Healthy active living: Physical activity guidelines for children and adolescents Flashcards

1
Q

What is the WHO definition of health?

A

a state of complete physical, mental and social well-being and not merely as the absence of disease or infirmity

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2
Q

How does Health Canada describe “healthy living”?

A

making choices that enhance physical, mental, social and spiritual health

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3
Q

What percentage of children 2-17yo are overweight or obese?

A

26%

41% of Aboriginals

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4
Q

What are some health consequences of childhood obesity?

A
  1. Insulin resistance
  2. Type 2 diabetes
  3. Dyslipidemia
  4. Hypertension
  5. OSA
  6. NASH
  7. Poor self-esteem
  8. Lower health-related quality of life
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5
Q

What are some causes of obesity?

A
  1. Excessive caloric intake
  2. Sedentary behavior patterns
  3. Inadequate physical activity
  4. Lack of exercise
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6
Q

What is the definition of sedentary behavior?

A

Behaviours associated with low energy expenditure, such as prolonged sitting or lounging in transit or at work, home or leisure

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7
Q

What is the definition of physical activity?

A

Any body movement that works muscles using more than resting energy

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8
Q

What is the definition of exercise?

A

Planned, structured and repetitive PA to condition any part of the body

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9
Q

What is aerobic exercise?

A

Moderate-to-vigorous activity which increases heart rate and sweat production and improves cardiovascular endurance.

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10
Q

What is the benefit of flexibility?

A

Increases muscle/joint range of motion.

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11
Q

What is the benefit of anaerobic exercise?

A

Weight training, improves muscle strength

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12
Q

What is the benefit of high impact weight-bearing exercise?

A

Promotes bone health

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13
Q

What factors can reduce physical activity?

A
  1. Older children
  2. Female
  3. Aboriginal
  4. “Over-scheduled”
  5. Disability
  6. Living in public housing
  7. Extremes of climate
  8. Heavy climate
  9. Local crime rates
  10. Lack of green space
  11. Urban sprawl
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14
Q

What percentage of young Canadians actively commute?

A

24%

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15
Q

What are the benefits of aerobic physical activity?

A
  1. Reduce weight
  2. Reduce visceral/SC abdominal fat
  3. Reduce systemic BP
  4. Improved early markers of atherosclerosis
  5. Improved insulin resistance
  6. Improved type 2 diabetes
  7. Improved NAFLD
  8. Improved sleep disordered breathing
  9. Improved cardiorespiratory breathing
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16
Q

What are the recommendations regarding screen time?

A

None in children <2yo

<1h/day in children 2-4yo

<2h/day in children 5-17yo

17
Q

What are the recommendations for sedentary behaviors?

A

Caregivers should minimize the time children <4yo spend being sedentary during waking hours including prolonged sitting or being restrained for >1h at a time

Limit sedentary transport, extended sitting time, and time spent indoors during the day

18
Q

What are the recommendations re: physical activity?

A
  1. Infants <1yo: physically active several times per day particularly through interactive floor-based play
  2. Toddlers (1-2yo) & pre-schoolers (3-4yo): at least 180m of physical activity of any intensity spread throughout the day, including:
    a) a variety of activities
    b) activities that develop movement skills
    c) progression toward at least 60min of energetic play by 5yo
  3. Children (5-11yo) and youth (12-17yo) at least 60min of mod-to-vigorous intensity physical activity daily, including:
    a) vigorous-intensity activities at least 3 days/week
    b) activities that strengthen muscle and bone at least 3 days/week
19
Q

What are recommendations regarding strength training?

A
  1. > 9yo
  2. Well-supervised
  3. Use small free weights w/ high repetitions (15-20)
  4. Demonstrate proper techniques
  5. Avoid heavier weights
  6. Avoid maximum lifts
20
Q

What are strategies to reduce sedentary activities?

A
  1. Remove TV and computers from the bedroom
  2. Avoid eating in front of the TV
  3. Replace screen time with physical activity
  4. Avoid sitting for prolonged periods of time
  5. Increase active transportation
  6. Families should engage in games promoting physical activity rather than computer games
  7. Engage families to mentor young children so they can develop suitable physical activity skills
21
Q

What are strategies to increase physical activity?

A
  1. Create individual physical activity Rx
  2. Post photos or posters demonstrating families eating together without TV and children involved in active play/dancing during TV shows
  3. Determine child/adolescent access to free play, sports, and high quality school PE. Provide current information about local activities for families, community events, or recreational programs
  4. Increase incidental movement: take breaks from sedentary activities, avoid sitting for prolonged periods, walk throughout the day, take the stairs
  5. Provide educational information in waiting rooms
  6. Encourage inviting an older child to motivate a younger one to adopt recreational PA or sport
22
Q

What are strategies to overcome lack of time?

A
  1. Build activity into each day – active transportation
  2. Take the stairs
  3. Get off bus a stop early
  4. Take PE in school
  5. Play active games with friends
23
Q

What are strategies for overcoming dislike of sports/lack of sport specific skills?

