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Bright Futures in Practice: Physical Activity

PHYSICAL ACTIVITY IN
CHILDREN AND ADOLESCENTS

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Participation in physical activity is beneficial to children and adolescents. Regular physical activity contributes to overall health and well-being and reduces the risk of disease (e.g., coronary heart disease, osteoporosis, colon cancer, diabetes mellitus) in adults. Regular physical activity also helps prevent hypertension and helps reduce blood pressure in persons with elevated levels.1 Regular physical activity helps children and adolescents develop healthy physical activity behaviors they can sustain throughout their lives.

Participating in regular physical activity also

  • Increases muscle and bone strength.

  • Increases lean muscle mass and helps decrease body fat.

  • Helps maintain weight and is a key part of any weight loss program.

  • Enhances psychological well-being.

  • May reduce symptoms of depression and anxiety and improve mood.1

  • Physical Activity and Health: A Report of the Surgeon General concludes that

  • People of all ages, both males and females, benefit from regular physical activity.

  • Significant health benefits can be obtained by participating in a moderate amount of physical activity (e.g., 15 minutes of running, 30 minutes of brisk walking, 45 minutes of playing volleyball) on most, if not all, days of the week.

  • Additional health benefits can be gained by participating in a greater amount of physical activity. People who participate regularly in physical activity of longer duration or of more vigorous intensity are likely to derive greater health benefits.2

To help people better understand physical activity recommendations, the Activity Pyramid was developed. Similar to the federal government's Food Guide Pyramid, the Activity Pyramid (Figure 1) illustrates a "balanced diet" of weekly physical activity and various forms of traditional exercise.3

Figure 1. Activity Pyramid

This figure is currently no available on the Web site.

Preventing Chronic Disease

Increasing physical activity levels joins other preventive health measures (e.g., eating healthy foods, obtaining and maintaining a healthy weight, avoiding cigarette smoking) in reducing the risk of chronic disease in adults. Examples of benefits of preventing chronic disease follow.

Osteoporosis

Osteoporosis, which causes serious and disabling bone fractures in older adults, may result if too little bone building occurs during childhood and adolescence. Physical activity helps build greater bone density in childhood and adolescence and maintain peak bone density in adulthood. To increase bone mineralization and develop strong bones, children and adolescents need to participate in weight-bearing physical activities (e.g., jumping rope, walking, playing soccer or basketball).4–6 They also need to consume optimal calcium and maintain appropriate levels of hormones, particularly estrogen.

Obesity

Physical activity is crucial for obtaining and maintaining a healthy weight. In combination with family intervention and a moderate reduction in caloric intake, physical activity has produced significant reductions in the prevalence of childhood and adolescent obesity.7 Reducing sedentary behaviors (e.g., watching television and videotapes, playing computer games) may be an important activity-related intervention for obesity intervention.7 (See the Obesity chapter.)

The incidence of children and adolescents with type 2 diabetes mellitus, which is closely associated with obesity, has increased significantly over the past decade. In addition, obesity during childhood and adolescence is a risk factor for type 2 diabetes mellitus in adulthood, even after accounting for adult obesity.8

Hypertension

Hypertension (i.e., abnormally high blood pressure) causes strokes, renal failure, coronary artery disease, congestive heart failure, and peripheral vascular disease in adults. Most of these conditions are related to essential hypertension, which is usually hereditary and often develops during childhood. Regular physical activity can substantially lower both systolic and diastolic blood pressure in adults with hypertension. And it appears that regular physical activity can also lower blood pressure in children and adolescents.9

Hyperlipidemia

In adults, regular aerobic physical activity has been found to improve blood lipid levels, particularly by increasing high-density lipoprotein cholesterol (HDL-C) levels. High HDL-C levels are associated with a reduced risk of atherosclerosis. Therefore, hyperlipidemia prevention strategies have included aerobic physical activity.10

The impact of physical activity on blood lipid levels in children and adolescents is unclear. HDL-C levels in young athletes are higher than those of children and adolescents who do not participate in regular physical activity.11 BFPAIN_ILP09

Mental Health

Although the evidence is mixed (not all studies find significant changes), regular physical activity has the potential to promote psychological health in children and adolescents (e.g., improve their self-esteem, reduce their level of anxiety and stress).12,13 Participating in regular physical activity appears to enhance self-esteem and reduce symptoms of depression and anxiety in children and adolescents with emotional disorders or developmental disabilities.

Opportunities for Improving Health Outcomes

It is important to offer children and adolescents opportunities to make physical activity a regular part of their lives. Participating in any type or amount of physical activity during childhood and adolescence can provide important health benefits. Physical activity helps improve children's and adolescents' health outcomes.

Caloric Expenditure

Participating in physical activity helps children and adolescents expend energy (calories), which helps them obtain and maintain a healthy weight. Physical activity appears to favorably affect body fat distribution. Aerobic activities (e.g., distance running, swimming, biking) are best for expending calories.

