James Davis, Ed.M., MA
For thousands of years, doctors used bloodletting to treat a variety of illnesses. This continued through the early/mid 1800s before the field of medicine pivoted, realizing that the best place for the blood was inside the body, especially for the weak and infirmed. Once bloodletting was no longer an endorsed option, practitioners adjusted. After all, “do no harm” is the first rule of ethical work.
Doctors, educators, and servant leaders of all kinds are tasked with staying current with evolving science and methods for their given domain. No matter how pure their intentions, they must take care not to make situations worse.
Education, the epicenter of ethical work, has been coming to terms with similar concepts in recent years. For example, if school start times influence mental health outcomes, schools should adjust – and many are (Davis, 2021; Davis, 2022).
A 2018 systematic review and meta-analysis of school age youth revealed that U.S. students are spending about 63% of their time fully sedentary (Egan et al, 2018). The number is high, thought the true average is likely much higher than that, as the only schools included in the review were interested in improving those outcomes. In a recent, teachers at a California school reported that 89% of student time was spent in Level One (described below), wherein the bulk of their day is comprised of sitting, with the movement occurring only as they walk between classes.

Sedentariness has regularly been connected to mental health issues like major depressive disorder (Schuch et al, 2017) and physical health issues like heart disease (Michos, 2021). In one of the most decisive and declarative reviews of the adverse effects of a sedentary lifestyle, Jung Ha Park and team claim that “it is indisputable that the negative health impacts intensify with increases in the total daily sedentary times,” (Park, 2020).
It is right reconsider an educational system which too often standardizes sedentariness, especially when the flip side of sedentariness, exercise, is regularly linked to improvements in affect (Reed and Buck, 2009), focus and calm (Davis and Newlon, 2022), and improved cardiovascular health (Pinckard et al, 2019).
When reevaluating the educational landscape and aiming to incorporate movement into the day, remember that all exercise is not created equal. We recommend creating a model to evaluate the level of student exercise within an organization. Below, we will explain a framework to evaluate exercise and sedentariness within an organization.
Four Levels of Exercise: an evaluation framework
When evaluating activity levels, many leaders we have worked with find it helpful to refer to our Four Levels of Exercise (fig. 1) framework. At Level One, we recognize that students are mostly sedentary. The is the all-too-standard, schoolhouse, sit and listen model. The bulk of a student’s movement (which would be tough to call exercise) occurs as they move about the building from classroom to classroom.
Depending on the size of the school, this adds up to an embarrassingly limited amount of movement between class periods. If these students were to be picked up from school, or dropped off by a bus, then go home to work on homework, eat dinner and go to bed, then there is no way they would accomplish the CDC-recommended 60 minutes per day.
In addition to the emotional and cognitive issues that accompany prolonged sedentariness, negative health impacts intensify with increases in total sedentary time. Too much time spent in this “Level One” state aligns with major public health concerns. The World Health Organization claims that “sedentary lifestyles increase all causes of mortality, double the risk of cardiovascular diseases, diabetes, and obesity, and increase the risks of colon cancer, high blood pressure, osteoporosis, lipid disorders, depression and anxiety.” Educators need to confront this truth.
Level Two is where we find many of the active classroom initiatives. Thoughtful teachers will deliberately engage students in a learning environment that allows them to move around the space and engage with their surroundings. Edutopia and other trusted journals share helpful examples of how to build movement into lessons. In this category we also find thoughtful approaches to breathing, stretching, power-posing, and low-level yoga-like interventions. This is the “brain break” space. Many of these efforts would fall short of true exercise, but can serve as wonderful additions to the school day and should incorporated as often as possible.

During Level Two interventions, educators should be aware of how a movement-filled environment impacts focus. Exercise has been shown to increase focus in students, but not while the student is exercising. There should be a balance. Exercise can enhance the learning environment for those with ADHD and other concerns, but expectations should be managed, as mobile classrooms also risk overstimulation. These spaces should also allow for students to find stillness and quiet, if deep work is a priority.
Level Three is where the bulk of the SPARK-like research lives. John Ratey’s 2008 book, Spark: The Revolutionary New Science of Exercise and the Brain, highlighted the positive connection between exercise and brain function. He notes that the positive impact requires semi-vigorous activity for an extended amount of time. In these exercised states, studies have demonstrated exercise-induced increases in neurochemicals such as dopamine, serotonin, and norepinephrine (Lin & Kuo, 2013). Here, facilitators create situations where a student must challenge their physiological state past the degree to which other learning might occur (for example, it is difficult to retain information while jogging) – unlike an active classroom, Level Three initiatives pause learning to exercise, with an intention to enhance future learning. For methods, check out the 8.2.8.2. Model we created back in 2016.
In this state, the human system is activated to a level which inspires a cascade of neurochemicals linked to improved cognition, concentration, mood, and executive control. This is what we refer to as the Exercise MVP; it is the Minimum Viable Product for exercise-induced enhancement for a school intervention. In a recent whitepaper published by Brain Co. Technologies, we used electroencephalogram (EEG) technology to measure brainwaves before and after a Level Three exercise intervention. Results showed a nearly 40% improvement in a student’s focus and calm (Davis and Newlon, 2022).

