Did you know that physical inactivity has been documented to cause numerous physical and mental health problems, is responsible for an estimated 200,000 deaths per year, and is shown to contribute to the obesity epidemic? Among preschool children and adolescents, obesity has doubled since the 1970s. The percentage of obese children 6 to 11 years old has tripled. Turning these statistics around means increasing children’s physical activity and improving what they eat. Much research has focused on educating children and changing their behavior, but these approaches have had limited success. Changing the environments in which children eat and play is now seen as an essential strategy in fighting the obesity epidemic.
Environmental barriers to healthy eating and activity
A panel of experts convened by the Institute of Medicine recently identified five factors in the environment that are barriers to healthy eating and physical activity for children:
• Pressures on families to minimize food costs and preparation time, resulting in frequent consumption of convenience foods high in calories and fat;
• Reduced access to and affordability of fruits, vegetables, and other nutritious foods;
• Urban and suburban designs that discourage walking and other physical activities;
• Decreased opportunities for physical activity at school, after school, and reduced walking or biking to and from school;
• Competition for leisure time that was once spent playing outdoors with sedentary screen time.
Listed below are some ways to change these five environmental factors to help solve the childhood obesity epidemic:
Changing the environment to increase children’s physical activity:
Safe places to walk and play help children to be more active. Many children and youth lack opportunities to be physically active. Walking or bicycling to school is increasingly uncommon and daily physical education has been cut from most schools (only 6 percent of middle schools provide it). More than one-third of high-school students nationwide are not getting recommended levels of moderate or vigorous physical activity.
Children need safe and accessible places where they can be active. Special attention may be needed for lower-income and minority communities, which tend to have fewer parks, sports facilities, bike paths, pools, and other places to be active.
There is strong evidence that access to facilities, like parks, and activity programs is associated with more activity for both children and adolescents. Some studies of preschool children have found that the more time spent outdoors, the higher the activity level.
Active living for children: The trip to school
Children can get regular, sustained physical activity walking, bicycling, or skateboarding between home and school, but distance, traffic, and crime are all barriers. Research shows environmental changes can help.
More children walked to school where there were sidewalks. For example, A Safe Routes to School program in Marin County, California, that included both safety improvements and encouragement, increased the number of children walking to school by 64 percent in two years. Children whose route to school passed a completed Safe Routes to School safety project at 10 elementary schools in California were more likely to increase walking to school (15%) than children whose route did not pass the improvement (4%).
Creating activity-friendly environments at school
Once at school, research shows the environment influences children’s activity levels. This environment includes the presence of effective PE classes and opportunities to be active during recess and the lunch break. A Centers for Disease Control review of 14 studies found that enhancing PE classes by increasing their length, or having students be more active throughout the class, consistently improved students’ physical fitness.
Five to seven year old students spent 18 additional minutes per day in active play after the pavement on school grounds was marked for play. Providing balls and other equipment to ten and eleven year olds increased their active play during recess by 24 percent.
Middle school students were more active throughout the school day if school activity areas had more facilities and if equipment and supervision were provided.
Improving safety to increase activity
In at least one study, adolescent girls were less active outdoors when they lived in high-crime neighborhoods. Parental concerns about traffic and ‘stranger danger’ are clearly linked to children’s activity levels. A Chicago study found children were physically active for an extra 49 minutes a week in safer neighborhoods than in unsafe neighborhoods.
Traffic safety is critical, pedestrian injuries are a leading cause of injury death for children five years and older. Several studies show that specific street improvements can improve child pedestrian safety. Speed bumps reduce the chance of child injury. Children were about half as likely to be injured by a car in their neighborhood if they lived within a block of a speed bump. It is more important and probable to reduce speed than to reduce traffic volume to improve child safety.
Changing the environment to reduce screen time
Kids spend more time watching TV than in school. While the results are somewhat mixed, studies show that TV and video time may encourage obesity both by displacing time that might be spent being physically active and through exposure to advertisements that encourage children to eat high-calorie, low nutrition foods. The American Academy of Pediatrics and Healthy People 2010 recommend no more than 2 hours per day of TV.
Interventions aimed at decreasing sedentary behavior can increase physical activity and reduce body mass index. Eliminating screen time for 10 days, and then restricting it to 7 hours a week was linked to lower body mass indexes for 3rd and 4th graders who also took classroom lessons and had a “TV budget” device to use at home.
If children must ride a stationary bicycle to activate the TV at home (1 min. pedaling = 2 min. viewing) TV viewing drops dramatically. At the end of one study the children were watching 1.6 hours of TV weekly, compared to 21 hours for a control group.
The research to define healthier food and physical activity environments for children and adolescents is starting to suggest some fruitful strategies. Studies have shown correlations between environmental factors and physical activity levels or eating habits, and several have demonstrated that changing the environment can change behavior. Few studies show a direct link between environments, or environmental changes, and reduced obesity. Nonetheless, the limited research to date does point to environmental change as a promising strategy in fighting childhood obesity.
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