Healthy isn?t something you are or aren?t. It?s a hundred little things: eating a banana, walking in the park, putting a bandage on a boo-boo, playing tag, reading up on ways to keep you and your family well and safe. It?s a balance between living well and taking care, and you can start right where you are.
A blog by Christina Elston
Healthy isn't something you are or aren't. It's a hundred little things: eating a banana, walking in the park, putting a bandage on a boo-boo, playing tag, reading up on ways to keep you and your family well and safe. It's a balance between living well and taking care, and you can start right where you are.


Archive for the ‘Kid Fitness’ Category

Student Athletes Are Safer On the Field With a Good Night’s Sleep

Tuesday, October 23rd, 2012

If your kids play sports and you want to keep them from getting injured, enroll them in a program with good coaches, and make sure they wear proper safety gear and play by the rules.

And tuck them in regularly for a good night’s sleep.

When Children’s Hospital Los Angeles researchers asked 112 middle and high school athletes at Harvard-Westlake School in Studio City about their sports participation, they found the amount of sleep the students got each night was a better predictor of how likely they were to be injured while playing sports than the number of sports they played, how much time they played, whether they participated in strength training, or whether they used a private coach.

Student athletes who reported sleeping eight or more hours a night were 68 percent less likely to be injured than those who regularly slept less.

“When we started this study, we thought the amount of sports played, year-round play, and increased specialization in sports would be much more important for injury risk,” said orthopedic surgeon Matthew Milewski, M.D., in releasing the study, which was presented Oct. 21 at the American Academy of Pediatrics national conference in New Orleans. “What we found is that the two most important factors were hours of sleep and grade in school.”

Athletes in the study had a 2.3 times greater risk of athletic injury for every additional grade in school, potentially because older athletes are bigger, faster and stronger, Milewski noted.

Health Gaps Based On Race, Income and Education Start Early

Wednesday, August 22nd, 2012

Black and Latino fifth-graders are much more likely than whites to witness gun violence, be obese and ride in a car without a seatbelt. These kinds of health gaps have gotten plenty of attention among teens, but attempts to fix them need to begin much earlier – especially in schools.

That’s the message Boston Children’s Hospital researchers are trying to get out on the heels of an extensive look at health disparities among elementary school children in various regions across the U.S. They also note that health gaps narrowed across all races when children had the advantages of educated parents with higher income, or attended certain kinds of schools.

In interviews with 5,000 children ages 10 and 11 and their parents, researchers asked about several health-related measures. Gaps they found included:

• Black children were four times more likely and Latino children and two times more likely than whites to have seen someone threatened or injured with a gun.

• Black fifth-graders were more likely to smoke cigarettes and drink alcohol than Latino and white fifth-graders.

• Obesity rates were nearly twice and high among Latino and black children as among white children, and these children reported less vigorous exercise than white children did.

• Black and Latino children were less likely than white children to wear a seatbelt or bike helmet.

The interviews were conducted between 2004 and 2006 among families living in and near Birmingham, AL; Houston, TX; and Los Angeles, CA. Because the behaviors detailed can have serious long-term impact on health (patterns of seatbelt use and violence, for instance, are known to persist into adulthood), the authors believe intervention efforts should begin before the teen years.

“We should be thinking about these issues when children are young enough to prevent bad outcomes before they occur,” says lead author Mark A. Schuster, M.D., Chief of General Pediatrics at Boston Children’s Hospital. And because schools seemed to have a major impact on narrowing health gaps, they should be a key focus. “Is it a visionary principal, committed teachers, a strong commitment to health education, an engaged PTA?” asks Schuster. “We need to learn more.”

The study appears in the Aug. 23 issue of the New England Journal of Medicine.

To Get Kids Off the Couch, Parents Have To Pitch In

Friday, June 22nd, 2012

The amount of time young kids spend sitting in front of a screen (be it TV, computer, or smart phone) may have more to do with the kind of parents they have than the kind of gadgets and games those parents provide.

Almost all kids sit too much, but studies out online June 21 in the journal Early Child Development and Care found those whose parents were more involved were active around 30 minutes more a day than those whose caregivers spent less time with their kids.

