They're fat. Out of shape. Sedentary. Where did we go wrong?

WebMD Feature

April 10, 2000 (San Francisco) -- Ask any parent of a little kid and they'll tell you that their wiggly-squiggly wee one is constantly in motion -- chasing birds, scrambling up hills, and booting balls. But it's become a sad fact of American life that many of these frisky small fry wind up out of shape and overweight by the time they reach their teens.

The latest statistics are all too familiar: Only 25% of the nation's high school students participate in physical education (PE) classes, according to the Surgeon General's "Healthy People 2000" update. American teenagers work up a sweat far less often than their peers in many other countries, reports a recent World Health Organization survey. And even though most U.S. middle schools have designated areas for exercise, few students visit them except when forced to for PE classes, finds a study published in the January issue of Preventive Medicine.

To change this dismal state of affairs, researchers have begun to focus on the early teen years as the most critical time to keep kids' interest in physical activity from flagging. The right interventions during adolescence, they say, give kids the best chance of developing an exercise habit that will stick with them for life.

Some of the reasons energetic adolescents become sluggish teens are familiar to anyone who's struggled to make exercise an everyday practice. "Kids live in the same world we do," says Russ Pate, PhD, an exercise physiologist at the University of South Carolina in Columbia. "They have the same attractive sedentary pursuits -- TV, videos, and computers -- staring them in the face." But Pate and other experts agree that children face a host of obstacles all their own, including limited PE classes, cutbacks in school recesses, and a lack of safe places in which to play.

For kids hitting their teen years, just getting rid of these barriers may not be enough. During the middle-school years, says Thom McKenzie, PhD, a physical activity researcher at San Diego State University, differences in students' size, strength, and skills become more pronounced, leading to a bigger gulf between the jocks and everybody else. Kids who aren't highly athletic often get turned off around this time. Indeed, McKenzie and his colleagues published a study in the January 2000 issue of Preventive Medicine showing that only about 30% of boys and 8% of girls in 24 Southern California middle schools visited the gym, weight room, basketball court, or other play spaces during lunchtime. And most of those who did just stood around instead of playing.

But researchers say that parents can make a difference, even at this difficult age. It's vital, they say, that parents help their children find an activity they like -- and help them keep up with it.

"The key here is letting the child choose," says Jim Sallis, PhD, a physical educator also at San Diego State. "If the kid wants to take a karate or aerobics class, it's the parents' job to help them find the class, or drive them there, or do whatever it takes to make that happen." In fact, kids whose parents transport them back and forth are the most likely to stick with their sports.

When teenagers start high school, they run up against a more adult impediment to exercise: a lack of time. When after-school activities, jobs, and socializing all become increasingly important, a fitness routine can easily fall by the wayside. At this stage, it's crucial for parents to help adolescents find activities they can fit into their schedules -- and encourage them to carve out the time to do them. Non-competitive activities -- salsa dancing or kayaking, perhaps -- are likely to be attractive because they can be enjoyed with peers of all fitness levels.

Of course, the onus to address this problem isn't entirely on parents. The Centers for Disease Control and Prevention (CDC) is trying to get kids of all ages walking to school again, since only one out of every ten children does so these days. In May, the CDC will publish a community-based walk-to-school program guide that includes tools for assessing the condition of sidewalks and tips on how to keep kids safe. ("If a stranger offers you a ride, say 'NO!' ") Some high schools are introducing health clubs -- complete with hair dryers -- to try to entice teens to work out. And fitness educators are setting up junior high and high school programs designed to teach teens about the importance of creating a personal fitness regimen.

So far, research suggests that kids involved in some of these programs are less likely to be sedentary than kids who take traditional PE. "Opportunity is the critical element here," says Chuck Corbin, PhD, a physical activity educator at Arizona State University in Phoenix. "If you give kids an opportunity to be active and help them find something that clicks, then they stand a much better chance of making exercise a lifelong habit."

In other words, those lively little ones don't have to morph into torpid teens. Encouraging an adolescent to try an activity -- whether it's hurling a football in front of a crowd, hiking a tranquil mountain trail, or hip-hopping in the street with a gaggle of pals -- can make all the difference.

Sarah Henry, a freelance writer in San Francisco, has written extensively on health and medical issues.

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