Monday, November 30, 2015
Childhood obesity is a chronic disease that has become a worldwide epidemic (WHO, 2010; Biro, 2010; Temple, 2014) and as a result, many of these obese children are acquiring severe medical problems prior to reaching adulthood. Multiple complications are associated with childhood obesity including: cardiovascular diseases, digestive diseases, respiratory diseases and even psychological disorders such as depression (Biro, 2010).
Frequently, children who are obese tend to be obese in adulthood (WHO, 2010; Biro, 2010). Immaturity combined with environmental and family influences stack the odds against these children to alter their course (Biro, 2010). In order to begin this reversal of childhood obesity, there must be a full intervention dealing with all of the associated problems. The idea of energy in versus energy out – excess calories gained from eating need to be lost through physical activity - must be taught and reinforced. Education on nutritional choices and physical activity must be incorporated into the daily lives of children (Biro, 2010).
In 2012, seven of the top ten causes of death in the world could be linked to obesity: cardiovascular disease, stroke, chronic obstructive pulmonary disease, lower respiratory infections, cancer, diabetes, and hypertension (WHO, 2010). In America, obesity leads to 100,000-200,000 annual deaths, making it the second leading cause of premature death (Biro, 2010). Additionally, obesity costs the United States about $200 billion dollars annually (Cawley, 2012).
Childhood obesity is directly associated with adult obesity with statistics showing that nearly half of adults who are obese were obese when they were children (Biro, 2010). Obese children are five times more likely to have an impaired health-related quality of life than a healthy child; in fact they are similar to a pediatric cancer patient (Daley, 2006).
Obesity in children is defined as being above the 95th percentile in the body mass index (BMI), while overweight is defined as between the 85-95th percentile (Ogden, 2010). Under this categorization, 32% of children in the United State are considered overweight or obese (Temple, 2014). Without intervention, obesity will continue to spiral out of control. Exercise and physical activity, especially when integrated into the everyday lives of children, will help to combat this rampant disease. However, getting children who are overweight or obese to exercise may be challenging.
Obese or overweight children may be accustomed to sedentary behavior, low physical activity and idle habits. Some may get less pleasure in participating in physical activity and have a less positive attitude towards it than children of a healthy weight. Thus, physical activity and exercises should be developed with fun and entertainment in mind. For this, and many other reasons, the aquatic environment is fantastic for children. Children usually love the water and a well-designed exercise programs will seem more like playtime than exercise.
Exercising in the aquatic environment has many advantages and benefits that are not seen when exercising outside the pool. These benefits include:
The buoyancy of the water helps to support the body; it offloads weight, which relieves stress to joints. When joints are under less pressure, they are less painful to move.
The hydrostatic pressure helps the cardiovascular system to work more efficiently and decreases pooling of blood in the lower extremities. At the same oxygen consumption level, aquatic heart rates are lower than those seen in land-based activity.
The water’s resistance is multidirectional, offering challenge to working muscles in all directions of submerged movement.
(AEA, 2010)
Although individualized exercise programs offer optimum results, group fitness classes geared towards children have also shown success. Age-appropriate exercises must be used; children have less muscle mass and coordination, as well as reduced attention spans. Combining their interests will make children want to be more active. For example, if a child enjoys playing video games, incorporate the gameplay or the theme into the exercise routine. If the child is competitive or enjoys being timed, create a game that includes those elements. Children will respond better when they are involved and immersed into the program. It is also important to integrate education. Children may not understand why they are not healthy or how to make smarter decisions in their daily lives. Help to provide guidance and redirection.
To overcome health issues associated with obesity, physical activity and exercise must be encouraged and assimilated into the lives of children. The entertaining aspects, as well as the beneficial properties, of the aquatic environment make it a perfect place for children to achieve these exercise aspirations and goals. Get moving, have fun, and make a splash!
REFERENCES
Aquatic Fitness Professionals Manual sixth edition (2010). Aquatic Exercise Association. Human Kinetics, Champaign, IL.
Biro FM, Wien M. Childhood obesity and adult morbidities. The American Journal of Clinical Nutrition. 2010; 91(5):1499S-505S.
Daley AJ, Copeland RJ, Wright NP, Roalfe A, Wales JKH. Exercise Therapy as a Treatment for Psychopathologic Conditions in Obese and Morbidly Obese Adolescents: A Randomized, Controlled Trial. Pediatrics. 2006; 118(5):2126-34.
Ogden CL, Carroll MD, Curtin LR, Lamb MM, Flegal KM. Prevalence of high body mass index in us children and adolescents, 2007-2008. JAMA. 2010; 303(3):242-9.
Temple M, Robinson J, C. A systematic review of interventions to promote physical activity in the preschool setting. J SPEC PEDIATR NURS. 2014; 19(4):274-84.
World Health Organization. Population-based Prevention Strategies for Childhood Obesity: Report of a WHO Forum and Technical Meeting. World Health Organization, Geneva. 2010.
Keith Goodenough is a senior exercise physiology student at West Virginia University. Keith is preparing to enter a doctorate of physical therapy program at the University at Buffalo.