no Japanese government recommendations for9

in children (4-9yr) was 4.7±3.7 types a year for boys and5.5±3.9 types a year for girls, respectively. The numberof different types of active play increased until 7 years
old for boys, 8 years old for girls (SSF, 2015).

・ Playing with large blocks indoors and ball toss bothindoors and outdoors are considered as MVPA inpreschool children. Indoor play is not always lightintensity (Tanaka C. et al. 2007, Kawahara et al. 2012).
Moreover, in primary school children, ball toss bothindoors and outdoors is also a MVPA (Hikihara et al.
2014).

Main findings of previous studies inJapanese children and adolescents・ The prospective longitudinal Toyama Birth Cohort Study(Takahashi et al. 1999) found that among obese children
the percentage of one hour or less outdoor play time
per day (n=288，67.4%) was significantly higher thanthat in normal weight children (n=508，59.5%) in 3 and6 year olds. However, after modifying the participants’characteristics (e.g. body weight), the percentage of one
hour or less outdoor playtime per day wasn’t significantly
different among both groups (Kagamimori et al. 1999).
・ Medical examinations in Okayama Prefecture found that
73.8% of 1.6 year olds played outdoors almost every day
and 55.8% of 3 year olds played outdoors every day.
(Kano et al. 2009).
・ Outdoor playing time and the percentage of outdoor
playing time for more than 60 min/day in preschool children
in the Kanto region were 81±62 min/day and 64% for boys
and 78±61 min/day and 62% for girls, respectively. Datafor outdoor playing time using questionnaires for parents
were not significantly correlated with MVPA using triaxial
accelerometers (Tanaka C. et al. 2015).
・ There is an association between persistent expression of
liking outdoor physical activity and self-reported healthamong both 6 and 12 year old children (n=5238) fromthe prospective, longitudinal Toyama Birth Cohort Study(Liu et al. 2015).
・ Outdoor playing times were not significantly difference inurban areas (Kyoto city: in boys 46±39 min/day (n=77)
and in girls 35±29 min/day (n=79)) and in rural areas(Tohoku region: in boys 32±27 min/day (n=45) and ingirls 34±27 min/day (n=26)) children (11–12 years old)
(Itoi et al. 2012).
・ From 1999 (n=125) to 2009 (n= 108), time spent playing
outdoors in girls was significantly less (46 vs. 31 min per
day in boys; ns and 31 vs. 12 min per day in girls) (Itoi etal. 2015).

How to improve the grade of the Japan
report card
1) How to improve the monitoring system of the Japan
report card
・ Recommendations for active play in children andadolescents need to be established by the Japanese
government.
・ A regular monitoring system is needed to evaluate
the present state of active play including regional andseasonal differences.
2) How to improve active play time in children andadolescents・ According to the above surveys and previous studies,
further study/research is needed, because the numberof studies of active play are few, although there aresome previous studies which used questionnaires forpreschools and primary schools.
・ Preschool and primary school children spend MVPA inindoor play activities. Therefore, it is necessary to focus
on both outdoor and indoor play.
・ An increase in active play environments that allow
for safe active play with diversified physical contents(e.g. Comprehensive sport clubs, NPOs), greatercommunication with friends and the local community
about activities, as noted below, and the establishmentof a safe environment for active play for children andadolescents, are all needed.
・ Further study is needed on thetypes of play, the quality andquantity of indoor and outdoor
play, the clarification of the stateof active play, and effect of playon the health of children andadolescents.

4 Active Transportation
Percentage of active transportation to school (%)

The 2015 SSF National Sports-Life Survey of Children reported that 28% of Japanese preschool school
children (4-5 years old) regularly commuted actively (walking) to school. The 2015 SSF National SportsLife Survey of Young People reported that 93% of Japanese elementary school children (6-11 years old)
regularly commuted actively (walking or cycling) to school, and 88% of junior high school students (12-14
years old) and 68% of high school students (15-17 years old) regularly commuted actively.

The results of the nationwide survey

・ The SSF database was used to estimate the prevalenceof active transportation to school for the purposes ofgrading in this report card, as it provided recent andnationally representative data. The details are shown inthe section on organized sport participation as above.
・ According to a survey by MEXT (2008), 95% ofelementary school children (10 years old) and 69% ofjunior high school students (13 years old) regularly
commuted to school on foot. Time spent waking toschool was 17.3 minutes for children (10 years old) and17.6 minutes for adolescents (12 years old) on average.

100
90
80
70
60
50
40
30
Boys

20

Girls

10
0

4-5

6-11
12-14
Age (year)

15-17

Figure 4 Percentage of active transportation to school.
(This ﬁgure was drawn from the results of the SSF survey in 2015.)

10

boys; and 46 (n=63) vs. 39 (n=52) min/day in girls) (Itoiet al. 2015).

Main findings of previous studies inJapanese children and adolescents

How to improve the grade of the Japan
report card

・ According to a survey of the state of health in children
and adolescents in 2010(Japanese Society of School
Health, 2010)(n=10163), the average time Japanese
students commuted actively (walking or cycling) toschool was 18 min 35 sec in boys and was 19 min
33 sec in girls, respectively. There was no difference
between primary and junior high school students (1620min), Commuting time among high school age children
was higher (23min). There was no difference between
genders in every age group.
・ In the Kanto region 5-6 year old preschool children(n=361) commuted almost 10min each way by walking toschool (Tanaka C. et al. 2014).
・ In rural areas almost 80% of 4th to 6th grade preschool
children commuted to school by private motor vehicles.
Time spent walking to school was 5min each way (Itoi etal. 2007).
・ Time spent walking to school was significantly lower inrural areas (Tohoku region: in boys 4±7min/day (n=79)(percentage of walking to school: 31.1 %) and in girls 2±6min/day (n=26)) (23.1 %) than in urban areas (Kyoto
city: in boys 37±23min/day (n=77) (100 %)) and in girls
42±25min/day(n=79) (98.4 %)) children (n = 227, 11–12
years old) (Itoi et al. 2012).
・ From 1999 to 2009, time spent walking to school was
significantly less (41 (n=62) vs. 35 (n=56) min/day in１) How to improve the monitoring system of the Japan
report card
・ There are no Japanese government recommendations
for active transportation.
・ A national survey of preschool was conducted by the
SSF (2015), however the usefulness of the survey islimited by its small sample size. Extensive investigation isneeded.
・ 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.

