Fitness
MAHA Commission promotes fitness as a vital sign for children. What does that mean?
Nobody’s against fitness for children. But health secretary Robert F. Kennedy Jr.’s proposal to make physical activity a “vital sign” akin to blood pressure or growth is raising questions among physiology experts.
Physical fitness for all and children’s health are two tentpoles of Kennedy’s Make America Healthy Again mission, articulated in the MAHA Commission’s initial meeting in May, outlined in a draft Make Our Children Healthy Again report in August, and solidified in the full report Tuesday. The report promotes “physical activity as a vital sign,” a concept that usually defines a healthy level as 150 minutes of movement per week.
The commission, though, urges states to establish specific metrics of fitness, for example, a “predicted VO₂ Max” as a baseline for evaluating Medicaid managed care organizations on how much they were improving health. Other factors would include sleep, nutrition, and potentially “select high-quality supplements.”
And decades after President John F. Kennedy introduced it, the Presidential Fitness Test will return to gauge the speed and strength of America’s schoolchildren, the report says.
When the test was introduced in the 1960s, people worried that kids were spending too much time indoors, sitting around and watching television. To jump-start their fitness, physical activity at school was encouraged with routines from running to rope climbing, culminating in an annual test.
STAT has requested comment from the Department of Health and Human Services, which directed inquiries to the White House, asking about the basis for these ideas and what might come next.
What is VO₂ max, anyway?
Experts told STAT they were puzzled by the mention of VO₂ max as a metric. VO₂ max stands for the maximum volume of oxygen the body can take in and use in a single minute during intense physical activity. It’s determined by a standard exercise stress test that measures breathing with a mask to calculate oxygen consumption to define fitness.
As a measure of cardiorespiratory fitness, higher is better. It’s less clear whether it makes sense to apply an adult athlete’s numbers, aka VO₂ max, to children at play.
“It’s a really great test. It’s not really something you can do in someone under 9, 10 years old in a really good way,” Jared Hershenson, a pediatric cardiologist who directs cardiac exercise and rehabilitation at Children’s National Hospital, told STAT. “If you’re talking about trying to measure someone’s fitness who’s younger than that, there really is not any objective test that can do that, or quantitative test that can be done.”
VO₂ max is difficult to measure, even for adults, I-Min Lee, a professor of epidemiology at the Harvard T.H. Chan School of Public Health who studies the role of physical activity in preventing chronic diseases, also told STAT. You need lab equipment and you need participants to exercise to the point of exhaustion. Picture people on an exercise bike or a treadmill, going full out while wearing a mask to track their oxygen levels. Many people won’t or can’t do that, she said.
There are predictive equations that do not rely on lab tests, but instead use age, sex, body mass index, or other numbers. With varying degrees of accuracy, they are more feasible in large numbers of people to advance health.
Lee underscored that physical fitness and physical activity are related, but not identical constructs. Activity is something we do; fitness is a physiological construct.
There’s this catch: Fitness can be improved by regular activity, but it’s also partially genetically determined, she said. “I could exercise to death, but I will never be as fit as Lance Armstrong, since I don’t have his genes.”
Outside the lab, VO₂ max is familiar to weekend warriors who upload their runs, swims, rides, and hikes to sports/social media sites like Strava to track training and add up kudos from their friends. That less-than-lab-quality number is derived from heart rate and other data collected by the watches on their wrists, made by Garmin or Apple or Coros, among others in the burgeoning market for wearables.
In June, Kennedy predicted wearables for all in the next four years, but later pulled back, saying in a statement to Axios that “they are not for everyone because of concerns like cost and personal privacy.”
Eric Topol, a cardiologist and geneticist at Scripps Research Institute, scoffed at measuring VO₂ max in kids when for adults, studies have shown there are more practical ways to measure fitness that don’t involve lab testing or expensive wearables.
“To do that in children? Are you kidding me?” he said in an interview. “That is just absurd. But that’s just the anti-science movement that keeps spewing out things that are not substantiated or possible or likely.”
Topol himself gets his VO₂ max data on his iPhone, but acknowledges its limits compared to a physiology lab. For children, it would make more sense to give them a wristband with a pedometer to measure activity. “Let’s go with something simple and cheap like that, that everybody could have,” he said.
We’re not there yet for children’s wearables, Hershenson said, while acknowledging its potential if government and private sector entities work together. There are no reliable fitness data from wearables in pediatric patients, for the children Hershenson’s center sees who have significant challenges or for healthier kids. Companies on their own might have variations in how they measure fitness.
“In any of the technology, as far as I know, nothing’s been correlated with exercise tests. You’d have to have some sort of standard testing to compare it to,” he said. “I think it’s going to have to be some sort of surrogate,” maybe heart rate recovery, which tracks how fast the heart rate returns to its normal resting state after exercise.
Presidential Fitness Test, redux
Then there’s the metric President Trump wants to bring back to life: The Presidential Fitness Test. Started in the 1960s by President Kennedy and modified decades later by President Obama, it sent schoolchildren racing the mile and doing situps, pushups, pullups, and rope climbs. The new report says HHS and the Department of Education will partner with the President’s Council on Sports, Fitness, and Nutrition to help states and schools reintroduce it.
