Intervening Early Can Lead to Prevention
"Obesity is one of the major problems we're facing as we head into this new century." So says Steve Daniels,MD, PhD, co-author of a recent study on outdoor playtime as a measure of physical activity in preschool-aged children."We need to start early in identifying kids at risk and try to intervene to prevent it," continues Dr. Daniels, of the Division of Cardiology at Cincinnati Children's.
The study was led by Hillary Burdette, MD, MS, as part of her fellowship at Cincinnati Children's. Dr. Daniels oversaw her research which compared two parental-report measures of outdoor playtime in preschoolaged children. The need to explore and measure physical activity in young kids is becoming more important as the incidence of childhood obesity continues to rise. The study leads to a larger question of how to prevent obesity in children.
Dr. Daniels cites several reasons why obesity is becoming more prevalent in the United States. Kids are less active nowadays than they used to be. Less physical education is being offered in schools. Daily life involves more driving and less walking. And more snacks and foods -- especially high-calorie foods -- are easily available to kids."It's easy to see why the balance is tipping," Dr. Daniels says. With all of these factors coming into play, "you don't have to go very far over the norm to result in weight gain."
Accurate Measures Needed
The study used two measures. One was a two-question checklist parents used to record the amount of time their child spent playing outdoors. The other was an accelerometer, a device worn around the child's waist that recorded physical activity."One of the problems we have in dealing with overweight is getting a precise look at measures," Dr. Daniels says."That makes research on abnormal weight gain difficult."
There are few tools available to measure activity in preschool-aged kids. The results of this study showed that the time spent playing outdoors, as measured by the checklist, corresponded to the accelerometer's measure of activity. The researchers determined that the outdoor playtime checklist can be effective in certain circumstances, and should be considered for evaluation as a survey measure for future studies.
To help with prevention efforts, Dr. Daniels emphasizes that pediatricians should be getting an overall picture of how physically active their patients are."The important first step is recognizing that overweight is a problem," he says. He feels pediatricians should be looking at body mass index the same way they look at height and weight. This can help in identifying those at risk and addressing the situation early.
Influencing Communities
"To deal with childhood obesity, it's going to take a broad range of approaches," Dr. Daniels says. "Pediatricians have a lot of influence in their communities. I'm hopeful that as pediatricians,we can further the understanding of the importance of kids being active. And I hope pediatricians can have more of a populationbased approach by using their broader influence."
As the rates of obesity continue to climb, this study offers a tool that other investigators can use to study physical activity in young kids. Health care professionals interested in obesity prevention counseling may find it useful as well.
"The next generation of kids may not live longer than their parents," Dr. Daniels says."A lot of things are happening that are setting us up for adverse outcomes, and will lead to lots of ripple effects for our society. It will take a lot of people working from a lot of different directions to improve it."
Dr. Daniels' paper was published in Archives of Pediatrics and Adolescent Medicine, (158[4]:353-7, 2004 April).
