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Your Teen

90% of High School Kids Need More Exercise

1:30

Nine out of ten high school students are not exercising enough to stay healthy and fit, setting up a pattern that often continues after they graduate, according to a new study published in the journal Pediatrics.

Researchers followed students at 44 high schools for four years, and found that only 9 percent met current exercise recommendations throughout that time. For the most part, those habits held steady after high school -- though college students were more active than non-students.

For students that continued to college, those living on campus exercised more than those living at home.

It's not clear why those students were more active. They might have been more involved in sports, for example, or simply walked more -- running from classes to dorms and other campus buildings, said lead researcher Kaigang Li.

"The walkability of your environment is important," said Li, an assistant professor of health and exercise science at Colorado State University, in Fort Collins.

This is not the first study to look at the physical condition of high school and college students.  Several other studies have found that these two groups struggle with getting enough meaningful exercise. 

According to Peter Katzmarzyk, a professor at Louisiana State University's Pennington Biomedical Research Center, in Baton Rouge, "This study really confirms the low levels of physical activity in adolescents, which appear to be maintained over time as they transition into young adulthood."

The strength of this study, he said, is that it objectively measured teens' activity levels: Students wore devices called accelerometers, which tracked how much they moved over the course of a week.

Katzmarzyk, who was not involved in the study, conducts research on child exercise patterns, obesity and health.

According to the U.S. Centers for Disease Control and Prevention (CDC), teenagers should get at least one hour of physical activity each day that includes exercise that boosts the heart rate, such as running. Kids should also try some strength-building activities -- for example, push-ups or lifting light-weights.

The CDC noted that a lack of physical education in U.S. schools may be a contributing factor in students’ understanding of exercise and how it can improve their health. 

At one time, PE was a part of every student’s daily school activities, today, according to the CDC, only 29 percent of high school students have gym class every day.

The evidence from this new research and other studies makes a good argument for more physical education, according to Katzmarzyk.

"Any way that we can increase physical activity levels in adolescence might translate into maintaining higher levels of physical activity in young adulthood," he said. "So physical education in high school is certainly an important outlet for this."

Still, Li said, there are probably numerous reasons for teenagers' low exercise levels.

He noted that in elementary school, most U.S. kids do get enough physical activity. But there is a steep drop-off after that. According to Li, that could be related to many factors -- including heavier homework loads starting in middle school, and more time on cellphones and computers.

While schools and communities can advance opportunities for kids to be more physically fit, families that put a high priority on exercise and a healthy lifestyle give their children the ability to independently remain physically fit for a lifetime.

Story source: Amy Norton, https://consumer.healthday.com/kids-health-information-23/adolescents-and-teen-health-news-719/9-of-10-teens-don-t-get-enough-exercise-study-shows-715167.html

Your Baby

Pregnant? Exercise is Good For You!

2:00

For years, the prevailing thought has been – if you didn’t exercise before, during pregnancy wasn’t the time to start. That’s no longer the case says, Alejandro Lucia, a professor of exercise physiology at the European University of Madrid.

A group of researchers want women to know that when it comes to exercise, there is a strong consensus of benefit for both the mother and developing fetus.

"Within reason, with adequate cautions, it's important for [everyone] to get over this fear," said Lucia.

According to the American College of Obstetricians and Gynecologists (ACOG), which updated its recommendations in 2015, women without major medical or obstetric complications should get at least 20 to 30 minutes of moderate-intensity aerobic exercise — enough to get you moving, while still being able to carry on a conversation — on most days of the week.

Lucia noted that evidence now suggests that starting an exercise program while pregnant can provide health benefits to both the mother and the growing fetus. Obviously, though, if you're new to exercise, take it slowly — you can work up to that 20 or 30 minutes.

The authors of the study say physical activity can prevent excessive weight gain, which can complicate the pregnancy and contribute to obesity. A review of existing research published in 2015 by the Cochrane Library found "high-quality evidence" that exercise during pregnancy can help prevent gaining too much weight, and may possibly lower the likelihood of a cesarean section, breathing problems in newborns, maternal hypertension and a baby that is significantly bigger than average. And of course, exercise promotes general cardiovascular and muscular health.

Other health problems can be helped such as chronic high blood pressure, gestational diabetes and women who are overweight or obese. Researchers say women with these conditions should be encouraged to exercise.