Hershenson isn’t sure measuring how many pullups a child can do is going to help gauge fitness, strength, or flexibility as they pertain to future health.
“I think it’s useful to have some sort of baseline. But you need to know what to do with that,” he said. “We’re not just gonna throw a ball around. Let’s find ways that we can improve this person’s strength and this person’s fitness by doing stuff that’s fun.”
That also means thinking about barriers to exercise.
“To me the best approach is always treating each person individually to figure out how I can help them be the best version of themselves,” Hershenson said. “That’s extraordinarily difficult when you’re making massive public policy for however many millions of people, but I think it’s going to be different for everybody.”
“Is it a questionnaire? Is it measuring heart rate recovery? Is it measuring how many steps you take?” he asked. “It’s probably not going to be perfect.”
STAT’s coverage of chronic health issues is supported by a grant from Bloomberg Philanthropies. Our financial supporters are not involved in any decisions about our journalism.
SIOUX FALLS, S.D. (Dakota News Now) – Finding time to work out as a mom with young kids can be a challenge in itself, especially when you’re new to an area and don’t know where to start. However, a new fitness option strolled into Sioux Falls today. iStroll offers moms the chance to work out and meet other moms all while their kids can play or even join alongside them.
iStroll is a national organization that has more than 35 locations in the country but this is the first time one opened in South Dakota. It’s a full body workout that incorporates dumbbells, body weight, and jogging strollers when the weather’s nice.
“I found iStroll in Oklahoma and fell in love,” said Kelsi Supek who started the affiliate in Sioux Falls. “We made friends. It became our entire social network. The kids loved it and then we moved to Arizona during COVID. And all the moms were stuck at home. They were inside with our kids and lonely, honestly. And we were like, why can’t we start an iStroll and be out at the parks with the kids every day? And it took off.”
When Supek moved to Sioux Falls, she was encouraged by her family to start an affiliate and own it herself.
“Gym daycares did not work out for my children,” said Supek. “I would get 10 minutes into a class and then I’d have that person trying to knock outside the yoga studio going, Can I have Kelsey and her kids screaming in daycare? And it just didn’t work for us. So at iStroll they could be with me or I could be breastfeeding the baby as I was teaching in class.”
Classes are planned to continue each Wednesday and Friday at We Rock the Spectrum and First Presbyterian Church. For a full schedule for January and February, you can look at their Facebook. The first class is also free and memberships are for the whole family.
“Letting the kids see you work out is, it’s similar to homeschooling where like, you know, how are they going to love working out if they don’t see you working out,” said Kelly Jardeleza, a stay-at-home mom of three kids. “Whereas at other gyms they put them in a room and they don’t get to watch you. And how are you going to inspire them if they’re not watching you do it?”
Copyright 2026 Dakota News Now. All rights reserved.
There’s no bad time to take a more active interest in your health, but the new year, for lots of us, feels like a fresh start. Maybe you’re planning to sign up for a 10k or finally have a go at bouldering, eat a bit better or learn to swing a kettlebell. Maybe you want to keep up with your grandkids — or just be a little bit more physically prepared for whatever life throws at you.
To help things along, Guardian Live invites you to a special event with public health expert Devi Sridhar, journalist and author Mariella Frostrup, and health and fitness columnist Joel Snape. They’ll be joining the Guardian’s Today in Focus presenter Annie Kelly to discuss simple, actionable ways to stay fit and healthy as you move through the second half of life: whether that means staying strong and mobile or stressing less and sleeping better.
To make the whole event as helpful as possible, we’d love to hear from you about what you find most challenging — or confusing — when it comes to health and exercise. What should you actually be eating, and how are you going to find the time to make it? What sort of exercise is best, and how often should you be doing it? Is Pilates worth the effort — and should we really all be drinking mugfuls of piping hot creatine?
Whether your question is about exercise, eating, or general wellness, post it below and we’ll put a selection to our panel on the night.
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Jan 6 (Reuters) – The U.S. Food and Drug Administration said on Tuesday that it will limit regulation of wearable devices and software designed to support healthy lifestyles, issuing new guidance to clarify its regulatory approach.
The guidance, along with comments from FDA Commissioner Marty Makary, adds to existing policy that classifies low-risk wellness tools, such as fitness apps and activity trackers that encourage exercise, as non-medical devices exempt from stringent regulation, provided they do not make claims related to disease diagnosis or treatment.
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“We have to promote these products and at the same time, just guard against major safety concerns,” Makary said in an interview with Fox Business about artificial intelligence software such as ChatGPT, adding that “if people are looking up a symptom on an AI-based tool, let’s have that conversation when they come in to see their doctor or do a virtual visit.”
“We want to let companies know, with very clear guidance, that if their device or software is simply providing information, they can do that without FDA regulation,” Makary told Fox Business.
“The only stipulation is if they make claims of something being medical grade … like blood pressure measurement. We don’t want people changing their medicines based on something that’s just a screening tool or an estimate of a physiologic parameter.”
The agency also sent out a broader warning to consumers about the risks posed by unauthorized devices.
Reporting by Puyaan Singh in Bengaluru; Editing by Peter Henderson and Sherry Jacob-Phillips
Our Standards: The Thomson Reuters Trust Principles.
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