The Physical Inactivity Epidemic: Are Canadian Children at Risk?

1
The Physical Inactivity Epidemic Are Canadian
Children at Risk?

• Claire LeBlanc
• MD, FRCP, Dip Sport Med

2
Physical Inactivity Statistics

• 63 of 5-17 y.o. not active enough for optimal
  growth
• Adolescents less active than children 2-12 years
  old (33 vs 43)
• Decline in activity with age and gender (girls at
  14-15 yrs vs boys 16-17 yrs)
• Girls less active than boys 30 vs 50 at 5-12
  yrs vs 25 vs 40 at 13-17 yrs
• Girls - less intense physical activities

Physical Activity Monitor 1999. CFLRI
3
Health Implications of Physical Inactivity

• WHO definition of health comprehensive state of
  physical, psychological, and social well being
• Childhood obesity
• Type 2 diabetes
• Hypertension
• Osteoporosis
• Depression
• Smoking/alcohol/drugs
• Adolescent pregnancy

4
High Blood Pressure

• 3 million USA youths affected
• Associated with obesity
• Tracking from adolescence into adulthood
  established 50 boys, 40 girls
  remained HT 8 yrs later

Anderson and Haraldsdottir J Int Med
1993234309-315
5
Osteoporosis

• 1 in 4 women gt 50 y with osteoporosis
• Annual cost hip fracture treatment 650 million
• Bone accretion in first 20 yrs major factor in
  final bone mass bone health later yrs

Wiktorowicz et al. Osteoporos Int
200112(4)271-8
6
Canadian Youth Mental Health - Depression

• 113,000 Canadian 12-17 year olds depressed
• Suicide 2nd leading cause of injury-related death
  in adolescence
• 35 grade 10 students depressed 1 or more
  times/week in prior 6 months (1998)

Trends in Health of Canadian Youth. Health
Canada 1999
7
Canadian Youth Mental Health - Smoking

• Average age onset smoking ? from 16 to 12 years
  over past 2 decades
• 1998 grade 10 smokers 28 boys, 34 girls
• Weekly smokers unlikely to quit thus become adult
  smokers

CPS position statement Ped child health
20016(2)89-95 Trends in Health of Canadian
Youth. Health Canada, 1999 Kelder et al Am J
Public Health 199484(7)1121-26
8
Canadian Youth Mental Health Drugs

• 1998 grade 10 students gt 90 had tried alcohol
• 43 grade 10s very drunk gt 2 x in 1998
• 1998 grade 10s 42 MJ, 13 LSD, 6 cocaine, 9
  amphetamines

Trends in Health of Canadian Youth. Health
Canada 1999
9
Canadian Youth Mental Health - Delinquency

• 20 School drop out rate in 1991
• ? Youth violence 106 vs ? 45 adults 1986-1991
• 75,000 youths/yr charged with crimes in Canadian
  courts

Smart et al J Psychoactive Drugs
199729(4)369-373
10
Canadian Youth Pregnancy

• Teen pregnancy dropped between 1975-1987 but has
  increased since 1990
• 2.7 incidence pregnancy 15-17 y.o. in 1990
• 52 15-17 year olds continue pregnancy to term

CPS position statement Canadian J Ped
19941(2)58-60 reaffirmed Jan 2000
11
Is Physical Activity the Answer?
12
P A reduces Hypertension and Osteoporosis

• Aerobic exercise reduces systolic and diastolic
  BP in adolescents with hypertension
• High impact exercises during puberty improves
  bone mineral content

Hansen et al. BMJ 1991303682-5 Heinonen et
al Osteoporos Int 2000111010-17
13
Physical Activity Improves Mental Health

• Regular PA may increase self esteem
• Regular PA may decrease anxiety/depression
• Some evidence shows teen girls have lower rates
  of sexual activity and pregnancy when ? PA
• Some evidenced regular PA associated with ?
  smoking, alcohol and drug abuse

K.J. Calfas, W.C. Taylor. Ped Exerc Sci 1994.
6406-423 Sabo et al. J Adolesc Health
199925207-16
14
Physical Activity Improves School Performance

• Positive associations with PA and academic
  performance
• Some evidence good grades same or better with ?
  regular PA despite reduction in academic class
  time
• Regular PA may improve attitudes, discipline and
  behavior

R.J. Shephard. Pediatric Exercise Science 1997.
9113-126 Keays and Allison. Can J Public
Health 199586(1)62-65
15
Why are Canadian Children Inactive?

• TV, computer, Nintendo
• Inactive parents
• Inadequate access to quality physical education
  classes
• Lack of recreational facilities

16
The Battle Against Physical Inactivity Is Not a
Solo Fight
17
Recommendations

• Parents, children, youth, schools, school boards,
  recreation leaders, medical and allied health
  personnel, all levels of government need to work
  together to promote regular PA
• Limit sedentary behaviors (TV, video/computer
  games)
• Parents to lead by example (Family oriented PA)
• PA outside of gym class curriculum
• School and community co-operative efforts
• Policies to ensure safe equipment, facilities and
  routes to and from school
• Policies to mandate daily K-12 quality school
  phys-ed classes by trained specialists

18
Recommendations

• Promote and help disseminate Canadas Physical
  Activity Guide for Healthy Active Living for
  Children and Youth