21st Century PE outcomes: Are Children Fitter, Fatter or Fazed

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"21st Century PE outcomes Are Children Fitter,
Fatter or Fazed?"

• Tom CUDDIHY PhD.
• QUT Australia
• TAIWAN, Dec. 2005

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Queensland to Taiwan December 2005


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The Fattening of the Developed World

• At least one in three Australians and other
  westernized countries citizens are overweight or
  obese
• Fat free and sugar free foods are in abundant
  supply yet peoples weight continues to increase
• The fitness push by the authorities has not
  slowed the obesity epidemic among youth

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Why?

• We have found many ways to avoid physical
  activity and this is to the detriment of our
  health.
• We now fail to see another option (movement)
  even when it is right under our noses.

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Count the Fs in this paragraph

• FINISHED FILES ARE THE RE-SULT OF MANY YEARS OF
  SCIENTIF-IC STUDY COMBINED WITH THEEXPERIENCE
  OF MANY YEARS.

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Count the Fs in this paragraph

• FINISHED FILES ARE THE RE-SULT OF MANY YEARS OF
  SCIENTIF-IC STUDY COMBINED WITH THEEXPERIENCE
  OF MANY YEARS.

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How much physical activity is enough?

• The correlation between pa and C-V fitness is
  approx. r 0.35
• We have data from different parts of the world
  which indicate that childrens pa levels are
  extremely variable.
• Mean data imply that levels of pa does not drop
  off during the ages 5 to 12 years. BUT!! Great
  variability

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Statements of P.A. Guidelines
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Physical activity andschool aged children

• Data on 1200 school age youth in 3 countries
  (aged 6 to 12 yrs)
• Pedometer step counts and BMI
• Data gathered using the same protocol Data
  gathered in Autumn

Vincent, Pangrazi, Raustorp, Tomson, Cuddihy.
(August, 2003). Activity levels and BMI of
children in the U.S., Sweden, Australia.
Medicine Science in Sports Exercise.
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Sweden Australia USA
Boys
Girls
most active
most active third
least active
least active
AGE in Years
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Adolescent pa behaviour?
Previous research concerning primary school boys
daily steps has shown that they take an average
of 14400 3400 steps. No significant difference
existed between the ages of 6 and 12 years.
Girls daily steps were reported by the same
researchers as 11500 3100 steps (Vincent et
al., 2003 MSSE).
This daily movement time may be translated as
approx. 115 to 144 minutes. (Tudor-Locke et al.,
2003). A sig. negative correlation was shown of r
-0.3 between Daily steps and BMI. (Vincent et
al., 2003 MSSE).
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Questions addressed!

• Are daily steps of boys aged
• 13 to 15 years significantly different from
• those reported for boys aged 6-12 years?

2. Do daily step differences occur between young
males aged 13 to 15 years? 3. Does BMI have any
relationship with their daily steps?
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RESULTS
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No significant correlations between daily steps
and BMI

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N 1348 boys (gt 100 per age group)
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Most Active Tertiles
Boys Age
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Differences between Most Active and Least Active
Tertiles
Boys Age
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Intra-individual variability over 4 days
Mean 5150 Sd 3150 N 778
Mean 5950 Sd 3650 N 758
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Differences between Most Active and Least Active
Tertiles
Gap 6000 steps Gap 10000 steps
Boys Age
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CONCLUSIONS
The decline in daily steps for boys is sig.
by Year 10. Their average movement time equates
to approx. 110 minutes.

Students in the most active group do not show
this decline. However, in contrast those in the
least active group experience a daily movement
time which is 100 minutes per day less than
their active peers OR less than 50.
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IMPLICATIONS
We must halt the trend evident in our schools
of the Rich getting Richer and the Poor
getting out of the picture also reflected in
the high drop out rates seen in organised
sports.

