Wonderfully Made

Physical Activity And Childhood Obesity

Three Angels Broadcasting Network

Program transcript

Participants: Don Morgan

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Series Code: WM

Program Code: WM000357


00:01 The following program presents principles
00:03 designed to promote good health and is not
00:04 intended to take the place of personalized
00:06 professional care. The opinions and ideas
00:09 expressed are those of the speaker.
00:11 Viewers are encouraged to draw their own
00:13 conclusions about the information presented.
00:37 Hello and welcome to Wonderfully Made.
00:40 My name is Don Morgan and I'm an exercise
00:43 physiologist and I teach at Middle Tennessee
00:46 State University. This is the sixth program
00:50 in a series that is devoted to promoting
00:53 the health benefits of adopting and
00:55 maintaining of physically active lifestyle.
00:59 In our last program we discussed the epidemic
01:03 of adult obesity in the United States.
01:06 And examined the role of physical activity
01:10 in combating this chronic lifestyle disease.
01:13 Today, I want to turn our attention to the
01:17 prevalence of childhood obesity in America.
01:21 Identify some of the factors which contribute
01:23 to sedentary living in the overweight child.
01:27 And then offer some practical strategies
01:30 that can be used to promote and encourage
01:32 home and school based physical activity.
01:38 As mentioned in the previous program,
01:40 the United States has the highest incidents
01:43 of obesity in the world. Adult obesity has risen
01:48 steadily over the past 20 years.
01:51 With about 30 percent of the United States
01:54 population classified as obese.
01:57 And another 35 percent or so classified as being
02:01 overweight. It should be noted that the
02:06 prevalence of obesity varies from 25 to 51
02:10 percent. With higher values reported in
02:13 Mexican Americans, African Americans
02:16 and Native Americans. In addition, the financial
02:21 burden that is associated with being overweight
02:24 and obese has been paid at a 117 billion
02:28 dollars per year. With over 39 million work
02:32 days being lost annually to obesity related causes.
02:39 Paralleling the alarming increase in adult obesity
02:42 over the past 15 years, recent childhood
02:45 surveys have revealed that the prevalence
02:48 of overweightness for all age groups has
02:52 increased markedly over the last 25 years
02:55 to reach their highest levels ever.
02:58 As shown in our first graphic, the incidence
03:01 of obesity in children between the ages of
03:04 6 to 11 depicted in the light blue bars,
03:08 and adolescents ages 12 to 19 depicted
03:13 in the purple bars, was relatively stable from
03:16 the 1960s to the 1980s there was not
03:19 a lot of change. However from 1980
03:24 on you can see that the rate of increase
03:27 in obesity in both age groups has risen
03:30 dramatically. And currently 16 percent
03:34 of children aged 6 to 19 are obese.
03:40 This rate is quadrupole the percentage seen
03:43 in the 1960's. More over another 31 percent
03:48 of youngsters having classified as being
03:51 at risk for obesity. What this means
03:55 when you put it all together, is that 47
03:58 percent or nearly one out of the every
04:01 two American youth are either obese
04:05 or at risk of becoming obese.
04:09 In terms of the economic cost of
04:11 childhood obesity, yearly obesity related
04:15 hospital costs for children ranging in
04:18 age from 6 to 17 years more then
04:21 tripled between 1979 and 1999.
04:28 What are some of the health risks
04:30 that are associated with obesity in youth?
04:34 Adolescents who are obese can develop
04:37 a negative self image and a low-self esteem
04:41 that can persist into adulthood.
04:43 The observation that heavier children are
04:47 at greater risk for type II diabetes
04:50 and the fact that hospital discharges
04:53 of obesity related diabetes, nearly
04:57 doubled between 1979 and 1999,
05:00 this suggests that the disease effects
05:03 of recent increases in obesity prevalence
05:06 have already stated. Children who are obese
05:11 are more like to display an unfavorable lipid
05:14 profile. Featuring higher cholesterol,
05:17 triglyceride and low density lipoprotein
05:20 levels, as well as lower high density lipoprotein
05:24 values. Persistently higher blood pressure
05:28 levels have also been found to occur
05:30 9 times more frequently among obese youth.
05:35 Orthopedic complications like pain and range
05:39 of motion limitations can be a problem for
05:42 the overweight child. While sleep apnea
05:46 or the temporary stoppage of breathing
05:48 during sleep is thought to be present in
05:52 about 7 percent of obese children.
