The Pica Perspective

Strength Training for the Little Ones

I briefly addressed strength training for children in my very first post on this blog, but a recent article in the Tampa Tribune got me thinking about it again.

Muscular strength and muscular endurance are two of the five health-related fitness factors we want to work to promote in young children. Muscular strength is fairly self-explanatory but is described as the ability  to exert force with a single maximum effort. Strong muscles are necessary not only for performing certain tasks, like throwing for distance, hanging and swinging, climbing, and carrying heavy books and groceries, but also for preventing injury and maintaining proper posture. An added bonus is that increasing muscle strength also increases strength in tendons, ligaments, and bones.

Strength training -- also known as resistance or weight training -- is the best way to build muscular strength. But we have to view things differently than if we were discussing strength training for adults! While there's a lot of debate over the appropriateness of involving young children in strength training, there are some points on which the experts agree.

First, it's never a good idea to modify an adult strength-training program for children. Adults' bodies are fully developed; children's are not. Adults have long attention spans and the motivation to endure the monotony of repetitive exercises; children do not. For these reasons the best "strength training" for children involves the use of their own weight in physical activities they'd be performing anyway, like jumping, playing tug-of-war, and pumping higher and higher on a swing.

The experts also agree that children under the age of 8 shouldn't be using weights or machines -- child-sized or not. The general rule of thumb is that only children mature enough to follow specific instructions and understand the risks and benefits of such training should be handling strength-training equipment. It's recommended that children wait until they're 10 or 12 to use apparatus, as before puberty children may not have the judgment necessary to use it safely.

There's a good deal of interest in children's fitness right now and plenty of programs cropping up to take advantage of that interest. These programs will heartily endorse the benefits of strength training, convincing parents that it will prevent their children from injury and improve their sports skills. And, yes, if children are participating in organized sports without the requisite strength, strength-related activities may help prevent sports-related injuries. But strength training, handled improperly, can do more harm than good, particularly in children under 6, who are most prone to injury. And the truth is, the best way for children to improve their sports skills is to learn and practice their specific sports skills.

If you're considering the pros and cons of strength training, here are some things you should know:

• Children should always begin by using the resistance of their own body weight. In addition to the examples cited earlier, this could include such formal exercises as heel raises, curl-ups, leg lifts, and wall push-ups. (But you'll have to make them fun and exciting for children...because these can be boring!)
• If your older (6- to 8-year-old) child is going to participate in some sort of formal regimen, that regimen should include a warm-up (for example, jogging lightly in place to circulate blood throughout the body) and a cooldown (gentle stretches held for 10 to 12 seconds). Stretching shouldn't be used as a warm-up because "cold" muscles shouldn't be stretched.
• Once children do begin to use apparatus, they should do so without any added weight or resistance. When a child can perform 8 to 15 repetitions of an exercise, weight can be added in small increments. Children should never lift the maximal weight!
• A knowledgeable adult should constantly monitor children participating in strength-training programs.
• Children benefit more from additional repetitions of moderate weight than from fewer repetitions of heavy weights.
• Strength training may further elevate the blood pressure in children with hypertension.
• The National Strength and Conditioning Association cites improper training techniques, lifting heavy or maximal weights, improper equipment, and lack of qualified adult supervision as the most common reason for injuries.

The American Academy of Pediatrics states that gains in strength, muscle size, and power are lost after only six weeks once strength training is stopped. So, if your child is to improve muscular strength, "strength training" must be continuous. And, honestly, the only way that's going to happen for young children is if it's part of what they naturally do -- and it's fun.

Celebrate Earth Day!

It probably won't surprise you to learn that, according to reports, fewer than 10% of U.S. children currently learn about nature from being outside. Instead, one-third of them learn about it at school, and more than one-half of them learn about it via such electronic devices as computers and television!

Surely you don't need me to convince you that books and electronics offer no substitute for the real thing. Being outdoors is an experiences of the senses (which is how much of young children's learning takes place). Outside there are myriad amazing things to see: creatures in the clouds, hummingbirds hovering, and four-leaf clovers. To hear: birdsong, leaves rustling in the breeze, brooks babbling. To smell: lilacs, the rain-soaked ground, and Concord grapes (a favorite scent from my childhood; every time I smell it I'm transported back in time). To touch: the velvety softness of a petal, the fuzziness of a pussy willow, a fallen feather, the bark of a tree, or mud puddles. There are even things to taste, like a freshly picked blueberry or, in the winter, freshly fallen snow.

