The greatest health risk facing children today is not a terrible disease such as Leukemia or unthinkable trauma such as abuse. It is obesity. Recent statistics show that the number of obese and overweight children is increasing. The National Center for Health Statistics reports that the percentage of elementary-age children who are considered obese has doubled since 1980, from 7% to 14%. Generally, children who are between 10 and 20% over the appropriate weight for their height and age would be classified as overweight. Children who are 20% or more over the ideal weight are classified as obese. About 85% of obese children continue to be classified as obese for the rest of their lives. These health risks are frequently found in higher concentrations among populations of minority and low-income children. The impact of obesity on these children may be exacerbated because they are less likely to have access to community recreation centers and are more likely to live in high crime areas.
Obesity is more than just a cosmetic concern. Short- and long-term physical and psychological concerns can result from childhood obesity. It has been linked to shorter life spans and a number of health factors that can affect children including Type II diabetes, cardiovascular disease, high blood pressure, stress on bones and lungs, high cholesterol, joint disease, irregular menstrual cycles, stroke, gall stones, gout, sleep apnea, and possibly cancer. Furthermore, obese children are often teased and discriminated against, and psychological effects of can include feelings of inadequacy, low self-esteem, and embarrassment. People who remain obese as adults are often discriminated against with regards to jobs and relationships.
Children who are obese are more likely to become adults who are obese. As children get older, this possibility increases. By the time obese children reach the age of 6 years, their probability of becoming obese adults is more than 50%. Obese adolescents have a 70-80% chance of remaining obese when they become adults. Having one obese parent also increases the possibility that obese children will become obese adults.
Obesity is the end result of an inversely proportional relationship between activity level and caloric intake. Children who take in more calories than they burn become obese and less physically active. These children experience physical activities differently from non-obese children. Rigorous physical play is difficult and they are often physically inept. In a recent study investigating the developmental progression of young children’s overhead ladder usage, approximately 120 children ages 3 to 10 were observed traversing the apparatus. Although obesity was not an objective of the study, it was noted that the only children who were unable to successfully navigate the equipment were obese. Another study reveals that obesity also is an influence on children’s walking patterns. Obese children generally walk slower, are flat footed, walk with turned out toes, and walk asymmetrically. These poor walking habits have the potential to impose cumulative consequences such as body tissue damage and structural deformities.
When considering ’solutions’ for the childhood obesity problem, the basic factors involved in obesity must be considered. These include genetics, emotional stability, hormone levels, and intake-activity relationships. For the majority of people involved with children, the intake-activity relationship is the only factor with which it is possible to engage. And of that factor, only the ’activity’ aspect is within reach. But increasing the physical activity level among children is complicated. Schools, under pressure to increase test scores, are decreasing children’s opportunities to participate in recess and physical education (PE). In fact, the Center for Disease Control (CDC) reports that PE classes are disappearing from schools in the United States, as evidenced by the drop in percentage of schools that have PE programs. In the 1990’s alone, the percentage of schools that offer PE classes dropped from over 40% to around 25%, and that number is still on the decline. As a result, schools are increasing the amount of time children’s bodies remain relatively stationary. Reductions in the amount of physical activity in schools may be leading to serious consequences. Researchers have found that children who were not engaged in a PE program at school gained 1 inch more around the waist and 2 pounds more overall than those who were involved in a PE curriculum.
Children are not compensating for this lost physical activity time by increasing their physical activity level after school. In fact, they may also engage in sedentary activities after school. More and more, children’s free time is consumed with sedentary activities like watching television and playing computer games. Researchers have reported direct correlations between the amount of television watching and obesity. The sedentary habits found in our schools and homes may be compounding the growing number of obese bodies.
A promising area for increasing physical activity is through improving children’s access to areas where they can have high rates of challenging physical activity. A recent study published in Pediatrics suggests a direct link between physical activity and the environment to which children are exposed. The CDC in 1998 sent out a call for an increase in environments that encourage physical activity. Furthermore, the American Heart Association (AHA) recommends that children get 30 minutes of vigorous cardiorespiratory exercise at least 3 times a week.