Researchers from Oregon State University found that among the 200 families they studied, all of the kids ages 2 to 4 were sitting around four to five hours a day – a fact the authors called “disturbing.” But those whose parents reported being away from home more, and less involved with their children, spent an average of 30 minutes longer watching TV, playing video games or otherwise engaging in “screen time.” And these parents didn’t make up for weekday absence with extra play on weekends. In fact, their kids spent around one our of additional couch potato time on weekend days.

It might not sound like much, but over the course of a week it means these children spent four to five more hours in front of screens than kids with more involved parents did.

Children are naturally active early in life, but become less active once they enter school. So experts say these early years are an important time to establish good habits.

When the researchers talked with parents whose children were more active, they found that these parents were most likely to actively play with their children. But any level of encouragement to move – whether watching their child play, or driving them to the park or another activity – helped counteract the lure of the screen.

Diabetes In Teens More Than Doubles In a Decade

Monday, May 21st, 2012

Twenty three percent of kids ages 12 to 19 in the U.S. now have diabetes or prediabetes, according to a study out today in the journal Pediatrics. A decade ago that figure was just nine percent.

Looking at risk factors for heart disease and stroke in adolescents, researchers from the U.S. Centers for Disease Control and Prevention (CDC) examined data on more than 3,300 adolescents participating in a national survey from 1999 to 2008. Along with the increase in diabetes, they found that:

• 61% of obese teens in the survey had one risk factor for cardiovascular disease – such as high LDL cholesterol, high blood pressure, physical inactivity or diabetes – besides their weight

• 49% of overweight teens had one additional cardiovascular risk factor

• 37% of normal-weight teens had at least one cardiovascular risk factor

“I think this is an eye opener,” says Steven Mittelman, M.D., Ph.D., of the Children’s Hospital Los Angeles Center for Endocrinology, Diabetes & Metabolism, who was not involved in the study. “Parents really need to think about what their kids are eating and what their activity level is. Parents have to step up and help prevent these devastating diseases that last a lifetime.”

One of every three children with diabetes now has type 2 (which used to be called “adult-onset diabetes,” but is now far too common in children to merit that name), and Mittelman points out that the disease is not easily managed in kids. Adults with type 2 diabetes can improve their health with lifestyle changes and medications, but 50 percent of kids diagnosed with type 2 will end up on insulin within five years – and need it for the rest of their lives. “Over time that number will get worse, so eventually most teenagers diagnosed with type 2 diabetes will need insulin,” he says.

The prevalence of obesity among teens did not increase during the study period. “The prevalence of obesity and overweight really plateaued in the last 10 years,” says Mittelman, who credits public education about the obesity epidemic with spurring some progress. There are still far too many overweight kids, “but at least it’s not going up like it was 10 years ago,” he says.

His suggestions for parents looking to improve their kids health:

Pay attention during checkups. Doctors should be checking children’s height, weight and blood pressure at every visit, and taking the time to calculate Body Mass Index (BMI, a measure of height related to weight) for patients. Under some circumstances, they should also test kids’ cholesterol levels, and test for diabetes.

Know your family history. Let your pediatrician know if your child’s parents or grandparents have high cholesterol, diabetes or heart disease. Find out what medications your child’s grandparents take, and share that information as well. “That helps us know what might run in the family,” Mittelman says.

Check out resources that get kids moving. Mittelman recommends the CDC childhood obesity page (cdc.gov/obesity/childhood), Michelle Obama’s Let’s Move! campaign (LetsMove.gov) and your local YMCA (YMCA.org) as great places to start. “I often send my parents who say they have a tough time getting their kids to exercise [to the YMCA],” he says. “They really are focused on healthy weight.”

Mittelman is quick to point out that heart disease and diabetes are just two of the many life-threatening conditions caused by obesity. He specializes in studying the connections between obesity and cancer (and says that 20% of cancers in the U.S. are now caused by obesity). Studies show that many kids carry their weight problems into adulthood, but Mittelman and other experts consider adolescence a key window for change. And much of that change is up to moms and dads.

“Parents do have the power,” he says.