5 Sedentary Behaviours

２) How to improve active transportation in children
and adolescents・ 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 andbicycle tracks, neighborhood safety, etc. are all needed.
・ A future survey of active transportation and its effecton the health of children and adolescents is needed.

More than 1hour TV viewing on weekdays (%)

The Report of National Survey on Physical Fitness, Athletic Performance and Exercise Habits of the JSA(2015) reported that 71-76% of grade 5 Japanese primary school children and second year in junior highschool children spent more than 1 hour per day of watching TV, videos or DVDs viewing (Not playing
video games). In addition, 30-60% reported 1 hour per day playing video games (PCs, portable electronic
devices having a game function, cellular or smart phones). The 2015 SSF National Sports-Life Survey ofYoung People reported that 31% of Japanese preschool children (4-5 years old) spent more than 2 hour per day of screen
time (watching TV, PCs etc.).

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 in recreational screen time. There are no Japanese
government recommendations for sedentary behaviour.

100
90
80
70
60
50
40
30

Boys

20

Girls

10
0

10

13

100

100

90

90

More than 1hour spent playing
games on weekdays (%)

More than 2 hours of screen time on
weekdays and weekends (%)

Age (year)

80
70
60
50
40
30
Boys

20

Girls

10
0

80
70
60
50
40
30
Boys

20

Girls

10
0

4-5
Age (year)1013
Age (year)

Figure 5 Status of sedentary behavior.
(These figures were drawn from the results of the JSA and SSF surveys in 2015.)

11

・ The JSA survey reported that 5th grade primary schooland 2nd grade junior high school students who watched
TV or used games/cell phones/smart phones for morethan 3 hours a day was lower than the others (JSA,2015).

Main findings of previous studies inJapanese children and adolescents
・ In a cross-sectional survey with 9261 school children(mean age of 12.8 years) from 93 junior high schools in
Toyama prefecture, percentages of TV viewing time inboys and girls were <1h: 14.1% and 13.9%, 1-2h: 39.8%
and 35.2%, 2-3h: 27.8% and 26.5%, 3-4h: 10.7% and13.3%, and >4h: 7.6% and 11.0%, respectively. Computer
and TV-video game time were 0h: 20.0% and 56.1%,<1h: 41.1% and 28.3%, 1-2h: 27.8% and 10.5%, 2-3h:
7.2% and 3.1%, and >3h: 3.9% and 2.1%, respectively.
With respect to TV viewing time, a gradual increasein TV time was also associated with an increase in riskof sleepiness in boys. A TV viewing time of 3 hours ormore significantly affected the child’s sleepiness. The
maximum risk (OR=1.73) was found for a TV viewing timeof more than 4 hours. In girls, a TV viewing time startingfrom 1 hour significantly affected the child’s sleepiness;interestingly, 4 hours or more spent on such activities
presented a higher risk (OR=2.30) in comparison toboys. In girls, playing computer and TV video games had
no impact on sleepiness. However, in boys, more than
1 hour of computer and TV video games significantly
affected the child’s sleepiness. Thus, more than 1 hourspent on such activities significantly increases the risk
for sleepiness (OR=1.41) (Gaina et al. 2007).
・ Preschool children (3 to 5 year old: n=569) in Okayama
prefecture who had long TV viewing times went to bed
later, had shorter sleeping times, an irregular rhythm ofgoing to bed or waking up in the morning, and were in
the habit of watching television while they eat (Hattori etal. 2004).
・ There were no significant differences in TV and video
viewing times between age, gender, the presence ofbrothers or sisters, a nuclear family or extended family,
being a kindergarten or nursery school student in 868
Japanese 3-5 year preschoolers in Shimane prefecture(Kuritani & Yoshida 2008). Children who went to bed
before 21:00 and got up before 7:00 had a significantly
shorter TV and video viewing time. Time spent playing
games grew significantly longer in older children, boys,
those having brothers or sisters, and those who attended
kindergarten.
・ According to a survey by questionnaire in a medical
examination for 1.6 year old (n=695) and 3.5 year
old (n=995 children) in 2001 in Okayama prefecture,children’s TV watching time was significantly shortenedby parental regulations such as deciding the length oftime children were allowed to watch TV, fixing times forchildren to watch television and videos, limiting watchingtime during meals，and encouraging children to engage
in other activities such as playing outdoors or going to
day care facilities (Kano et al. 2009).
・ 30% of Japanese preschool children (n=599, 3.79 years
old) in Kouchi prefecture had their own video gamedevices. Children who played video games every day
had went to bed later and woke up later and were more
active in the evening than those who did not play video
games every day. Children who played video games
between 18:00-21:00 went to bed later and woke uplater and were also more active in the evenings thanthose who did not (Krejci et al. 2011).
・ Primary school children (5 grade to 6 grade: n=445) inOkayama prefecture who played TV games for longer
hours and watched TV/videos for longer hours went to
bed at later than their peers who did not. (Hattori et al.
2008).
・ Among 30 Japanese adolescents (11.7±0.4year old) inOsaka prefecture, sedentary behaviour (TV or Videoviewing, playing video games or card games, reading)
had a significantly positive relationship with a higher
percentage of body fat. Subjectively sedentary behaviour(246.6±629.1 min/day) in obese boys (170.8±611.4 min/day) was significantly higher than in normal weight boys
(Mikami et al. 2003).
・ The relationship between video game use including thetendency toward video game dependence and/or violent
game use, and mental health regarding social relations,communication abilities, normative consciousness,aggressiveness, and other psycho-social problems ofstudents was examined in primary schools (4th to 6th
grade) students to high school students (n=2858) in
Saitama prefecture. Both in primary school students andin junior high and high school students, the tendency
toward video game dependence was significantly
related to mental health, relationships to parents,
communication, abilities, intentions towards family andschool, normative consciousness, and aggressiveness.
Violent game use was also related to aggressiveness.
On the other hand, video game use time was not related
to any dependent variables. These results suggest thatthe tendency toward video game dependence wasrelated to problems in mental health and psycho-social
development of children and adolescents who use video
games (Tobe et al. 2010).
・ Among primary school children (First to 4th grade)and junior high school students (n=2688) in Tokushima
prefecture, time spent in TV watching among thosechildren who ate meals with their family every day was
shorter than that in children who ate their meals alone(first grade girl’s students: 2.1±1.60 h/day vs 2.7±2.07
h/day, and adjusted grade: 1.8±0.79 h/day vs 2.2±0.6
h/day). There was no difference among primary school
children (Yuasa et al. 2008).
・ Among 98 Japanese elementary school boys (at baseline:
8.9 ± 1.8 years) and 111 elementary school girls (atbaseline: 9.1 ± 1.8 years), daily sedentary behaviour
was significantly higher in the summer vacation than in
the school year for both boys and girls. Moreover, theincrease in sedentary behaviour in girls were significantly
lower in those who participated in sports compared tothose who did not. The change in sedentary behaviour
for boys was significantly associated with having a TV in
the bedroom (Tanaka C. et al. 2016).
・ In the Tohoku region struck by the 2011 Great East Japan
Earthquake, the association of screen viewing time andstudy time with physical fitness among second-year highschool students was examined in 322 boys and 356 girls
enrolled from 2011 to 2013. Longer screen viewing time
was associated with poorer endurance running speed inboth boys and girls. Longer screen viewing time was also
associated with lower standing broad jump distance in boys
and grip strength in girls. In boys, longer study time wasalso associated with lower grip strength after adjustment
for potential confounders. On the other hand, there was no
relationship in girls was found (Chujo et al. 2015).