Studies also show that physical stature largely dictates in which activities children can participate and what areas of play environments are accessible. Thus, it becomes a responsibility of playground designers to provide challenging activities for obese children who are not as physically adept as their non-obese peers; as a result, they will have opportunities to be physically active during play times. Responsibility also lies with parents to advocate for instilling sufficient recess and physical education times during the course of the school day. Furthermore, children who participate in physical education programs and/or have access to community recreation areas are more likely to be physically active. Increasing opportunities for challenging active play, physical education, and recess, as well as the development of community recreation centers in low-income areas, may have an important impact on the greatest health risk facing our children today. The AHA recommends requiring PE classes for K-12 students, encouraging extra-curricular activities that promote and increase physical activity, and promoting active lifestyles in schools and colleges.
- Active youth: Ideas for implementing CDC physical activity promotion guidelines (1998). Champaign, IL: Human Kinetics.
- Barbour, A. (1999). The impact of playground design on the play behaviors of children with differing levels of physical competence. Early Childhood Research Quarterly, 14 (1), 75-98.
- Bowser, B. A. (2001). Obese children. PBS Online News Hour (May 1, 2001). http://www.pbs.org/newshour/bb/health/jan-june01/obesekids_05-01.html.
- Dale, D., Corbin, C., & Dale, K. (2000). Restricting opportunities to be active during school time: Do children compensate be increasing physical activity levels after school. Research Quarterly for Exercise and Sport, 71 (3), 240-248.
- Epstein, B. A. (2001). Obese children, a ’growing’ problem. The Doctor’s Office: http://www.allkids.org/Epstein/Articles/Obese_Children.html.
- Epstein, L., Paluch, R., Kalakanis, L., Goldfield, G., Cerny, F., & Roemmich, J. (2001). How much activity do youth get? A quantitative review of heart-measured activity. Pediatrics, 108 (3). Online at www.pediatrics.org/cgi/content/full/108/3/e44.
- Frost, J., Brown, P., Thornton, C., Sutterby, J., & Therrell, J. (2001). The developmental benefits and use patterns of overhead equipment on playgrounds. Unpublished study commissioned by GameTime, a PlayCore, Inc., Company. Fort Payne, Alabama, U.S.A.
- Gabbard, C. (2000). Physical education: Should it be in the core curriculum. Principal, 79 (3), 29-31.
- Gordan, Larsen, P., McMurray, R., & Popkin, B. (2000). Determinants of adolescent physical activity and inactivity patterns. Pediatrics, 105 (6). Online at www.pediatrics.org/cgi/content/full/105/6/e83.
- Hills, A. (1994). Locomotor characteristics of obese children. In A. Hills & M. Wahlqvist (Eds.), Exercise and obesity, pp. 141-150. London: Smith-Gordon, Nishimura.
- Horvat, M. & Franklin, C. (2000). The effects of the environment on physical activity patterns of children with mental retardation. Research Quarterly for Exercise and Sport, 72 (2), 189-195.
- Moran, R. (1999). Evaluation and treatment of childhood obesity. American Family Physician (February 15, 1999). http:/www.aafp.org/afp/990215ap/861.html.
- Pangrazi, R. & Dauer, V. (1992). Dynamic physical education for elementary school children (10th edition). New York: Macmillan Publishing Company.
- Sallis, J., McKenzie, T., Kolody, B., Lewis, M., Marshall, S., & Rosengard, P. (1999). Effects of health-related physical education on academic achievement: Project spark. Research Quarterly for Exercise and Sport, 70 (2), 127-134.
Pei-San Brown, John Sutterby, and Candra Thornton are from the Children’s Institute for Learning & Development (CHILD). This article reprinted by permission from IPEMA.