Health Benefits of Outdoor Time

Original Editor - Andrea Sturm
Top Contributors - Top Contributors - Robin Tacchetti, Jess Bell, Aminat Abolade and Kim Jackson

Introduction[edit | edit source]

Risky outdoor play is observed not just in children of all cultures, it can also be found in many mammal species, and is considered an adaptive function.[1] [2] Risky play plays a role in the development of the offspring on many levels, and supports them to pick up cognitive, emotional, motor, functional and social abilities. Through play, they can gradually learn about ways to overcome fear, or anger by engaging in rough-and-tumble play. Free play has an important role in the neurophysiological maturation of the prefrontal cortex, known as influencing the self-regulation of behaviour and impulsiveness, and encouraging self-reflection.

World Health Organization (WHO) Recommendations on Physical Activity in Children[edit | edit source]

Children aged 3–4 years should spend at least 180 minutes engaged in various types of physical activity of any intensity, of which at least 60 minutes is moderate- to vigorous-intensity physical activity (MVPA), spread throughout the day. Following these recommendations during the first 5 years of life is associated with better motor and cognitive development, psychosocial (emotional regulation) and cardio-metabolic health, bone and skeletal health and reduced risk of injuries. Over the course of a day, a combination of more physical activity, less sedentary screen time and longer sleep duration results in the greatest benefits.[3]

Children and adolescents between the ages of 5 and 17 are encouraged to engage in a minimum of 60 minutes per day of moderate-to-vigorous intensity physical activity, primarily aerobic in nature, throughout the week. It is recommended that they also include vigorous-intensity aerobic exercises, as well as activities that enhance muscle and bone strength, on at least 3 days each week. Additionally, it is important for children and adolescents, including those with disabilities, to limit sedentary behavior, particularly recreational screen time. By following these guidelines from early childhood through the first 5 years of life, individuals can experience improved bone health, better weight management, enhanced cardiorespiratory and muscular fitness, improved cardiovascular and metabolic health, enhanced cognitive abilities, and reduced risk of depression.[4] The situation regarding the physical activity of children and youth is a universal concern, with an estimated 80% of children aged 5 to 17 years not meeting the WHO recommendation of 60 minutes of physical activity a day.[5]

The following video by Safefood TV discusses how much physical activity children need:


Using a scale ranging from 0 to 10, with 0 representing sitting and 10 representing the highest level of activity, moderate-intensity physical activity falls within the range of 5 or 6. During moderate-intensity activity, children experience an elevated heart rate and significantly increased breathing compared to when they are at rest or sitting. On the other hand, vigorous-intensity activity corresponds to a level of 7 or 8 on the scale. When engaging in vigorous-intensity activity, a child's heart rate exceeds its normal pace, and their breathing becomes noticeably more intense than usual.[3]

Physical inactivity contributes to the rise of non-communicable diseases in children, such as childhood obesity or diabetes. Physical activity and sedentary behaviour habits primed during childhood tend to persist into adulthood. Restricting opportunities for outdoor and risky play has been discussed as potentially negatively impacting physical activity behaviours of children.[7] Physical activity and related behaviours are recognised by the World Health Organization’s Global Strategy to combat non-communicable diseases.[4] [8] Strategies to promote healthy child development through the prevention of obesity and inactivity are much needed. It is a worldwide priority to develop approaches to target these concerning issues that are accessible, acceptable, cost-effective, culturally adaptable and feasible.[9]

Physical Activity[edit | edit source]

Physical activity is clearly related to better health outcomes and recognised to be one of the most efficient ways to enhance a person’s health across their lifespan.[10] An estimated 80% of children between the ages of 5 to 17 years are not meeting the WHO recommendation of 60 minutes physical activity a day.[5] [9] Parallel to these developments, current generations of children play for shorter durations and also play less frequently outside than their parents' generation. There is a shift from children’s physical activity away from unsupervised and unstructured outdoor play toward structured and supervised activities that are primarily performed indoors.[9] [11] However, research suggests that increased outdoor time/play limits sedentary behaviour and increases physical activity and fitness in children.[9] Children's’ physical activity (moderate and vigorous physical activity/abbreviated: MVPA) was observed to be higher outdoors than indoors. Some studies showed that in total, physical activity is 2.2 to 3.3 times higher when children are outdoors than indoors. The results were consistent across different age groups, sexes, and contexts (weekends, at school/preschool). Therefore, it has been recommended to increase the amount of time that children spend outdoors, which seems to be a promising strategy to increase their physical activity levels and to promote healthy active living.[9]

Sedentary Behaviour[edit | edit source]

Children who spend one hour or more outside are less sedentary than children who spend less than one hour outdoors. Also, sedentary time is lower when children are outdoors than when they are indoors. For example, when preschoolers are indoors, they spend up to twice as much time being sedentary than when they are outdoors.[9] Loose parts in the environment (to move, carry, combine, stack, line up, redesign, take apart and put back together, with no directions or specific way of playing) empower creativity. Children playing on playgrounds containing loose parts, which enhance creativity and support risky play, showed a significant decrease in sedentary time per day, after a 13-week intervention period, though small.[2] [7]

Motor Skills and Cardio-respiratory Fitness[edit | edit source]

Outdoor playtime correlates with faster completion of a 10 meter-run.[9] A study including 25,782 students showed that fracture frequency and severity were not associated with the height of playground equipment (risky play category ‘great heights’). In this study ulnar-radius fractures (accounting for 42% of playground fractures, and therefore the most frequent type of fracture on playgrounds) were likely to occur below the height of 59’ or 180 cm, as well as tibia fractures. No fractures to the head or spine as a result of falling from playground equipment were reported.[7]

