Taking the pulse–do exercise programs get kids in shape?

New York Times blogger Gretchen Reynolds, in her Oct. 3, 2012, piece, Do Exercise Programs Help Children Stay Fit?, profiled a recent British journal article that shows such weight-reducing and health-promoting efforts from the past two decades have flopped. (Scroll below to take a quick one-question pool on this very question.)

Citing the study published by Brad Metcalf and colleagues in the August 2012 edition of the journal BMJ (a journal accessible to all users), Reynolds reports that the authors found that “programs almost never increase overall daily physical activity. The youngsters run around during the intervention period, then remain stubbornly sedentary during the rest of the day.”

Two decades of interventions to help kids move more and weigh less may be failing.
Two decades of interventions to help kids move more and weigh less may be failing.

The British team of researchers from the Peninsula College of Medicine and Dentistry in England found 30 acceptable studies that met their criteria for examining if exercise interventions for kids work. The articles reviewed were published between January 1990 and March 2012. According to Reynolds, the programs simply failed to do what they were supposed to do: get young people to move more.

The article said their data covered 14,326 participants–6,153 with accelerometers that measured physical activity. The authors concluded that interventions “had only a small effect (approximately 4 minutes more walking or running per day) on children’s overall activity levels. This finding may explain, in part, why such interventions have had limited success in reducing the body mass index or body fat of children.”

An accompanying editorial  by Sally and Richard Greenhill notes that current United Kingdom guidelines state that all children and adolescents should have 60 minutes of moderate to vigorous exercise a day. And in the United Kingdom, only a third of boys and a fifth of boys are meeting those guidelines. In the United States matters are worse, and kids’ levels of inactivity now ranks as harried parents’ No. 1 concern, according to an August 22, 2012, USA Today story. Yet, parents appear to be a big part of the problem, too, along with ubiquitous and highly, highly, highly addictive technology. Nearly six out of 10 children spend less than four days a week playing outside because “parents find it more convenient to spend time in front of a television or computer.”

Times writer/blogger Reynolds quoted Frank Booth, a professor of physiology at the University of Missouri-Columbia, who worked on the meta-analsysis in the BMJ: “So if structured classes and programs are not getting children to move more, what, if anything, can be done to increase physical activity in the young? It’s a really difficult problem.”

Such a finding begs the question: Do interventions to promote physical activity work, or are they a waste of time and resources?

Maine’s Efforts: Cutting Edge or a Good Idea Needing a Makeover?

The Let's Go program in Maine is one of many in the United States trying to get kids to exercise for an hour daily.
The Let’s Go program in Maine is one of many in the United States trying to get kids to exercise for an hour daily.

One influential program, that combines exercise with nutrition and is being duplicated across the country, is the Let’s Go! 5-2-1-0 program from Maine. This stands for:

5 – fruits and veggies,
2 – hours or less of recreational screen time,
1 – hour or more of physical activity, and
0 – sugary drinks, more water, and low-fat milk [editorial note, I find the promotion of milk as a drink for kids questionable, given the inordinate influence of big agri-business on the U.S. Department of Agriculture and the availability of other fortified, non-dairy drinks].

Let’s Go! founders claim the program is successful and is grounded in three principles: 1) changing environments and policies; 2) consistent messaging across sectors–like “5-2-1-0”; and 3) approaches that use science and are recommended by the medical community.

Places as diverse as Kentucky and Hawaii are attempting to duplicate this program, despite apparently non-conclusive evidence of its efficacy.

Maine launched the program in response to the obesity epidemic (as of 2005, more than 60% of all adults in Maine reported being either overweight and 36% of kindergarten students, 26% of 6th-8th graders, and 29% of 9th-12th grade youth were reported being overweight or at-risk for overweight).

According to the program’s own evaluation of its efficacy tackling issues such as weight, the prevalence of overweight and obesity among children decreased from 33% in 2006 to just 31% in 2009 and was not statistically significant. However, among females, between 3 and 5 years, a smaller proportion were overweight and obese in 2009 compared to 2006 (25% vs. 31%). In short, this confirmed the findings from the BMJ study.

But what do you think?

Walking and why it is the secret to longevity and happiness

This week, a physical education columnist with the New York Times named Gretchen Reynolds was all over the radio. In 48 hours I heard her interviewed by Terry Gross of Fresh Air  and then interviewed by the BBC World Service. She has published a book with a catchy title called The First Twenty Minutes. It appears to be catching fire.

I liked a lot of the things she was saying, and how she communicated. Reynolds is a communicator attempting to take peer-reviewed journal articles, which to nonscientists are impenetrable with graphs and meaningless numbers and confusing P values and unconnected to their lives, and make them fit into the larger problems this country faces with the obesity and overweight epidemic. I applaud her for calling attention to this problem that is bankrupting our medical system and leaving tens of millions of Americans unable to live more productive, happier lives.

I caught most of her interview with Gross, and while upbeat, I found some of the discussion on the health benefits of activities like standing up often while sitting to be out of touch with larger systemic issues causing the health crisis that led to two-thirds of this country to become obese or overweight.  Encouraging people to do minor things is not asking anything resembling sacrifice or commitment, which is what is required both in a personal sense and a larger policy sense. It is as if we have completely dumbed down all of our messaging to the lowest denominator. But then again, Reynolds is someone making a living as a writer and health expert — and selling a popular message as a product is critical to success.

Instead of the media talking to experts about whether 30 minutes of exercise is  good enough to keep us healthy, media should be talking about the primary reasons why people aren’t exercising—the overconsumption of TV and screen use, the built environment that promotes the utter dominance of the internal combustion engine, and the failure of each individual to take ownership for their health from the food they eat to how much they move their bodies. (And, yes, I know it is more complicated than this, especially for many minorities and lower-income Americans, but these factors matter a lot).

I was delighted, however, that Reynolds praised the health benefits of walking. She rightly called walking the single best exercise that exists on the planet and what humans are built for. She is right. It reduces your risk for heart disease and diabetes, and it apparently increases memory capacity in mammals (makes sense, blood flow stimulates oxygen and chemicals produced by the body to be delivered to the brain). As for me, there is no better exercise in the world than walking. A walk anywhere, anytime, in any weather, beats sitting on my butt and not walking at all. I feel healthy, happy, and more level-headed after a walk. I just wish more Americans could embrace walking and voted to support measures that promote walking – sidewalks in neighborhoods, parks and trails – and support politicians who want to change how we deal with public transportation funding in this country. Even one of the biggest promoters of lopsided transportation priorities, the car- and petroleum-friendly federal government, notes that a tiny sliver (0.7%) of federal transportation funds are spent on improving pedestrian facilities.

Maybe we need what Scotland has, the right to roam about in a responsible way (yeah Scotland).

Walking the Coastal Trail in Anchorage on a lovely summer night.
My favorite place to walk in Anchorage Alaska, along Westchester Lagoon.