Academics Tied to Physical Fitness

Aside from their own home, children spend more time at school than any other place. In many cases children are fed at school, they are socialized in this setting and they are taught many things that have nothing to do with reading, writing and arithmetic.

Because society has decided that the accumulation of knowledge is the primary purpose of schools and they punctuate this decision with funding incentives, most school boards, administrators and teachers feel that academic achievement is the only objective of schools. To the disappointment of public health experts, pediatricians and physical education teachers, schools have become ambivalent about physical fitness and the obesity epidemic among students.

As a result of this, when funding issues arise in public schools, one of the first programs to be discontinued is physical education. A recent study in California suggests that low aerobic fitness which leads to obesity is associated with lower standardized test score in children in the state.

A Tie Between Aerobic Exercise
and Academic Performance

In an article published in the "Journal of Pediatrics," Dr. Christian K. Roberts and two other colleagues set out to investigate whether aerobic fitness and obesity in school children are associated with standardized test performance. To undertake this test, the researchers choose an ethnically diverse group of 5th, 7th and 9th graders attending California schools. The data were collected from 2,703 kids enrolled in public school during the spring school term.

Aerobic fitness was determined by a 1-mile run/walk test. The body mass index (BMI) of each child was obtained from state-mandated measurements. The state's standardized test scores were obtained from the students' school districts.

The results were not surprising to physical education advocates. Students whose mile run/walk exceeded (i.e. took longer) than the California FitnessGram standards or whose BMI exceeded the Center for Disease Control sex and age specific body weight standards, scored lower on California standardized math, reading and language tests than students with desirable BMI or fitness levels even when this was controlled for parent education.

The researchers concluded that low aerobic fitness is common among youth and varies among ethnic groups and that aerobic fitness level predicts performance on standardized tests across all ethnic groups. They further noted that more research was needed to uncover the physiological mechanisms by which aerobic fitness might contribute to performance on standardized academic tests.

What This Means for All Schools

The suggestion that physical activity, health education and other lifestyle behaviors might affect brain functions such as learning, memory and decision-making, while largely untested, is becoming a focus for many cognitive development experts. The best-selling book, "Spark: The Revolutionary New Science of Exercise and the Brain" by Dr. John Ratey has become a must-read for teachers, administrators and parents because it give countless anecdotes and substantive research on the multiple ways fitness is tied to academic performance and growth.

This California study is just one of many others that are beginning to show that fitness may influence learning. In practical terms, this type of research will affect the way the parents of obese children are counseled by pediatricians and school counselors. It might very well be helpful for a pediatrician to be able to address the evidence for a possible link between academic achievement and the child's body weight and then offer guidance on its remediation.

Let's Move in All Grades

Physical educators, parents and the recently formed "Let's Move' task force set up by First Lady Michelle Obama, have noted that moderate to vigorous exercise for all grades from kindergarten to high school is critical to the heath and academic success of children. This will require innovative curricula, equipment and teacher training to succeed.

Exergaming products such as GameBike and GamePad along with a wide range of other cutting edge products have been proven to engage kids of all ages by immersing them in the game-play. When this occurs, the aerobic exercise is less boring and the child gets fitter. If this research is any indication, the standardized tests scores should also rise.

Does Childhood Obesity
Lead to Heart Disease in Adults?

Should parents of very young children be concerned about heart disease affecting them later in life? A recent research project suggests that they should and this is especially true if these youngsters are overweight.

In a comprehensive study of more than 16,000 children, ages 1 to 17 in the United States, obese children as young as 3 showed signs of an inflammatory response that has been linked to heart disease later in life. This would suggest that obesity-related disease processes may begin earlier than previously thought.

A Marker for Heart Disease - CRP

The research, funded by the National Institutes of Health and published in the March 2010 issue of the journal "Pediatrics," found that almost 30 percent of obese 3 to 5-year olds had elevated blood levels of C- reactive protein (CRP) as compared to 17 percent of healthy weight kids of the same age. CRP is a widely studied health marker for inflammation. The report also found that the disparities between obese and healthy weight children widened as the kids aged.

By ages 15 to 17, the CRP was elevated in about 60 percent of the obese teens, compared with 18 percent of the teens whose weight was healthy. The study noted that the increase in CRP was even more pronounced for the very obese kids with almost 83 percent of this group showing the marker.

