The Physical Inactivity Epidemic: Are Canadian Children at Risk? Claire LeBlanc MD, FRCP, Dip Sport Med

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 yrs vs boys yrs) Girls less active than boys: 30% vs 50% at 5-12 yrs vs 25% vs 40% at yrs Girls - less intense physical activities * Physical Activity Monitor CFLRI

Health Implications of Physical 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 ~ 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:

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 Health - Depression 113,000 Canadian year olds depressed Suicide 2 nd 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 Mental 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):

Canadian Youth Mental Health – Drugs * 1998 grade 10 students > 90% had tried alcohol 43% grade 10’s “very drunk” > 2 x in grade 10’s: 42% MJ, 13% LSD, 6% cocaine, 9% amphetamines * Trends in Health of Canadian Youth. Health Canada 1999

Canadian Youth Mental Health - Delinquency ~ 20% School drop out rate in 1991  Youth violence 106% vs  45% adults * 75,000 youths/yr charged with crimes in Canadian courts * Smart et al J Psychoactive Drugs 1997;29(4):

Canadian Youth Pregnancy * Teen pregnancy dropped between but has increased since % incidence pregnancy y.o. in % year olds continue pregnancy to term * CPS position statement Canadian J Ped 1994;1(2):58-60 reaffirmed Jan 2000

Is Physical Activity the Answer?

P A reduces Hypertension and Osteoporosis 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:

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

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

Why are Canadian Children Inactive? TV, computer, Nintendo Inactive parents Inadequate access to quality physical education classes Lack of recreational facilities

The Battle Against Physical Inactivity Is Not a Solo Fight

Recommendations 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

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