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Children Worldwide Aren’t Getting Enough Exercise — Here’s What We Can Do About It
By Matt Berger
It's not just kids in the United States.
Children worldwide aren't getting enough physical activity.
That's the main conclusion of a new World Health Organization (WHO) study released Wednesday.
The researchers report that slightly more than 80 percent of adolescents ages 11 to 17 were insufficiently physically active in 2016.
WHO says it's the first global estimates of adolescents' physical activity levels, a major factor in obesity, diabetes, and other health problems.
How rich the country was didn't matter much, although nations in the Asia-Pacific region had the highest rates of insufficient physical activity, at 89 percent.
What did matter was gender.
On average, girls got less physical activity than boys. That includes the U.S., where the discrepancy was more than 15 percentage points.
The percentage of boys getting enough physical activity actually increased slightly between 2001 and 2016, while the percentage of girls stayed the same.
A Global Problem
Overall, experts say, the study paints a picture of a global "pandemic" of insufficiency that will require a multipronged and perhaps even cross-border approach to rein in.
"In relation to the high levels of inactivity in so many countries, the decreases (in some countries) are still relatively small and levels are still high in most countries," Regina Guthold, Ph.D., a scientist with WHO's noncommunicable diseases department and the study's lead author, told Healthline. "A lot of work remains to be done."
Guthold says those small decreases could be due to actions such as school programs, increased participation in sports, creating new places for activities, and increased awareness of the importance of physical activity through education and media campaigns.
But, she said, "These actions seem to only have reached boys, not girls."
A Gender Problem
In the United States, the overall percent of adolescents getting insufficient physical activity dropped from about 76 percent to 72 percent.
But that was largely driven by improvements in boys. Girls remained around 80 percent.
Guthold points to potential flaws in certain efforts to increase physical activity levels.
Organized sports or after-school programs may primarily reach boys. Girls may not feel as safe as boys in places such as public parks.
"To increase activity levels in girls, and close the gender gap, it will be very important to develop strategies that specifically address girls' physical activity behavior," she said.
Some Cautionary Words
There are two important aspects to be noted in the study, experts say.
One, the data is self-reported, notes Dr. Scott Kahan, MPH, director of the National Center for Weight and Wellness in Washington, DC.
"This is an important study in that it gives us additional data across dozens of countries to help inform the long-term planning and goal of addressing inadequate physical activity," Kahan told Healthline. "At the same time, we have to take the data with a grain of salt."
He says that in countries like the U.S., the increased messaging about the importance of physical activity may be leading to an unintended complication.
"It begs the question, do these results suggest adolescents are moving more, or that they recognize that it's important to move more and therefore they say they're moving more?" Kahan said. "This is a common challenge with self-reported survey data."
The other issue is that the 2001 numbers were already so high: 85 percent for girls globally and 80 percent for boys.
"When you have 80 percent of kids who are inactive, it gets kind of hard to have much more than that," said Dr. Blaise Nemeth, a pediatric orthopedist at the University of Wisconsin School of Medicine and Public Health who has served on the American Academy of Pediatrics' Council on Sports Medicine and Fitness.
Making Exercise More Fun
On the gender discrepancy, Nemeth told Healthline that in addition to gender norms and rules keeping girls from physical activity in some countries and families, it "suggests that girls don't have the same opportunities as boys to be physically active when they're younger."
He also connects that idea to recent revelations about Nike's athlete training programs.
Part of those stories is that current training — beyond just at Nike — is often based on the physiology of male bodies.
That ties in to some possible solutions.
"The number one factor for kids participating in sports is that what they're doing is fun," Nemeth said. "Physical activity has to be something we're enjoying."
Beyond making sure it's fun, "to make change on this is going to require a societal shift in how we view physical activity — from something to lose weight to something for overall good health," he said.
Starting at the Top — and Bottom
Kahan says that tackling insufficient physical activity requires an approach similar to that used against problems such as tobacco use: both bottom-up and top-down.
"This is the only way we've made progress on a host of other pandemics," he said.
Bottom-up would include building knowledge among parents, teachers, and others so they can inform and encourage children to be healthy.
Top-down would be decreasing barriers to physical activity. That could include things such as building more gym time into school life and addressing the environment, so cities are more walkable and have more places and opportunities for physical activity.
Guthold notes that the lack of those two possible solutions in some countries may be contributing to their exceptionally low physical activity levels.
In South Korea, for example, 97 percent of girls and 91 percent of boys didn't get enough physical activity.
Guthold speculates that in such countries, those rates could be due to a strong focus on academic achievement at school at the expense of promoting physical activity.
She also points to the built-in environment in countries like South Korea with high urban density.
"Increased traffic and environments that are not safe for walking or cycling might be another explanation, particularly in big and growing cities," Guthold said.
To really know how active kids are and how the factors around them affect that, we'd need more and better data, though.
That's expensive, particularly in developing countries, but it can be done with tools like accelerometers and pedometers, Kahan says.
Then, instead of self-reported data, we'd have better information "so we know where we stand and what trends are and how much resources are needed."
"This pandemic of inadequate physical activity is an aspect of modern life," he said.
Technology makes physical activity less necessary, either for work or fun, and factors such as sprawl only add to that, Kahan says.
"It all sets the stage for physical activity, obesity, and diabetes pandemics," he said.
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