Do you remember how even the simplest foods taste better outside? Somehow, a peanut butter sandwich is just a sandwich when it's eaten in the kitchen. But make it part of a picnic, and suddenly it's special!

If T-ball and soccer are among your child's activities, you may believe she is indeed spending plenty of time outdoors. And while it's true she may be getting fresh air and sunshine (both important!), such organized activities don't allow for the appreciation of nature that outdoor experiences are meant to provide. When free to explore the outdoors on her own, she can lie on her back and absorb the feel of the grass against her skin, or track a caterpillar's progress. Heaven forbid she be doing either of those things during an organized game!

How about taking a "senses walk" on this Earth Day? Whether you walk around the backyard or around the block, you and your child can discover how many things you can hear, smell, or touch. How many red things can you see? How many natural things? An activity like this serves so many purposes! It stimulates the senses, provides physical activity, heightens awareness of the surrounding beauty, offers science lessons, and fosters a love of nature. Choose one sense to focus on today and then tomorrow, when it's no longer Earth Day, go outside and choose another to explore!

Electronic Exercise?

Turns out this past Wednesday was National Start! Walking Day. Who even knew there was such an event? But I'm glad for anything that calls attention to this very basic -- and wonderful -- form of exercise.

Interestingly enough, this past week two pieces about electronic games that promote physical activity also arrived in my inbox. One told the story of a physical education teacher who uses "Dance, Dance Revolution" and Sony's "Eye Toy" (the latter of which I'm not familiar with) as part of the stations in her gym. She's having such success with them that one student wrote, "It was so fun I did not even know I was working out!"

The other was a blog by a mom who's wondering if video games may be the solution to childhood obesity. She writes:

I must confess I have mixed feelings about this. On the one hand, it might be effective for getting otherwise sedentary youngsters in the habit of exercising. On the other, it seems sad that society has been reduced to using bribery, trickery and high-tech toys to get kids to engage in activities that have long been considered part of a healthy childhood.

I agree! As I wrote in the comment I posted at her blog:

Two thoughts come to mind. First, I can only hope that these video games create a lifelong love of physical activity in general. Second, I’d like to think the children are only using them when the weather is absolutely, positively too terrible for them to go outdoors — where they belong!

Video games are certainly creating an enjoyment of physical activity in the above-mentioned PE class. That's obviously a good thing. But should we be depending on them in our homes? Aren't children better served by playing the old-fashioned way?

There are so many questions parents need to answer today that never had to be posed with children of earlier generations. So many challenges that are unique to our times. I can't help but wish that kids would get their exercise by going outside and running and jumping around. I can't help but wish that families would take a daily (or almost-daily) walk together -- for the sake of both their health and their happiness. (Walking is a truly satisfying activity.) I can't help but wish that we could save the "trickery and high-tech toys" for adults who need some additional motivation to move. Children, after all, are supposed to just want to move!

Inactivity & Heart Disease

Here are the findings of a frightening new study published in Dynamic Medicine: the risk of developing  heart diseases during the teenage years increases about 600% if the individual has history of inactivity during childhood!

The study followed approximately 400 children (ages 7 to 10) for 7 years in North Carolina. Different factors were evaluated in those children. Among them: height, body mass, percentage body fat, blood pressure and cholesterol levels. Also, their activity level was evaluated by means of surveys, interviews, and a fitness test.

Almost 7 years later, the same kids were evaluated again. The results? Children with low levels of exercise (less than 20 minutes a day of intense physical activity) were 500-600% more prone to have developed three or more of the characteristics of what is known as metabolic syndrome (MS).

Metabolic syndrome is a medical disorder or a group of medical disorders of unknown causes associated with an increased the risk of cardiovascular disease  and diabetes. High blood pressure, visceral adiposity (central obesity), low HDL cholesterol, and low high triglycerides in blood are the main signs of metabolic syndrome, although a complete diagnosis is difficult to do since it is a syndrome and not a well-characterized disease. The study found that at least three of these  characteristics of MS were observed in teenagers who had a very low physical activity during childhood.

Dr. Robert McMurray, lead investigator and professor of sports science at the University of North Carolina department of exercise and sports science, said (according to the study) that this is the first time a research study has tracked a group of children over time to investigate if childhood activity levels had something to do with the risk of developing heart disease during the teen years.