05:56 What is the likelihood that an obese child
05:59 would become an obese adult?
06:02 According to published data, about one third
06:05 of obese pre-school children become obese
06:08 adults. While 50 percent of obese
06:11 school age children carry their obesity
06:14 into adulthood. Unfortunately,
06:18 this figure rises even higher with age,
06:21 with 80 percent of obese adolescents,
06:24 remaining obese as adults.
06:27 To me these findings provide a strong
06:31 rationale to launch aggressive measures
06:35 early in a child's life to promote healthy
06:38 eating and an active lifestyle.
06:41 Since being overweight and obese is linked
06:46 to a number of adverse health consequences.
06:48 It is important to determine how
06:51 these variables are calculated?
06:54 Well many laboratory based methods exist
06:56 to quantify body composition.
06:58 The use of the Body Mass Index or BMI,
07:02 has become wide spread in the past few years,
07:06 because it is fairly easy to determine
07:09 all you need is height and weight and
07:11 they are very easily measured.
07:13 And it's been shown to correlate reasonably
07:15 well with direct measurements of body fat.
07:18 The following graph shows how to calculate
07:22 BMI for a 13-year-old boy who weighs 141
07:27 pounds and is 5 foot, 3 inches tall.
07:31 In this example the first step is to convert
07:35 height through inches. And we can do that
07:38 by multiplying 5 feet by 12 inches per foot.
07:42 And adding the extra 3 inches to arrive
07:46 at a height of 63 inches, next you
07:50 take the 63 inches and you square it.
07:53 All that means is that we will multiply
07:55 63 by itself. In this case 63 multiplied by
08:01 63 gives you 3969. The next step is to divide
08:08 the child's weight which in this example is a
08:11 141 pounds by his squared height value,
08:15 which is 3969. And when you do all of that
08:21 the number you get, is a very small one.
08:23 In this case 0.0355253.
08:29 The last step is to multiply this very
08:33 small number by 704.5, now this number acts
08:39 simply is a constant value and it's always used.
08:42 And when you multiply that small number by
08:45 704.5 you will get your BMI value, which in
08:50 this example is 25.0. Notice that the units
08:55 of this number are kilograms per meter
08:58 squared, in the abbreviation that
09:00 it's kg/m2 but that's what that means.
09:03 Kilograms of body mass per meters of height
09:06 squared. Now, I know that for some all of
09:10 this might have been a little complicated,
09:13 so the next graphic shows you how you
09:16 can determine BMI using tools found on
09:18 the internet. Simply go to www.cdc.gov/growthcharts
09:28 once you're there, just click on tools to
09:31 calculate BMI and then once you there click
09:35 on BMI Web Calculator and then simply follow
09:40 the instructions to derive your child's BMI value.
09:47 At this point what you need to do is to
09:50 translate your child's BMI value to BMI
09:53 percentiles that are adjusted for age and sex.
09:56 And you can see this in this graphic here,
09:58 what you do again is you go to
10:00 www.cdc.gov/ growthcharts,
10:05 then you click on Clinical Growth Charts,
10:09 then scroll down to children 2 to 20 years
10:13 and then finally click on boy's BMI-for-age
10:18 or girls's BMI-for-age. When you follow these
10:23 steps you will see a plot of BMI percentile
10:27 curves that can be use to determine
10:29 your child's BMI percentile based
10:32 on their age and sex. Once you have this
10:36 information, you'll want to find out where they
10:39 fit in relation to existing BMI standards
10:42 for youth. If your child's BMI for age percentage
10:47 is equal to or greater then the 95 percentile,
10:51 your child would be considered obese.
10:54 If their BMI for age percentile is equal to
10:58 or greater then the 85th percentile
11:01 but less then the 95th percentile they would
11:05 be classified as being overweight.
11:08 If your child's BMI for age percentile lies
11:11 between the fifth and the 85th percentiles
11:14 it is considered to be in the normal range.
11:19 Youngsters with an age and sex adjusted
11:21 BMI in the 5th percentile or lower
11:24 would be considered underweight.
11:28 When one looks at variables that underlie
11:30 obesity and weight gain, heredity is often
11:34 mentioned as a potential contributing factor.
11:37 Studies of families have shown that about
11:40 25 to 40 percent of the variability and human
11:44 obesity is related to genetic factors.
