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Prevention of Pediatric Obesity

According to the American Academy of Pediatrics, the prevalence of pediatric obesity has reached epidemic proportions. The AAP recommends this easy way to remember the best plan for a healthy lifestyle: 5,2,1,0

5—Take in 5 servings of fruits and/or vegetables daily
2—Limit all total screen time to less than 2 hours per day
1—Incorporate 1 hour of activity into every day
0—Avoid sugar sweetened beverages (such as juice, soda, sweet tea, sports drinks)

As part of promoting a healthy lifestyle, physical activity should be instituted at home, in the community, and at school. At PAMPA, we encourage parents and caregivers to limit sedentary activity and to emphasize physical activity and sports that are consistent with the developmental level of the child. Children can increase their physical activity levels in many other ways during school and nonschool hours, including active transportation (such as walking or biking), unorganized outdoor free play, personal fitness and recreational activities, and organized sports. Parents of children in organized sports should be encouraged to stimulate their children to be physically active on days when they are not participating in these sports, and to not rely solely on their sport of choice to provide all their away-from-school physical activity. This should include participation in physical activities with the entire family. Below are guidelines from the AAP for different age groups.

Infants and Toddlers
Exercise programs or classes for infants and toddlers can be a means of promoting increased physical activity or preventing obesity in later years. The AAP has recommended that children younger than 2 years not watch any television. Encourage a safe, nurturing, and minimally structured play environment for infants. Infants and toddlers should also be allowed to develop enjoyment of outdoor physical activity and unstructured exploration under supervision. Such activities include walking in the neighborhood, unorganized free play outdoors, and walking through a park or zoo.

Preschool-Aged Children (4-6 Years)
Encourage free play with emphasis on fun, exploration, and experimentation while being mindful of safety and proper supervision. Preschool-aged children should take part in unorganized play, preferably on flat surfaces with few variables and instruction limited to a show-and-tell format. Appropriate activities might include running, swimming, tumbling, throwing, and catching. Preschoolers should also begin walking tolerable distances with family members. In addition, reducing sedentary transportation by car and stroller and, as applies to all age groups, limit screen time to <2 hours per day.

Elementary School-Aged Children (6-9 Years)
In this age group, children improve their motor skills, visual tracking, and balance. Continue to encourage free play involving more sophisticated movement patterns with emphasis on fundamental skill acquisition. There is little difference between the sexes in weight, height, endurance, and motor skill development at this age; thus, co-ed participation is not contraindicated. Encourage children to walk, dance, jump rope, or participate in organized sports (soccer, baseball). Sports should have flexible rules and short instruction time, allow free time in practices, and focus on enjoyment rather than competition. These children have a limited ability to learn team strategy. 

Middle School-Aged Children (10-12 Years)
Preferred physical activities that focus on enjoyment with family members and friends should be encouraged as with previous groups. Emphasis on skill development and increasing focus on tactics and strategy as well as factors promoting continued participation are needed. Participation in complex sports is more feasible as visual, verbal and motor skills are more developed. Parents should be mindful that puberty may begin at different rates, making some individuals bigger and stronger than others. 

Adolescents are highly social and influenced by their peers. Identifying activities that are of interest to the adolescent, especially those that are fun and include friends, is crucial for long-term participation. Physical activities may include personal fitness preferences (eg, dance, yoga, running), active transportation (walking, cycling), household chores, and competitive and noncompetitive sports. Ideally, enrollment in competitive contact and collision sports should be based on size and ability instead of chronologic age. Weight training may be included, and as the individual reaches physical maturity, longer sets using heavier weights and fewer repetitions may be safely pursued while continuing to stress the importance of proper technique.

This article was written by Dr. Julia Worly
on behalf of PAMPA

© 2011 Pediatrics and Adolescent Medicine.
PAMPA is a pediatric medical practice in north Atlanta, Georgia consisting of twelve pediatricians, five nurses,
and four locations in Roswell, Woodstock, Atlanta, and Marietta. area.
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