Television & Children's Bedrooms Don't Mix!

An article by Tara Parker-Pope in today's New York Times certainly caught my attention. It's called "A One-Eyed Invader in the Bedroom," and despite the fact that this stuff is involved in how I make my living, its statistics surprised even me.

Here's one: According to a study of 80 4- to 7-year-olds, having a TV in the bedroom increased a child's viewing time by almost 9 hours a week! Not surprisingly, parents were unaware of just how much time their children were watching TV and seriously underestimated viewing time.

I guess what I found most puzzling was the study's finding that decreased viewing time did not lead to an increase in physical activity levels. That's the bad news, from my perspective. The good news is that children who viewed less snacked less, consuming over 100 fewer calories  per day. Since preschoolers with bedroom TVs are more likely to be overweight, with higher body fat and body mass index, that truly is good news.

Here are some of the results of other studies related to television in children's bedrooms:

• A television in the bedroom has a negative impact on schoolwork, with 70% of the 400 children in a 2005 study scoring "significantly and consistently lower on math, reading and language-arts tests."
• Kindergartners with televisions in their bedroom have more sleep problems.
• Kids ages 12 to 14 with bedroom TVs are more than twice as likely to start smoking!

Bottom line: If children are going to watch TV, it's best for them to do it in common areas, at common times, with other family members.

This week's featured interview on Body, Mind and Child is with Sara Bennett, co-author of The Case Against Homework. I blogged about this topic on February 5th!

What Causes Childhood Obesity?

As I may have mentioned before, I've signed up to receive Google alerts on topics that are of interest to me. "Childhood obesity" is one such topic, and it's certainly the one for which I receive the most alerts!

Every day there are stories from all around the world about the problems associated with and the causes of this epidemic. But today I found it particularly interesting because, in one e-mail, there were stories pointing in two different directions. One study has determined that children who get the least sleep have a 92 percent higher chance of being overweight or obese than children who sleep enough, while another determined that children who get fat tend to do so because they have a genetic predisposition towards obesity. In other words, the first study pointed toward "nurture" as the culprit and the other pointed toward "nature."

So what's the truth? What really causes childhood overweight and obesity? I don't think anybody can say for sure! But here's what I think:

• It only makes sense that heredity would play a role in a child's weight. My concern is that news of this study may convince some parents that they have no control over the situation. That they're relieved of the responsibility of ensuring their children eat right and get the appropriate amount of physical activity. The truth is, every child needs to eat right and be physically active in order to achieve optimal health. Weight shouldn't be the only motivation!
• Whether or not it plays a role in an individual's weight, children need a lot of sleep -- and often much more than they're currently getting! Children from birth to age four require 12 to 15 hours of sleep in a 24-hour period! Children ages 5 to 12 need 10 to 11 hours of sleep. According to the National Sleep Foundation, sleep is especially important for children as it directly impacts mental and physical development.

Yes, these studies are important; I don't think we as a society should ever stop looking for answers and solutions. But for every problem there will surely be conflicting answers and solutions. Our only choice, therefore, is to use common sense -- and common sense, as it regards children's health, is that kids need to eat right, move often, and get enough rest.

Resolve to Stay Active through the Winter!

I'm very big on goals and resolutions, and one of the goals I'm proud to say I checked off my list from last January was the one about being more physically active! Yes, you can surmise from that that I wasn't previously practicing what I preached -- at least not on a regular enough basis. But last spring I discovered the joy and ease of simply going for a walk at the start of each weekday morning, and it quickly became something I wanted to do and missed when I couldn't. So, as the temperatures plunged below 20 degrees here in New England and I discovered that 16 degrees was my limit for tolerating the cold, the question became: What now?

The answer came in the form of an old love: dancing. These days, when the thermometer tells me I won't like it outside -- or the snow in the driveway is too steep to get through, as it was this morning -- I put on either Ricky Martin's Vuelve or the soundtrack from Moulin Rouge and take to the living room floor for 25 minutes! My heart starts pumping, the endorphins start flowing, and if I close my eyes I can even imagine I'm on a tropical island somewhere!