Gross motor functions such as running, jumping, throwing, climbing, crawling, rolling, swinging and sliding are predominant when children play in nature compared to traditional kindergarten areas.[12] Children who do not get the chance to swing, climb, run are more likely to have poor motor skills.[2] Landscape structures such as steep slopes, rough cliffs and trees facilitate activities such as climbing and sliding.[12] Children playing in wild nature areas showed improved motor skills and spatial skills. These children were also reported to learn risk assessment and ways to master risk situations.[12] Outdoor activity in children is related to lower diastolic blood pressure. In children and youth, outdoor time can be related to greater aerobic fitness.[9]

Mental Health and Social Competence[edit | edit source]

Children with greater independent mobility were reported to meet more often to play with their peers, schoolmates and neighbours than children with less independent mobility (risky play category ‘disappear/get lost'). For boys, rough and tumble play was associated with higher interpersonal cognitive problem-solving, but not with increased aggression.[7] Interactive play is mostly common on adventurous playgrounds, whereas on prebuilt playgrounds, the use is focused on the equipment. Children were also reported to become more social, creative and resilient after they were exposed to loose parts on playgrounds, than before.[7]

Risky play may have an anti-phobic effect in a child’s normal development. Children are motivated to investigate their environment by conducting behavioural experiments, which reduce safety behaviour. In a normal developmental process, a child will first show normal adaptive fears which protect a child against ecological risk factors. Risky play is a stepwise fear-reducing behaviour. Outdoor risky play improves a child’s coping skills, and they learn to master such situations and stimuli, which, as a consequence, are no longer feared. Not allowing children to take part in age-adequate risky play may result in increased neuroticism or psychopathology in society, as the fears may continue, despite no longer being relevant due to a child’s physical and psychological maturation. These fears can potentially even turn into anxiety disorders.[1]

The mental health of children has been reported to be deteriorating in all Western countries: For example, 20% of the child population in the United States present with mental health issues, such as depression and anxiety. Although many different factors are attributed as causes of this phenomenon, research has shown a clear correlation between a deprivation of free play and the growing emergence of mental health issues of adolescents and children.[2] Furthermore, it is important that children’s basic needs for well-being are met. Otherwise, it becomes difficult for them to concentrate to get really involved in experiences. Indicators of true involvement are deep concentration, focus and commitment.[10]

Resources[edit | edit source]

References[edit | edit source]

  1. 1.0 1.1 Sandseter EB, Kennair LE. Children's risky play from an evolutionary perspective: The anti-phobic effects of thrilling experiences. Evolutionary psychology. 2011 Apr 1;9(2):147470491100900212.
  2. 2.0 2.1 2.2 2.3 Caprino F. WHEN THE RISK IS WORTH IT: THE INCLUSION OF CHILDREN WITH DISABILITIES IN FREE RISKY PLAY. Today's Children are Tomorrow's Parents. 2018 Feb 1.
  3. 3.0 3.1 World Health Organization. Guidelines on physical activity, sedentary behaviour and sleep for children under 5 years of age. World Health Organization; 2019.
  4. 4.0 4.1 WHO. Physical activity [Internet]. 2020 [cited 2022 Jun 13]. Available from:
  5. 5.0 5.1 Aubert S, Barnes JD, Abdeta C, Abi Nader P, Adeniyi AF, Aguilar-Farias N, Tenesaca DS, Bhawra J, Brazo-Sayavera J, Cardon G, Chang CK. Global matrix 3.0 physical activity report card grades for children and youth: results and analysis from 49 countries. Journal of physical activity and health. 2018 Jan 2;15(s2):S251-73.
  6. SafefoodTV. How much physical activity do children need? Available from: [last accessed 6/21/2023]
  7. 7.0 7.1 7.2 7.3 7.4 Brussoni, M., Gibbons, R., Gray, C., Ishikawa, T., Sandseter, E.B.H., Bienenstock, A., Chabot, G., Fuselli, P., Herrington, S., Janssen, I. and Pickett, W., 2015. What is the relationship between risky outdoor play and health in children? A systematic review. International journal of environmental research and public health, 12(6), pp.6423-6454.
  8. World Health Organization. Global strategy on diet, physical activity and health. 2004. Available from:
  9. 9.0 9.1 9.2 9.3 9.4 9.5 9.6 9.7 Gray C, Gibbons R, Larouche R, Sandseter EB, Bienenstock A, Brussoni M, Chabot G, Herrington S, Janssen I, Pickett W, Power M. What is the relationship between outdoor time and physical activity, sedentary behaviour, and physical fitness in children? A systematic review. International journal of environmental research and public health. 2015 Jun;12(6):6455-74.
  10. 10.0 10.1 Sando OJ, Kleppe R, Sandseter EB. Risky play and children’s well-being, involvement and physical activity. Child Indicators Research. 2021 Aug;14(4):1435-51.
  11. Tremblay MS, Gray C, Babcock S, Barnes J, Bradstreet CC, Carr D, Chabot G, Choquette L, Chorney D, Collyer C, Herrington S. Position statement on active outdoor play. International journal of environmental research and public health. 2015 Jun;12(6):6475-505.
  12. 12.0 12.1 12.2 Sandseter EB. Restrictive safety or unsafe freedom? Norwegian ECEC practitioners' perceptions and practices concerning children's risky play. Child Care in Practice. 2012 Jan 1;18(1):83-101.