A generation of inactive children is headed toward a lifetime of preventable pathologies unless clinicians enact a fundamental shift in attitudes toward exercise and physical activity.
Avery Faigenbaum, EdD, FACSM, FNSCA
At a Glance: Physical Inactivity
Margaret Whitehead, PhD
Current guidelines on physical activity for children and adolescents recommend accumulating at least 60 minutes of moderate to vigorous physical activity (MVPA) daily. The majority of children and adolescents, however, are not meeting this goal.
Furthermore, efforts to spark an ongoing interest in active play, outdoor games, and sport activities are falling short of expectations. In addition, school districts are considering physical education an expendable curriculum component, and parents are chauffeuring their kids everywhere.
Collectively, these issues have resulted in a generation of boys and girls who are weaker, slower, and heavier than previous generations, and who also are at long-term risk for a lifetime of preventable pathology, said Avery Faigenbaum, EdD, FACSM, FNSCA, in a session titled “Promoting physical literacy to combat physical inactivity” at the American Academy of Pediatrics (AAP) 2018 National Conference and Exhibition in Orlando, Florida, on November 4. Faigenbaum discussed physical literacy as a new conceptual approach to overcoming the growing problem and consequences of physical inactivity.
“The World Health Organization now recognizes physical inactivity as the fourth leading risk factor for mortality from noncommunicable diseases, and the economic costs associated with physical inactivity are staggering. A change in current attitudes and pediatric healthcare practices is urgently needed because our current strategies are suboptimal,” says Faigenbaum, professor of Pediatric Exercise Science, Department of Health and Exercise Science, College of New Jersey, Ewing, New Jersey.
“Yet we remain stuck in the mindset that is grounded in guidelines that focus solely on accumulation of at least 60 minutes of MVPA daily,” Faigenbaum says. “Simply asking boys and girls to ‘walk to school’ or ‘play sports’ is not enough. We need to expand our conceptual approach to combat physical inactivity so we are better prepared to identify and treat youth who are physically inactive before they proceed too far down the path to chronic disease.”
Physical literacy defined
Faigenbaum explains that the term “physical literacy” refers to attributes and behaviors that influence physical activity throughout the life course. Young persons who are physically literate value human movement, understand the importance of physical activity, and participate in a variety of exercise and sport activities with energy and enthusiasm.
“Importantly, literacy in the physical sense is not just about participating in daily bouts of MVPA. It is also about moving proficiently in a variety of physical activities with confidence, competence, and enthusiasm because when children are equipped with those characteristics, it is more likely they will participate in the recommended amount of MVPA,” Faigenbaum says.
The pediatrician’s role
Efforts to enhance physical literacy should start early in life and focus on developing and reinforcing fundamental movement skills in a supportive environment. Whereas active free play is important, regular exposure to different exercise and sport activities with qualified instruction is needed to enhance physical literacy and facilitate ongoing participation in a variety of physical activities in different settings, Faigenbaum suggests.
Pediatricians have a role in educating patients and their families about the benefits of an active lifestyle and educating, guiding, and encouraging patients to attain a high level of physical literacy. Specific strategies to enhance physical literacy in youth include teaching movement skills, monitoring progress, inspiring innovation, teaching cooperative play, and having fun.
When faced with an inactive patient, pediatricians should consider providing a referral to a qualified youth fitness professional who can spark an ongoing interest in active games and sport activities while enhancing physical literacy, Faigenbaum says.
Dr. Avery Faigenbaum’s views in his presentation “Promoting physical literacy to combat physical inactivity” are both timely and important for pediatricians who can play a very significant part in counseling parents about the central role of physical activity in the life of young children.
It would seem to be the case that previous efforts to promote activity either through the lens of physical fitness and disease prevention or from the perspective of cultivating high-level performance have not been successful. Dr. Faigenbaum’s focus on valuing physical activity and, as a result, participating in a range of activities with energy and enthusiasm sows the seeds of a different approach.
Key to participation, as set out in texts on physical literacy, is the importance of personally meaningful and rewarding experiences in physical activity. These experiences should foster the self-respect and self-confidence that provide a sound basis for developing a genuine motivation to continue in participation. Positive experiences that are personally meaningful lead the participant to value physical activity.
Physical literacy is grounded in a monist approach to human nature and takes up many tenets of existentialism and phenomenology. The definition of physical literacy describes the concept as a human disposition in which the individual has the motivation, confidence, physical competence, knowledge, and understanding to value and take responsibility for engaging in physical activities for life.
As Dr. Faigenbaum suggests, strategies that foster this commitment need to be identified and enacted. Significant here are approaches that:
· Boost self-belief and motivation;
· Employ differentiation to meet the needs of individuals;
· Involve participants in a range of activities with sufficient time to master particular physical challenges;
· Devolve some responsibility to participants; and
· Chart an individual’s progress without comparison with others.
Physical literacy is relevant and valid to all throughout life. However, early involvement in physical activity is very important to lay the ground for future participation. There is a temptation, in the interests of safety, for parents to ring-fence physical activity in preschool-aged children. This is regrettable as these young children need time and space to foster physical competence and establish confidence in this field. Moreover, writers such as Sally Goddard Blythe, MSc, identify the role of movement in all-round human development. Active children use movement to explore the world, find out about their human potential, and develop self-assurance.
It is never too early to establish a positive attitude to physical activity and thus facilitate the development of physical literacy. There is little doubt that a lifelong commitment to physical activity can make a positive contribution to human flourishing.
Margaret Whitehead, PhD, visiting professor, University of Bedfordshire, Luton, United Kingdom.