Despite the advent of game-centred approaches (GCAs) to teaching sport games (e.g. teaching games for understanding (TGfU)), traditional direct instruction approaches remain prevalent in physical education. Moreover, the latter have tended to produce high levels of student inactivity. What remains unclear is whether and how much GCAs aid in students reaching the UK and USA recommendation of 50% of lesson time being spent in moderate to vigorous physical activity (MVPA). Participants for this study were 85 students (41 girls) from three separate physical education classes (n = 23, n = 26, and n = 36) at one middle school in the western United States. A licensed teacher/soccer coach with expertise in GCAs taught units of soccer (n = 8 lessons per class; M_length = 34 minutes 43 secsonds; SD = 3.13). Data on students’ physical activity levels and lesson context were collected using the system for observing fitness instruction time. Teacher behaviour data were collected using the West Virginia teaching evaluation system. Data were analysed using standardized protocols from each instrument. GCA-focused soccer units resulted in students accumulating recommended MVPA levels in physical education, suggesting that skill/game learning goals and public health goals are two sides of the same coin and need not be mutually exclusive when a teacher employs a GCA.