However, there are some health conditions in pregnancy where exercise should be avoided. According to the ACOG guidelines, women should avoid aerobic exercise if they have significant heart disease, persistent bleeding in the second or third trimester, severe anemia and risk of premature labor, among other conditions. And certain symptoms, such as contractions or dizziness during exercise, should be checked out quickly.

The bottom line is that women need to make a plan with their physician, taking into account their exercise history, their health, and the risk of pregnancy complications, says James Pivarnik, a professor of kinesiology and epidemiology at Michigan State University. He wasn't an author of the viewpoint but has conducted research on exercise and pregnancy.

Moderation is the goal during any exercise program. Long distance running and heavy weight lifting are not recommended. ACOG also recommends against contact sports, hot yoga, and exercises done in the supine position, i.e. lying face up, starting in the second trimester.

There are always exceptions to the rule, particularly with women who are highly trained athletes before they become pregnant. These women should still form plan with their OB/GYN on how much and what kinds of exercises are safe for them.

Among the general population and pregnant women specifically, people will respond differently to an exercise program. "But we know if you do the kind of things they're talking about here, the odds are your risk will be lower," says. Pivarnik.

Story source: Katherine Hobson, http://www.npr.org/sections/health-shots/2017/03/21/520951610/exercising-while-pregnant-is-almost-always-a-good-idea

Daily Dose

National Walk to School Day

This day and the entire month of October is meant to bring awareness back to the need for children to walk to school when possible.Today is ‘National Walk to School Day' and as a seven year old so aptly stated, "this was fun and good for my mom's health too." It seems that it has become uncommon these days for children to walk to school, although it was something that used to be one of the best parts of the day. This day and the entire month of October is meant to bring awareness back to the need for children to walk to school when possible. There are many reasons to encourage this, as a form of exercise to promote childhood obesity, to save on gas during skyrocketing gas prices, and to promote environmental consciousness.

It is a privilege to live close to a school and have leisurely walks where you can talk about the day ahead, kick a rock or pick up the first leaves of fall. But we need to change community cultures to promote safe routes to walk to school and to promote neighborhood children and parents to walk together. This same idea needs to be encouraged for those children who might want to ride their bikes to school, of course with a helmet, and get their parents to ride along. It also teaches the rules of the road and safety for crossing streets and intersections. So....pick a few days this fall to opt out of carpool, get the dog and a cup of coffee and walk to school with your child. It is guaranteed to create lots of conversation and most likely fond memories of your childhood walks to school. That's your daily dose, we'll chat tomorrow. More Information: International Walk to School Day in the U.S.A.

Daily Dose

Sudden Cardiac Deaths in Young Athletes

2.00 to read

I have received several questions via our iPhone App about recent discussions in both the media and in the medical community surrounding sudden cardiac death (SCD) in young athletes.

Each year between 10–12 million kids in the U.S. participate in sports.  The tragedy of a sudden death in an otherwise  “presumably healthy” child causes not only sadness, but concern as to how the death might have been prevented. Doctors are often asked, “isn’t there a test or something to prevent this? “.

Depending on the studies I have read, the sudden cardiac death of a child or adolescent accounts for about 100 deaths a year in the U.S.  The prevalence rate for sudden cardiac death is 1:100,000- 200,000 and is higher among males than females.  Statistics show that 90% of these sudden deaths occur immediately post training or competition with football and basketball having the highest incidence.

In 2007 the American Heart Association came out with guidelines to evaluate athletes who may be at risk for sudden cardiac death. The most important screening mechanism has been found to be the “gold standard” in medicine, a thorough history and physical exam.

The history that should be taken on any athlete who is being screened for sports participation should include a history of any unexplained or sudden death in a family member. Are there any family members with unexplained fainting episodes or seizures? Are there family members who had unexplained deaths (drowning or single car accidents)?   Are there any family members with a known genetic disorder that predisposes to sudden cardiac death?  The history should also ask about any fainting (syncope) in the athlete.

After a good history is taken (which should be updated yearly), the child/adolescent needs a complete and thorough physical exam. This exam should include blood pressure measurements, and a careful cardiac exam looking for new murmurs.  Symptoms such as palpitations during exercise, visual changes, fainting while exercising or immediately after exercise, and chest pain should all warrant further evaluation.