11:48 While acknowledging the influence of heredity
11:51 on weight gain, much of the increase in obesity
11:55 over the past two decades has been linked
11:58 instead to a variety of lifestyle and
12:01 environmental influences including
12:04 less physical activity. What are some of the
12:07 factors that contribute to a sedentary lifestyle
12:11 for the obese child. Well there is no simple
12:15 answer to this question. Let me offer a few
12:17 suggestions. First, children and adolescents
12:22 who are overweight are often the object
12:25 of teasing, jokes and ridicule.
12:27 All of which can help to reinforce a negative
12:30 body image. This in turn may help foster
12:35 the self perception that they are clumsy
12:38 or unskilled which then further detracts
12:42 from any joy or incentive that they might have
12:44 to participate in physical activity.
12:48 Second, just as very young children are
12:52 much more likely to engage in physical
12:55 activity if their parents are active,
12:57 parental inactivity has been shown to be a
13:01 strong predictor of child inactivity.
13:06 Third, obese children tend to perceive a given
13:10 exercise level has been more strenuous
13:13 then a non-obese child, consequently
13:16 they maybe reluctant to participate in physical
13:19 activity. Television viewing, Internet surfing,
13:24 video games and the accompanying sedentary
13:27 behavior they spawn are additional factors
13:31 that have been linked to reduced activity levels
13:33 in children. Finally, more states are reducing
13:38 the physical education requirement, at the
13:40 elementary, middle, and high school level.
13:44 Where daily physical education was once
13:47 the norm, many schools now offer PE
13:51 instruction only once or twice a week.
13:54 The unfortunate result of this decision
13:57 is that many students now receive fewer
14:00 opportunities to be physically active during
14:03 the school day. Given the potentially
14:07 damaging affects of childhood obesity.
14:09 How do we begin to develop strategies
14:12 to help you offend off the accumulation of
14:15 extra weight? Before I discuss some specific
14:19 ways to address this question,
14:21 I would like to talk first about a few basic
14:24 concepts regarding physical activity
14:27 in children. Young children are inherently
14:31 active, as you parents know all too well.
14:36 Consequently if you provide opportunities
14:39 for children to be active it's a good bet that
14:43 they would take advantage of them.
14:45 Unfortunately, the inverse of this statement
14:48 is also true, in other words children and
14:52 youth will learn to be sedentary if they
14:55 are not given chances to play and to be active.
15:00 Second, many skills use an adult recreation
15:04 and leisure time activities are acquired
15:07 during the school age years.
15:09 As a result children who don't for example
15:13 learn how to swim or play basketball maybe
15:17 less likely to participate in these activities
15:20 when they become adults. A third point
15:24 to keep in mind is that self efficacy
15:27 or a feeling that you can be successful
15:30 and strongly related to lifetime adherence
15:33 to physical activity. And fourth, children
15:38 who have active parents and family
15:40 members are more likely to be physically active,
15:44 compared to youth whose family tend to
15:46 gravitate towards the sedentary lifestyle.
15:51 Now, using these general principles
15:53 as a foundation it is possible to formulate
15:57 approaches to help families and schools
16:00 promote an active environment
16:02 for youngsters. Let's start by looking at
16:05 ways to foster physical activity at home.
16:08 First off, replace sedentary activities with
16:12 more physical options. Here are some examples,
16:16 instead of allowing your son or daughter
16:19 to chat on the telephone for hours with friends,
16:22 suggest that they get together and do their
16:26 chatting while they walk around the block.
16:29 If your child's playmate doesn't live too far away
16:33 and it's safe have them ride their bike
16:36 or walk to their friends house, instead of
16:39 getting a ride there. And if your child has
16:44 been studying or watching television for a while,
16:47 encourage them to take a physical activity
16:50 break by shooting baskets in the driveway
16:53 or taking a 5 to 10 minute ride around
16:56 the neighborhood. The point here is to
16:59 be creative, and to realize that ordinary
17:03 life is full of fitness and activity
17:06 opportunities. All you have to do is
17:08 just reach out and grab him.
17:11 If you are with your children at the mall
17:13 and you have some spare time,
17:15 take some detours when walking from
17:17 one store to the next. And expand a few
17:20 extra calories, likewise if you have errands
17:24 to run in the neighborhood
17:26 or only need to pick up a few items at the
17:29 local drug store, consider leaving the
17:32 car parked at home and taking the kids
17:35 with you to accomplish these tasks on foot.
