Governments around the world should consider introducing school fitness scheme The Daily Mile to improve the health of children, new research suggests.
The first study of the initiative which involves pupils taking a 15-minute break from class for physical activity found it improves fitness, body composition and activity levels.
Researchers studying nearly 400 pupils found those doing The Daily Mile ran on average 39.1 metres more on a bleep test shuttle run than a control school.
Elaine Wyllie, then head teacher of St Ninians Primary School in Stirling, founded the initiative in 2012 to improve pupils' fitness.
Children are encouraged to run, jog or walk around their school grounds during a 15-minute break, in addition to normal intervals and physical education lessons.
Researchers studied pupils at two primary schools in the Stirling Council region, with a total of 391 pupils aged between four and 12 taking part.
The children had an initial assessment and were given monitors to record activity levels, then one school did The Daily Mile while the other did not.
A second assessment was carried out later in the academic year and the results were corrected for age and gender.
Joint lead researcher, Naomi Brooks of Stirling University, said: "We observed a relative increase of 9.1 minutes per day in terms of average daily minutes of moderate to vigorous intensity physical activity and a relative decrease of 18.2 minutes per day in sedentary time.
"Children at the intervention school covered, on average, 39.1 metres more during the shuttle run, while their body composition improved too."
Her colleague Colin Moran, who co-led the study, said: "Our research observed positive changes in children who participated in The Daily Mile intervention, compared to our control school where the scheme was not introduced.
"It suggests that The Daily Mile is a worthwhile intervention to introduce in schools and that it should be considered for inclusion in government policy, both at home and abroad."
Since the initiative began in 2012 around half of Scotland's primary schools have taken it up, and the Scottish Government has said it wants the country to be the first Daily Mile nation.
Belgium, the Netherlands, and parts of the US have adopted the scheme.
Scottish Public Health and Sport Minister, Aileen Campbell, said: "Scotland's Daily Mile initiative is catching the imagination of the UK and beyond, and this research is even more validation of the impact it can have on people's lives."
Ms Wyllie, of The Daily Mile Foundation, said: "I founded The Daily Mile as I became concerned about the lack of physical fitness displayed by pupils and wanted to find a solution."
She added: "With my pupils I saw that 15 minutes of daily activity rapidly improved pupils' fitness, health and concentration in the classroom.
"I am delighted that this new research underlines what I found and I look forward to the day when every school does The Daily Mile."
The research paper is published in the journal BMC medicine.
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