Magazine 2013
International Peer-Reviewed Journal
RH, VOL. 3 JULY 2013
FOOD & NUTRITION
Green ClothPhysical Activity And Fitness In Children
Rita Patil and S.A.Udipi
ABSTRACT
The importance of physical activity is known in the treatment and prevention of various lifestyle disorders.
Physical activity helps maintain good health. The benefits of physical activity vary from improved
physical fitness, low risk of obesity and other lifestyle disorders like diabetes mellitus, metabolic
syndrome and cardiovascular disease. The intensity, frequency and duration of physical activity are
important aspects as they are also protective against diseases such as osteoporosis, depression, and
anxiety, extending to adults and children. All countries in the world, rich and poor facing the problem of
reduced physical activity and higher incidence of obesity. This review highlights the importance of
physical activity and fitness as well as the factors affecting them. The effects of low activity in children
and also parental encouragement of exercise, level of education, participation in organized sports after
school years and contribution to changes in physical activity patterns are highlighted. Recommendations
for physical activity are suggested. The changes in the type and amount of free play in children are
identified. Therefore special efforts have to be taken to increase physical activity in children. Parents
play a big role in helping kids to remain active. Active behaviours of parents are copied by children.
Thus they can and should encourage children to participate in active sports in school and active play in
leisure time. There is also a need for parents to limit a child’s daily TV and computer time.
Keywords - Physical Activity, Obesity, Disease, Children, Parents.
Physical activity is defined as any physical movement produced by skeletal muscles that result in energy
expenditure whereas; exercise is planned, structured, systematic and purposeful activity (Haskell and Kiernan,
2
000). Physical activity is important in the treatment and prevention of various physical and psychological
disorders (Peluso and Andrade, 2005) and has an important role in all round development of children Byrne and
Hills, 2007).
Physical activity and fitness is affected by gender and socio-cultural factors in childhood and adolescence.
Children appear to become less active as they get older, and show decreases in activity levels during adolescence.
Fitness parameters change before puberty (Keller, 2008).
The term ‘physical activity’ is often used alternately with ‘physical exercise’ and ‘physical fitness’, however
each of them have specific meanings. Fitness involves daily physical activity or exercise (Ortega, 2008). Physical
fitness is the ability to perform daily tasks with ease or without fatigue. It is an integrated function involving
skeletal, muscular, cardio respiratory, neurological, endocrine and other body systems (Deforche et al., 2003).
Physical activity is known to have a positive role in maintaining health. It is reported that regular physical
activity leads to improved physical fitness, reduced risk of obesity and metabolic problems (diabetes mellitus,
metabolic syndrome, heart disease). Regular involvement in physical activity is protective against diseases
such as coronary heart disease, hypertension, noninsulin-dependent diabetes mellitus, osteoporosis, depression,
and anxiety in children (Simons- Morton et al., 1997; Powell et al., 2006; Parfitt et al., 2009). Countries with
lower incomes and lower education levels are equally facing the problem of increased incidence of obesity like
the developed or affluent countries (Kelishadi et al., 2007). It is therefore important to study physical activity
and fitness, and the factors affecting them.
Activities of daily life, such as standing, walking slowly, lifting lightweight objects and climbing stairs are
called baseline activities. They are of light intensity. Those who do only baseline activity are called inactive. The
additional activity like brisk walking, jumping rope, and dancing, lifting weights, climbing on playground
equipment and doing yoga is called health enhancing activity. Each of these activities has its own health
benefits. Aerobic activities are running, hopping, skipping, jumping rope, swimming, dancing, and bicycling.
These activities increase cardio respiratory fitness. Muscle-strengthening activities over loads muscles while
doing work and strengthens the muscles. Playing on playground equipment, climbing trees, and playing tug-
of-war are examples of this type of activity. Bone-strengthening activities promote bone growth and strength.
Running, jumping rope, basketball, tennis, and hopscotch are bone strengthening activities (Shetty, 1997).
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Types of Physical Activity
Inactivity is when there is no activity beyond baseline activities of daily living.