12

・ Among 4th-6th grade primary school children (n= 265) inthe public and private school, screen time was associatedwith higher psychological stress reactions and more daysof absence from school, absenteeism independent of theabove-mentioned adjusting factors (Nagano et al. 2015).

How to improve the grade of the Japan
report card
１) How to improve the monitoring system of the Japan
report card
・ An official national sedentary behaviour guideline forchildren and adolescents between 6 and 17 years old
based on Japanese research is necessary.
・ A regular monitoring system is needed to evaluate thepresent state of daily sedentary behaviour including
regional and seasonal differences.
・ Objectively measured daily time in sedentary behaviour
and breaks of sitting position (e.g. accelerometers,
posture) should be used in public health surveillance(Tanaka C. et al. 2014).

２) How to improve sedentary behaviour in children
and adolescents・ According to the above surveys and previous studies, inprimary school children, long TV viewing time by parents
has an effect on developing long TV viewing times inchildren．
・ In adolescents, screen time has an affect on their mental
health.
・ 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 which 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
such as appropriate body weight management, highphysical fitness like aerobic fitness, better mental healthand better academic achievement, and so on (Tremblay
et al. 2011).

6 Physical Fitness

The Report of Survey on Physical Strength and Athletic Performance of the JSA (2015) comprehensively
evaluated physical fitness by 5 gender- and age-specific ranks (A-E). The percentage of A and B rank
among Japanese 6- to 17-year-olds was 42-67%. The physical fitness test data suggest that currently
physical fitness level in children and adolescents are lower than that in the 1980s.

・ 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,
the evaluation value is not robust, although it is useful incomparing past results.
・ According to the MEXT physical fitness survey (2014),
conducted since 1964, the physical fitness level ofJapanese children and adolescents reached a peakduring the 1980s and then declined until around 2000. In
the last ten years, physical fitness has flattened out, andshown a gradual upwards tendency.
・ According to the MEXT survey (2014), 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 orparticipate in sports. Moreover, these students said they
liked sports and exercise and had better exercise skills
including in active play.
・ The MEXT survey (2014) 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 thesechildren who answered that they participated in “different
type of activities “during preschool play was 42.8%. Thiswas higher by 7.7% than those who answered “always
the same activities”, and was 23.1% higher than those
who reported 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
and 64.5% of girls in primary school and 88.7% of boys
and 69.4% of girls in junior high school exercised on

Saturdays and Sundays. The physical fitness of students
who exercised on Saturdays and Sundays was higher
those didn’t exercise during weekends.
・ The MEXT survey (2010) also found that primary school
children who participated in sport events in their local
community had higher total physical fitness scores thosechildren who didn’t participate in sports.
100
90
Percentage of A and B rank (%)

The results of the nationwide survey

80
70
60
50
40
30
Boys

20

Girls

10
0

6-11

12-14

15-17

Age (year)

Figure 6 Percentage of A and B ranks among Japanese 6- to 17-year-olds.
(This ﬁgure was drawn from the results of the JSA survey in 2015.)

