Health Effects of Physical Activity
in Children and Youth: Strengths
and Limitations of the Scientific
Evidence
Russell R....
Outline
• Background
• Health Benefits of Physical Activity
• Limitations to the Science
Current PA Guidelines for Children &
Youth
• Children and adolescents should do 60 minutes
or more of PA daily
• Aerobic: ...
PA Guidelines Mid-Course Report

US DHHS 2012
PA Guidelines Mid-Course Report
• Summarized evidence on effective strategies to
increase PA in children ages 3-17 years f...
PA Guidelines Mid-Course Report
Setting

Conclusion

School – Multi-component

Sufficient evidence

School – Physical educ...
IOM – Early Childhood Obesity
Prevention Policies
IOM Physical Activity Guidelines
for Young Children
Toddlers and preschoolers should be provided
with “opportunities for l...
New PA Guidelines for Young Children
Organization, Date

Physical Activity Guidelines

Commonwealth of
Australia, Dept. of...
Health Benefits of Physical
Activity for Children and Youth
Physical Activity Guidelines Advisory Committee
Report, 2008
Purpose
• To address the strength of the evidence
upon which these initiatives are based
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 old...
Favorable Cardiovascular &
Metabolic Disease Risk Profiles
• Children and youth who are physically active have
healthier c...
Higher Cardiorespiratory Fitness
• Pre-adolescents & adolescents can increase their
CRF by 5-15% with exercise training
• ...
Increased Muscular Strength
• Children and adolescents can increase their muscular
strength with resistance training 2 or ...
Increased Bone Density
• Children and adolescents can increase their bone
mineral content and density with weight-loading
...
Reduced Symptoms of Depression
• Children and adolescents can reduce their
symptoms of depression & anxiety with PA
• Motl...
Health Benefits of PA – Comparison with
Other Reports
Health Benefits

US
(6-17 y)

Australia
(5-18 y)

UK
(5-18 y)

Canad...
Limitations to the Science
Limitations
• Little evidence in children under 6
• Influences on weight status – poorly
understood
• Dose-response – litt...
Factors associated with development of
excessive fatness in children and
adolescents: a review of prospective
studies
Pate...
Review Findings
• Low PA & genetic factors are associated with excessive
fatness in children & youth
• Mixed evidence for:...
Russell Pate, Ph.D. - "Health Effects of Physical Activity in Children and Youth"
Russell Pate, Ph.D. - "Health Effects of Physical Activity in Children and Youth"
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Russell Pate, Ph.D. - "Health Effects of Physical Activity in Children and Youth"

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Russell Pate, Ph.D. - "Health Effects of Physical Activity in Children and Youth"

  1. 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. 2. Outline • Background • Health Benefits of Physical Activity • Limitations to the Science
  3. 3. 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
  4. 4. PA Guidelines Mid-Course Report US DHHS 2012
  5. 5. 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
  6. 6. 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
  7. 7. IOM – Early Childhood Obesity Prevention Policies
  8. 8. 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.
  9. 9. 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”
  10. 10. Health Benefits of Physical Activity for Children and Youth Physical Activity Guidelines Advisory Committee Report, 2008
  11. 11. Purpose • To address the strength of the evidence upon which these initiatives are based
  12. 12. 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
  13. 13. 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
  14. 14. 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
  15. 15. 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
  16. 16. 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
  17. 17. 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
  18. 18. 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 √
  19. 19. Limitations to the Science
  20. 20. 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
  21. 21. 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
  22. 22. 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
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