Low activity is activity more than baseline but less than 2 hours 30 minutes of moderate physical activity a week
or 75 minutes-1 hour 15 minutes of vigorous activity.
Medium activity is 150 minutes to 300 minutes of moderate activity a week or 75 to 150 minutes of vigorous
physical activity per week.
High activity is more than 300 minutes of moderate physical activity every week.
(
www.health.gov/paguidelines, 2008).
The intensity, frequency and duration of physical activity are important. Intensity indicates how hard a person
works to do the activity. Moderate intensity is a term used for brisk walking. Vigorous intensity is when a person
is running/jogging. Frequency is how often a person does aerobic activity and duration is for how long a
activity session is.
The benefits of regular physical activity are-
•
•
•
•
•
•
•
Increases lean muscle and decreases body fat.
Helps maintain weight.
Increases bone strength.
Helps to reduce depression, anxiety and improves mood.
Lowers the risk of obesity and other lifestyle disorders.
Relieves tension and stress.
Decreases mortality.
(
Naidu and Sakalkale, 2011).
Overall Mortality
Higher levels of regular physical activity are associated with lower mortality rates among adults. Even
moderate activity on a regular basis results in lower mortality rates as compared with those who are least active.
Physical inactivity ranks fourth on the WHO list of causes of death (WHO, 2009).
Cardio-vascular Diseases
Hypertension causes strokes, coronary artery disease and congestive heart failure in adults. Regular
physical activity can lower both systolic and diastolic blood pressure in adults with hypertension. It appears
that regular physical activity can also lower blood pressure in children and adolescents. Physical inactivity and
poor levels of physical fitness are associated with obesity and coronary heart disease risk factors in children.
Aerobic activity burns calories, reduces weight, decreases the risks of heart disease and high blood pressure.
It also helps to gain stamina and endurance (Byrne and Hills, 2007). Running, skating, cycling, walking, hiking
and jumping rope are examples of aerobic activities (Shetty, 1999). Several studies have reported cardio-
vascular fitness to be better in children who were physically active (Hussey et al., 2001; Gutin et al., 2005;
Stratton, 2007; Burgi et al., 2011). Children should do activities at a brisk and comfortable pace for at least 20
minutes three times per week. Exercises for gaining muscle strength and endurance should be three times a
week after cardiovascular activity as this is also important for children (Brambilla et al., 2011).
Maintains Skeletal Health and Body Composition
Physical activity is necessary for normal skeletal development and is also associated with body fat
levels. Development of bones is at the peak during the pubertal year. Physical activity helps build greater bone
density in childhood as well as maintain peak bone density in adulthood. Regular physical activity regimens
are advised for children and adolescents to maintain and improve bone development (Pitukcheewanont et al.,
2010).
Youth who are relatively high in physical activity tend to have lower skin folds and total body fat. Physical
activity is significantly correlated with body fat by several researchers (Mikkelsson et al., 2006; Ruiz et al., 2006;
Rowland et al., 2006). Fitness is significantly affected by body fat. Lean body mass and physical activity
contributes to good fitness (Ortega et al., 2010; Dencker et al., 2011).
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Social and Mental Development
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Regular physical activity promotes psychological health in children- it improves self-esteem, reduces
anxiety level and stress. It relieves the symptoms of depression and is a mood enhancer. Psychological well-
being has been associated with vigorous and structured aerobic activity in adolescents and children (Crews et
al., 2004; Stella et al., 2005).
Prevents Obesity and Life Style Disorders
The associations between obesity, cardio vascular disease and type II diabetes are well established
today in adults and even in children. Sedentary lifestyle increases the risk of obesity. Reducing sedentary
behaviors like watching television and playing computer games, is important for preventing obesity (Denney-
Wilson and Baur, 2007; Brambilla et al., 2011; Michalopoulou et al., 2011).
