The Youth-Nex Conference on Physical Health and Well-Being for Youth, Oct 10 & 11, 2013, University of Virginia
William H. Dietz, M.D., Ph.D. - "What Can We Do To Increase Physical Activity in Youth?"
Until July 2012, Dietz was the Director of the Division of Nutrition, Physical Activity, and Obesity at the CDC. Prior to his appointment to the CDC, he was a Professor of Pediatrics at the Tuft's University School of Medicine, and Director of Clinical Nutrition at the Floating Hospital of New England Medical Center Hospitals.
Website: http://bit.ly/YNCONF13
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William H. Dietz, M.D., Ph.D. - Keynote - "What Can We Do To Increase Physical Activity in Youth?"
1. What Can We Do to Increase Physical
Activity in Youth?
William H. Dietz MD, PhD
Consultant, Institute of Medicine
Senior Adviser
Robert Wood Johnson Foundation
2. Obesity Trends in Children < 5yo
Pediatric Nutrition Surveillance System
3. Obesity Trends in Youth over the Past 12 Years
Ogden et al. 2012, NCHS data brief
4. Childhood Obesity: Signs of Progress
Kearney, NE
Fitchburg, MA
Somerville, MA
NYC
West
Virginia
California
Philadelphia, PA
New
Mexico
Vance, NC
Chula Vista, CA
El Paso, TX
Anchorage, AK
Mississippi
5. Energy Deficits Necessary to Achieve the HP 2010
(Prevalence = 5%) by 2020
Age
2-5 yo
6-11 yo
12-19 yo
Deficit
33 Kcal/d
149 Kcal/d
177 Kcal/d
Wang YC et al. Am J Prev Med 2012; 42:437
6. Effects of Physical Activity on Morbidity
and Mortality across the Life Span
Physical Activity
Physical Activity
In Childhood
In Childhood
Morbidity in
Morbidity in
Childhood
Childhood
Physical Activity
Physical Activity
in Adolescence
in Adolescence
Morbidity in
Morbidity in
Adolescence
Adolescence
Physical Activity
Physical Activity
in Adulthood
in Adulthood
Hallal et al. Sports Med 2006;36:1019
Morbidity in
Morbidity in
Adults
Adults
Mortality in
Mortality in
Adults
Adults
7. Physical Activity Guidelines –
Children and Adolescents (ages 6–17)
• 1 hour (60 minutes) or more of daily physical
activity that is at least moderate:
– Most of the 1 or more hours a day should be either
moderate- or vigorous-intensity aerobic physical
activity
– Do vigorous-intensity physical activity at least
3 days a week
http://www.health.gov/paguidelines
7
8. Key Guidelines – Children and Adolescents
(ages 6-17) (cont.)
- Include muscle-strengthening activities at least 3
days a week
- Include bone-strengthening activities at least 3 days
a week
• Physical activities should be age appropriate,
enjoyable, and offer variety
http://www.health.gov/paguidelines
8
9. % High School Students Achieving 60’
MVPA - YRBS 2011
CDC. Youth Risk Behavior Surveillance. MMWR 2012; 61:1
10. Average Minutes/d of AccelerometerMeasured MVPA
Kohl HW III, Cook HC. Educating the Student Body, IOM 2013.
12. Decline in Active Transportation to and from School in
1969 and 2001; Nationwide Personal Transportation
Survey
Kohl HW III, Cook HC. Educating the Student Body, IOM 2013.
14. Frequency of School PE – SHPPS 2006
Elementary
Middle
High School
Daily PE
4%
8%
2%
PE 3d/w
14%
15%
3%
Note: No school level data in 2012 SHPPS
Lee SM et al. J School Health 2007;77:435
15. Changes in Required or Recommended
Recess 2006-2012
38%
33%
%
Lee SM et al. J School Health 2007;77:435; Lee SM et al. SHPPS 2012
www.cdc.gov/healthyyouth/SHPPS/2012
16. Percent of Schools that Do Not Provide
Recess to First Grade Students
Kohl HW III, Cook HC. Educating the Student Body, IOM 2013.
17. Changes in Activity Breaks SHPPS 20062012
% of
Schools
Lee SM et al. J School Health 2007;77:435; Lee SM et al. SHPPS 2012
www.cdc.gov/healthyyouth/SHPPS/2012
18. Energy Costs of Opportunities for PA in
Schools
11
17
27
33
37
Bassett DR et al. PCFSN Research Digest March 2013; Series 14 #1
19. Evidence of Effectiveness of School
Programs for PA
School-based PA interventions
•Increases duration of PA for 5 - 45’/day
•Decreases TV time from 5 – 60’/day
•Increases VO2 max
•Participants 3 times more likely to engage in
MVPA
Dobbins M et al. School-based PA programs for promoting PA
and fitness in children and adolescents aged 6-18. Cochrane
Rev 2013
21. Percent of Boys and Girls Participating in
Sports 1971-2011
Kohl HW III, Cook HC. Educating the Student Body, IOM 2013.
22. Participation in Interscholastic Sports by Boys and
Girls by Availability of Sports Facilities 2009-2011
Colabianchi N. Bridging the Gap in Kohl HW III, Cook HC. Educating
the Student Body, IOM 2013.
