Background The benefits of physical activity and a reduction of sedentary behaviour are undoubted in childhood and adolescence. There is good evidence in terms of the reduction of cardio-metabolic risk factors, improvement of musculoskeletal health, as well as a benefit for cognitive and psychosocial development, especially at primary school age. In general, a higher amount of physical activity is associated with more health benefits. Preschool age children should achieve 180min of physical activity daily, from primary school age at least 90min daily are recommended. Sedentary behaviour, especially screen time, are to be reduced to a minimum. However, there is a growing decline in physical activity and an increase in screen time worldwide as well as in Germany. This is associated with a decrease in physical fitness correlating inversely with chosen health parameters like body mass index (BMI), blood pressure and/or lipids. So far, there is no gold standard how this negative trend can be countered. Community based approaches are currently the most promising, but they need the corresponding political will for consistent implementation.