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Why Pediatricians Are Being Urged to Write ‘Physical Activity Prescriptions’ for Children

Health + Wellness
Doctors report that only 1 in 4 children are getting the recommended 60 minutes of physical activity per day. Ronnie Kaufman / DigitalVision / Getty Images

By Dan Gray

Pediatricians are being urged to start writing "exercise prescriptions" for the children they see in their office.


That's the recommendation of a report published Sunday by the American Academy of Pediatrics (AAP) titled Physical Activity Assessment and Counseling in Pediatric Clinical Settings.

In it, AAP officials encourage pediatricians to go beyond simply recommending that kids get exercise and take the step of actually issuing a prescription for physical activity.

"Currently, most pediatricians recommend that children get 60 minutes per day of physical activity, but this is not commonly elaborated upon or provided as a prescription," Dr. Natalie D. Muth, a co-author of the clinical report who's also a pediatrician and registered dietitian in California, told Healthline.

"Additionally, there is an important opportunity to consider physical activity as a routine part of the treatment plan for many conditions, such as ADHD," she added.

Another pediatrician interviewed by Healthline agrees with the recommendations.

"In reading through the clinical report, what they do is recommend the prescription in the first 2 years," Dr. David Fagan, vice chair of the department of pediatrics at Cohen Children's Medical Center in New Hyde Park, New York, told Healthline.

"I think the reason they are going to that extreme is to promote the idea of physical literacy to impart on a family, even at that early age, the importance of being physically active," he said.

Fagan also notes the report represents a shift toward more directly confronting the rising rates of childhood obesity.

"Previously, we've focused on healthy nutrition in combating obesity and then focusing on kind of eliminating the sedentary behaviors — gaming and things like that," he said. "But this report states that we need to be more proactive in promoting activity."

Sedentary Lifestyles

The AAP points to a few statistics in their report.

For starters, only 1 in 4 children reports getting the recommended 60 minutes of physical activity per day.

Additionally, in their 2017 Youth Risk Behavior SurveillanceTrusted Source, the Centers for Disease Control and Prevention (CDC) found that only slightly more than a quarter of teens in the U.S. are getting the recommended amount of activity per day.

In addition, 15 percent of teens said they hadn't been physically active for even a single hour of the previous week.

The AAP also reports that the average preschooler is sedentary for more than 6 hours a day, and more than 40 percent of schoolchildren spend 3 or more hours in front of a television per school day.

In 2016, the AAP rolled out new guidelines that recommended minimal screen time for young kids and zero screen time for the first 18 months of life.

"Some people may say that it's extreme or not realistic in this day and age, but the emphasis of the message there is that we want children — infants and toddlers — to be on the floor, playing with toys, and moving around from an early age," Fagan said.

"That's what we're really imparting on families: the importance of being physically literate and understanding how vital physical activity is to the development of children," he added.

Academic pressures can also prevent children from getting the physical activity they need, says Muth.

"Physical activity in the school day has been compromised by a push toward more 'academic' subjects, even though we know well that physical activity in the school day improves concentration and attention, improves academic performance, improves behavior, and helps children and adolescents adopt habits for lifelong health," she said.

How Can Families Help?

As a pediatrician, Fagan says he tries to motivate his young patients by asking them what activities they like.

Sedentary activities, such as video games and social media, are a nonstarter.

"I ask, 'Besides video games, what do you like to do?' and then offer some suggestions. You have to find something that they like," he said.

"If you tell a child or teen that they need to be on a treadmill 60 minutes a day, 3 days a week, and it's not something they like, they're not going to do it. So I think it's critical to find out what the child or teenager enjoys doing in terms of physical activity. Even going out for a walk for 15 or 20 minutes is a step in the right direction," Fagan said.

The AAP notes in their report the importance of role models when it comes to physical activity.

Muth points out that kids who grow up in active households are more likely to be active themselves. She offers some suggestions for parental role modeling.

"Parents can help kids build activity into their day, whether that's walking or biking to school when possible, taking family walks together after dinner, and helping kids get to sports or active hobbies. The key is to help kids find physical activities that they enjoy doing," she said.

With childhood obesity rates on the rise, it's more critical than ever to encourage kids to get active — and a formal prescription, rather than a recommendation, may help spur them into action.

"I think the importance of this clinical report is giving the pediatrician the tools to dive deeper, so we can offer more specific recommendations in terms of how much moderate to vigorous physical activity a child should achieve," Fagan said.

"This can be promoted through referral to community-based organizations and providing families with lists of resources in the community, whether it's parks or recreation centers," he added.

Reposted with permission from Healthline.

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