The World Health Organisations (WHO) recommendations
The World Health Organization has a goal to implement physical activity in preschool improving motor competency in all children; this is associated with a higher level of physical activity later in childhood and reduces the risk for obesity. This effort is a response to the research showing that sedentary behavior and obesity is the fourth leading cause of death in the world today. Teens today are the first generation in many, many years that is not predicted to live longer that their parents!! As musculoskeletal experts we are part of the team promoting these physical activity guidelines and making information available to our patients.
Acquiring motor skills in infancy and at a minimum in preschool is important for encouraging physical activity throughout childhood and into adulthood. Motor skill training should be sequential and age-appropriate with a focus on performing them equally well from the right and left sides. The recommendation is to incorporate these skills into the preschool environment so all children gain proficiency in these areas. This should be done with games and the setting should be fun.
Motor skills on the floor are the starting point and included in this is getting up and down from the floor. Rolling to both right and left from stomach and back is important and can be made to be a fun exercise. Children having difficulty can be encouraged to start by looking to the right, turning the head to the right and then roll the body to the right. This integrates vision, balance and neck movements. Rolling back and forth from head to tail is also a skill to be mastered and with age, finding balance can be added. Using the concept of crawling in the pattern of an eight, and then crawling in the opposite direction integrates the both hemispheres of the brain.
The next step is to train fundamental gross motor patterns which provide the foundation for complex movement strategies. Again as age and skills advance, training from both the right and left is important. Starting early on to walk to day care or school is a goal for children. Starting the day by being active increases the level of physical activity for the entire day.
As children grow and develop, play activities can be encouraged which improve gross motor skills. Again, making the active transport to school a game can be a way to incorporate play into a daily active routine.
The other behavioral recommendations targeted to reduce childhood obesity are the following:
• Regular meal times
• Reducing sedentary time
• Drinking water instead of other beverages
• Avoiding calorie dense, nutrient poor foods and drinks
• Avoiding grazing between meals
• Eat fruits for snacks
• Getting adequate sleep
• Boosting activity levels
The recommendations for school age children are to be moderately but mostly vigorously active for at least one hour total a day. During moderate to vigorous activity it is difficult to talk. Other activities during the day should include climbing, running, jumping and hopping. Sitting inside during the day should be limited. Screen time should be less than 2 hours.
Recent research supports targeting the school as a modifiable environment for increased physical activity, reaching particularly those who are less active. The strategies employed are active transport to school, physically active teaching methods, activity breaks, active homework and active classroom settings. Organized activities after school should be promoted as well as increasing the amount of physical education classes. This has been promoted in a community in Finland and it is the only place in the world where the trend of obesity has been reversed in all ages. As a parent, there is the possibility to bring these ideas to the child’s preschool/school setting.
Let’s work together to promote a more active school and work environment and a healthy lifestyle.