Many Obese Children With Asthma Held Back By Weight, Not Breath

Wednesday, May 9th, 2012

Two current health crises in children – asthma and obesity – often strike together. And among kids dealing with both, lack of physical activity frequently comes in to create a “perfect storm” that hits health hard.

Looking at one of these kids, it is easy to imagine a sequence of events:

1. The child is diagnosed with asthma.

2. Asthma impairs the child’s ability to exercise.

3. The child gains weight.

But if a child’s asthma is well controlled, this doesn’t have to be the case. That is the message from new research out of The Children’s Hospital at Montefiore and Albert Einstein College of Medicine in New York.

Pediatric pulmonologist Deepa Rastogi, M.D., and colleagues found that when obese children with asthma were asked to walk for six minutes, it was their obesity – not their lung function – that held them back.

Researchers looked at 140 children, among them obese children with and without asthma, and normal-weight children with and without asthma. All children in the study with asthma had their disease under good control, meaning they had not needed prednisone, a medication used to treat an exacerbation, in at least three months. Researchers tested each child’s lung function and measured the distance they could walk in six minutes.

For children who were not obese, both asthmatic and non-asthmatic, their distance was linked to their lung function. The lower their lung function, the less ground they could cover.

But for obese children, their distance was linked to their BMI (a measure of weight compared to height). Whether or not they had asthma, the higher their BMI, the shorter the distance they could walk.

“If you have well-controlled asthma, then your exercise limitation may not be your asthma, it may be your body weight,” says Rastogi.

She explains that parents often discourage children with asthma from being active because they are afraid of bringing on attacks. “By the time they are in school they become programmed that they have asthma and they can’t exercise, and by then we have missed the opportunity to teach parents about keeping their children active with appropriate use of controller medications,” Rastogi says. Instead, the focus should be on keeping kids as active as they can be while maintaining good control of asthma.

Her message to parents is to partner with their healthcare provider to get their child’s asthma under control. “That’s the first step, always,” she says. “Then, with good control, encourage activity. If it appears that your child is limited in their exercise ability, talk to your health care provider to investigate further into the cause for the limited ability.”

Her study was published in March in the journal Pediatric Pulmonology.

Getting Kids Active Is a Matter of Choice

Wednesday, April 25th, 2012

If you want your kids to be physically active, make sure they have lots of active toys and games to choose from. That’s the take-home message from recent research published by University at Buffalo experts.

Working with 8-12-year-olds, a team led by James Roemmich of the university’s school of medicine first looked at whether giving children more toy choices increased their physical play. They found that if there was just one toy to play with, boys played actively 1.3 times longer than girls. But given a choice of active toys – mini hockey, bean bag toss plus tic-tac-toe, mini indoor basketball and jump rope – girls increased their physical play nearly 200 percent.

Physical play for boys increased as well, but by just 42 percent, possibly because girls enjoy the mental challenge of evaluating the toys and choosing which to play with more than boys do. Having a choice of toys increased exercise intensity for both groups.

Next, the researchers looked at whether the exergames motivated kids to increase play time. They did, but Roemmich points out that while kids played Wii basketball twice as long as actual basketball, they expend only half the energy on the Wii.

He advises parents to find three to five active games and toys their children enjoy, and make them easily accessible at home. Exergames are best when they replace watching TV or playing other types of video games, rather than taking the place of other physical activities. Away from home, parents should look for a variety of activities – dance, zoomba, sports or martial arts – and find fitness or youth centers that promote choice by including a variety of programming with membership, rather than charging extra.

His studies were funded by the National Institutes of Health. The first was published in the Journal of Science and Medicine in Sports, and the second in the International Journal of Behavioral Nutrition and Physical Activity.

Can the Neighborhood Make Kids Fat?

Thursday, April 12th, 2012

With nearly 18 percent of school-aged children and adolescents in the U.S. now classified as obese, health experts and organizations have increasingly been pointing to nurture, rather than nature, as a possible culprit. Specifically, they’ve been looking at where kids live for clues about why they’re getting fatter. And a study out this week suggests they’re right.

Researchers have found that children living in walkable neighborhoods with plenty of parks (with high-quality play equipment), lots of grocery stores and few fast-food outlets are almost 60 percent less likely to be obese than those living in areas without these perks.