Main findings of previous studies inJapanese children and adolescents・ There are significant relationships between daily physicalactivity and physical fitness and fundamental motor
skills in children and adolescents (Hikihara et al. 2007,
Sasayama et al.2009，Nakano et al. 2010，Sasayama &Adachi 2011, Tanaka C. et al. 2012, Nakae et al.2013，
Nakano et al. 2013，Niimoto ＆ Yamazaki 2013，Mishima
et al. 2013，Tanaka C. et al. 2014, Hanawa 2015).
・ The development of seven different fundamental
motor patterns (patterns of running, jumping, throwing,catching, ball bouncing, forward rolling, and moving on

13

a balance beam) and the acquisition situations of thesefundamental motor patterns were compared in primaryschool children (3-to-5 years old) using the results ofstudies conducted in 2007 (n=154) and in 1985 (n=123)
using the observational evaluation method. The motor
patterns of the seven fundamental movements in recent
young children remained at an immature movement
development stage. The acquisition of fundamental
movements in recent five-years-olds was similar tothat of three-year-olds in 1985. A significant increase
was seen with age in both the individual motor patternscores for the seven movements and the motor patterndevelopment scores (Nakamura et al. 2011).
・ The relationships between the frequency of 37
fundamental movement patterns observed byteachers (n=526) in nurseries and kindergartens andmotor abilities using 6 items, in 3–5-year-old children(n=11130) were examined. The relationship of thefundamental movement pattern of manipulation withthe corresponding motor ability was stronger than thatof locomotion. Overall, each motor ability measurement
item was shown to be significantly related to various
fundamental movement patterns. (Yoshida et al. 2015).
・ Among 4th-6th grade primary school children (n= 249),
children with lower physical fitness levels had longer
screen time, and less time in after school activities suchas sports, after school tutoring and/or cultural activities,
and outside play. Moreover, the lower fitness levels wereassociated with high psychological stress reactions
and absenteeism, after adjusting for school type anddifferences in lifestyle (Nagano et al. 2015).
・ Elementary school students in grades 5 and 6(n=53)
were examined to clarify how physical fitness levels or
doing exercise are related to the psychosocial factorsthat underpin the motivation to exercise. The group witha high rank of physical fitness had a higher recognitionof the benefits of exercise, and a lower recognition of

the burdens. Also, the higher rank group scored higher
for levels of enjoyment of movement and skill in exercise,as well as family support and approval (Hanawa 2015).
・ Physical fitness in elementary school first and fifth grade
children with (n=160) or without (n=210) short-term(10min) extracurricular activities (EA) was compared. The
distance jogged by the students who participated in EA
was 1357 ± 333 m and average speed was 170 ± 42m/min. Multiple items on the physical fitness test werescored significantly higher in the extracurricular activities
group than in non-EA subjects in fifth grade children. On
the other hand, there are no significant difference in first
grade children (Morimura et al. 2014).

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, children in grades past thefirst grade should be evaluated using the JSA survey.
・ In the future, a regular monitoring system is needed
to evaluate the present state of physical fitness andfundamental motor skills of under 5-year-old children
including regional and school differences.
２)How to improve the physical fitness of children andadolescents・ It is important that the public realizes that improving
physical fitness in children
and adolescents can have apositive influence on many
aspects of children’s lives suchas appropriate body weight
management, better mental
health and better academic
achievement, and so on.

7 Weight Status

The School Health Survey data (2015) by the MEXT reported that 2.24-11.34% of 5-17 year old Japanese
boys and girls were obese. Overall, however, the levels are high compared to the 1980s. On the other hand,the percentage of underweight children was 0.40-4.33%.

20

The results of the nationwide survey
Percentage of obesity（%）

18

・ The Annual Report of School Health Statistics Researchhas been continuously conducted every year since 1948
by MEXT to evaluate the growth and state of healthin children and adolescents. The participants wererandomly selected by prefecture, school type, genderand age using a two-stage stratified random sampling forevery school in all age groups. The survey is a national
representative survey.

16
14
12
10
8
6
Boys

4

Girls

2
0

5

6-11

12-14

15-17

Main findings of previous studies inJapanese children and adolescents

Figure 7 Prevalence of obesity in children and adolescents.
(This ﬁgure was drawn from the results of the MEXT survey in 2015.)

・ 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 reportsof the School Health Survey published by the MEXT.
Cross-sectional analysis of 5-, 8-, 11-, 14-, and 17-yearolds showed that the prevalence of obesity has gradually

Age (year)

