Want Kids to Lead an Active Lifestyle; Be an Active Parent

Human growth and development depend on an active lifestyle that includes a proper balance of nutrition, physical activity, and rest:

  • Volumes have been written on the best methods to achieve optimal nutritional benefits:
  • Physical activity stimulates the development of bone and soft tissue cells that respond to increasing physical forces;
  • And rest allows recovery from physical activity, but its effects are more difficult to monitor.
active Kids

Photo by Torbak Hopper

The lifestyles of parents directly influence the lives of infants and children, as parents attempt to provide the proper balance between nutrition, physical activity, and rest.

As kids progress beyond adolescence into their teenage years, their balance is subject to many other outside forces — most notably, their peers. Adult lifestyles are often established early in life, so those early years are crucial in establishing good habits. The American Heart Association recommends that kids (aged 6-17 years) get at least 60 minutes of moderate to vigorous activity every day.

An active lifestyle for Adults, on the other hand, means they should get 150 minutes of moderate-intensity aerobic activity or 75 minutes of vigorous aerobic activity per week.

One avenue to keep kids active is sports. At an early stage, sports must be fun or it’s unlikely that kids will be remain interested and participate. As kids mature physically, their motivation to participate may develop as they experience the challenge of competition.

Some young athletes will thrive on competition as it motivates them into more rigorous training and conditioning routines. Others, often the less talented, may wither as competition intensifies, choosing other pursuits for their time. Keeping all kids in the game becomes more challenging as their varied paths of interest emerge.

How Much Activity Should Kids Get

As parents, coaches, and administrators strive to keep youth active, the risks of low and high physical activity levels as well as athletic injuries should be considered thoughtfully and assessed individually. Kids nowadays are influenced by many voices other than authority figures. Lifestyles of today’s youth are heavily influenced by digital and social media—governed heavily by cell phones and the internet. Connectivity appears to be unbroken for many, with constant communication with today’s world. Some fall victim to an ever-increasing demand for their time as they incorporate more and more social platforms into their daily routine.

For many, these social and digital opportunities subtract from an ideal active lifestyle. The report by Nelson on the physical activity vital sign is a good indicator of the active lifestyles of today’s youth. This study covered 255 consecutive pediatric patients (aged 5-18 years) in a family medicine residency clinic. Only 51% of the adolescents reported sufficient physical activity, with the older kids doing worse than the younger. Most important, a higher body mass index (BMI) was associated with lower physical activity, hinting at the balance issue between nutrition and physical activity. As the number of days of physical activity rose, the systolic blood pressure numbers fell, emphasizing the positive influence of physical activity.

While many of today’s youth are trapped in a sedate digital lifestyle, some kids are at the other end of the spectrum. They fall victim to pressure from their parents and/or coaches and focus on a single sport at a very early age.

The Danger of Kids and Sports

This temptation to specialize has been the subject of many reports in Sports Health, with the negative results outweighing the positive. The scenario is common: A slightly bigger, possibly stronger child is identified by the coaches as “talented.” Many a time, the better physical attributes are simply due to a birth date earlier in the year matching them against younger children from later in the same year.

This “potential” that coaches speak of often garners children preferential treatment and often launches the trajectory for the child to sports specialization. While the attraction of playing for elite teams is easy to comprehend, especially with the lure of college athletic scholarships, the negative impact of overuse and acute traumatic injury should be considered.

The report by Post nicely details some of the risks of such an athletic career path. In a review of 716 youth athletes competing in various athletic events, 42% were highly specialized, with 32% experiencing an overuse injury in the past year. Women’s basketball stands out, with overuse injury 4 times higher than in men’s basketball, raising serious questions about the training and conditioning parameters of these female athletes.

ACL Tears Common in Women’s Basketball

ACL Injuries

Photo by Sheri Hooley

One of the more common acute traumatic injuries in women’s basketball is an anterior cruciate ligament (ACL) tear. The initial consequences of ACL injuries are well known, with rehabilitation and surgery eating up approximately 1 year in most athletes — if things go well.

There are long-term consequences to these injuries that are often not discussed. The most common of which is posttraumatic osteoarthritis (PTOA).

Whether caused by the initial injury, imperfect surgical procedures, inadequate rehabilitation, or subsequent injuries, the results can significantly diminish the physical activity component of an individual’s lifestyle. Decreasing physical activity, whether out of necessity or choice, often has negative consequences.

The report by MacAlpine brings to light another consequence of ACL tear in young patients: weight gain. Quite surprisingly, BMI increases after injury persists beyond the normal rehabilitation timetable, as well as after return to play. These weight increases may be especially problematic in those knees developing PTOA at an early age.

The 3 articles highlighted in this editorial on physical activity, sports specialization, and the consequence of sports injury are good food for thought when trying to provide balance to the active lifestyle of today’s youth. Clearly, there are hazards at both extremes, and striking a safe balance should be the goal.

—Edward M. Wojtys, MD

1. American Heart Association . www.heart.org. Accessed October 10, 2019.
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3. MacAlpine, EM, Talwar, D, Storey, EP, Doroshow, SM, Lawrence, JTR. Weight gain after ACL reconstruction in pediatric and adolescent patients. Sports Health. 2020;13:2935.
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4. Myer, GD, Jayanthi, N, Difiori, JP, et al. Sport specialization, part I: does early sports specialization increase negative outcomes and reduce the opportunity for success in young athletes? Sports Health. 2015;7:437442.
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5. Myer, GD, Jayanthi, N, Difiori, JP, et al. Sports specialization, part II: alternative solutions to early sport specialization in youth athletes. Sports Health. 2016;8:6573.
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6. Nelson, VR, Masocol, RV, Asif, IM. Associations between the physical activity vital sign and cardiometabolic risk factors in high-risk youth and adolescents. Sports Health. 2020;13:2328.
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7. Pappas, E, Zazulak, BT, Yard, EE, Hewett, TE. The epidemiology of pediatric basketball injuries presenting to US emergency departments: 2000-2006. Sports Health. 2011;3:331335.
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8. Post, EG, Biese, KM, Schaefer, DA, et al. Sport-specific associations of specialization and sex with overuse injury in youth athletes. Sports Health. 2020;13:3642.
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9. Taylor, JB, Ford, KR, Nguyen, A-D, Terry, LN, Hegedus, EJ. Prevention of lower extremity injuries in basketball: a systematic review and meta-analysis. Sports Health. 2015;7:392398.
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