A
  1. Dance, swim, walk or hike with a friend or pet

2. Increase active hobbies/transportation

24
Q

What are strategies for overcoming an unsafe neighbourhood?

A
  1. Dance to music or do a workout video at home
  2. Join the community recreation centre
  3. Participate in PE at school
  4. Take an after-school activity
25
Q

What are strategies for overcoming being out of shape?

A

Start slow - 10 min

26
Q

What are advocacy strategies for healthy active living at the federal level?

A
  1. Mandate socially responsible media to promote PA and reduce inactivity
  2. Modify the 2007 Children’s Fitness Tax Credit to benefit families living in poverty
  3. Continue to provide provincial and municipal funding for sport infrastructure
  4. Continue to provide provincial and municipal funding for active transportation projects
  5. Continue to provide 100% GST rebate for municipality infrastructure HAL-promoting projects
  6. Fund robust PA monitoring and surveillance systems
  7. Fund revisions of early years, child and youth PA guidelines and resources
  8. Create new guidelines/guides for children with special health care needs
  9. Support ParticipACTION free of commercial bias
  10. Maintain Joint Consortium for School Health
  11. Develop and fund suitable PA promotion strategies for First Nations, Inuit and Métis children and youth
  12. Provide sufficient funding for population-based PA- and obesity prevention-related research
27
Q

What are advocacy strategies for healthy active living at the provincial level?

A
  1. Enhance access to recreational facilities during school hours
  2. Enhance access to school gyms after hours
  3. Promote PA before, during and after school
  4. Mandate quality daily PE led by qualified teachers in all schools (kindergarten-grade12)
  5. Implement PE curriculums that emphasize developing knowledge, attitudes, motor and behavioural skills required for healthy active lifestyles
  6. Offer PE classes for everyone, regardless of ability, illness, injury, and developmental disability
  7. Plan adequate resources for program funding, trained PE personnel, safe equipment, and facilities
  8. Ensure safe sport and recreational facilities
  9. Promote active transportation
28
Q

How can physicians and HCP promote HAL?

A
  1. Documenting the number of hours/day spent on sedentary activities by families.
  2. Discouraging the use of screen-based activities for children under two years of age; limiting recreational screen time to <1 h/day for children two to four years of age, and to ≤2 h/day for older children.
    HCP should discuss these recommendations with families.
  3. Counselling families to become more active by finding alternatives to sedentary (ie, motorized) transport, and by limiting time spent simply sitting or being indoors throughout the day.
  4. Encouraging families to keep television sets, video games, cell phones and computers out of childrens bedrooms.
  5. Identifying barriers to the adoption of PA as part of family routine.
  6. Determining sources of PA for family members at regular health care visits, and promoting PA at every well-child or adolescent visit.
  7. Advising parents and caregivers that preschoolers should have an accumulated 180 min/day of PA at varying intensities, and that older children and adolescents should be accumulating at least 60 min/day of moderate-to-vigorous-intensity PA. These goals should include vigorous-intensity activities at least three days/week and activities that strengthen muscle and bone at least three days/week. More information can be derived from the Canadian Physical Activity Guidelines.
  8. Helping parents to become more active role models by building on PA that family members of all ages and abilities can do together as a family routine.
  9. Using anticipatory guidance to ensure that children play outside safely, with appropriate protective equipment (eg, bicycle helmets, personal flotation devices).
  10. Advising parents to support their child’s preferences in sport and recreational activities, provided that they are safe and appropriate to the child’s age and developmental stage.
  11. Encouraging older students to become HAL role models and leaders for younger schoolmates.
  12. Being active role models themselves.
  13. Calculating and plotting BMI trajectories and identifying obesity-related co-morbidities at every well-child or adolescent visit.
29
Q

What should clinicians and their professional organizations advocate for?

A
  1. Regular revisions of the Canadian Physical Activity Guidelines for children and youth, to reflect current, evidence-based recommendations.
  2. Creating Canadian Physical Activity Guidelines for Aboriginal children and youth, and for young people with special health care needs.
  3. Developing and funding strategies to promote PA specific to First Nations, Inuit and Métis children and youth – in collaboration with Aboriginal groups.
  4. Social marketing to promote PA involvement and participation.
  5. The elimination of television advertising that promotes fast food, unhealthy foods and sedentary behaviour during children’s programming.
  6. Establishing a school wellness council, on which local physician representation is encouraged.
  7. A school curriculum teaching students the health benefits of regular PA.
  8. Compulsory, quality, daily PE classes in schools (kindergarten through grade 12) taught by qualified, trained teachers. Also, the provision of a variety of school-related PA in addition to PE, including the protection of childrens’ recess time and extracurricular PA programs and non-structured PA before, during and after school hours.
  9. Accessible community sport/recreation programs where school gyms or local facilities are open before and after regular hours and PA opportunities are available to all children and youth at low or no cost.
  10. Safe recreational facilities, parks, playgrounds, bicycle paths, sidewalks and crosswalks.
  11. Funding quality research on the promotion of healthy active living.