Studies show that about half of pediatric patients who succumb to sudden cardiac death had experienced a warning sign.  There are about 20 causes for SCD, with the most common causes being hypertrophic cardiomyopathy, anomalous coronary artery, and myocarditis.

While some may advocate routine EKG screening and echocardiograms on athletes (this is done in Italy), many studies have been done which show that it would take the screening of 200,000 student athletes to prevent 1 death.   At the same time you will certainly identify some children with clear risk factors for SCD, but for every positive finding there may be 10–20 athletes who have “borderline” or questionable findings that would require even more expensive follow up.

These pediatric patients might also be told they cannot participate in sports during the evaluation time and some might be told that they cannot participate even if they were not found to have disease, but were excluded just due to liability concerns.  There does not seem to be one right answer to this issue.

If your child is going to begin competitive sports make sure to see your pediatrician for a complete physical exam including a good family history.  Also advocate that your school have automatic external defibrillators viable at all times and personnel that know how to use them.

That’s your daily dose for today.  We’ll chat again tomorrow.

Your Child

Are Playgrounds Too Safe?

1.45 to read

It takes a lot to bore a preschooler. They are so inquisitive that just about everything seems interesting. But, believe it or not, playgrounds may have become so “safe” that they bore even preschoolers. A new report suggests that may be one of the reasons these little ones are not getting enough exercise.

Researchers have found that strict safety rules for equipment and low budgets at childcare centers were largely blamed for playgrounds that don't make kids feel like playing,

Kristen Copeland, MD, of Cincinnati Children's Hospital Medical Center, and her colleagues wrote in the February issue of Pediatrics that fixed playground equipment that meets licensing codes is unchallenging and uninteresting to children.

Another reason kids may not be exercising enough is that schools are focusing on academics at the expense of recess and gym.

"Societal priorities for young children -- safety and school readiness -- may be hindering children's physical development," they wrote in the paper.

According to an online article in Medpagetoday.com, three-quarters of U.S. kids, ages 3-5 years, attend childcare and most of their time is spent being sedentary.

"Because children spend long hours in care and many lack a safe place to play near their home, these barriers may limit children's only opportunity to engage in physical activity," Copeland's group explained. "This is particularly concerning because daily physical activity is not only essential for healthy weight maintenance, but also for practicing and learning fundamental gross motor skills."

The investigators conducted nine focus groups with a total of 49 childcare providers taking care of preschool-age children at 34 centers in Cincinnati, which varied from inner-city to suburban locations and included some Head Start and Montessori centers.

The providers interviewed were nearly all women with at least some college education. These providers commonly expressed concern that the children they cared for had little chance of outdoor playtime when they went home, particularly those who were picked up late in the day or whose parents worked multiple jobs.

Many of the parents didn't have a dedicated room indoors where kids could be active during bad weather.

To prepare kids for grade school, an emphasis has been placed on teaching children shapes, colors, and skills that prepare them for reading, but not giving them time for outdoor and active play- both of which have been shown to increase a child’s learning ability.

That pressure came directly from parents -- both upper- and lower-income families -- as well as from state early-learning standards.

Some parents also told providers to keep their children from participating in vigorous activities so that they would not be injured.

Providers felt that the playground equipment was safe to let kids play on because of beefed up state inspections and stricter licensing codes, but all the safety measures sort of back-fired and kids just weren’t interested.

"To keep it challenging, teachers noted that children would start to use equipment in (unsafe) ways for which it was not intended," the researchers wrote.

They quoted one provider who explained that with new equipment fitting the tighter standards, "you see children trying to climb into places they're not supposed to climb in because it's just not challenging. They're walking up the slide much more than they ever did with the other one. You can see they are just trying to find those challenges."

Pediatricians may be able to help address this problem by emphasizing the learning and physical benefits of active outdoor play, encouraging parents to dress their child for it, and not suggesting that physical activity is inherently dangerous when giving injury prevention advice, the researchers noted.

Source: http://www.medpagetoday.com/Pediatrics/GeneralPediatrics/30493

Daily Dose

Don't Let Your Child Become an Obesity Statistic

Healthy eating begins with the first foods that you feed your infant.An alarming statistic was released today which shows that one in five 4-year-old children are obese and these numbers are even higher in minority children. This study was just published in The Archives of Pediatric and Adolescent Medicine, and followed over 8,000 children looking at height and weight. The findings were quite concerning, showing a trend toward obesity at an age younger than predicted, and numerous long term health problems associated with obesity, such as heart disease, diabetes, high blood pressure and bone and joint problems.