A team from the Seattle Children’s Research Institute evaluated the nutrition and physical activity environments of neighborhoods in King County in Seattle, Washington, and San Diego County, California from 2007 to 2009. They then assessed the weight of 730 children ages 6-11, plus one parent for each, living in those neighborhoods.

They found that 16 percent of children living in the poorest nutrition and activity neighborhoods were obese – a figure in line with the national average – but just 8 percent of kids in active neighborhoods with access to healthier foods were obese.

“People think of childhood obesity and immediately think about an individual’s physical activity and nutrition behaviors, but they do not necessarily equate obesity with where people live,” says lead study author Brian Saelens, Ph.D. “Everyone from parents to policymakers should pay more attention to zip codes because they could have a big impact on weight.”

The study appeared April 10 in the American Journal of Preventive Medicine.

Parents of Preschoolers: Take Your Kids Outside

Wednesday, April 4th, 2012

Kids (and parents) need at least an hour a day of physical activity – ideally spent playing outside – to stay healthy. But nearly half of parents of preschoolers don’t take their children outdoors daily, a study out this week found.

Even preschoolers in child care spend the majority of their time with their parents, so moms and dads are the biggest influences over their healthy behavior. Researchers from Seattle Children’s Research Institute found that computer and television time weren’t a factor in whether kids made it outdoors, but they did note several other traits that made a difference. Preschoolers had outdoor play with parents more often if:

They were boys. The study found that girls were less likely to play outside, and that mothers took their children outside more often (44%) than fathers (24%).

They had playmates. Preschoolers with three or more regular playmates were twice as likely to get outside every day as those with fewer playtime pals.

Their parents were white. Asian moms were 49 percent less likely, black mothers 41 percent less likely and Hispanic moms 20 percent less likely to take their children outside than white mothers were.

Their mothers exercised. Mothers who reported exercising more than four times a week were 50 percent more likely to take their kids outside daily than mothers who said they didn’t exercise at all.

The 8,950 families in the survey were part of the Early Childhood Longitudinal Study-Birth Cohort (collected from 2001 to kindergarten entry), and represent approximately 4 million U.S. children. The current study appears in the April 2 Archives of Pediatric & Adolescent Medicine.

Lead author Pooja Tandon, M.D., MPH, says that parents should ask childcare centers about outdoor playtime, talk up the importance of outdoor play to friends, and make an extra effort to encourage girls to play outdoors. Even if you don’t get home until after dark, or it’s a bit rainy, a flashlight and umbrella are all you need to turn a walk around the block into an outdoor adventure.

Click here for tips from Dr. Tandon on getting your kids outdoors!

Some Sports Kids Overdo It

Monday, April 2nd, 2012

Their injuries have names like “runner’s knee,” “gymnast wrist” and “baseball shoulder,” and their numbers are on the rise. Amid a national epidemic of children who are inactive and obese, there are also more and more kids on the flip side of that trend. They specialize in a single sport, playing year-round and on multiple teams without a break, and they’re wearing out their growing bodies with overuse injuries.

“These kids are doing too much, too fast, too soon, and getting hurt,” says Amy Valasek, M.D., a pediatric sports medicine expert at Johns Hopkins Children’s Center. Around 30 million to 45 million U.S. kids ages 6-18 participate in organized sports, and Valasek says she sees around 50 children per month – about half her patient load – with repetitive use sports injuries.

More subtle than a broken bone, sprain or concussion, these types of injuries tend to happen to kids ages 10-14 and older, who are at special risk because of open “growth centers,” plates in their bones that do not finish closing until they are 13-17 years old.

Kids with overuse injuries experience dull aches, tenderness, or decreased range of motion. But because young athletes sometimes hide their injuries so they can stay in the game, parents need to look for decreases in ability and agility. Your pitcher’s fastball time might be off, your runner’s or swimmer’s lap speed could decrease, or you might find your gymnast avoiding certain moves. “That’s usually the first clue that there’s something wrong,” Valasek says.

