Russell Pate, Ph.D. - "Health Effects of Physical Activity in Children and Youth"
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This document summarizes the evidence on the health effects of physical activity in children and youth. It outlines current physical activity guidelines for children and discusses limitations in the scientific evidence. Specifically, it notes that there is little evidence on the effects of physical activity in children under age 6. Additionally, the influences of physical activity on weight status and the dose-response relationships for most health outcomes are poorly understood. The document also reviews limitations such as a lack of prospective longitudinal studies and large-scale clinical trials.
Russell Pate, Ph.D. - "Health Effects of Physical Activity in Children and Youth"
- 1. Health Effects of Physical Activity in Children and Youth: Strengths and Limitations of the Scientific Evidence Russell R. Pate, PhD Arnold School of Public Health University of South Carolina
- 2. Outline • Background • Health Benefits of Physical Activity • Limitations to the Science
- 4. Current PA Guidelines for Children & Youth • Children and adolescents should do 60 minutes or more of PA daily • Aerobic: moderate- or vigorous-intensity aerobic PA, including vigorous-intensity PA at least 3 days/week • Muscle-strengthening: at least 3 days/week • Bone-strengthening: at least 3 days/week US DHHS 2008
- 5. PA Guidelines Mid-Course Report US DHHS 2012
- 6. PA Guidelines Mid-Course Report • Summarized evidence on effective strategies to increase PA in children ages 3-17 years from a review of reviews • Summarized evidence as follows • Sufficient • Suggestive • Emerging • Insufficient US DHHS 2012
- 7. PA Guidelines Mid-Course Report Setting Conclusion School – Multi-component Sufficient evidence School – Physical education Sufficient evidence School – Active transportation Suggestive School – Activity breaks Emerging School – Physical environment and after-school Insufficient Preschool & Child Care setting Suggestive Community – Built environment Suggestive Community – Camps, youth organizations, other programs Insufficient Family & home Insufficient Primary care setting Insufficient
- 8. IOM – Early Childhood Obesity Prevention Policies
- 9. IOM Physical Activity Guidelines for Young Children Toddlers and preschoolers should be provided with “opportunities for light, moderate, and vigorous physical activity for at least 15 minutes per hour while children are in care.” This is equal to 3 hours of physical activity over a period of 12 waking hours.
- 10. New PA Guidelines for Young Children Organization, Date Physical Activity Guidelines Commonwealth of Australia, Dept. of Health and Aging, 2010 The 4 UK Chief Medical Officers, 2011 “toddlers and pre-schoolers should be physically active every day for at least 3 hours, spread throughout the day.” “children of pre-school age who are capable of walking unaided should be physically active daily for at least 180 minutes (3 hours), spread throughout the day.” Canadian Society for “Toddlers (aged 1-2 years) and preschoolers Exercise Physiology, (aged 3-4 years) should accumulate at least 2012 180 min of PA at any intensity spread throughout the day”
- 11. Health Benefits of Physical Activity for Children and Youth Physical Activity Guidelines Advisory Committee Report, 2008
- 12. Purpose • To address the strength of the evidence upon which these initiatives are based
- 13. Lower Body Fatness • Youth with high PA have lower body fatness • Gutin et al. Am J Clin Nutr 2002;75:818-26 • 13-18 y olds, n=80 • 8 month intervention: Lifestyle Education & Training vs. Lifestyle Education • Significantly greater decrease in %fat & visceral adipose tissue with Lifestyle Education & Training
- 14. Favorable Cardiovascular & Metabolic Disease Risk Profiles • Children and youth who are physically active have healthier cardiovascular & metabolic risk profiles than children who are inactive • Andersen et al. Lancet 2006;368:299-304 • Tested metabolic syndrome cluster scores • Youth with more MVPA had better scores than inactive youth • ≥ 360 min/week of MVPA associated with good risk profile
- 15. Higher Cardiorespiratory Fitness • Pre-adolescents & adolescents can increase their CRF by 5-15% with exercise training • Baquet et al. Sports Med 2003;33:1127-43 • Reviewed 22 controlled training studies • CRF was improved with: • Intensity > 80% HR Max • Frequency of 3 – 4 days/week • Duration of 30-60 min/session
- 16. Increased Muscular Strength • Children and adolescents can increase their muscular strength with resistance training 2 or 3 times/week • Malina RM. Clin J Sport Med 2006;16:478-87 • Reviewed 22 experimental studies • Muscular strength improved with: • Intensity range 50% to 85% • Frequency of 2 – 3 days/week with rest • Duration of 8- or 12-week programs
- 17. Increased Bone Density • Children and adolescents can increase their bone mineral content and density with weight-loading activities • Arnett & Lutz. Med Sci Sports Exerc 2002;34:1913-9 • Improved bone density in 14-15 y old girls with: • Type – high-intensity jumping rope • Intensity – ground reaction force=3.2 x BW • Duration – 4 months
- 18. Reduced Symptoms of Depression • Children and adolescents can reduce their symptoms of depression & anxiety with PA • Motl et al. Psychosom Med 2004;66:336-42 • Prospective study of 7th graders followed for 2 y • Measured non-school related PA • Increases in PA reduced depressive symptoms
- 19. Health Benefits of PA – Comparison with Other Reports Health Benefits US (6-17 y) Australia (5-18 y) UK (5-18 y) Canada (5-17 y) Lower body fatness, healthy weight √ √ √ √ Improves cardio-metabolic health √ Increases cardiorespiratory fitness √ √ √ Increases muscular strength √ √ √ Increases bone density √ √ √ Improves psychological well-being (self-esteem, depression, relaxation, self-confidence, & happiness) √ √ √ √ √ Improves flexibility, balance, & posture √ Healthy growth & development √ Develops motor skills √ √ Provides opportunities to make friends & have fun while playing with friends √ √ Improves academic achievement √
- 20. Limitations to the Science
- 21. Limitations • Little evidence in children under 6 • Influences on weight status – poorly understood • Dose-response – little known for most outcomes • Design limitations – few prospective longitudinal studies; few large-scale clinical trials
- 22. Factors associated with development of excessive fatness in children and adolescents: a review of prospective studies Pate RR, O’Neill JR, Liese AD, Janz KF, Granberg EM, Colabianchi N, Harsha DW, Condrasky MM, O’Neil PM, Lau EY, Taverno Ross SE. Obesity Reviews 2013; 14: 645-658
- 23. Review Findings • Low PA & genetic factors are associated with excessive fatness in children & youth • Mixed evidence for: • • • • • Sedentary behavior Dietary intake Biomarkers Family factors PA environment • No conclusions could be made about: • • • • Social cognitive factors Peer factors School nutrition and PA Nutrition environment Pate et al. Obesity Reviews 2013; 14:645-658