Fitness
Physical activity is beneficial for better fitness and preventing obesity (Elnashar and Mayhew, 1984;
Jopling, 1988). Physically active adults had significantly better childhood physical fitness test scores than the
inactive adults. The risk of physical inactivity in young adulthood was significantly related to the low scores in
the run and sit-ups tests as children. Parental encouragement of exercise, level of education, participation in
organized sports after school years and spousal encouragement of exercise contributed significantly to the
physical activity. Therefore physical fitness testing in childhood can help identify those at increased risk of
becoming physically inactive young adults (Dennison et al., 1988).
Sallis et al., (1997) reported that physical activity was significantly associated with fitnesscomponents.
Active childrenappeared to participate in various activities which were beneficial to health-related fitness. Similar
observations were made by other researchers (Prista et al., 2003; Tremblay et al., 2005; Christodoulos and
Flouris, (2006; Trudeau et al., 2009; Zarrouk et al., 2009; Burgi et al., 2011).
Chen et al., (2008) assessed physical fitness and activity in 331 children, aged 7 – 8 years in Taiwan. The
study reported the effect of socio economic status factors and physical activity on fitness. Older children had
significantly better flexibility than younger children. Urban school boys had poor flexibility than rural school
boys. Urban girls also had better flexibility and higher scores than rural girls.
Sedentarism
Sedentarism is defined as purposeful and extended engagement in behaviours characterized by minimal
movement, low energy expenditure and rest (Tremblay, 2010). Sedentarism/physical inactivity is closely linked
to skeletal health, cardiovascular disease risk, fitness and psychological factors. This change is due to rapid
economic growth, modernization, urbanization, globalization of food markets. (Hills, 2009).
Causes of Inactivity
•
•
•
•
•
•
•
•
•
•
Increased TV viewing time.
Reduced physical education in schools.
Lesser time for free play before, during, and after school.
Lack of facilities like grounds, gyms, parks, stadiums.
Increased use of transport rather than walking.
Use of equipment, labor saving appliances such as washing machines.
Lesser physical activity in the workplace due to computers.
Use of remote controls and computers for entertainment and leisure activities.
Use of elevators and escalators.
Reduced outdoor play because of cyber gaming, Internet and chat programmes.
(Shetty, 1999).
TV viewing and fitness of children
Television viewing and playing video games and even a poor participation in sports is a cause of obesity,
as against physical activity which is protective. The link between television viewing and children’s risk of overweight
has been studied and a close association between physical activity and increased levels of obesity among
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children has been reported by Gortmaker et al., (1996); Hanley et al., (2000); Shingo and Takao, (2002); Gray
and Smith, (2003); Jago et al., (2005); Wiecha et al., (2006); Fairclough et al., (2009) and Mota et al; (2010).
Role of family in fitness
An active lifestyle is learnt from the family in early life. Involving children in activities gives them a positive
role model and they can also remain motivated to be active in later life too. The habit of daily physical activity
can be a good alternative to sports. Families have reported that neighbourhood safety and availability of
recreational facilities influence physical activity in children (Floriani, (2007); Telford et al., (2008); Conwell et al.,
(2010).
Role of school in fitness
Schools play an important role in maintaining good physical activity and health. Educational programs
in school can help children to exercise which will be good for their health in later life too. Sallis et al., (1997)
evaluated physical education to increase physical activity in and out of school. They reported that children
were physically active for more time when they were led by experts/ teachers than the control. Manios et al.,
(
1998) reported that children performed significantly better in various fitness tests after three years of health
intervention programme. Simsilar observations were reported by Koutedakis and Bouziotas, (2003); Zahner et
al., (2006); Hesketh et al., (2008) and Lundgren et al., (2010).
Legarde and LeBlanc (2010) reviewed the school environment for physical activity. They suggested that
schools are an ideal surrounding as they can provide a variety of activities to improve physical activity levels in
children. They also suggested interventions which included safe physical education and physical activity,
extracurricular physical activity and active transport to school.
Promotion of active commuting to school can be an important way to increase levels of physical activity
in school children. This was suggested by Panter et al (2011) after studying the associations between active
commuting, levels of physical activity and distance to school in 9–10 year old children. For both boys and
girls, significant positive associations were observed between walking to school and physical activity as well as
in moderate to vigorous physical activity during weekday travel to school. The association was also better
when the distance of the school was longer.