14

decreased since the early 2000s, with the highest
prevalence in the late 1990s to early 2000s, except forin 17 year-old boys. Longitudinal studies showed thatthe critical periods for developing obesity were in earlychildhood (between 5 and 6 years of age) and in the highschool period in boys, and mainly in early childhood ingirls (Yoshinaga et al. 2010).
・ In the Toyama Birth Cohort Study (n= 9674), obesity wassignificantly associated with obesity-related lifestyles inthree year olds (n=9668). Obese children (n=474) had alarger irregular snack intake (3 or more times), less than
10hrs sleeping time, a larger family, and a mother who
worked as compared to non-obese children (n= 8360)(Kagamimori et al. 1999). On the other hand, in the sex
and birth month matched comparisons between obese
and normal-weight 3-year-old children, the following
factors were significantly related with the developmentof obesity in 3-year-old children: the mother's job, limited
playtime outdoors (1 hour or less), irregular snacking, an
overweight father (body mass index ≧ 24), an overweightmother (body mass index≧ 24), and a high birthweight (birth weight ≧ 3,500 g). An overweight motheror father, limited playtime outdoors, weight at birth, andirregular snacking were significantly related to obesity in
3-year-old children (Takahashi et al. 1999). The cohort
elucidated both environmental and behavioural factorsthat influence body mass index among Japanese children
from ages 3–6(n=8170). Significant factors associatedwith overweight children were rapid eating, short sleep
duration, early bedtime, long periods of television viewing,
avoidance of physical activity (Sugimori et al. 2004). A
maternal family history of hypertension was also positively
associated with the risk of being overweight in children at
the age of 12 (n= 7249) (Liu et al. 2014).
・ In the Ibaraki Children’s Cohort Study (n=4592), children
cared for by grandparents at age 3 had a higher
prevalence of between-meal eating before dinner forboys and girls at ages 6 and 12 years than those cared
for by their mothers. By the age of 22, boys who werecared for by their grandparents had a higher risk/
chance of being overweight than those cared for by theirmothers (18.5% versus 11.2%), but no such difference
was noted in girls. However, both boys and girls cared
for by grandparents had higher mean BMI over time thanthose cared for by their mothers (Sata et al. 2015).
・ Among kindergarten children aged from 3to5 years(n=742) in Shizuoka prefecture, obese children withparents who were also obese spent more time watching
TV (more than 3h), and spent less time playing outside thehouse than non-obese children (Shiraki & Marui 2005).
・ Among 3-6yrs olds in the Tohku region (n=1765),
grandparents who care for pre-school children in placeof mothers were more likely to contribute to a childbeing overweight and obese than maternal employment(Watanabe et al. 2011). Children’s lifestyles that weresignificantly associated with above average weight andobesity included irregular mealtimes, watching TV for
more than 2h per day and a nighttime sleep duration ofless than 10h.
・ The multiple relationships between body proportion,
physical fitness, and lifestyles of young children were
examined using three years of longitudinal data in 148
preschool children. Significant differences were observedin standing long jump and body support time between
the obesity trend group and the slim trend group.
Regarding lifestyles, the time spent watching TV andvideo systems was shorter among children in the slim
trend group (Nakano et al. 2013).
・ In Japanese 5-6 year preschool children (n=425) in the
Kanto region, physical activity in overweight children wascomparable to that in normal-weight children. However,thin children spent significantly less time engaged inlight-intensity physical activity and MVPA than normalweight and overweight children, and less time engaged
in higher-intensity physical activity than normal weightchildren (Tanaka C. & Tanaka S. 2013).
・ Among 30 Japanese adolescents (11.7±0.4year old) inOsaka prefecture, the relationship between percentage
of body fat as evaluated with caliper and daily step
counts was strong (r=-0.88). The relationship between
percentage of body fat and subjectively sedentary
activities was moderate (r=0.79). Daily step counts inobese boys (8729± 61450 steps/day) were significantly
higher for children than in normal weight boys(247±629 steps/day).Subjectively sedentary behaviour (246.6±629.1 min/day) in obese boys (170.8±611.4 min/day) was significantly higher than in normal weight boys
(Mikami et al. 2003).
・ Among primary school boys(n=140) and girls (n=159) (9.1
± 0.3 years) in Okayama prefecture, the link between bodymass index (BMI), peak oxygen consumption, and metabolic
syndrome (MetS) risk factors was determined. The MetS
risk score of the High BMI group was significantly higher
than that of the Low BMI group for both sexes. However,the High BMI/High Fitness group had a significantly lower
MetS risk score than the High BMI/Low Fitness group forboth sexes (Sasayama et al. 2015).
・ Among 131 boys and 171 girls (9-10 years old) inprimary school in Nagasaki prefecture, 11000 steps
per day were essential in preventing childhood obesity.
Additionally, >2 hrs TV viewing per day is a significant
risk factor for childhood obesity (OR=3.43). TV viewing
time per day was found to be strongly associated withchildhood obesity. Sports club participation, breakfast
consumption, hours of sleep per night, number ofsessions of physical exercise per week, and exercise time
per session were not associated with childhood obesity(Minematsu et al.2015).
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/daysalt) in adults should be adjusted downward based on
the energy requirements of children relative to thoseof adults”. Therefore, the Dietary Reference Intakes forJapanese 2015 calculated the target values for eachsex and age category by extrapolation from the value
for adults using the estimated energy requirements. As
a result, the target 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 Healthand Nutrition Survey were about 1.5 to 2 times of thetarget values. Therefore, the mean values of the target
values based on the WHO Guideline and the current
mean intake were adopted as the tentative Dietary Goalfor preventing lifestyle-related diseases. It is thought thatsuch conditions should be improved.
As for calcium, current mean intakes are comparable

15

with or slightly more than the estimated average
requirements in 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 estimatedaverage requirements in some sex and age categories.
The tentative dietary goal for preventing lifestyle-relateddiseases for percentage of energy intake from fat is set
as 20 to 30 %. In contrast, according to the National
Health and Nutrition Survey (2013), the mean intakes
for boys and girls aged 7 to 14 years were 29.1%
and 29.8%, those for boys aged 15 to 19 years were
27.6% and 31.1%, those intake values are around upperboundary of the tentative dietary goal for preventing
lifestyle-related diseases.
According to the results of the National Health andNutrition Survey and the Dietary Reference Intakes
for Japanese 2015, which are based on domestic andinternational evidence, there are no other nutrients which
especially need to be careful at present.
Thus, the nutrients of which are at risk of deficiency
are calcium and iron. On the other hand, sodium intake,which is important for prevention of hypertension,
was much higher, about 1.5 to 2 times of the dietary
goal values for preventing lifestyle-related diseases.
Percentages of energy intake from fat are aroundthe upper boundary of the tentative dietary goals forpreventing lifestyle-related diseases.

How to improve the grade of the Japan
report card1）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 in children
and adolescents・ According to the above surveys and previous studies,
the state of care at home and lifestyles in preschool
children seems to have a great influence on children
and adolescents being obese or overweight later in life.
Therefore, providing parents and grandparents withaccess to information on how to care for their children isneeded.
・ 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.

Settings and Influences on Physical
Activity and Health

8 Family and Peer Influence

The National Health and National Survey (2014) reported that daily step counts were 7,860 for males aged
20 to 64years old, and 6,794 for females, respectively. The prevalence of obesity in Japanese adults was
29% in males and 21% in females which is based on over 25㎏ /m2 of BMI (body mass index). Participationin sport twice or more a week, 30min or more per time over 1 year was reported by 31% of males and
25% of females. In grade 5 Japanese primary school students and second year junior high school students,
the percentage of participation in sport or exercise with a guardian more than once per week was 7-36%
by the Report of Survey on Physical Strength and Athletic Performance of JSA (2015). The 2015 SSF
National Sports-Life Survey of Young People reported that 72% of Japanese preschool children (4-5 years
old) participated in exercise or sport with their parent “often” or “sometimes”.
encouraged to participate in exercise or sports by family
members were at 37.4%. Adolescents’ with total exercise
time under 60 min/week who were encouraged toexercise or participate in sports by family members wereat 11.3%. Adolescents’ with a total exercise time overof 420 min/week who weren’t encouraged to exercise
or play sports by family members were at 43.8%.
Adolescents’ with total exercise time of over 420min/
week who were encouraged to exercise or play sports
by family members were at 72.6%. The encouragementof exercise or sport by family members was positively
related with adolescents’ exercise time. There was asimilar tendency in second year boys in junior highschool (13-year-olds), in the fifth year boys and girls inprimary school (11-year-olds) (MEXT, 2014).
・ There were no significant differences of time in MVPA,
as measured using an accelerometer, and family situation(family size, number of brothers and sisters, birth order,

