It was time for the Presidential Physical Fitness Test in the fall of 1961. It must have been late November because football season had just ended, and I believed I was in the best physical condition of my 16 short years. On the strength of my performance in the sit-up segment, I was leading the entire school. I have always claimed that I did 70 sit-ups in the 1-minute time limit, which, in hindsight, seems impossible. Nonetheless, I went home pumped with pride.

William G. Wilkoff, MD

However, I had not remembered that the Presidential Physical Fitness Test was a 2-day event. I rolled out of bed the next day, unable to stand fully erect because my abdominal muscles were telling me I had failed to pace myself. I limped through the second day’s challenges and just managed to achieve a score that put me in the 85th percentile and earned me a Presidential Physical Fitness Award certificate.

President Eisenhower convened the President’s Council on Youth Fitness in 1956, in large part motivated by the results of a study of US, Swiss, Italian, and Austrian youth in which 60% of American children failed at least one component of the physical fitness test. The result was a rollout of a five-part assessment that was officially introduced during Lyndon Johnson’s administration.

My football teammates and I treated the test as a competition and relished the chance to participate. I suspect most of the other students dreaded the experience and understandably found it anxiety-producing and embarrassing. By the 1990s, the program had begun to shift its focus from what was too often perceived as a head-to-head competition to the student bettering his or her own performance with the goal of reaching the current standards.

By 2012, the program had dropped the “test” from its label and became the Presidential Youth Fitness Program. Under First Lady Michelle Obama’s direction, the focus turned toward childhood obesity and a comprehensive health and fitness program titled “Let’s Move!” There were no awards. On the other hand, parents, schools, communities, and the children themselves were encouraged to learn more about the causes of obesity and develop their own programs to improve nutrition and encourage physical activity.

None of these programs have halted the steady decline in the fitness of young people in this country. In 2022, a nonprofit coalition called the Physical Activity Alliance (PAA) issued a report card on the physical activity of children and youth in the United States. On the basis of research it had reviewed and its own observations, the PAA gave this country a D-. When the group repeated the grading process in 2024, the result was unchanged.

The state of the physical fitness of children has not gone unnoticed by some members of the current administration. An executive order was signed at the end of July to reestablish the Presidential Fitness Test. The order is short on details but includes a policy to prioritize and expand children’s participation in youth sports and active play to promote the physical, mental, and civic benefits of daily movement, exercise, and good nutrition.

I’m concerned that this may portend a return to a program that will again reward those who excel. The “winners” will be those who are already physically active. Such a program will be doing little or nothing to support those less fortunate and unmotivated. The devil will be in the details.

Regardless, the Presidential Fitness Test is probably doomed to failure if it is simply words and suggestions. Success is unlikely even if the program includes some teeth, in the form of financial incentives or penalties that are tied to a school’s participation.

We need look no further than Isaac Newton’s First Law of Motion, which states that an object at rest stays at rest. Getting young people off the couch and moving takes a tremendous amount of effort and creativity, which we haven’t come close to mounting.

The logical environment in which to attack the scourge of inactivity has always been and should continue to be the schools. Unfortunately, despite encouragement from programs such as “Let’s Move!”, many parents have difficulty both setting a good example and enforcing restrictions that discourage sedentary behavior.

In addition to reestablishing the Presidential Fitness Test, the current administration might choose a model in which every student is involved in a military-style group exercise program that occurs daily. Newsreel photos of a whole class (maybe in uniform) all doing jumping jacks comes to mind. Or, it may opt for mandating that every class be given two recess periods per day in addition to a physical education class that meets daily and offers a variety of games and activities. To be effective, this format would require fine-tuning under the direction of trained physical educators to ensure that all students would participate, regardless of their abilities.

Whichever approach is chosen, the school day would have to be lengthened by at least an hour to be effective. Newton’s Third Law predicts that this addition would spawn a significant reaction from educators and taxpayers.

The bottom line is, it will be difficult for any program to alter the current downward trend in physical fitness. Once they reach a certain age, most children will no longer gravitate toward physical activity without significant prompting. I once thought that “certain age” coincided with second or third grade. However, the magnetic force and ubiquity of screens has pushed that transition much earlier. Until we stop providing children with the abundance of appealing and addictive sedentary alternatives, no Presidential Fitness Test will turn the tide.