Environmental Factors Influencing Physical Activity
The environmental factors affecting physical activity include availability of activity promoting facilities
(grounds, gyms, parks, stadiums, drive in facilities, elevators and escalators); automation and computerization;
efficient and sedentary transport; cyber gaming, Internet and remote controls (Dietz, 1996; Wen et al; 2003).
Urbanisation and increased mechanisation have led to a decrease in physical activity. It has caused a change
in occupations, life-styles, dietary practices and family structures, (Shetty, 1999). Lack of proper streets and
sidewalks is associated with lowered physical activity and increased risk of obesity. Leisure time has increased
but is spent in television viewing, internet and cyber games resulting in reduced sleeping time (Lopez and
Hynes, 2006).
Other Factors Affecting Physical Activity
Physical activity patterns can vary with ethnicity, gender, age, season and BMI. Rural schools reported
availability of more play area compared to urban schools. However, urban children had accessibility to exercise
equipment at home (Loucaides et al, 2004). Duncan et al., (2008) have reported boys to be significantly more
active than girls.
Conclusion
It is important that children are physically active throughout the week. The American Academy of Pediatrics
recommended in 2006 that children and adolescents should have 60 minutes of physical activity daily. The
United States Department of Health and Human Services also recommended that vigorous physical activity
should be included at least once a week and strength training exercises should be included three days per
week (ADA, 2008). People who participate regularly in physical activity for a longer duration or of high intensity
may receive better health benefits. At the age of five years a child having regular 10 minutes of moderate to
vigorous activity will have 0.2 kg less body fat at 8 years (Janz et al., 2009).
Organized sports are one strategy to have a daily physical activity pattern. Physical activity can be of
varying frequency, duration and intensity depending on the sport it is associated with. Children between 6–14
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years who are involved in sport tend to be more physically active (Wickel and Eisenmann, 2007; Katzmarzyk
and Malina, 1998).
The type and amount of free play in children has changed (Burdette and Whitaker, 2005). Therefore
special efforts have to be taken to increase physical activity in children. Parents play a big role in helping kids
to remain active. Active behaviours of parents are copied by children. They can and should encourage children
to participate in active sports in school and active play in leisure time. Parents should also limit a child’s daily
TV and computer time (Yeung et al; 2007).
Most of the physicalactivity in preschoolers is motor play and therefore the term play should be used to
maintain or increase physical activity in small children. Play aids social,emotional and cognitive development
of children. Regular physical activity in childhood will help children to develop healthy and fitness friendly
behaviors throughout life. Family, health professionals, schools and communities all need to get together and
make an effort to increase the physical activity levels of children. (Burdette and Whitaker, 2005). Thus it will be
useful if physical activity is promoted byencouraging play.
Moderate physical activity for children can be in the form of walking fast, bicycling, jumping, dancing
and playing active games like football, cricket, basketball etc. Walking does not require special facilities. It can
be encouraged for all age groups; males, females as well as for any income group (MacAuley, 1999).
The physical activity pyramid shows the different types of activities and recommendation for them. Physical
Activity Pyramid-
Do Less
Play Computer
games, Watch
TV, Use labor
saving devices.
Recreational Activities
2
-3 days/week
Football, Basketball, Hiking,
Skating, Dancing, Yoga,
Martial Arts
Aerobic Exercise Flexibility Exercise
Strength
Exercise
2-3 days/week
8-10 Exercises
3
-5 days/week
2
-3 days/week
2
0-60 minutes
Running, Cycling,
Stair stepping
Physical Activity
Most Days of the week
Accumulate more than
Take the Stairs
Walk, clean your house.
Play
3
0 minutes
(www.gsu.edu, 1999)
The fast moving lifestyle and the constantly increasing variety of entertainment available is moving children from
active play to being sedentary. Physical activity can be promoted by doing the following-
•
•
•
Increasing the awareness of physical fitness and the importance of physical activity.
Encouraging physical activity at home and schools.
Providing facilities for physical activity.
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