Participants: Don Morgan
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. |
Revised 2014-12-17