Physical activity in children and the future health of the nation

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Physical activity in children and the future
health of the nation
Dr Z.L. Hudson MCSP PhD Centre for Sports and
Exercise Medicine, Barts the London School of
Medicine and Dentistry, Queen Mary University of
London, UK
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Centre for Sports and Exercise Medicine
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Centre for Sports and Exercise Medicine
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Background

• PA essential for physical and mental well
  being

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Intervention/Prevention

• Cardiovascular disease
• Respiratory disease
• Type II diabetes
• ? Blood pressure
• ? HDL and ? LDL
• Elevate mood in those with depression
• Improve well being

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CMO 2004 Report
Adults 30 minutes moderate intensity 5 times a
week
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CMO 2004 Report

• Adults 30 minutes moderate intensity 5 times a
  week
• For children 60 minutes of moderate intensity
  activity every day to stay healthy

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Game Plan A strategy for delivering Governments
sport and physical Activity objectives
December 2002

• Adults taking 30 mins moderate exercise 5 days
  a week

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Game Plan A strategy for delivering Governments
sport and physical Activity objectives
December 2002

• Adults taking 30 mins moderate exercise 5 days
  a week

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Game Plan A strategy for delivering Governments
sport and physical Activity objectives
December 2002

• Adults taking 30 mins moderate exercise 5 days
  a week

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70
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Game Plan A strategy for delivering Governments
sport and physical Activity objectives
December 2002

• Adults taking 30 mins moderate exercise 5 days
  a week

57
70
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Game Plan A strategy for delivering Governments
sport and physical Activity objectives
December 2002

• Increasing adult activity by only 10 would
  save around 6,000 lives a year in England alone -
  and cut 500 million a year from NHS costs

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20056 Active People Survey

• Adults
• 21 Nationally
• 29.8 Richmond
• 14.5 Newham

Quantile classification   - 14.3 - 19.5
(low)   - 19.6 - 21.2 (low-middle)   -
21.3 - 23.1 (middle-high)   - 23.2 - 29.8
(high)
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2010 more than one third of all children 2-15
will be overweight or obese
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• 90 percent of todays children could be
  overweight or obese by 2050
• We all need to address the rise in obesity
• The importance of health care practitioners
• As trusted advisers, you are influential and many
  in the health service will be the
• first point of contact for young families with
  at-risk children

http//www.nhs.uk/change4life/
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Challenges

• How do we increase activity levels in children?
• How do we evaluate this?

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Research

• Pedometer-defined physical
• activity and body composition
• in 11 to 12 year old children in
• East London. A cross-sectional
• pilot study

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Body Composition

• BMI international childhood BMI classification
  (Cole 2000 BMJ)
• Not based on health risk as for adults
• Evaluated in mainly caucasian children
• Waist Circumference
• Waist-hip ratio
• Skinfold measurement
• Percentage body fat (BIA)

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Physical Activity

• Pedometers
• Accelerometers
• Heart rate monitors
• Questionnaires
• GPS trackers
• Oxygen uptake

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Recruited from entire year 7 group (11-12 years
old). n214
Signed parental consent forms returned. BMI,
waist circumference and percentage body fat
measured. Questionnaire completed. Given
pedometer to wear for 1 week n185, female86,
male99
Pedometer returned n141 (76)
Pedometers lost or not returned during study
period n44 (24)
Data excluded 1. Less than 2 weekday and 2
weekend data (Step count lt1,000 or gt30,000)
n53 (29) 2. Error in measurement of
percentage body fat n2 (1)
Data included for final analysis n86 (46)
male42, female44
Participant Flow Chart
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Results pilot data

• More than a third of all year 7 were overweight
  or obese (Forecasting obesity to 2010)

Physical activity steps per day
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Body Composition
BMIbody mass index WCwaist circumference BF
percentage body fat Classified by the
international age- and sex-specific BMI
cutoffs6 Classified by the age- and
sex-specific WC cutoffs proposed for British
children7 Classified by the age- and
sex-specific BF cutoffs proposed for British
children8
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Discussion

• Low levels of physical activity
• High levels of obesity
• Results at odds with other published studies but
  very different demography
• Target increased exercise on weekdays
• Look at dietary intake
• Longitudinal study needed to establish cause and
  effect

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Challenges

• How do we increase physical activity levels in
  children?
• This is part of a much bigger picture of
  promoting healthy lifestyles
• London 2012 - health legacy was a strong factor
  in the successful bid.

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Solutions examples of local initiatives
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Solutions examples of National initiatives
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National Local

• DoH local PCTs
• Department of Education - local schools
• Town planners the built environment
• Community engagement how to access different
  ethnic groups eg. access to the local Mosque
• ? Incentives for a healthy lifestyle ? tax
  junkfood

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Conclusion

• Numerous local and national initiatives to get
  children moving
• The evidence for physical activity is extremely
  limited in children
• Need for longitudinal cohort studies

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QMUL 2010, 9-11 September
ECOSEP proposes to establish what level of
training in SEM takes place in the Member States
to identify the best standards and to facilitate
Member States in improving skill levels in SEM
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Thank you