PHYSICAL
ACTIVITY IN
CHILDREN AND ADOLESCENTS
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).46 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
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
-
U.S.
Department of Health and Human Services. 2000. Healthy
People 2010. Washington, DC: U.S. Department of Health
and Human Services.
-
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.
-
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.
-
Bailey
DA, Martin AD. 1994. Physical activity and skeletal health
in adolescents. Pediatric Exercise Science 6(4):330347.
-
Sallis
JF, Patrick K. 1994. Physical activity guidelines for
adolescents: Consensus statement. Pediatric Exercise
Science 6(4):302314.
-
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.
-
Epstein
LH, Myers MD, Raynor HA, Saelens BE. 1998. Treatment of
pediatric obesity. Pediatrics 101(3/2):
554570.
-
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):13501355.
-
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. 1748).
London, England: Health Education Authority.
-
Physical
activity and cardiovascular health. 1995. NIH Consensus
Statement 13(3):133.
-
Armstrong
N, Simons-Morton B. 1994. Physical activity and blood
lipids in adolescents. Pediatric Exercise Science 6(4):381405.
-
Calfas
KJ. 1999. The relationship among physical activity and
the psychological well-being of youth. In Rippe JM, ed.,
Lifestyle Medicine (pp. 967979). Malden, MA: Blackwell
Science.
-
Calfas
KJ, Taylor WC. 1994. Effects of physical activity on
psychological variables in adolescents. Pediatric Exercise
Science 6(4):406423.
Suggested
Reading
Armstrong
N, Bray S. 1991. Physical activity patterns defined by continuous
heart rate monitoring. Archives of Disease in Childhood 66(2):245247.
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):219228.
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):406423.
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.