This is a national health issue and a call to action for all families to teach and model healthy eating. One of the problems is that many of the government sponsored food programs provide foods high in carbohydrates, and low in fresh fruits and vegetables, and this promotes obesity. School lunches have also been found to be high in fat and carbohydrate and continue to promote poor food choices. With the bad economy and recession, families have cut back on groceries and may be eating more fast foods, breads and pastas, again providing more carbohydrate than protein. Healthy eating begins with the first foods that you feed your infant. A well balanced diet with grains, fruits, vegetables and meats begins in the high chair and should continue at the family dinner table. The meals may be simple and healthy. Being a short order cook, or providing your child's favorite pizza and fried food on a daily basis, even in a young toddler will have deleterious effects for the rest of their life. Don't let your child become a statistic heading toward lifelong health issues secondary to childhood obesity. Change your own eating habits, improve your children's and remain committed to family meals. We, as parents, cannot afford to raise a generation where obesity is the norm: the change must begin now. That's your daily dose, we'll chat again tomorrow. More Information: 1 in 5 Preschoolers Obese

Your Child

Exercise Boosts Kids’ Grades!

2:00 to read

We all know that exercise is good for the heart, lungs, weight-control and now a new study suggests that it’s good for increasing academic performance as well.

The Dutch researchers reviewed several prior studies conducted in the United States, one from Canada and another out of South Africa. What they discovered was that all the studies showed that the more physically active students are, the better they do in the classroom.

"We found strong evidence of a significant positive relationship between physical activity and academic performance," the researchers, led by Amika Singh of the Vrije Universiteit University Medical Center at the EMGO Institute for Health and Care Research in Amsterdam, the Netherlands, said in a journal news release.

"The findings of one high-quality intervention study and one high-quality observational study suggest that being more physically active is positively related to improved academic performance in children," the authors noted.

A total of 14 studies were reviewed. They involved students between the ages of 6 and 18. Some studies were smaller, working with 50 students, while another study had as many as 12,000 students. 

Researchers noted that students who exercised had increased blood flow and oxygen to the brain. These school-age children did better in the schoolroom. The analysis suggests that exercise also increases the levels of hormones responsible for curtailing stress and boosting mood, while at the same time establishing new nerve cells and synapse flexibility.

In recent years, there has been increasing evidence that has shown that many functions of the brain are highly dynamic, or “plastic”, meaning that the brain is able to continually change in response to stimulus and experience. This flexibility is thought to be a key property in allowing the nervous system to support short-term and sustained changes in output, associated with learning and memory.

Other studies have shown that people with early dementia benefit from exercise. Again, the increased blood flow and oxygen to the brain helps improve memory and learning function.

So, getting the kids off the couch and onto the playground (no matter whether it’s a public playground or the backyard) can help children stay physically fit and mentally alert.

The Dutch researchers would like to see more high quality studies conducted in this area of investigation.

"Relatively few studies of high methodological quality have explored the relationship between physical activity and academic performance," they acknowledged. "More high-quality studies are needed on the dose-response relationship between physical activity and academic performance and on the explanatory mechanisms, using reliable and valid measurement instruments to assess this relationship accurately."

It’s a pretty safe bet though, that the more a family exercises together, the healthier everyone will be.

The findings are published in the January issue of the Archives of Pediatrics & Adolescent Medicine.

Sources: http://consumer.healthday.com/Article.asp?AID=660288 / http://www.sussex.ac.uk/aboutus/annualreview/2011/mindandbrain

Daily Dose

Flu Season Isn't Over Yet

Just when you least expect it, those nasty viruses can rear their angry heads and guess what, they seem to be back.This has certainly been a weird end of winter and early spring in our office. I have always been very protective of my newborns and try to keep them "isolated" from all of those terrible winter viruses and germs for the first six to eight weeks of the infant's life. Especially for those newborns born during the winter months. Because we are fortunate to live in a temperate climate, we have lots of sunny days in the winter which allows for parents and babies to get out for walks in their neighborhood and even strolls in the park.