17:38 Not only does this provide an opportunity
17:41 for all of you to be physically active.
17:44 You can also give the children a monetary
17:46 bonus out the gas money that you saved
17:49 by waking. In order to help your child address
17:54 their weight problems, it is absolutely essential
17:57 for the whole family to participate in a variety
18:00 of physical activities like walking, bicycling
18:04 or rollerblading that everyone can enjoy.
18:08 You can plan special family outings like hiking
18:11 or skiing or you can join forces with other
18:14 families in the neighborhood
18:15 to play basketball, touch football, soccer
18:19 or even hide and go seek. Closer to home,
18:24 active household duties can be assigned
18:27 to each family member, such as vacuuming,
18:30 washing the car or mowing the lawn like
18:33 my son is doing now. If your children express
18:37 an interest, consider involving them in extra
18:40 curricular activities like basketball, gymnastics
18:44 or swimming that have reasonable
18:46 time commitments. Cutting back on television
18:50 viewing or video game playing as a means of
18:54 reducing sedentary behavior might be a
18:57 tough sell in the beginning.
18:59 So, start by gradually reducing the time spent
19:02 in these activities. The key is this, if you can
19:07 help your children find active alternatives that
19:10 are enjoyable. They will realize that the
19:13 process of making lifestyle
19:15 changes can be a positive experience.
19:20 Let me share a real life example of
19:23 how adding small amounts of physical activity
19:26 to one's daily routine, led to visible changes
19:30 in a child's appearance and his outlook on life.
19:34 Chad was a young boy who attended
19:37 my son's elementary school.
19:39 He was noticeably overweight and experience
19:43 difficulty keeping up with the other children,
19:45 during recess and physical education class.
19:49 He fatigued easily and tried to avoid physical
19:53 activity whenever possible.
19:56 His mother become increasingly concerned
19:59 about Chad's weight, and decided to make
20:01 some positive lifestyle changes that would
20:04 affect them both. Within a month
20:07 they have moved out of their house
20:10 and found an apartment that was much closer
20:13 to her son's school. They began waking
20:16 up a few minutes earlier each morning
20:18 so that she and Chad could ride their bicycles
20:21 a couple of miles to his school instead of using
20:24 the car. In addition to this change in physical
20:28 activity she also started making healthier food
20:32 selections at the grocery store and began
20:35 preparing meals that were noticeably lower
20:38 in fat content. Within a few months
20:42 it was obvious that Chad had dropped
20:44 a fair amount of weight when people asked
20:47 his mother what she had done to help
20:49 her son lose his weight. She explained that
20:53 just making a few adjustments in their
20:55 lifestyle riding bikes instead of driving,
20:58 making healthier food selections and
21:01 trying to eat in a more healthy manner,
21:03 all of these small changes had made
21:06 a huge difference in how both of them
21:09 looked and felt. What's the moral of the story?
21:14 I believe it's simply this that small changes
21:18 that are carried out and committed to on
21:21 a daily basis can overtime lead
21:25 to positive health outcomes
21:27 and an improved quality of life.
21:31 Another important role that parents can play
21:34 in helping their child lose weight is to
21:36 model a physically active lifestyle.
21:39 You don't have to be an excellent athlete
21:42 or in really, really top-notch condition
21:45 to be a role model for your child, but they
21:48 need to see you participating in some
21:51 form of physical activity on a regular basis.
21:54 Be it walking, jogging, playing basket ball,
21:58 weightlifting, working out in the yard or even
22:02 jumping up and down on a rebounder if you want.
22:05 When your children see you enthusiastically
22:08 embracing an active lifestyle this will spark
22:11 their interest in physical activity and speak
22:14 volumes about how important it is for them
22:17 to establish healthy physical habits that
22:20 they can carry with them for the rest
22:22 of their lives. When kids and parents play
22:27 together not only do they receive a good
22:30 physical workout, they also get the chance
22:33 to connect emotionally. What children want
22:37 most is to spend more time with their parents
22:40 and sharing physical activity time is a
22:43 perfect way to make this happen.
22:46 This type of family bounding can be
22:48 especially important for the overweight child,
22:51 because it can satisfy their emotional needs
22:55 and make them less likely to use food
22:58 as a way of ridding themselves of stress
23:00 and then happiness. It is vital for parents
23:04 to let their children know that they're loved
23:06 and appreciated no matter how much they weigh.