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.
・ The percentage of A and B ranks among Japanese
adults was 42.5% and 36.5% according to the Report ofSurvey on Physical Strength and Athletic Performance of
the JSA (2014). The percentage of Japanese adults withmore than 1/week sports participants was 50.1% and44.3%, respectively. The recommendation isn’t shown.

Main findings of previous studies inJapanese children and adolescents・ According to the national physical fitness survey by
MEXT, second year junior high school girls (13-year-olds)
with total exercise time under 60min/week, who weren’t

16

90
80
70
60
50
40
30
Boys

20

Girls

10
0

4-5
Age (year)

Participation in sport or exercise with a guardian (%)

Participation in sport or exercise with a guardian (%)

100

100
90
80
70
60
50
40
30
Boys

20

Girls

10
0

10

13
Age (year)

Figure 8 Percentage of participation in sport or exercise with
Figure 8 Percentage of children participating in sports or exercise with a guardian.
guardian(These figures were drawn from the results of the JSA and SSF surveys ina 2015.)

living with grandparent, age of parents and mother’s
employment status), number of friends at home, andsleeping time in 213 Japanese 5-6 year preschoolers in
the Kanto region (Tanaka C. et al. 2015).
・ A survey by questionnaire was conducted at the one andhalf-year health examination (n=695) and three and half‘year health examination (n=995) in Okayama prefecture(Kano et al. 2009). The relationship between children’sand parents’ TV viewing times were moderate and weakin each survey, respectively. The length of televisionand video watching time by children was significantly
shortened by parental regulations such as deciding theamount of time and fixing times for children to watch
television and videos and limiting watching during meals,
and other activities such as playing outdoors, or going
to day care facilities. The proportion of children who
watched less than 2 hours gradually decreased as themother’s viewing time was longer, and the proportion ofchildren who watched TV for 4 hours or more showedsignificant increases when the mother’s viewing timeexceeded 4 hours. It was shown that when the parent
has a long viewing time, children also easily develop longviewing times．

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 survey of the National Health and Nutrition
Survey, the JSA and the SSF.
・ A future national representative survey of therelationship between participation in sports and family
support in children and adolescents is needed.
・ Future research on the effect of health in children andadolescents by family and peer support is needed.
２) How to improve family and peers influence ofphysical activity in children and adolescents・ It is important to show for the public in Japan tounderstand that family and peer support can positively
affect the amount of participation of exercise or sports
by children and adolescents.

9 School

The MEXT sets the educational curriculum guidelines for all primary and secondary schools including
the content of physical education, the number of physical education classes, and guidelines for school
infrastructure and equipment ministry. The guidelines for nursery schools and centers for early childhood
education and care are set by the Ministry of Health, Labour and Welfare and the Cabinet Office. Those
guidelines require physical activity during childcare for young children. However, physical education inprimary schools or active play in nursery schools or kindergarten isn't carried out by specialized course
teachers who have studied physical education. Also, in primary schools, only physical education classes don't use
textbooks.

The results of the nationwide survey
・ The MEXT sets educational curriculum guidelines forelementary schools, junior high schools, and high schools
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 and centers for earlychildhood education and care are set by the Ministryof Health, Labour and Welfare and the Cabinet Office.
Those guidelines require physical activity 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 are 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.
・ According to the MEXT survey, 73.9% of 5th grade boys
answered positively to whether they wanted to continue
exercise and sports after graduating from elementary
school. The percentage of students who have positive
feelings towards physical education is high, especiallyamong children who reported having fun in their physicaleducation classes where the percentage was 83.8%. This17

is higher than average. A similar tendency was shownin primary school girls and in students in junior highschools of both genders (MEXT, 2014).
・ Elementary schools that allocated a physical educationteacher (as a full-time job) was only 6 % (JSA, 2015).
・ Schools which took the initiative to improve theirstudents’ physical fitness was 89.1% in elementary
school and 63.2% in junior high school (JSA, 2015).
・ In the course of study in elementary school, children(mainly 4th to 6th grades) are given the opportunity
to do exercise and sports at school outside of physicaleducation classes throughout the year. This activity,
namely “Club Activity” includes sports and culturalactivities, and children can voluntarily choose which
activities they would like to do. Self-motivated andvoluntary extracurricular clubs activities (commonly called“Bukatsu”) at school are also stipulated in the course of
study for junior high and senior high schools. In juniorhigh schools, 77.4% of boys and 56.5% of girls belong to
an extracurricular sports activity club (JSA, 2015).
・ According to a physical fitness survey by the JSA, timespent doing physical activity of those who belong to asports club in junior high school was 990.0 min/week on
average and 147.6 min/week in those who do not belong
to a sports club (JSA, 2015).
・ Fitness levels of children in elementary schools which
made concrete efforts to improve the physical fitnessof the children (outside of physical education classes)
tended to be high when compared to children in schools
which did not make any extra efforts (JSA, 2015).