So, if you're also a wimp when it comes to winter but want to make sure you and your family stay fit, here are some ideas:

• Set aside time every day for active indoor play. Make sure there's someplace where you and your child can safely move -- where knickknacks and sharp corners aren't a concern -- and do some dancing yourselves. You might also put on a lively march, or break out the pots and pans, and hold a lively "parade" around the house. Play an energetic game of Follow the Leader, or set up an obstacle course using furniture, empty boxes, a jump rope, and other props.
• If you've purchased active toys, as recommended in my previous blog "Ask Santa for Active Gifts," be sure they're not neglected in favor of more sedentary toys and games. Play Twister as a family, join your child in juggling colorful scarves, and time yourselves to see how long you can keep a balloon in the air!
• Join a program like Gymboree, ensuring both social interaction and physical activity on a weekly basis.
• Bundle up and go outside! If I can go outdoors when it's above 16 degrees, so can you! Take a walk, play in the snow, catch falling snow on mittens or pieces of black construction paper. You can even give your little one a child-sized shovel so she can "help" with the driveway or walk!

Spending time outdoors and physical activity are both essential to your health and to your child's. Don't let him get the impression that, for three months during the year, neither is possible!

Overweight Kids, Heart Disease, & Denial

If you're not familiar with Google Alerts, they're a wonderful way to learn when something important to you has appeared on the internet. I've signed up to receive alerts for children's sports, children's physical activity, and childhood obesity, among others. The latter is the one that nets me the most e-mails; the subject of childhood obesity is all over the internet: in news stories, columns, and blogs. And even though the alerts come daily and are never repeated, I often get the feeling that I've seen these stories before. Unfortunately, the same applies to the studies I'm alerted to. There's a redundancy about them that makes me want to yell, "Why do we need more studies? We already know the results; let's just get on with solving the problems!"

Nevertheless, I'm about to report on two recent studies -- neither of which offers surprising information -- but that I think we'd better take seriously.

The first, a long-term Danish study, reported at WebMD, shows that overweight children grow into adults at high risk of early heart disease and early heart death. The basis for that determination was data from 10,235 men and 4,318 women born in Copenhagen from 1930 to 1976. The bottom line: After the age of 7, overweight children have an increased risk of adult heart disease. The higher a child's body mass index, the higher the risk that the child will become an adult with heart disease.

With childhood obesity an escalating problem, experts predict that by 2020, 30% to 37% of 34-year-old men and 34% to 44% of 35-year-old women will be obese. By 2035, there could be up to a 16% increase in heart disease cases, with over 100,000 cases due to obesity. Harvard researcher David Ludwig (whom I recently interviewed for Body, Mind and Child) predicts that by 2050, the obesity crisis in this country will cut Americans' life expectancy by two to five years. That would equal the effect of all cancers combined.

All of this means that we really need to take the second study quite seriously. Because the report is brief, I'll excerpt it directly from the New York Times. Eric Nagourney wrote this piece titled "Growing Pains: Many Parents Fail to See Obesity in Children":

When researchers from the University of Michigan surveyed more than 2,000 parents about their children’s health, they heard some good news. Despite the growing obesity problem, many of these parents could report that their sons and daughters, at least, were “about the right weight.”

The numbers, alas, told another story. The parents were also asked to provide information about the children’s height and weight — and many of the 6-to-11- year-olds turned out to be obese. Yet more than 40 percent of their parents appeared unaware of this.

The findings grew out of the National Poll on Children’s Health by the C. S. Mott Children’s Hospital. The researchers found that over all, 25 percent of the children whose parents were surveyed were overweight or obese.

Among the parents of obese children ages 6 to 11, only 13 percent described their child as very overweight (the percentage was 31 percent for parents whose obese children were 12 to 17).

Dr. Matthew M. Davis, a pediatrician and internist who directed the poll, said he and other doctors wondered why parents who brought overweight children in for appointments so often did not seem concerned.

But, Dr. Davis said, “If they don’t actually perceive their children to have excess weight, then how can we realistically expect them to make changes?”

Maybe having the schools sent home notices to parents isn't such a bad idea after all?

Health Club Memberships for the Little Ones

In my very first post for The Pica Perspective, I blogged about the rise in personal trainers for the preschool set. Yesterday I came across an article in the New York Times about the rise in health club memberships for toddlers and preschoolers. And you just know I can't let something like that go unnoticed -- especially when it's accompanied by a photo of children 2 to 4 years old doing leg lifts!

