Saturday, September 15, 2012

Don't treat the sneeze!

The Centers For Disease Control and Prevention (CDC) just released updated state-by-state obesity rates and Colorado has the lowest rate in the nation at 20.7%.  However, between 2005 and 2009 Colorado was the only state with an obesity rate below 20%. [1] In 1990, no state had an obesity rate of more than 15 percent, according to the CDC.  Even though the people of Colorado may be in first place in this contest their rate is trending in the wrong direction.  My opinion has always been that obesity is nothing more than a sneeze a side effect of our behaviors and the current culture we live in.  In America we all strive for the quick fix and we are all trying to get more done and be in more places in the same 24-hour window.  Quality home cooked meals; family fun and active free play have been sacrificed to a fast paced, high-tech, hyper-competitive race to the bottom culture.

It is my strong belief that this generation of children while more active in team sports are as physically unfit than at any time in recent memory.  Three topics that have shaped my opinion in recent years are the following:

Youth Sport Injuries are at an all time high

High school athletes account for an estimated 2 million injuries and 500,000 doctor visits and 30,000 hospitalizations each year

More than 3.5 million kids under age 14 receive medical treatment for sports injuries each year

Children ages 5 to 14 account for nearly 40 percent of all sports-related injuries treated in hospitals. On average the rate and severity of injury increases with a child's age

Overuse injuries are responsible for nearly half of all sports injuries to middle and high school students [2]

National youth obesity rates

Childhood obesity has more than tripled in the past 30 years

The percentage of children aged 6–11 years in the United States who were obese increased from 7% in 1980 to nearly 20% in 2008. Similarly, the percentage of adolescents aged 12–19 years who were obese increased from 5% to 18% over the same period

In 2008, more than one third of children and adolescents were overweight or obese [3]

National Security Concerns
Department of Defense data indicates that an alarming 75 percent of all young Americans 17 to 24 years of age are unable to join the military because they failed to graduate from high school, have criminal records, or are physically unfit

Being overweight or obese turns out to be the leading medical reason why applicants fail to qualify for military service. Today, otherwise excellent recruit prospects, some of them with generations of sterling military service in their family history, are being turned away because they are just too overweight

Mission: Readiness, an organization of retired senior military leaders, is warning Congress that at least nine million 17- to 24-year-olds in the United States are too fat to serve in the military. That is 27 percent of all young adults [4]

All is not lost however.  Awareness is key in order to turn the tide and improve the health and fitness of the youth in our community and adults seems to understand this.

Adults across the U.S. rate not getting enough exercise as the top health concern for children in 2012, according to a new University of Michigan C.S. Mott Children's Hospital National Poll on Children's Health.

In the poll's annual top 10 list, a nationwide sample of adults were asked to identify the top 10 biggest health concerns for kids in their communities. For the first time, most adults rated not getting enough exercise as the top health concern (39 percent). That was followed closely by childhood obesity (38 percent) and smoking and tobacco use (34 percent).

"Childhood obesity remains a top concern, and adults know it is certainly linked to lack of exercise," says Matthew M. Davis M.D., M.A.P.P., director of the C.S. Mott Children's Hospital National Poll on Children's Health.

"But exercise offers many more benefits other than weight loss or preventing obesity – such as better attention and learning in school and improved sense of well-being," says Davis, associate professor of pediatrics and internal medicine at the U-M Medical School and associate professor of public policy at the Gerald R. Ford School of Public Policy.

The rest of the poll results were:

4. Drug abuse (33 percent)
5. Bullying (29 percent)
6. Stress (27 percent)
7. Alcohol abuse (23 percent)
8. Teen pregnancy (23 percent)
9. Internet safety (22 percent)
10. Child abuse and neglect (20 percent) [5]

The American Orthopedic Society for Sports Medicine (AOSSM) initiated the development of the STOP (Sports Trauma and Overuse Prevention) Sports Injuries campaign along with it’s organizational partners, including the American Academy of Orthopedic Surgeons, the American Academy of Pediatrics, the National Athletic Trainers' Association, the American Medical Society for Sports Medicine and SAFE Kids USA. These organizations shared AOSSM's concern about the increase in youth sports injuries and came together under the common goal to STOP Sports Injuries.  And according to the group, more than half of all sports injuries in children are preventable.