The research team was led by Asheley Skinner, a professor of pediatrics at the University Of North Carolina School Of Medicine. It was noted that in the United States, 14 percent of the 2 to 5 -year old are considered overweight or at the 85th percentile (or greater) of weight for height in this age group.

The American Heart Association and others who have been involved in researching heart disease have long been aware of the predictive value of CRP in adults. Previous studies have found that overweight and obese adults show elevated levels of CRP and it has been used to predict risk of heart disease, stroke and death under certain conditions.

Less is known about CRP in children and in order to find out more it will be necessary to follow overweight and obese children until adulthood. However, Dr. Skinner noted that there wasn't any evidence that CRP response would be different in children than in adults.

Is a Chubby Toddler a Healthy Toddler?

Inflammation is the body's response to infection or injury and as a marker for this inflammation, CRP points to its existence. The concern of finding CRP elevation in children as young as 3 is that the deleterious effects could be cumulative, culminating in premature death due to heart disease or stroke. Further research is needed to determine whether remedial action, such as losing weight, could reduce the CRP response in children.

Many parents encourage excessive eating by babies and toddlers. In many ethnic groups, a chubby baby is seen to be a happy and healthy baby. Clearly, this is not the case.

Countless studies have shown that childhood obesity can and does lead to unhealthy teens and adults. Rates for diabetes are skyrocketing and premature death due to the effects of obesity is being predicted for the current generation of children. This latest research on the CRP marker for heart disease being elevated in overweight children is even more bad news.

Let's Move! An Update

In February, First Lady Michelle Obama announced the formation of a task force to make children and families in the United States healthier. As was noted in the last issue of News Cycle, this task force was composed of some of the most powerful advisors within the Administration along with many thought-leaders in the campaign to fight childhood obesity. The final document had input from 12 federal agencies and more than 2,500 submissions from parents, teachers and health care providers.

After 90-days of intense research, public input and best-practices discussions the task force issued its 70 recommendations in May 2010. It was entitled: "Solving the Problem of Childhood Obesity in a Generation." Since most readers of this newsletter are involved in physical education or fitness in some form, we will focus on the final group of recommendations, "Increasing Physical Activity."

There were four other areas that relate to reducing childhood obesity. These include:

• Getting children a healthy start on life, with good prenatal care for their parents; support for breastfeeding; adherence to limits on "screen time"; and quality child care settings with nutritious food and ample opportunity for young children to be physically active.
• Empowering parents and caregivers with simpler, more actionable messages about nutritional choices based on the latest Dietary Guidelines for Americans; improved labels on food and menus that provide clear information to help parents make healthy choices for children; reduced marketing of unhealthy products to children; and improved health care services, including BMI measurement for all children.
• Providing healthy food in schools, through improvements in federally-supported school lunches and breakfasts; upgrading the nutritional quality of other foods sold in schools; and improving nutrition education and the overall health of the school environment.
• Improving access to healthy, affordable food, by eliminating "food deserts" in urban and rural America; lowering the relative prices of healthier foods; developing or reformulating food products to be healthier; and reducing the incidence of hunger, which has been linked to obesity.

Increasing Physical Activity Recommendations

This section of the report discussed how important quality physical education programs in schools will be to solving the childhood obesity epidemic within a generation. The task force had a total of 17 recommendations that can be summarized as:

• Encourage children to be more physically active through recess, physical education and other opportunities.
• Include strong physical activity components in local school wellness policies.
• Have the Environmental Protection Agency work with school districts to determine whether students can safely walk or bike to school.
• Have federal government, local governments and the business sector work together to improve access to safe parks, playgrounds, and indoor and outdoor recreational facilities.

Interestingly, exergaming equipment such as GameBikes and GamePad was highlighted in the report under the title of "The Promise of Technology." The task force wrote:

"Innovative and engaging teaching methods can motivate students to participate in PE, particularly those students who are not natural athletes or who do not enjoy "traditional PE." Some students have been motivated by the use of technology in the PE classroom that enhances individual skills and teaches students how to monitor their own fitness levels. Examples of technologies that have been incorporated into PE classrooms in recent years include hear rate monitors and equipment that combines activity with video or television enabled games."

The report goes on to note that more research on the long-term viability of exergames to reduce weight and enhance the students' health is needed. Since one of the primary goals noted at the outset of this set of recommendations was to encourage daily exercise that is moderate to vigorous, research has shown that exergaming meets this goal, particularly with regard to the non-athletic student.

A digital version of the report is available for download at http://www.letsmove.gov/taskforce_childhoodobesityrpt.html