Skeletal Development

Weight-bearing activities promote the growth of strong bones during childhood and adolescence and help prevent osteoporosis in adulthood. These activities (e.g., jumping rope, walking, playing soccer or basketball) require children and adolescents to move their own weight.

Cardiorespiratory Fitness

Cardiorespiratory fitness, also referred to as cardiorespiratory capacity, aerobic power, or endurance fitness, is largely influenced by regular physical activity. Activities such as running, biking, and swimming for 30 minutes three times a week promote cardiorespiratory fitness and help decrease resting blood pressure in children and adolescents with hypertension.

Muscle Fitness

Participating in physical activity to improve muscle fitness can reduce children's and adolescents' risk of injury. Common measures of muscle fitness are muscle strength, endurance, and
flexibility.

Summary

Children and adolescents can substantially improve their health and quality of life by making physical activity a part of their daily lives. Being physically active early in life has many physical, social, and emotional benefits and can lead to a reduced incidence of chronic diseases in adulthood. Health professionals, families, and communities need to make a concerted effort to increase the physical activity levels of children and adolescents.

References BFPAIN_PE10

  1. U.S. Department of Health and Human Services. 2000. Healthy People 2010. Washington, DC: U.S. Department of Health and Human Services.

  2. Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion; President's Council on Physical Fitness and Sports. 1996. Physical Activity and Health: A Report of the Surgeon General. Washington, DC: Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion; President's Council on Physical Fitness and Sports.

  3. Institute for Research and Education HealthSystem Minnesota, Health Education Center. 1999. Building Your Activity Pyramid. Minneapolis, MN: Institute for Research and Education HealthSystem Minnesota, Health Education Center.

  4. Bailey DA, Martin AD. 1994. Physical activity and skeletal health in adolescents. Pediatric Exercise Science 6(4):330–347.

  5. Sallis JF, Patrick K. 1994. Physical activity guidelines for adolescents: Consensus statement. Pediatric Exercise Science 6(4):302–314.

  6. Biddle S, Sallis JF, Cavill N. 1998. Young and Active? Young People and Health-Enhancing Physical Activity: Evidence and Implications. London, England: Health Education Authority.

  7. Epstein LH, Myers MD, Raynor HA, Saelens BE. 1998. Treatment of pediatric obesity. Pediatrics 101(3/2):
    554–570.

  8. Must A, Jacques PF, Dallal GE, Bajema CJ, Dietz WH. 1992. Long-term morbidity and mortality of overweight adolescents: A follow-up of the Harvard Growth Study of 1922 to 1935. New England Journal of Medicine 327(19):1350–1355.

  9. Riddoch C. 1998. Relationships between physical activity and physical health in young people. In Biddle S, Sallis JF, Cavill N, Young and Active? Young People and Health-Enhancing Physical Activity: Evidence and Implications (pp. 17–48). London, England: Health Education Authority.

  10. Physical activity and cardiovascular health. 1995. NIH Consensus Statement 13(3):1–33.

  11. Armstrong N, Simons-Morton B. 1994. Physical activity and blood lipids in adolescents. Pediatric Exercise Science 6(4):381–405.

  12. Calfas KJ. 1999. The relationship among physical activity and the psychological well-being of youth. In Rippe JM, ed., Lifestyle Medicine (pp. 967–979). Malden, MA: Blackwell Science.

  13. Calfas KJ, Taylor WC. 1994. Effects of physical activity on psychological variables in adolescents. Pediatric Exercise Science 6(4):406–423.

Suggested Reading

Armstrong N, Bray S. 1991. Physical activity patterns defined by continuous heart rate monitoring. Archives of Disease in Childhood 66(2):245–247.

Armstrong N, Welsman JR. 1997. Young People and Physical Activity. Oxford, England: Oxford University Press.

Armstrong N, Williams J, Balding J, Gentle P, Kirby B. 1991. Cardiopulmonary fitness, physical activity patterns, and selected coronary risk factor variables in 11- to 16-year-olds. Pediatric Exercise Science 3(3):219–228.

Bar-Or O. 1983. Pediatric Sports Medicine for the Practitioner: From Physiologic Principles to Clinical Applications. New York, NY: Springer-Verlag.

Fish HT, Fish RB, Golding LA. 1989. Starting Out Well: A Parents' Approach to Physical Activity and Nutrition. Champaign, IL: Leisure Press.

Goldberg B. 1995. Sports and Exercise for Children with Chronic Health Conditions. Champaign, IL: Human Kinetics.

Pate RR, Long BJ, Heath G. 1994. Descriptive epidemiol-ogy of physical activity in adolescents. Pediatric Exercise Science 6(4):406–423.

Rowland TW. 1990. Exercise and Children's Health. Champaign, IL: Human Kinetics.

U.S. Department of Health and Human Services; U.S. Department of Education. 2000. Promoting Better Health for Young People Through Physical Activity and Sports: A Report to the President from the Secretary of Health and Human Services and the Secretary of Education. Atlanta, GA: U.S. Department of Health and Human Services.

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