It seems a lot of moms with memberships at fitness clubs don't want to plop their little ones in the clubs' child-care rooms, where they too often do nothing more than watch TV. That's commendable. Unfortunately, these same moms also believe that their children should be doing something enriching. (I really used to like that word, but today's culture has made it almost as obnoxious as "self-esteem.") And the health clubs, sensing another great source of revenue when they see one, are accommodating them by offering classes in ... wait for it: salsa dancing! Of course, that's not the only option. Children 2 to 5 can also take rock climbing, trampoline jumping, soccer, hip-hop, and disco.

Honestly, I can barely write those words without an emotional reaction; but I don't know which emotion to experience: uproarious laughter or tears of frustration. The latter, I guess, when I read quotes like: "There is an opportunity for strengthening and conditioning, even at those little bitty ages" and "They are getting exposed to sports and team play, which I think is a beneficial skill to learn -- the earlier the better." Now there's a phrase -- "the earlier the better" -- I'd like to never again hear in relation to children.

As I pointed out in "Personal Trainers for the Preschool Set," it's not possible to accelerate children's development. But parents keep trying anyway. Also, early childhood is not the time for such structured activities as leg lifts and disco dancing! But where health clubs, specifically, are concerned, there are a lot of reasons why enrolling toddlers and preschoolers isn't a good idea. Here's just one: Children who are enrolled in health clubs may come to think of physical activity and fitness as things they have to go somewhere else to get. The possibility then exists that as they get older and life becomes busier, they'll eventually be unable to find the time to go to a health club or gym. Children should learn -- okay, the earlier the better -- that they don't have to go out of their way to move!

And here's just another little tidbit I came across this week, which also results from society's incessant need to push children to grow up too fast: According to a study published in Journal Watch Pediatrics and Adolescent Medicine, during 1990 to 2003 about 1.6 million children suffered soccer-related injuries. Although 87% of the injuries occurred in children ages 10 to 18, children ages 2 to 4 had a higher proportion of face and head or neck injuries and were more likely to be hospitalized than older children!

Well, that's my rant for the day. Thanks -- I needed that.

Kids & High Blood Pressure

The topic of high blood pressure in children has been in the news lately, and I've been determined to address it here. But this morning I came across a Q&A from Dr. Andrew Weil that addresses the issue as well as anyone could; so I'm offering it in lieu of my own thoughts.

The latest news on this subject comes from a study involving more than 14,000 youngsters, from age three to age 18 in the Cleveland, Ohio area. The study began in 1999 and ended in 2006. During those years, the kids were observed at least three times at outpatient clinics. The diagnosis of hypertension or pre-hypertension wasn't made on the basis of a single elevated reading - instead, a child's blood pressure would have to have been recorded as high on three different visits. Of the more than 14,000 kids participating in the study, 507 (3.6 percent of the total) were found to have hypertension. Of this number, only 131 had been diagnosed with high blood pressure in the normal course of their medical care. By extrapolating those numbers to the whole population of the United States, the study authors concluded that approximately two million American kids have high blood pressure, but only 500,000 cases will be diagnosed. The study was published in the August 22/29, 2007 issue of the Journal of the American Medical Association.

Surprising as it may seem, high blood pressure can occur among children and, sadly, it often goes undiagnosed. This is very bad news because unchecked high blood pressure at any age can lead to serious health problems.

These numbers are shocking, but we don't have to look far for the cause - the epidemic of childhood obesity is largely to blame. It's estimated that about 30 percent of overweight and obese kids have high blood pressure - and if the epidemic continues, the problem is likely to get worse.

The reason so much of this high blood pressure is being missed is because blood pressure considered "normal" for kids isn't readily apparent. It depends on their height, age, and sex. Few doctors are likely to remember the numbers that are normal for, say, a girl of four who is tall for her age versus a nine year old boy who is short for his age and so on - the variations are endless. Experts on this subject say that convenient new tools are needed to help the average pediatrician recognize the numbers that signal high blood pressure in children.

The strategies for treating high blood pressure even in very young patients are similar to those for hypertensive adults: exercise, cutting back on salt and making healthy changes in diet to slim down. If kids - or their parents - are not willing to make the necessary changes (or if those changes don't help), medication may be needed. Otherwise, these youngsters face increased risk of heart problems, stroke, and kidney damage in later life, just like adults with undiagnosed or uncontrolled high blood pressure.

Andrew Weil, M.D.

I want to wish all of my readers a very happy Thanksgiving! I have so much to give thanks for, and being able to communicate with you is definitely on the list! Enjoy the holiday!