The Physical Inactivity Epidemic: Are The Physical Inactivity Epidemic: Are Canadian Children at Risk?Canadian Children at Risk?

Claire LeBlanc MD, FRCP, Dip Sport Med

Physical Inactivity Statistics *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

Health Implications of Health Implications of Physical InactivityPhysical 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

High Blood Pressure 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 1993;234:309-315

Osteoporosis Osteoporosis

1 in 4 women > 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 2001;12(4):271-8

Canadian Youth Mental Canadian Youth Mental Health - DepressionHealth - 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

Canadian Youth Canadian Youth Mental Health - SmokingMental 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 2001;6(2):89-95 **Trends in Health of Canadian Youth. Health Canada, 1999***Kelder et al Am J Public Health 1994;84(7):1121-26

Canadian Youth Mental Canadian Youth Mental Health – Drugs *Health – Drugs *

1998 grade 10 students > 90% had tried alcohol

43% grade 10’s “very drunk” > 2 x in 1998

1998 grade 10’s: 42% MJ, 13% LSD, 6% cocaine, 9% amphetamines

* Trends in Health of Canadian Youth. Health Canada 1999

Canadian Youth Mental Canadian Youth Mental Health - DelinquencyHealth - 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 1997;29(4):369-373

Canadian Youth Pregnancy *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 1994;1(2):58-60 reaffirmed Jan 2000

Is Physical Activity the Is Physical Activity the Answer?Answer?

P A reduces Hypertension and P A reduces Hypertension and OsteoporosisOsteoporosis

Aerobic exercise reduces systolic and diastolic BP in adolescents with hypertension*

High impact exercises during puberty improves bone mineral content**

*Hansen et al. BMJ 1991;303:682-5**Heinonen et al Osteoporos Int 2000;11:1010-17

Physical Activity Improves Physical Activity Improves Mental HealthMental 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. 6:406-423**Sabo et al. J Adolesc Health 1999;25:207-16

Physical Activity Improves Physical Activity Improves School Performance*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. 9:113-126**Keays and Allison. Can J Public Health 1995;86(1):62-65

Why are Canadian Children Why are Canadian Children Inactive?Inactive?

TV, computer, Nintendo

Inactive parents Inadequate access to

quality physical education classes

Lack of recreational facilities

The Battle Against Physical The Battle Against Physical Inactivity Is Not a Solo FightInactivity Is Not a Solo Fight

RecommendationsRecommendations

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

RecommendationsRecommendations

Promote and help disseminate Canada’s Physical Activity Guide for Healthy Active Living for Children and Youth