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Get up and move! Suggestions for fighting childhood obesity with physical activity.

It shouldn’t come as a surprise that childhood obesity is on the rise in the United States and throughout the world. For that reason, there are strong recommendations to identify children at risk early on. Many parents are taken aback when they see “body mass index” listed on their child’s patient care summary, but given the obesity crisis, we are calculating body mass index at every well visit 24 months and older. This value is then graphed for a percentile.

A few things you should know:

  • BMI is the ratio between a child’s weight and body surface area which comes from his/her height.
  • The percentile rank of a child’s BMI is out of a hundred in that age/gender (65th percentile means that your child’s BMI is 65th out of a hundred).
  • Normal BMI for children 2 to 18 is 5th to 85th percentile.
  • Under the 5th percentile is underweight, whereas 85th to 95th percentile is considered “at risk for overweight”.
  • Over the 95th percentile for BMI is considered overweight.

As with adults, both diet and activity play a role in a child’s risk for being overweight. In future articles we will continue to discuss how to establish and maintain healthy eating habits in your children, but here I want to talk about physical activity recommendations.

There are strong recommendations that every child over 2 years of age (no matter what their BMI) should meet two goals every day:

  • 1 hour of active play
  • Limited screen time

At school, many children have seen their physical activity lessen in past years with fewer and shorter recesses and fewer gym classes per week. This means that families need to emphasize physical activity more at home. You don’t need to necessarily think of it as “exercise” per se because many activities meet this recommendation. A few examples include:

  • Jumping in piles of leaves
  • Riding bikes (with helmets of course)
  • Playing tag
  • Shooting baskets and playing catch

Even when it is cold and snowy, we can bundle up and go sledding, toss snow balls and make snow angels. The main point here is to just get up and move!

Screen time can be a contentious topic in families and the community. Medical professionals and educators agree that excessive screen time is detrimental to health and learning. The youngest brains are the most impacted. In fact, according to the 2016 update to screen time recommendations by the American Academy of Pediatrics, children under 18 months should have NO screen time except video-chatting (an understanding that so many families live at a distance from grandparents and extended family). If parents wish to introduce limited screen time after 18 months, it should be high-quality educational programming and parents should watch with their children to create an interactive experience (for example, “let’s count with her” or “What is hiding behind that tree?”).

Until age 5, no more than 1 hour of screen time per day is recommended. For ages 6 and above, screen time and the content of the material should be monitored with consistent limits. Though two hours is generally a good rule of thumb for this age, the newest guideline puts more emphasis on function: time spent on screens should not interfere with sleep, physical activity and meeting other health goals (including social and emotional growth). Designate screen-free time for the family like meal times and model good behavior yourself!

We recognize the challenges of busy family life! Showing your children how to be physically active and using limited screen time will allow for healhty lifelong habits.