Main findings of previous studies inJapanese children and adolescents・ Among 191 Japanese 5-6 year preschool children in
the Kanto region, time spent in high intensity physicalactivity (physical activity ratio ≧ 4)among children
who participated physical education class as preschool
children was shorter than that in children who didn’t
participate(Tanaka C. et al. 2014).
・ Scores in the jump over and crawl test and 25 m run
speed were lower in children who participated physicaleducation class in preschool than those in children who
didn’t participate among 191 Japanese 5 -6 year preschool
children in the Kanto region(Tanaka C. et al. 2014).
・ MVPA was significantly higher for children enrolled inkindergartens than those enrolled in nursery schools(4-6years old, n=157)(Tanaka C. & Tanaka S., 2009b).
MVPA on weekdays in girls did not differ significantly
both groups, those on weekends in girls weresignificantly higher for children enrolled in kindergartens
than those enrolled in nursery schools. On the other
hand, there were no significant differences among boys
(n=191)(Tanaka C. et al. 2015).
・ Chiba Prefecture implemented the three-year plan tophysical fitness in elementary school children (n=700),
first through fourth graders, and tested children on their
physical fitness twice and among the third through sixth
graders. The results showed that Rank A occupied 19.7%
and 46.3%. As for Rank E, it showed 7.5% and 2.3%.
The physical fitness of the children showed remarkable
improvement, and their life-styles have also changed to alarge degree (Suzuki, 2008).
・ Physical fitness and physical activity were comparedin two groups in two primary schools. One school
conducted a short-term extracurricular activity by havethe students jog (EA) (training group; n=160 in 1st, 5th
to 6th grade boys and girls (wearing a pedometer in
5th to 6th grade: n=24), control group; n=210 in 1st,
5th to 6th grade boys and girls (wearing a pedometerin 5th to 6th grade: n=24)) and the other school did
not have its students jog. Physical fitness test results
were significantly higher in the EA group than in non-EA
subjects. Total step counts were 15485 ± 1915 steps/
day for the EA group and 12363 ± 2464 steps/day forthe non-EA group on weekdays (Morimoto et al. 2014).
・ An intervention study in which primary school children(6th grade) learned the importance of exercise in their
physical education class and were recommended to playoutside during recess (intervention group n=10 each forboys and girls grade 6th, control group n=10 each forboys and girls grade 6th) was conducted by a primaryschool in Okayama prefecture for about three weeks. Theintervention group had significantly increased physicalactivity before and after intervention, and the volumeof change in the intervention group was significantly
higher than that of the control group in both genders on
weekdays. However, there were no differences in PA on
weekends in both groups(Adachi ＆ Sasayama 2009).
・ The present study examined physical activity levels anddifferences in PA by gender and grades during schoolrecess periods (25 minute break and 15 minute lunch
recess) in two elementary schools (n=184, grade 1st to6th) in Saitama prefecture. Boys had higher vigorous
physical activity times than girls in both periods. Younger
children engaged in less moderate physical activity thanolder children during break time. On the other hand, atlunch recess, younger children had significantly longer
vigorous physical activity than older children (Sato et al.
2011).
・ The effect of turf playgrounds on children’s physicalactivity before and after implementation of turf
playgrounds (about 2500 m2 on the inside of the track)
during recess in primary school was examined using the
Lifecorder (n=35 boys, n=21 girls from the grade 3 to 6of primary school). During the 25minute break, moderate
physical activity among girls increased significantly after
implementation of turf playgrounds (from 1.3 ± 0.7 min
to 1.6 ± 0.7min). However, the difference was only under
1min. Also, physical activity among boys during the breakand physical activity during lunch recess in both genders
didn’t change(Sato et al. 2012).
・ Differences in physical activity during recess according
to perceived school environment (equipment, facility, andsafety) among 103 public elementary school children in
Saitama prefecture were examined using the Lifecorder.
During lunch recess, boys in the high-equipment groupspent significantly more time in moderate physical activity(high: 1.5 min; low: 0.8 min). Boys in the high-facility
group spent significantly more timein vigorous physical activity (2.4 min,
1.4 min) during lunch recess, and girls
spent more time in moderate (2.1min,
1.2min) and vigorous physical activity(1.9 min, 1.3 min) during morning
recess. However, the differences were
only under 1min(Ishii et al. 2014).

How to improve the grade of the Japan
report card
1) How to improve the monitoring system of the Japan18

report card
・ In future Japan Report Cards, grades will be evaluatedusing the educational curriculum guidelines by the
MEXT, other guidelines, and the Report of the Survey on
Physical Strength and Athletic Performance of the JSA.
・ The MEXT, the JSA, and related organizations need toassess the actual situation of physical education classes
and activities across schools in a nationwide school
survey. In particular, it is important to examine theeffects of the allocation of physical education teachers
in elementary schools.
2) How to improve school and preschool facilities forchildren and adolescents・ Physical education in primary schools or active play innursery schools or kindergartens should be carried out
by specialized course teachers who have studied physicaleducation.
・ Difference in gender and of growth and development
should be considered in physical education class.
・ Teachers, researchers, and coaches should be taught thevalue of physical activity, how to improve physical activity
in preschools or schools outside of physical education
classes, and at home and/or in the local community.
Moreover, teachers, researchers, and coaches should
be provided the opportunity to participate in physicalactivity themselves.

10 Community 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 physical environment where residents can easily
exercise and be physically active stood at 17/47 prefectures (2012). The 2015 SSF National Sports-Life
Survey of Young People reported that 48% of Japanese parents of 4-9 year old children agreed they lived
in neighborhoods that allow children to engage into active outdoor play, exercise, or organized sports.
equipment available were similar among middle or larger
size of playgrounds and parks. Moreover, compoundplayground equipment, was available only in large parks.
However, these parks were few in number. With regard
to status of utilization, in questionnaires of 4111 primaryschool children from 1st to 6th grade, “not used” and “1-2times a week” answers were mostly selected (Hiratsuka& Hikihara 2015).

The results of the nationwide survey
・ Health Japan 21 (second term) by the Ministry of
Health, Labour and Welfare reported that the numberof local governments which were trying to provide anenvironment where residents can easily be active stoodat 17/47 prefectures (2012).
・ The SSF survey reported that 48% of Japaneseparents of 4-9-year-old children agreed they lived inneighborhoods that allow children to engage in active
outdoor play, exercise, or organized sports, safely (SSF,
2015).

