RESEARCH to PRACTICE
Overcoming Inactivity in Young People
James F. Sallis, PhD
THE PHYSICIAN AND SPORTSMEDICINE - VOL 28 - NO. 10 - OCTOBER 2000
The strongest health benefit of physical activity for young people may be improved psychological health (1). Because psychological health affects the daily well-being of young people and the adults in their lives, this may be reason enough to ensure that young people are active. In addition, physical activity constitutes part of effective weight loss programs for obese youth, and it can affect risk factors for cardiovascular disease and diabetes such as high-density lipoprotein cholesterol levels, blood pressure, and insulin resistance (1). The ultimate effects on disease in adulthood, however, are not known.
What's Behind Youth Inactivity
Youth physical activity seems to be influenced by a wide variety of psychological, social, and environmental factors (2). Gaining a better understanding of these factors could lead to interventions that are more effective at keeping young people active.
Young people spend large amounts of time in sedentary leisure pursuits such as watching television and using computers. Children who spend more time viewing television increase their risk of obesity (3). Recent studies show that reducing viewing hours can increase physical activity and help young people lose body fat (4). Several organizations have recommended that television viewing be limited to 2 hours per day, but the current average is more than 3 hours a day.
At virtually all ages, boys are more physically active than girls (2). The steepest decline in physical activity for both sexes is during the teen years. By high school, only a minority of adolescents are meeting health-related activity guidelines. It is not clear whether low-income and ethnic minority youth have lower activity levels than economically advantaged and white youth (5), but it is known that African American and Latino youths watch more television than whites (3). Finding ways to arrest this decline with age would help to solve the problem of youth inactivity.
Exercise Guidelines Vary
Many scientific and governmental organizations recommend regular physical activity for young people, but their guidelines differ. The Healthy People 2010 report applies the adult guidelines to adolescents: Accumulate 30 minutes of moderate intensity activity daily or three 20 minute sessions of vigorous activity each week (5). However, the National Association for Sports and Physical Education, the Year 2000 Dietary Guidelines for Americans, and a consensus group from the United Kingdom (1) all recommend that young people accumulate at least 60 minutes per day of moderate-to-vigorous activity. The 60-minute guideline is based on observations that (1) virtually all young people appear to be meeting the 30-minute guideline, yet obesity is rapidly increasing and (2) young people rarely do continuous vigorous exercise.
How to Increase Physical Activity
Parents want guidance from physicians on their children's physical activity. Assessment and counseling is recommended in the Healthy People 2010 report (5), and materials to guide counseling for youth physical activity are available (table 1) (6,7). In well visits, it is practical to ask whether the child is doing at least 60 minutes of physical activity every day. If not, the physician should emphasize that regular physical activity is essential for good mental and physical health. In addition, physical activity represents a good way to be with friends and have fun.
TABLE 1. Selected Information and Programs on Youth Physical Activity
The SPARK physical education program
The CATCH Program
PACE materials and training for healthcare providers
Physical Activity and Behavioral Medicine
The physician, parent, and child can then work together on a plan that ensures that the young person becomes engaged in daily physical activity. The activity will likely need to take place after school, it may involve less television or computer time, and the parent may need to arrange for transportation. Physicians can also be effective advocates for improved school physical education, community recreation programs, playgrounds, bike trails, and other community resources that will promote youth physical activity. Parents can help children reduce time spent in sedentary behaviors by giving rewards for watching less television, allowing sedentary recreation only after doing 60 minutes of physical activity, and by setting and consistently following family rules that limit television, computer, and video game time. Another helpful rule is to limit snacking to fruits and vegetables while watching television or playing on a computer.
More research is needed to document additional health effects and determine the amount of physical activity needed for young people to obtain those benefits. Another research challenge is to improve interventions for youth. School-based programs have been successful at improving physical education and using classroom curricula to increase physical activity and decrease television viewing (8), but interventions in other settings need to be evaluated (9).
Dr Sallis is professor of psychology at San Diego State University. Address correspondence to James F. Sallis, PhD, Dept of Psychology, San Diego State University, 6363 Alvarado Ct, No 103, San Diego, CA 92120; e-mail to [email protected].