It’s important to keep watch, because leaving overuse injuries untreated could lead to abnormal growth and development. “A wrist issue, for instance, could lead to one arm being shorter than the other,” says Valasek. Even better, help prevent overuse injuries with the following tips:

Don’t let kids specialize. Kids should play a variety of sports, and not focus in on a particular one before age 14.

Make them take breaks. Children should have no more than five days a week of sport-specific training, and no more than nine months a year in any particular sport.

See your doctor. A pre-participation physical is a great time to ask about preventive measures (i.e. inserts for the cleats of a soccer player with “flat feet” or extra stretches for a basketball player whose hamstrings have been tightened by a growth spurt).

Stretch them out. “Stretching can help prevent a lot of the overuse injuries, and kids don’t do enough of it,” Valasek says. After practice, kids are tired and ready to head home – but that’s the most important time for them to stretch, because the muscles are warm. “That’s when you get the most lengthening of the muscle,” Valasek says. So hop out of the car and encourage your child through five minutes of post-practice stretching.

Don’t feel qualified? Valasek recommends a visit to www.StopSportsInjuries.org, an online resource created by the American Orthopaedic Society for Sports Medicine and supported by a host of health organizations. The site includes sport-specific tip sheets and other resources for athletes, coaches and parents.

“Active” Video Games Not a Cure-All For Inactive Kids

Monday, February 27th, 2012

Bringing home a shiny new Wii Fit or Dance DanceRevolution game for your kids won’t make their days any more active than if you’d brought them Mario Kart. That’s the finding of a study published today (Feb. 27) in the journal Pediatrics.

Previous research has shown that children in laboratory studies using “active” games – games that require players to move their whole bodies, rather than just buttons or triggers on a controller – can get the equivalent of moderate or sometimes even vigorous physical activity. But Tom Baranowski, Ph.D., a professor of behavioral nutrition at Baylor College of Medicine in Houston, wanted to test the games under “real world” conditions, to see if receiving a new active game made kids move more at home.

Baranowski’s team selected 87 children ages 9-12 who did not already have a Wii console at home, and had Body Mass Index (BMI) high enough to put them at risk for obesity as adults. Age 10 has been pegged by experts as a critical window for increasing physical activity, because that’s the age where an obese child’s risk of carrying their weight problems into adulthood skyrockets.

Researchers gave all of the participating families Wii game consoles and necessary extras such as mats, controllers and balance boards. Half of the children were then allowed to choose an active game (Active Life-Extreme Challenge, EA Sports Active, Dance DanceRevolution-Hottest Party 3, Wii Fit Plus or Wii Sports), while half got to choose an inactive game (Disney Sing It-Pop Hits, Madden NFL 10, Mario Kart Wii, New Super Mario Bros. Wii or super Mario Galaxy). After six weeks, all the children were allowed to choose another game from the same group.

Activity levels for all children were monitored during the 12 weeks they had their games using an accelerometer, a device that’s worn to measure acceleration and exertion. Researchers found that the children using the active games were no more physically active during the study than those using inactive games.

“We were quite surprised,” says Baranowski. “We expected that we would detect a modest increase in physical activity during week one [among kids with the active games], which would be lost by week six, and detect another smaller increase in physical activity at week seven (after just having received their second active video game) which would also die out by week 12.”

Baranowski and his team theorize that children receiving the active video games either didn’t play them very intensely, or they offset activity from the games by choosing to be less active at other times of the day. “I would bet a little bit of both,” he says. “We have qualitative data that indicated the kids did play the games and enjoyed them, but obviously they didn’t play them intensely enough.” He explains that without actual instruction to play the games at a certain intensity level, or for a certain amount of time each day, kids didn’t get enough physical activity from the games to make a difference.

But he also notes something about the make-up of active games that could be getting in the way of extended play. “By themselves these active video games have little to no story,” he says. “Wrapping a story around these games also holds promise,” as a way to hold kids’ attention for longer periods. A colleague is working on research to test that idea.

Meanwhile, don’t count on a game to give your kids the exercise they need. “You need to do more than just purchase and provide your child an active video game,” says Baranowski, who suggests playing the game with your child on a regular basis (even daily), adding other activities like a nightly walk to the family calendar, or getting your child involved in sports teams at school or in your community.