Thursday, June 24, 2010

Getting Kids to Move -- Try Some of These Tips

From Medscape Internal Medicine

Felicia D. Stoler, DCN, MS, RD

I am a registered dietitian and exercise physiologist, and we are recording this video from the American College of Sports Medicine's annual meeting in Baltimore. What I would like to speak with you today about is the topic of childhood obesity, and, specifically, I would like to address exercise and childhood obesity because diet and exercise are the least expensive, least invasive, and most effective ways to prevent and treat disease, but it is up to you as a physician to instruct your patients and inform them that they need to do the exercise.

In making recommendations to parents about their kids, the easiest thing to do is start with asking the question of what is it that you are doing now, because when you are making a recommendation to change a behavior, you need to know what the behavior is.

With exercise, I like to always start with the basic, which is walking, and most people can walk anywhere. It does not involve a lot of cost and it is something that most of us can do, So, increasing steps -- how do we increase steps? Maybe recommend a pedometer, which can be a low-cost item and can actually be something that is fun for a family to do. Have a parent and child clip on a pedometer, measure their steps, and see how many steps they take every day. And can they increase that? Then, you could turn that into a lesson: How far did we walk, or did we walk across our city, or did we walk across the state?

That is a really simple thing to start with, like going to a playground and exercising or running around and playing -- putting the play back in the playground. Even for a parent to get on a swing with a child, I know for myself as a parent, when I started pumping my legs on a swing, I realized, "wow, this is a really great workout." I also realized that maybe I cannot hold myself up on a monkey bar anymore either, and that was something to work towards as a family. So, when I am having fun with my kids playing in the playground, it sets a good example.

Asking parents to lead by example is really important. It is not just running around and playing because I told you to. I need to do that as well. So, when speaking to parents about what their kids do, maybe it is also speaking to the parents about what they do and how they can be more active as a family.

Something else that is really easy and simple to do is just to put on music in your house and dance -- and dancing with your kids and letting them get up and move and feel the music, and -- hopefully it is a safe environment in your home -- so that is something that is real simple that does not cost anything. That is a way of increasing physical activity.

Using the term "physical activity" is something I have noticed over the years of counseling that is really key. When you say the word "exercise" to parents and to others, they get very intimidated. That word somehow means something that involves excessive perspiration and a very high out-of-breath heart rate, and wearing some skimpy clothes. So in speaking with your patients about physical activity, it is really important to emphasize that every little bit counts. So every 5 minutes or 10 minutes, it all adds to the big number of 30-60 minutes a day that you should be recommending that families exercise and do physical activity.

Now, I know that you are telling your parents that their kids should not be watching more than 2 hours of television a day, or as I like to say, less than 2 hours of technology time, but if kids are watching TV, you can ask parents to think about commercial breaks as an opportunity to get up and do some exercises. Instead of flipping the channel to find something else on TV, can you get up and do jumping jacks? Can you do push-ups? Can you do sit-ups? Can parents and kids do squats and lunges? These are things that, again, do not have to take up a lot of time. You do not need other resources or equipment to do that, and it can be done while you are doing something else. As a clinician, I find that very helpful.

I know that parents welcome the opportunity to learn about ways they can increase their physical activity -- the way they can get their kids to be physically active and make it fun and make it easy. You know, if I have to ask them to go someplace else to do it, they may not be apt to doing that. So, another way to encourage physical activity is that parents and families can go to parks and playgrounds to look for recreational things to do. Obviously, there is the playground setting, but a lot of parks have trails, and some have fitness trails. Sometimes just walking with kids or going on a hike can be a lot of fun and good exercise for the whole family to do together.

If people live in areas where they can bike safely, that is another great exercise, especially for kids. They enjoy it. As a parent and as a mom, what I have learned is that my kids love biking, and as they have gotten older, what has been really nice for them is that they have learned how to bike for longer distances, so we sometimes make a destination to go someplace. While it may not be safe to bike in my community, we will take our car someplace where it is safe, and we then bike together.

The important thing for you as a physician is to make sure that you make the recommendation and make the suggestion, because if you do not make it, the parents will not know.

http://www.medscape.com/viewarticle/723397?src=mp&spon=9&uac=71630FV

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