The present cross sectional study aims to investigate potential association between empathy related behavior and physical activity levels taking into account weight status. Our results suggest that self-reported PA levels were positively associated with empathy related behavior total score and also with attention to other feeling and prosocial action score domains in primary school children. Many recent literature suggest that PA levels is associated with physiological, mental, cognitive, and social health benefits in young people [19]. Our results are in line with recent literature suggesting that there was a link between physical education and empathy overcoming the dichotomous vision of body and mind as two distinct and independent domains. Garcia Lopez et al. conducted an experimental study in order to investigate the effect of sport education season in improving personal and social responsibility funding that to achieve higher results; teachers need to design and apply pedagogical strategies routinely, and pay very close attention to the dynamics created in the classroom [20]. Further studies need a specific focus on the effect of a physical education intervention towards classroom situations in general and empathy related behavior improvement. Empathy behaviors should probably be assessed by specific measures related to Physical Education and Sport Education as a step before measuring general empathy. It may also be true, however, that the longer interventions yield more positive results [20]. The correlations between PA levels and the three domains of empathy-related behavior show how emotional contagion differs from attention to the other's emotions and prosocial actions. Empathy and emotional contagion have common characteristics, but they are two very different forms of response to emotions. Empathizing means recognizing the other person's state of mind and understanding it; in the emotional contagion, on the other hand, in addition to recognizing the state of mind, other factors are also influenced [21]. Therefore, the results of this study indicate that physical and sporting activity facilitates the development of understanding of the emotions of others without them taking over our own.
In consideration of the weight status, the empathy related behavior score was not associated with BMI data suggesting that the anthropometric condition does not influence the domains. The distribution of children with obese and overweight condition within our sample is equal to 28.2%. This data is in line with the recent Italian data collected by the Okkio alla Salute Tuscany region surveillance system (2019) hat reported a 20.4% of overweight children and 9.4% obese children [22]. Lower percentages are achieved in the sample of athletes [23]. To our knowledge, the relationship between BMI and empathy has never been investigated in a sample of primary school children. Other studies have shown a negative association between increased of BMI and social-emotional wellbeing suggesting that weight status impacts on emotional and prosocial behavior problems for example, overweight children are more likely to experience teasing and stigmatization from peers, which can result in social marginalization and low self-esteem [24–26]. Within our sample, the BMI did not influence the development of empathy-related behavior, however the data collection methodology was self-reported. More studies are needed to affirm this result more confidently, based on objective tools such as expert measurements or bioimpedance.
This study shows how important it is to create a gym that trains the body and the mind. Considering the sample's age, this gym should be provided within the school. The educational proposals for children have a holistic vision; body and mind embrace each other, becoming one. There is no body without a mind, and there is no mind without a body [2]. Physical education provide important lessons because it encourages students to play with their peers by promoting socialization, allowing them to express their emotions and recognize each other's emotions. This emotional training could have positive repercussions in every area of life: children able to manage their emotions will also understand what would be the most appropriate behavior to obtain the best well-being for themselves and others.
Nowadays, sedentary behaviors are increasing, and technology seems to be able to guarantee stable social relationships [27]. However, the importance of physical activity for physical and mental well-being is neglected [28, 29]. Therefore, the family and school must promote active lifestyles for healthy physical and mental development in childhood [30, 31]. Moreover, school based interventions are becoming more and more relevant especially as a strategy to enhance PA levels within school hours but also a beneficial intervention to increase classroom behavior and social relationship between children [32–34].
In our study age and gender were not associated with empathy related behaviour. This results were in line with other literatures suggesting that aging has shown to produce little effect on “emotional” empathy[7] With regards of gender, women have consistently been found to be more empathetic, and show more sensitivity and emotional recognition than men[35] Probably we need to investigate more in depth age-related and gender-related differences among children moving to adolescents and not only inside primary school children.
There are limitations to be recognized in this work. First, the parent’s measured of empathy, and the study design was cross-sectional. Future work should consider additional indicators of empathy in parents, such as reporting a child or behavioral measures. Second, the majority of the parents who participated in our study were women. Although we statistically checked the gender of parents in all analyzes, mothers 'expressions of empathy may differ from fathers' expressions of empathy. It would also be important in future studies to simultaneously consider the views of empathy from different family members. Anthropometric information was self-reported and not objectively measured however, the normal weight overweight/obese distribution reflect the national trend. The PAQ-C questionnaire is a self-reported assessment of physical activity levels and not an objective measurement such as actigraph accelerometers; however, this questionnaire is valid and reliable for this age group. The main strengths of our study consist in the size of the sample, representative of many cities of the Tuscan region and the use of scientifically validated questionnaires.