24. Strategies to Increase Physical Activity in
Youth
• Implement the Physical Activity Guidelines
Midcourse Report
• Mobilize parents
• Convene all relevant groups to develop and
implement a strategic plan
• Improve the research base that links PA to
behavior and academic performance
• Use QRIS, state, and local policies to
implement PA standards in ECE
• Engage health providers at all levels in
Exercise is Medicine
25. Strategies to Increase Physical Activity
Among Youth – PAG Midcourse Report
Sufficient evidence
•Multi-component PA in schools
•Physical education program
Suggestive evidence
•Active transportation
•Early Care and Education
•Built environment
Emerging evidence
•Activity breaks
26. Strategies to Increase Physical Activity in
Youth
• Implement the Physical Activity Guidelines
Midcourse Report
• Mobilize parents
• Convene all relevant groups to develop and
implement a strategic plan
• Improve the research base that links PA to
behavior and academic performance
• Use QRIS, state, and local policies to
implement PA standards in ECE
• Engage health providers at all levels in
Exercise is Medicine
27. Parental Support for Physical Education
• A majority believe that PE is as important
as other subjects (CDC 2010)
• Over 90% believe there should be more
PE in schools (HSPH 2003)
• Over 75% think more PE could help
prevent or control childhood obesity
(NASPE 2009)
• 95% believe that daily PA helps children
do better academically and should be
part of K-12 curriculum (NASPE 2003)
28. National Physical Activity Plan – Strategy 2
Tactics
• Binding requirements for Pre K-12
standards-based PE that address
curriculum time, class size and
employment of certified PE teachers
• Local, state and national standards for
high levels of PA in PE
• Federal legislation to require school
accountability for the quality and
quantity of PE programs
29. National Physical Activity Plan – Strategy 2
Tactics
• Local state and federal funding to assure
that schools have the necessary
resources, especially for under-resourced
schools
• State-level policies to monitor quality and
quantity of PA and PE programs
• Require school districts to collect,
monitor and track fitness data including
BMI
30. Strategies to Increase Physical Activity in
Youth
• Implement the Physical Activity Guidelines
Midcourse Report
• Mobilize parents
• Convene all relevant groups to develop and
implement a strategic plan
• Improve the research base that links PA to
behavior and academic performance
• Use QRIS, state, and local policies to
implement PA standards in ECE
• Engage health providers at all levels in
Exercise is Medicine
31. Children in Early Care and Education Programs
In 2001, 73% of preschool children ages 3-5 years old (8.6
million children) participated in at least one weekly
non-parental care arrangement
Nearly 60% of children 3-4 years with employed mothers
participate in center-based care
41% of preschool children are in child care for 35 or more
hours/week
Capizzano J et al. www.urban .org/url.cfm?ID=309438; www.urban .org/url.cfm?
ID=309439
32. Strategies to Increase Physical Activity in
Early Care and Education
• Provide portable play equipment on
playgrounds and play spaces
• Train staff in delivery of structured PA
and increase PA session time
• Integrate PA into teaching and learning
activities
• Increase outdoor time
Physical Activity Guidelines Midcourse Report. www.health.gov/guidelines
33. Strategies to Increase Physical Activity in
Youth
• Implement the Physical Activity Guidelines
Midcourse Report
• Mobilize parents
• Convene all relevant groups to develop and
implement a strategic plan
• Improve the research base that links PA to
behavior and academic performance
• Use QRIS, state, and local policies to
implement PA standards in ECE
• Engage health providers at all levels in
Exercise is Medicine
34. PA Counseling by Pediatricians
• Over 60% of pediatricians and family
practitioners ask specific questions about
the dose of PA1
• Overweight and obese patients more likely
to receive PA counseling2
• Physician’s BMI predicts likelihood of
counseling3
1. Huang T, et al. Am J Prev Med 2011;41:24-32
2. Liang L, et al. Pediatrics 2012;130:67
3. Bleich SN et al. Obesity 2012;20:999
35. Five Conditions for Collective Success
Common agenda
Shared measurement systems
Mutually reinforcing activities
Continuous communication
Backbone support for ongoing
actions
Kania J and Kramer M. Collective impact. Stanford
Social Innovation Review 2100 (winter); 59
Hinweis der Redaktion
WALK?
I thought you might like to what see the map looks like now that we are including other communities and states that are reporting their results.
Of course The states, like Calif, have variation among their counties- with some showing improvements and others continuing to increase. We will continue to track down reports and include links to the reports and local news stories on our web. We aim to become the go to source for signs of progress
Children are often active in short bursts. For them, every minute counts (10 minutes at a time not required to count).
Guidelines for children and adolescents include aerobic and muscle and bone-strengthening activities. Note that they should do vigorous intensity physical activity at least 3 days a week.
Children are often active in short bursts. For them, every minute counts (10 minutes at a time not required to count).
Guidelines for children and adolescents include aerobic and muscle and bone-strengthening activities. Note that they should do vigorous intensity physical activity at least 3 days a week.
Nine partner organizations have agreed to adopt the three guiding principles