Level Three interventions can be paired with Level Two initiatives to enhance positive impact. Consider the Mindful Movement initiatives, where students exercise before practicing mindfulness, show encouraging results. In one study, the “collaborating teacher said that he ‘witnessed (his) high-anxiety, and significantly dysregulated students learn and apply meaningful mindfulness techniques throughout the course of the year.’ This instructor not only assisted in the facilitation of sessions, but participated as well, since he had seen the positive results firsthand.”
Level Four moves the human system closer to full exertion – sport practices and competition would allow someone to reach Level Four. Here, heart rate levels are higher and more sustained. The challenge is greater. The response to this sort of exercise is improved physical performance. However, this sort of physical challenge will take someone into a state where rest and recovery are prioritized over function. Where Level Three left someone in a state of increased mood, focus, and wakefulness, Level Four might have some of the positive “feel good” benefits (likely a combination of chemical production, social experiences, psychological sense of accomplishment), but the stress put on skeletal muscles and cardiorespiratory system will require the person to rest. When physical stress is high, the body prioritizes… the body. Level Four is good, but should probably be reserved for after school, as return to the standard day would be a challenge.

Fig. 1) Four Levels of Exercise in the Educational Setting. ©
Not all exercise is created equal. The “Four Levels” framework can help evaluate the total amount of movement within a system. If a school’s goal is to promote learning and set students up for a lifetime of success, then creating a system that promotes sedentariness is counter-mission. That behavior does not align with the stated goal. In pursuit of health, wellness, and lifelong learning, should create systems with regular Level Two movement, access to Level Three interventions, and thoughtful opportunities to play sports and safely engage in Level Four options.
Level Two can be a school-wide expectation, while Level Three can be used situationally, student-by-student, and in individualized education plans (IEPs). Does a student have difficulty in their double period biology class? Perhaps a Level Three exercise intervention just before (within a Physical Education class or an intramural on-campus option) would be beneficial. Perhaps they have been diagnosed with an attention disorder – exercise at this level has positive impacts on dopamine production in those with ADHD, (Mehren et al, 2020).
It will take a little hard work and some hand-scheduling, but it will be worth it. And if the intervention does not improve academic outcomes, was any harm done? The school will not have prescribed a pill, some pharmaceutical enhancement with unknown or variable side effects – they will have exposed students to exercise. Outcomes might include improved health and wellness. If that’s the downside, what could possibly stand in the way?
Call to Action
Look in the mirror. Leaders, if you agree with the scientific research and want to incorporate exercise and other active learning into the school day, ask yourself an honest question: are you? Does a traditional day in your educational environment allow for the benefits of movement, or are students mostly subject to sedentariness?
An easy self-check would be to give a simple report card (like the one below) to a set of students. Ask for their feedback. Have them fill out the second two columns to identify classes and level of activity in those classes.

Fig. 2) Sample School-Day Evaluation using Four Levels of Exercise framework.
You might find some disturbing patterns. Change them. Or you might be pleasantly surprised that many of your teachers are intentionally folding Level Two activities into the day. Celebrate that. Either way, shining a light on the truth of the student experience is always helpful.
As you might intuit, this applies to all domains. Teachers should do a similar evaluation. Administrators too. Why would this not apply to companies and organizations as well? Check in, be honest, adjust as needed.
It is time for leaders to reimagine an educational system which too often standardizes sedentariness and create an environment more conducive to healthy outcomes. When research calls systems into question, practitioners adjust.
If “do not harm” is the first rule of ethical work, then sedentary systems must go. Leaders, let’s move.
References
Davis, JD., and Newlon, M. (2022). Exercise-Induced Enhancement of Focus and Calm. [Whitepaper]. BrainCo Technologies: Neuroscience Education.
Davis, JD. (2022). The Role of School Leaders in Sleep and Student Wellness. Teacher Leadership Magazine (Northwestern University School of Education and Social Policy).
Davis, JD. (2021). Sleep and Mental Health in Students. Harvard Public Health Review (HPHR Journal online).
Egan, CA., Webster, CA., Beets, MW., Weaver, RG., Russ L., Michael, D., Nesbitt, D., & Orendorff, KL., (2019) Sedentary Time and Behavior during School: A Systematic Review and Meta-Analysis, American Journal of Health Education, 50:5, 283-290
Mehren, A., Reichert, M., Coghill, D., Müller, H., Braun, N., & Philipsen, A. (2020). Physical exercise in attention deficit hyperactivity disorder – evidence and implications for the treatment of borderline personality disorder. Borderline personality disorder and emotion dysregulation, 7, 1.
Michos, ED. (2021) Sitting Disease: How a Sedentary Lifestyle Affects Heart Health. Johns Hopkins Medicine: Wellness and Prevention. from https://www.hopkinsmedicine.org/health/wellness-and-prevention/sitting-disease-how-a-sedentary-lifestyle-affects-heart-health
Lin, T., & Kuo, Y. (2013). Exercise benefits brain function: The monoamine connection. Brain Science, 3(1), 39-53.
Park J.H., Moon J.H., Kim H.J., Kong M.H., Oh Y.H. Sedentary Lifestyle: Overview of Updated Evidence of Potential Health Risks. Korean J Fam Med. 2020; 41(6), 365-373.
Pinckard K., Baskin K.K., Stanford K.I. Effects of Exercise to Improve Cardiovascular Health. Frontiers in Cardiovascular Medicine 2019; 6, 69
Reed, J. Buck, S. (2009). The effect of regular aerobic exercise on positive-activated affect: A meta-analysis. Psychology of Sport and Exercise, 10(6), 581-594.
Schuch, F., Vancampfort, D., Firth, J., Rosenbaum, S. Ward, P., Reichert, T., Bagatini, N.C., Bgeginski, R., Stubbs, B. (2017). Physical activity and sedentary behavior in people with major depressive disorder: A systematic review and meta-analysis. Journal of Affective Disorders, 210, 139-150.
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