Obesity Prevention

Physical Activity is Essential for Public Health

By: Nancy Trout, MD, MPH

Physicians have long encouraged people of all ages to remain physically active and now new federal guidelines, as well as a new study published in the journal Pediatrics, provide further motivation for children and families to get moving.

Last month, the U.S. Department of Health and Human Services (HHS) released their 2018 Physical Activity Guidelines (PAG) for Americans. Based on a systematic review of the science supporting physical activity and health, the Physical Activity Guidelines Advisory Committee determined that approximately 80 percent of adults and adolescents are insufficiently active, to the detriment of their health. Physical activity enhances growth, development and health across the life cycle and has health benefits for all, regardless of age, sex, race, ethnicity, or body size. Health benefits of regular exercise for children and adolescents include improved bone health, healthier weight, improved sleep, improved cognitive function, and reduced risk for anxiety and depression.

Establishing healthy habits from birth is a key component of the Kohl’s Start Childhood Off Right (SCOR) program, and regular physical activity and play for infants and toddlers builds the foundation for healthy life habits. The PAG recommend that toddlers and pre-school aged children 3-5 years of age should be physically active throughout the day, and adult caregivers should encourage various types of activities to teach important movement skills. Parents and caregivers should be role models by engaging in their own regular activities and by supporting and encouraging young children. Toddlers are naturally active and need safe spaces where they can move and explore. Although specific quantitative guidelines have not been issued for this age group, three hours of activities of variable intensities per day is a reasonable target consistent with observation of children that age and supported by guidelines from other countries such as Canada and the United Kingdom. The community engagement arm of the Kohl’s SCOR program hosts community wellness events that encourage parents to engage in physical activity with their infants, toddlers and school aged children.  These events have included Baby and Me yoga at various venues, hula-hooping at the Hartford Public Library, and music and movement at the Family Resource Center at Connecticut Children’s Medical Center.

Read Dr. Trout’s blog Promoting the Power of Play here.

The school-aged years and adolescence from 6-19 years of age provide critical periods for children to develop healthy habits, learn movement skills, engage in sports, and lay a foundation for lifelong healthy habits. A recent study published in the journal Pediatrics showed that total physical activity declines and sedentary behavior increases significantly from 6-11 years of age. The guidelines recommend that children in this age group engage in 60 minutes or more of moderate-to-vigorous daily activity that includes muscle-strengthening, and bone-strengthening activities at least three days a week. Youth who are regularly active will be less likely to develop obesity, elevated insulin and blood lipid levels, and hypertension, and these are practices that if established early can last a lifetime. As the prevalence of anxiety and depression is rising among adolescence, physical activity offers natural relief. Acute and regular moderate-to-vigorous physical activity also improves cognitive functions of memory, executive function, processing speed, attention, and academic performance for these children.  Children and adolescents with disabilities should also meet key guidelines whenever possible by working with health care professionals to understand and define appropriate activities and the use of adaptive equipment.

The Robert Wood Johnson Healthy Eating Research program identified the first 1000 days from conception to age 2 years as a critical period for the development of childhood obesity. The research also identified several maternal factors that increased the risk of obesity for their children. These factors included high pre-pregnancy BMI, excessive maternal weight gain, and gestational diabetes. Physical activity during and after pregnancy benefits not only a woman’s overall health, but also that of her baby, by reducing her risk of excessive weight gain and gestational diabetes, as well as reducing symptoms of postpartum depression.  Post-partum exercise, along with breastfeeding, also helps women return to their pre-pregnancy weight, which is important for future healthy pregnancies.

Read additional blogs from Dr. Trout here.

The PAG also address evidence-based strategies to promote and support physical activity for all sectors of society.  These strategies focus on individuals and small groups as well as programs and policies to promote activities for entire communities. Health professionals can incorporate counseling or guidance into their patient visits to help set and monitor physical activity goals.  Technology can be used to provide physical activity feedback directly to the user as well as with remote guidance through text messaging, social media, or email. Health care professionals must also partner with stakeholders in other sectors such as business and industry, parks and recreation, schools, faith-based institutions, youth sports, and transportation and community design to promote, support, and advocate for physical activity in the workplace, in schools, in faith-based settings, and in the broader community.  The 2018 Physical Activity Guidelines supports the principal concept that regular activity over months and years will produce long-term benefits that are essential for a healthy society.  The public health community and policy makers must not only facilitate awareness of the content of the guidelines; we must also advocate for and invest in efforts to implement practices, programs and policies that lead to a more physically active and healthy population.

Nancy Trout, MD, MPH is co-director of Kohl’s Start Childhood Off Right, which is an initiative of Connecticut Children’s Office for Community Child Health.

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