23:11 The good news here is that all children can
23:14 learn to make healthy lifestyle choices
23:16 when they receive encouragement and
23:18 support from their parents.
23:21 When not at home children and adolescents
23:25 spend most of their time at school it makes
23:28 sense therefore, for all of us to support quality
23:31 school physical education and internal sports
23:34 programs that are developmentally
23:37 appropriate and that emphasize participation
23:40 in a variety of sport and physical activities.
23:44 Parents should insist that the physical
23:47 education programs at their child's school be
23:50 thought by credential physical education
23:52 teachers whenever possible.
23:55 In addition to the health and fitness benefits
23:57 gained from being in a physical education class.
24:01 Data from a recent study involving over
24:04 950,000 children indicate that higher academic
24:10 achievement is related to improve levels
24:13 of health related physical fitness,
24:15 in other words the more physical fit children
24:19 are the better they perform in school.
24:24 How much physical activity should children
24:27 receive? According to guidelines established
24:30 by the National Association for Sport
24:33 and Physical Education, school age children
24:36 should accumulate at least 60 minutes
24:38 and up to several hours of age appropriate
24:42 physical activity on all or most days of the week.
24:46 These guidelines state that physical activity
24:49 can take place in many short intermittent
24:51 exercise bouts, it does not need to be
24:54 performed in the longer continues exercise
24:57 periods that adults often perform.
25:00 Children should participate in a
25:02 variety of age appropriate physical
25:04 activities such as aerobics, active sports
25:07 and recreational pursuits and muscle
25:09 fitness and flexibility exercises to achieve
25:12 optimum health, fitness and performance benefits.
25:17 This varied approach reduces monotony
25:19 and increases the likelihood that they
25:22 will find physical activity fun and enjoyable.
25:25 It is also recommended that children avoid
25:28 prolonged periods of inactivity, lasting two
25:31 hour or more, especially during daylight hours.
25:36 Well, our discussion up to this point at least
25:39 has addressed the need to promote
25:41 health enhancing physical activity among
25:43 school aged children. There has being
25:46 growing interest in encouraging physical
25:48 activity in youth under the age of five to
25:51 counter increasing levels of obesity in
25:53 pre-school children. The position taken by the
25:57 National Association for Sport and Physical
25:59 Education on this issue is that all children from
26:03 birth to age five should engage in daily
26:06 physical activity that promotes health
26:09 related fitness and movement skills.
26:11 As a member of the task force that wrote this
26:14 document it became clear to me how important
26:17 it is for very young children to safely explore
26:20 and move about in different environments.
26:22 With respect to infants, physical activity can
26:26 promote the development of such basic skills
26:28 as reaching, grasping, sitting and crawling.
26:31 Once walking is possible a whole new list of
26:35 movement in physical activity possibilities
26:38 emerge for the young child.
26:40 From the ages of 1 to 4 children began
26:44 to acquire the fundamental motor
26:45 skills that will be the building blocks for
26:48 more complex movements, such as running, jumping,
26:51 throwing and kicking. Hence it is critical for
26:54 parents, caregivers, and pre-school teachers to
26:58 provide structured and unstructured physical
27:00 activity time for children to develop
27:03 and refine these motor skills.
27:06 Physical activity is a natural way of
27:08 preventing and reducing childhood obesity,
27:11 therefore the needs and interests of the
27:15 child rather than the desires of adults
27:18 should be preeminent in the selection of
27:21 fitness and sport pursuits. It is also
27:25 important to remember that whether we're
27:27 talking about a child or adult the process of
27:30 engaging in physical activity means being
27:33 involved, doing your best and participating
27:36 regularly. Finally, let me again highlight the
27:40 importance of being an active role model
27:42 for your child. As a parent of two children
27:46 my wife and I try to model many behaviors
27:48 that we want our children to emulate, honesty,
27:51 diligence, and respect for others.
27:53 So, that they will be able to function effectively
27:55 when they become adults. Viewed against
27:57 this backdrop, modeling physical activity is
28:01 one of the most enduring legacies that
28:03 we can leave our children. So, in closing, motivate
28:07 your kids to be active and until next time
28:10 keep moving step by step
28:12 towards greater health and fitness.


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Revised 2014-12-17