Lets start with a disclaimer- I am not a specialist in paediatrics, or public health, and this article is purely an opinion one, albeit one based on fact as much as possible. This article is meant to highlight some of the issues surrounding the childhood obesity problem, and open up avenues for discussion of how they may be solved by more intelligent people than myself.
A recent editorial in the British Journal of Sports Medicine (BJSM) highlighted the need to look at how physical education (PE) was being utilised to meet physical activity (PA) levels amongst school children, as it has been noted over recent years that the current system may be failing in this approach.
The report cited a meta-analysis done a couple of years back in the journal Preventive Medicine, which discussed the limited amount of moderate-vigorous activity that children were participating in at schools both here in the UK and in the USA. I have linked the article below for context and interest however it does require paid access, but fundamentally it showed that current PE lessons were not meeting the recommended moderate-vigorous PA level as recommended by the UK Association of Physical Education (afPE) or the US Centre for Disease Control and Prevention, of being moderately-vigorously active for over 50% of the available teaching time. Further to this afPE recommends children aged 5-18 should engage in at least 60mins of moderate-vigorous PA every day. This is in line with the current Public Health England guideline on physical activity in this age group.
Now the article in BJSM did highlight some of the flaws in the study, including the lack of standardised method of measuring physical activity levels in this population, but the point remained clear. Recommended levels of PA are not being met in schools currently, and this is a problem.
Okay so this doesn’t include PA done outside of the school context, but with children spending a good proportion of their waking hours in school, where young minds develop and good habits, including those around fitness and health, should be formed, I would argue that school is where children should be introduced to healthy habits, and where problems with obesity can begin to be tackled. So why isn’t more PA being done during PE? That is not an easy question to answer, there are likely multiple factors playing a role and I feel a more detailed report into this needs to be carried out.
We are getting fatter. That’s not some revolutionary secret, we all know it’s a problem whether you work in healthcare or not.
This is true for both adults and children; with the latest National Statistics report on obesity (England) showing that 1 in 5 children in year 6 (age 10/11 years) are classified as obese. That seems to be relatively unchanged over the last 10 years, which is somewhat reassuring, however with an estimated 12 million children in the UK, that’s 2.5 million already at risk of going on to develop heart disease, stroke, diabetes, respiratory problems before they’ve even reached childhood. And lets not forget this doesn’t include those classed as overweight, so that number is likely even higher!
Other interesting facts from the National Statistics reports included-
- Only 16% of children consumed 5 or more portions of fruit and vegetables a day.
- Children are more likely to be obese living in deprived areas
- 51% of children who were obese thought they were too heavy compared to their peers
Similarly the Active Healthy Kids – Wales 2018 Report showed that less than 1 in 5 teenagers engaged in the recommended activities levels per week, and only 16% of this same group did any exercise in their free time.
This has to change. We cannot sit by while the next generation walk (or sit) their way into poor health, poor self-esteem and an increased burden on an already burdened health service.
But how do we change this? That is the difficult question, with answers that are more difficult still, but school should be a foundation of learning, both for exams and for life. Here is where healthy habits can, and should, be established in an informed and safe space, and ideally this should be from a young age, where all are encouraged to participate not only in PE lessons, but after school activities, cookery lessons, and health and social education.
Beyond school there should be increased investment in community spaces. Places where physical activity can be encouraged in an informal manner and also in leisure centre, and gyms, where (although controversial) I am an advocate for younger people attending as long as activity is carried out safely and with appropriate supervision.
In the meantime I would argue that if sufficient PA is not being done at school then parents could encourage more to be done at home. The hard truth is this often means parents need to do more PA themselves. Children mimic what they see, so if you want to instil good habits while your children are young, you may need to look at some of your own.
School is not easy. The NSPCC reported an estimated 19000 calls to Childline for bullying related counselling sessions in the 2017/2018 academic year- so numbers of children being bullied are presumably much higher than that. We live in an instant gratification nation with Instagram and other social media platforms telling young people they must look a certain way otherwise they do not belong and this has been linked to a huge rise in mental health, self-esteem and other health problems in recent years. Only by creating an environment where such topics, as well as those around health and fitness, can be discussed openly and without repercussion will things improve- but lets leave the topic of social media to another post.
I do not have all the answers. But lets get the discussion flowing so maybe we can figure them out together, and lets not abandon children to a future of obesity, heart disease and a host of other medical conditions that we all know arise from lack of physical activity.
Reconsidering current objectives for physical activity within physical education
A systematic review and meta-analysis of moderate-to-vigorous physical activity levels in elementary school physical education lessons-
afPE guidelines on Physical Education-
PHE info graphic on current PA activity in children-
Statistics on Obesity, Physical Activity and Diet. England: 2018
Active Healthy Kids- Wales 2018 Report