Even so, many of the parents (and they say their babies too) are getting a little cabin fever and are ready to head out to the mall, church and restaurants (the list seems endless). All of these venues are all full of crowds, so it is a given that germs are lurking there. By this time it had seemed that flu was long gone in our area and we had not seen RSV for months. Just when you least expect it, those nasty viruses can rear their angry heads and guess what, they seem to be back? I saw several cases of Influenza B last week, and yes they were documented! I was so skeptical that I had the lab techs pull out the boxes of flu tests to just check for checking sake and what do you know?! At the same time I saw several cases of RSV and even had to hospitalize one infant due to respiratory distress, the first child I had hospitalized all winter! Even the hospital was out of the rapid screening kits that had not been used recently, so it took us a day to document RSV. I am happy to report that both the your-baby with RSV and the adolescent with the flu are now doing well. I guess the moral of the story is, we cannot always predict the "official" end of the winter viral season. So keeping infants isolated seems like a good practice for at least several more weeks, until it is hard to find a coughing, sneezing, feverish, person among us. By June it will be a memory until winter of 2009 - 2010 and unfortunately the cycle begins again. That's your daily dose, we'll chat again tomorrow.

Your Child

Kids Who Specialize In One Sport Have More Injuries

Kids who came to the clinic with injuries played organized sports an average of 11 hours a week, compared with fewer than nine hours in the uninjured group. Although the researchers did not specifically look at this, Jayanthi said he has noticed that more highly specialized sports such as tennis, gymnastics and dance tend to be linked to more severe overuse injuries.Because a child’s body is still growing, children who specialize in only one sport suffer repetitive injuries more often, a new study says.

In fact, kids are twice as likely to get hurt –playing just one sport- as those who play multiple sports said Dr. Neeru Jayanthi, medical director of primary care sports medicine at Loyola University Chicago Stritch School of Medicine. "We saw a pretty significant difference with this intensity of training, along with specialization," said Jayanthi. The findings are slated to be presented Monday at the American Medical Society for Sports Medicine annual meeting in Salt Lake City. Research presented at medical meetings should be viewed as preliminary. "It's been accepted for the last five years or so that kids who are not super-specific do better. They're cross-trained, so they're conditioned for other movements," said Dr. Kory Gill, an assistant professor at Texas A&;M Health Science Center College of Medicine. Jayanith’s research team had done earlier studies on 519 junior tennis players and found that the kids who only played tennis were more likely to get hurt. Jayanthi wanted to see if the same findings extended to other sports. "As a physician, you get frustrated seeing kids come in with injuries that keep them out for two to three months. It's devastating," said Jayanthi, who recently saw a young gymnast with a knee injury that will keep her off the mat for at least three months. Here, the researchers looked at 154 young athletes, average age 13, who played a variety of sports. Eighty-five of the participants came to the clinic for treatment for a sports injury, while 69 were just getting sports physicals. The investigation ranked each athlete on how specialized they were, basing the score on factors like how often they trained in one sport, whether they had given up other sports to practice just one, and if they trained 8 months a year or more to compete more than 6 months a year on one sport. What they discovered was that 60.4 percent of the athletes who had been injured were specialized in one sport, compared with only 31.3 percent who came in for physicals. Kids who came to the clinic with injuries played organized sports an average of 11 hours a week, compared with fewer than nine hours in the uninjured group. Although the researchers did not specifically look at this, Jayanthi said he has noticed that more highly specialized sports such as tennis, gymnastics and dance tend to be linked to more severe overuse injuries. Why did these injuries occur? "One reason is repetitive use of the same muscle group and stressors to growing areas, for example, the spine," explained Jayanthi, who stressed that the findings were preliminary. His team, in collaboration with Children's Memorial Hospital in Chicago, plans to enroll more athletes in follow-up research, and those athletes will be evaluated every six months for three years, to look more closely at how intense training can affect a young athlete's body during growth spurts. "Second is exposure risk," he added. "If you're getting really good at one sport, the intensity increases because you are getting better. People are developing adult-type sports skills in a child's body. The growing body probably doesn't tolerate this." Younger children -- those who have not entered high school -- tend to be especially vulnerable as their bodies are still growing, said Gill, who recommended that kids cross-train and condition for other movements, or just play another sport. "I tell parents to let kids be kids and play multiple sports," he said. "See what they're good at and what they enjoy." By high school, when bodies are more mature, specializing is safer, he added. When children play different sports in different seasons, they are using a wide range of motions and muscles. But when they begin playing one sport year-round, the risk of overuse injuries increases.

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