As a proven and recommended strategy, a quality
daily physical education program would go a long
way toward making a difference.
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Long Term Fatness and Fitness effects
Max. O2 Uptake (Ml/Kg/min)
Sum of skinfolds (mm)


P lt .05





Very hard Intensity Activities (mins)
BMI
Amsterdam Growth Health Longitudinal Study,
Ferreira et al. 2005)
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Girls - Overweight/Obese
Using International standards from Cole, et al.,
Br. Med. J. 3201-6, 2000.
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Boys - Overweight/Obese
Using International standards from Cole, et al.,
Br. Med. J. 3201-6, 2000.
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BMI (kg/m2) Gender and pa levels
Least Active
O/Wt
Most Active
AGE
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Prevalence of overweight and obesity in 15 year
old boys and girls in selected countries
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Prevalence of overweight and obesity in 10 year
old boys and girls in selected countries
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Physical self esteem and pa levels
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Self-esteem, self-concept, body image, body
dissatisfaction

• Physical appearance and social acceptance have
  important impact on self-worth.
• Poorly understood, particularly transition to
  adolescence.

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Interactions among fatness, fitness and physical
activity sample scenario
Overweight/obese children are less proficient in
motor skills and health-related fitness Decreased
likelihood of experiencing success in performance
of physical activity and sport Less likely to
engage in the above, in favour of inactive
behaviours Result poor perceived competence?
Motivation for physical activity and sport?
Discontinuation of activity?
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Focus Group Comments

• Low Perceived Competence in PA Gp.
• In response to try new pa or sport?
• I dont think so --I mean you would be trying
  totally different parts of your body and muscles
  and things like that OR Id keep thinking
  people are going to blame me for whats going
  wrong and I wouldnt want to stay?

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High Perceived Competence

• In contrast, the High Perceived Competence in PA
  Group
• In response to try new pa or sport?
• Sure I love to learn new skills OR
• The workplace has an emphasis on multi-skilling
  so you cant afford to get stuck with one set of
  skills and remain where you always have been.

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Vigorous pa Competence effects
Hi vs Lo P lt .05

Days
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Moderate pa Competence effects
Hi vs Lo P lt .05

Days/wk
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Bone Mineral Density

• Dual Energy X-ray
• Absorptiometry (g.cm-2)

• Measurement Sites
• Femoral Neck

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Skeletal Health and Perceived Competence

Grams
ns

p lt .05 Mean data, n 25
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The Fitness Pushhas failed obese kids

• For 45 years, countries (USA, China) emphasized
  fitness as a way to fight obesity, however,
  obesity continues to increase.
• This approach has failed because children and
  most adults do not buy in to fitness
• Are children active because they are fit or fit
  because they are active?

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Why Doesnt Fitness Work for Those Who Need It
Most?

• It has been forced on youth, creating a backlash
  when kids become adults no locus of control
• It has created a hierarchy of good to poor
  activity
• Teachers and students havent understood the
  genetic limitations of participants
• Unrealistic standards were set One for all

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Mass Prescription It Fails the Majority of Youth

• Assumes all people need the same workload
• Assumes a small set of exercises is appropriate
  for many different sizes and shapes of people
• Assumes we know the correct workload for all
  students
• Takes away exercise independence the intrinsic
  motivation to keep active

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Helping Obese Children

• It takes a village to succeed
• Overweight children can be served by physical
  education
• Obese youngsters may be better left to health
  experts
• Screening is the most important phase of the
  program
• It is better to not try than to try and fail

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National Assoc. for Sport and Physical Education
(NASPE) (1998).
All children should try to engage in at least 60
minutes of appropriate physical activity and up
to several hours during most, if not all, days.
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National Academy of Sciences Institute of
Medicine

• some benefits can be achieved with a minimum of
  30 minutes of moderate physical activity most
  days of the week. However, 30 minutes per day of
  regular activity is insufficient to maintain body
  weight in adults in the recommended body mass
  index range...
• 60 minutes of daily moderate intensity physical
  activity is recommended, in addition to the
  activities required by a sedentary lifestyle.

