Background A number of recent systematic reviews have resulted in changes in international recommendations for children's participation in physical activity (PA) for health. The World Health Authority (WHO) has recently released new recommendations. The WHO still recommends 60 min of moderate to vigorous physical activity (MVPA), but also emphasises that these minutes should be on top of everyday physical activities. Everyday physical activities total around 30 min of MVPA in the quintile of the least active children, which means that the new recommendations constitute more activity in total compared with earlier recommendations. Objective To summarise evidence justifying new PA recommendation for cardiovascular health in children. Methods The results of recent systematic reviews are discussed and supplemented with relevant literature not included in these reviews. PubMed was searched for the years 2006-2011 for additional topics not suffi ciently covered by the reviews. Results PA was associated with lower blood pressure and a healthier lipid blood profi le in children. The association was stronger when a composite risk factor score was analysed, and the associations between physical fi tness and cardiovascular disease (CVD) risk factors were even stronger. Muscle strength and endurance exercise each had an effect on blood lipids and insulin sensitivity even if the effect was smaller for muscle strength than for aerobic exercise. New evidence suggests possible effects of PA on C-reactive protein. Conclusion There is accumulating evidence that PA can have benefi cial effects on the risk factors of CVD in children. Public health policy to promote PA in children, especially the most sedentary children, may be a key element to prevent the onset of CVD later in the children's lives.