Obesity and physical activity in children

Promoting physical activity

Traditional approaches to addressing physical inactivity have focused on individual awareness and behavioural change. However, it is becoming increasingly well recognized that one’s social, physical, and cultural environments are strong determinants of the extent to which one is active.^3,7,8,10 In a recent survey of primary care physicians (family physicians and community pediatricians, 46% to 48% response rate), more than 70% of respondents identified the obesogenic environment (defined as a physical and social environment leading to lifestyles that encourage consumption of energy and discourage expenditure of energy) in which children live as a substantial barrier to pediatric obesity management.¹¹

Family support has been positively linked to increased physical activity levels, and family-based obesity treatment programs are among the most effective for combating pediatric obesity.^2,3,5,12 For lifestyle interventions to be effective, parents must be encouraged to be positive role models for their children and to incorporate safe physical activities that the whole family can enjoy.^4,7

The school system allows access to the largest proportion of Canadian children, and, as such, could play an important role in improving students’ healthy behaviour. The American Academy of Pediatrics advocates that 30 minutes of recommended daily activity occur during the school day.⁴ Several Canadian provinces have mandated daily physical activity in schools, defending the belief that school communities can provide a supportive environment for students to develop positive habits needed for a healthy, active lifestyle.⁷

Box 1 offers suggestions on tackling barriers to physical activity. For more information and resources, visit www.paguide.com for Canada’s Physical Activity Guides.

Friendly environment

In recent years, much attention has been paid to the ways in which communities can promote, or inhibit, physical activity. The built environment has been defined as “the range of structural elements in a residential setting: housing, roads, walk-ways, density, transportation networks, shops, parks, and public spaces.”¹⁰ The presence, proximity, and accessibility of recreational parks and facilities have been associated with both self-reported and measured physical activity.⁷ Furthermore, Canadian children who live in neighbourhoods with good access to parks, playgrounds, and recreational facilities are more likely to engage in sports with coaches.¹³

Children and their parents often report safety issues as barriers to physical activity.^4,7,10 Factors such as heavy traffic, lack of bicycle lanes, unmarked intersections, and poor street connectivity have reduced the number of children who transport themselves to and from school.¹⁰ In order to encourage active transportation as a means of increasing physical activity, community leaders and urban planners need to address safety and access issues when designing community infrastructure.

The extent to which our children and youth are physically active is influenced by a multitude of complex, interrelated factors. Addressing physical inactivity and its contribution to childhood obesity requires a comprehensive and holistic approach. Primary health care practitioners are well positioned to be leaders in tackling this important issue.¹⁴