This is certainly encouraging news and the resolution to youth sports injuries, obesity, and lack of military readiness involves getting back to the basics and using common sense.  Children first need to learn how to move generally and master/learn their own bodies before they can master the more complex movements involved in sports.  By establishing a basic foundation of general movement they learn to optimally coordinate and stabilize their bodies making them far more resilient to injury.  Additionally, establishing a solid foundation at a young age allows them the diversity of skill required to progressively improve and eventually master more complex movement patterns.  As an example a young baseball player should master the art of spotting a fastball and changing speeds before learning how to throw a curve ball.  Rotating sports seasonally is also important to prevent burnout and overuse injury. 

It should also be noted that seasonal sport participation while an excellent way to expand a child’s skill set is inadequate in regards to overall physical fitness.   Playing sports to get in shape is a backwards idea.  Professional athletes whose priority is to maximize their performance on the filed of play take off-field/court/ice training very seriously in the off-season.  They use general training to gain strength, power, mobility and core stability to play their sport at a high level.  Playing a sport will not necessarily improve these qualities, in fact long seasons and sport specialization can actually degrade these athletic qualities.  That said, strength, power, mobility and core stability are absolutely necessary to excel on the field of play and establishing a solid movement foundation early in life through free play best develops these qualities.   And as the demands of sport increase in the mid-late teen years a dedicated training program will be necessary to defend against future injury and keep developing athletes in top-notch condition.

I strongly believe that the lack of free play and general conditioning for children is at the heart of issues such as obesity, sports injuries, and lack of military readiness.  Let’s face it not all children like sports and those that don’t are usually relegated to sedentary pursuits such as video games or computer time.  It’s in all of our best interest to provide opportunities for vigorous activity for all children, yes, even those that play sports.  Children should gain basic fitness in order to play sports but because of the intense nature of the youth sport culture they predominately play sports to gain their fitness.

Organized sport participation is simply not able to accomplish the task of getting kids in shape.  Watch any game at any level and you will notice a lot of standing around interspersed with an occasional explosion of speed or a moderate tactical run.  Most teams have dedicated conditioning programs that support on field play and that is essential now more than ever because kids aren’t getting it away from the sporting environment.   However, it must be acknowledged especially for kids that do not aspire to anything beyond having fun with their friends that this type of conditioning is not fun and a big reason why many of them leave sports.  At the developmental stages of youth sports the goal should be to increase participation and not to decrease it.

As coaches and parents we need to be mindful of this and adapt our practices by making them more general in nature and emphasizing fun over performance especially in the developmental years (pre-high school).  At the high school level the intensity necessarily gets ramped up but even then making practices fun while also implementing general athletic development principals are essential for keeping kids motivated, resistant to injury while also providing them the environment to optimize their fitness levels, athleticism and their ability to serve if they are so inclined.

Phil Loomis
Youth Fitness/Nutrition Specialist


Additional Reading:

All of the articles and studies listed below were released in the last week and all had different takes on youth obesity.  I could have easily included over a half dozen others.  I don’t expect you to read through all of them but I include them just to point out that this issue is diverse and has a wide array of potential negative ramifications.

Early antibiotic use linked to childhood obesity

Childhood obesity puts kids at a higher risk for serious illnesses like heart disease, stroke, diabetes, asthma and certain types of cancer. It also is costly for our health care system: The obesity epidemic costs our nation $117 billion per year in direct medical expenses and indirect costs, with childhood obesity alone costing up to $14 billion per year in direct health care costs.

“If we don’t act to reverse the childhood obesity epidemic, we’re in danger of raising the first generation of American children who may live sicker and die younger than the generation before them,” according to the Robert Wood Johnson Foundation website. “Preventing obesity during childhood is critical, because habits that last into adulthood frequently are formed during youth.”

A 12-year-old boy has been barred from playing with his local Pee Wee football league in Texas because he exceeds the league’s maximum weight restriction. At 6-foot-1 and 297 pounds — 162 pounds over the 135-pound limit — the league says he is too big to play safely with other boys his age.  Very difficult situation here and this article presents two differing points of view.

Obese Youth Have Significantly Higher Risk of Gallstones
“Although gallstones are relatively common in obese adults, gallstones in children and adolescents have been historically rare," said study lead author Corinna Koebnick, PhD, of the Kaiser Permanente Southern California Department of Research & Evaluation. "These findings add to an alarming trend — youth who are obese or extremely obese are more likely to have diseases we normally think of as adult conditions."

Modern technology add to youth obesity:
"Technological innovations, more processed foods, a greater amount of 'screen time,' less exercise, and higher consumption of snack foods have all played a role," report co-author and economist Anusuya Chatterjee said in an institute news release. "These are all the adverse effects of a knowledge-based society."

Laws strictly curbing school sales of junk food and sweetened drinks may play a role in slowing childhood obesity, according to a study that seems to offer the first evidence such efforts could pay off.

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