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IASO Stock Conference (2002)

• There is compelling evidence that prevention of
  weight regain in formerly obese individuals
  requires 6090 minutes of moderate intensity
  activity or lesser amounts of vigorous intensity
  activity.
• Although definitive data are lacking, it seems
  likely that moderate intensity activity of
  approximately 45 to 60 minutes per day, or 1.7
  PAL (Physical Activity Level) is required to
  prevent the transition to overweight or obesity.

Saris et al. Obes Rev (2003)
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Implications

• to be effective for prevention of weight gain,
• PA recommendations may need to be
• 80 min/day of low-moderate intensity, OR
• 60 min/day of high-moderate intensity, OR
• 45 min/day of vigorous intensity.

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Cut points (Steps/day) for age and gender
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Health weight pa duration steps/day for children
(Tudor Locke et al, 2004)

• The selected cut points representing the
  likelihood for a child to belong to the group of
  healthy weighted participants for steps/day in
  6-12 year olds were-
• Above 12,000 steps/day for girls and
• Above 15,000 steps/day for boys
• Even those students classified as
  overweight/obese take more than 10,000 steps/day
  (Adult recommendation)

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Conclusions (Tudor-Locke et al., 2004 Pred Med)

• These steps/day recommendations translate to
  approximately 120 150 minutes per day of
  activity.
• These recommendations are higher than previously
  suggested normative standards but are not
  inconsistent with recent advances in our
  understanding of pa needs in youth.
• A weakness of this recommendation is that pa is
  NOT the only contributor to weight status.

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Summary

• During the last 30 years big ? in pa knowledge
• Many different pa guidelines
• Appear to conflict but in reality do not.
• Some supersede previous statements while others
  have different purposes
• Health vs weight maintenance

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Summary

• Physical activity in clearly defined contexts
  such as active transport, school PE and organised
  sports is declining in many countries
• Young people would like to be active but are
  often constrained by external factors such as
  school policy, teacher style, curricular
  priorities, parental rules re. safety and
  convenience and physical environmental factors.

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Summary

• Children may be less fit in terms of capacity to
  reproduce vigorous physical activity
• They are fatter than previous generations
• On average they lose confidence in their ability
  to be involved in different physical activity.
  Over time this leads to less pa involvement and
  they become fazed about pa in general.

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The End!
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Dose-response for weight management
Minimum Dose for weight-loss ACSM (1978) 900
kcal.wk-1 ACSM (1995) 1000 - 2000
kcal.wk-1 ACSM (1998) minimum 3d.wk-1 _at_ 250-300
kcal/session Rippe Hess (1998) 1500-2000
kcal.wk-1 ACSM (2001) 2.5h/wk minimum up to
3.3-5h/wk of moderate PA
Response
Minimum Dose for maintaining weight-lost Pavlou
et al. (1989) 1500 kcal.wk-1 Ewbank et al.
(1995) gt 1575 kcal.wk-1 maintained 76 gt 2000
kcal.wk-1 maintained gt85 Schoeller (1997) 3.4
kcal.kg-1/d 80min/d Weinsier et al. (2002)
4.0 kcal.kg-1/d 77min/d
Dose
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Importance of obesity in the growing years why
only a recent issue?

• Research expertise in body composition assessment
  has traditionally related to adulthood.
• Models developed in adulthood are not simply
  translated dynamic nature of change in body
  size, proportions, body composition and
  maturation of young people.
• Simplistic approaches considered the condition
  as a passing stage - one they would grow out
  of.
• Over reliance on quantitative analysis and search
  for simple indicators of complex processes
  tended to blur the sensitivity of children to
  cultural messages they receive and resultant
  behaviours.

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Physical self esteem and BMI levels
Lo
Hi
Hi
Lo
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Physical Activity Patterns