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D.iet & H.ealth : C.hildren & W.omen Last Updated: Nov 12th, 2006 - 20:38:00

Pediatricians should encourage healthy living by monitoring physical activity in kids
By Kathy Jones
May 1, 2006, 15:21

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May 1 ( - Soaring levels of childhood obesity in American children have sent alarm bells ringing among policymakers. The American Academy of Pediatrics is now calling on doctors and other healthcare professionals to play a bigger role in fostering healthy living in children.

Pediatricians should encourage physical activity and provide proper guidance on nutrition, the AAP says.

The AAP has released a policy statement titled Active Healthy Living: Prevention of Childhood Obesity Through Increased Physical Activity. This statement, which appears in the May issue of the journal Pediatrics outlines several methods that are required to gain some control over spiraling childhood obesity rates.

The policy says that pediatricians should take a keen interest in the well being of their patients as well as the kids' parents. Doctors are encouraged to enquire how active the kids are and what physical activities were undertaken in between regular visits.

Pediatricians should also document the time in which their patient is sedentary each day. Parents should be encouraged to follow the AAP policy of "No TV" for kids aged under two years and restrict the time spent by older kids in front of their screens, be it television, computer or video games, to 2 hours every day.

Doctors should also interact with parents and find out what hampers a healthy lifestyle in child patients and encourage them to alter their current practices when feasible. The policy says that schools should also actively participate in this initiative by reinstating compulsory physical education in kindergarten through high school.

Such classes should allow all children including the disabled to participate in various physical activities. Overweight or obese children must be encouraged to take up water-based sports and strength-training rather than weight-bearing activities, since these could prove difficult for them, the policy says.

Parents should take the first step and "become good role models by increasing their own level of physical activity." Children should be initiated into leading physically active lives right from their infancy when parents can start taking them for a walk in the park or the zoo. As preschoolers kids should take part in unorganized outdoor activities.

The policy adds that at this stage kids may also be allowed to walk for "tolerable distances" with family members. Older children and adolescents should take part in physical activity for at least an hour daily. Children may be permitted to start taking part in organized sports by school age.

"I've been giving this advice for a long time. Most of the time parents don't feel that it is an imposition," said the policy co-author Dr. Jorge Gomez, a pediatrician at the University of Texas Health Science Center in San Antonio. "A little is better than nothing. You don't have to play with your child every day, but on your day off, make a point of doing something outside with your child," including taking a walk, flying a kite, or playing ball.

The World Health Organization has declared obesity as a global epidemic having major health implications in 1997. A recent report published in the April 5 issue of the Journal of American Medical Association had revealed that obesity levels are peaking in American children.

The report, based on National Health and Nutrition Examination Survey (NHANES), conducted during 2003-2004 took the height and weight measurements of 4,000 U.S. children and adolescents and found that 33.6 percent of children and adolescents were overweight in 2003-04. This figure was worse as compared to as compared to about 28.2 percent in NHANES 1999-2000 study.

Sedentary lifestyle practices are the main reason behind this explosion of overweight or obese children. Obesity brings with it a lot of associated problems like type 2 diabetes mellitus, hypertension, obstructive sleep apnea, nonalcoholic steatohepatitis, heart disease, poor self-esteem, and a lower health-related quality of life. It is noted that type 2 diabetes is at an all-time high in American children.

The AAP policy report concludes by saying that prevalence of pediatric obesity has reached epidemic proportions and it would be unfair to expect medical profession alone to solve the problem. "The promotion of decreased caloric intake and increased energy expenditure will need to take place within all aspects of society," the report says.

The report recommends that community and school programs aimed at getting children active are to be instituted. Physicians should encourage "healthy nutrition, reducing sedentary time, and increasing physical activity levels while providing education and health supervision about regular physical activity and reduced sedentary time to families in their practices."

The policy advocates the allocation of more funds in order to study the implications of childhood obesity. It adds that there should also be a development and implementation of a school wellness counsel on which local physician representation is encouraged.

For the full AAP policy guidelines, visit

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