Main findings of previous studies inJapanese children and adolescents・ 53% of Japanese parents of 4-6 year old children (n=361)
reported that they considered their neighborhoods
to be safe (Tanaka C. et al. 2011). The relationshipbetween MVPA in preschool children as evaluated by anaccelerometer and the perceived safety and availabilityof natural spaces in their neighborhood as reported byparents was significant. The home environment (houseor apartment, number of rooms, presence or absenceof a garden, number of total floors or apartment floor,
the presence or absence of elevators in an apartmentbuilding, the presence or absence of a private motor
vehicle) did not relate with MVPA.
・ In Chiba prefecture most playgrounds/parks consisted
only of space for play equipment. The size of the area
was associated with the existence of open spaces
or natural spaces in the playground. The kinds of

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 Health Japan 21 (second term) by the Ministryof Health, Labour and Welfare report.
２) How to improve community and the built
environment for physical activity in children andadolescents・ Improvements of sports facilities, playgrounds/parks,
and safe 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
research is needed for Japanese children over 6years old.
・ Detailed data for community and built environment inJapan are needed.
・ Further research on the effect of the community and thebuilt environment on the health of Japanese children/
adolescents is needed.

11 Government Strategies and Investments
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 Plan, Health Japan 21 (second term) ，and so on. Physical activity guidelines are for preschool
children, adults, and the elderly. However, national physical activity guidelines for children and adolescents(6-17 years) are not established.

19

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
to four years. The Ministry of Health, Labour and Welfare
has investigated the number of steps and the proportionof 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
and environmental 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 theMinistry of 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 Child21 (second term). However, national physical activity
guidelines for children and adolescents (6-17 years) have
not yet been established.
・ In local governments, the education, sports, and healthrelated departments are responsible for measuresrelated to physical activity and exercise. In recent
years, there has been an increase in local governmentsthat address urban development and health throughinitiatives by mayors or governors. The Health Promotion
Law obligates all prefectures to formulate and initiate
their own 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 soon.

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, andenforcement.
・ It is necessary to establish guidelines for sport andexercise and physical activity for 6-18 years old children
and adolescents.
・ Regular and nation-wide surveys for children's growthenvironment are needed.
２) How to improve the participation levels in organized
sports in children and adolescents・ An official national physical activity guideline forchildren and adolescents between 6 and 17 years old isnecessary.
・ 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 year olds
should be clarified and solved.
・ It is necessary to improve physical education and sports
education for children, especially the enhancement of
the education system so as not to increase the numberof children who dislike playing sports and exercising.
・ It is necessary to develop parks and the environment
so that every child can safely and actively engage inphysical activity.

Next Steps
This is the first version of the Japan Report Card on Physical Activity for Children and Youth. We are planning to publish
the report continuously to examine changes to each grade before and after the Tokyo 2020 Olympic and Paralympic
Games. We are planning to publish the next Japan Report Card on Physical Activity for Children and Youth in 2018. To doso, we need further funding and are seeking partnerships with individuals or organizations who might consider providing
financial or other support-please contact the Active Healthy Kids Japan group (info@activekids.jp) for further information.
The short and long forms of this report card are available from our website (www.activekids.jp). An academic publication
based on the 2016 Japan Report Card on Physical Activity for Children and Youth was published in the Journal of
Physical Activity and Health.
The Cover of the 2016 Japan Report Card
A stated aim of physical education of the national educational curriculum guideline is to improve physical fitness andto promote a positive attitude toward exercise as a lifelong physical activity. However, as the cover of the 2016 Japan
Report Card suggests, students don’t move continuously during physical education class, because they have to sit or
stand during their teacher’s instruction and/or while waiting their turn. It is also worth noting that a recent systematic
review of the MVPA content of school physical education globally suggested that a minority of time in physical education
classes was spent in MVPA (Hollis et al.2016).
Acknowledgements
This card was produced with funding from the project research of Japanese Society of Physical Fitness and Sports
Medicine in 2015 (2015-2017: Chiaki Tanaka, Shigeru Inoue, Motohiko Miyachi, Koya Suzuki, Takafumi Abe: The
Physical education and Medical Research Center UNNAN, Shigeho Tanaka), and with research supports from the J.
F. Oberlin University and the Institute of Health and Sports Science & Medicine, the Juntendo University, and was apartnership between the J. F. Oberlin University (Dr. Chiaki Tanaka), the National Institutes of Biomedical Innovation,
Health and Nutrition (Dr. Shigeho Tanaka, Dr. Motohiko Miyachi), the Tokyo Medical University (Prof. Shigeru Inoue),and the Juntendo University (Dr. Koya Suzuki), and the University of Strathclyde (Prof. John J Reilly). We are grateful20

for the contributions of members of the project steering group and stakeholders who formed a wider working group,
especially the members of the Japan Society of Human Growth and Development.
References
Ministry of Education. Culture, Sports, Science andTechnology: The Report of FY2012 Survey on PhysicalStrength and Athletic Performance. 2013. http://www.
mext.go.jp/a_menu/sports/kodomo/zencyo/1342657.htm(accessed 18th Oct 2016) (in Japanese).
OECD: Obesity Update, 2014.
Hallal P.C. et al.: The Lancet Physical Activity Observatory:
promoting physical activity worldwide. Lancet, 384, 471-2,
2014.
The Active Healthy Kids Global Alliance: http://www.
activehealthykids.org. (accessed 7th Oct 2016)
Tanaka C. et al.: Relationship between daily physicalactivity and neighborhood environment among Japanesepreschool children. Japan Journal of Human Growth andDevelopment Research, 51, 37-45, 2011. (in Japanese)
Tanaka C. & Tanaka S.: Objectively-measured physicalactivity and body weight in Japanese pre-schoolers. Ann
Hum Biol, 40, 541-546, 2013.
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