Top 10 practical lessons learned from physical activity interventions in overweight and obese children and adolescents

July 8, 2013

Angela S. Alberga, Emily R. Medd, Kristi B. Adamo, Gary S. Goldfield, Denis Prud’homme, Glen P. Kenny, and Ronald J. Sigal.
Top 10 practical lessons learned from physical activity interventions in overweight and obese children and adolescents. Applied Physiology, Nutrition, and Metabolism. 38: 249-258, 2013.

Originally Published in the CSEP member newsletter, Communiqué, July 2013

Physical inactivity and obesity in children and youth are great public health concerns. Despite the well-known benefits of exercise that go above and beyond solely weight loss, participation rates are relatively low, and many who initiate exercise programs do not continue long-term. The difficulty lies in designing and implementing exercise programs for children and adolescents that are enjoyable, feasible and sustainable in the long run. Despite exercise being a focal point for obesity management in children and adolescents, practical advice on improving adherence to physical activity for overall health is lacking and warrants attention from the community at large.

The purpose of this paper was to propose practical advice on best practices related to physical activity interventions in overweight and obese children and adolescents. The practical recommendations stem from our collective clinical trial research experiences and are further supported by other published studies in this population.

The top 10 lessons learned are (1) Physical activity setting-context is important. It should take the participant’s social and cultural values into account and should be at an accessible location with a respectful and welcoming environment. (2) Choice of fitness trainer matters. They should be skilled and knowledgeable in kinesiology and health behavior change as well as understand the physiological and psychosocial complexity of pediatric obesity. (3) Physical activities should be varied and fun and should reflect the participant’s preferences to increase motivation and adherence to physical activity. (4) It is crucial to assess and involve parents and guardians in programs, especially for younger children. (5) Programs should be tailored to the individual’s physical (size, age, race-ethnicity, and sex) and psychosocial characteristics (personality traits, autonomy, perceptions of physical activity). These personal characteristics and preferences may determine the equipment usage, choice of activities within the program, trainer characteristics and level of parent/guardian involvement. (6) Realistic goals should be set and (7) regular reminders should be offered according to the participant’s preferred method of communication. (8) A multidisciplinary approach should be taken to provide continuous support and program adjustment from diverse health professionals to help deter from dropout. (9) Any social, familial, biological, behavioral, and environmental barriers to physical activity participation should be identified early by questionnaire or interview and a plan to overcome them developed. Lastly, (10) the right message should be communicated to participants: specifically, what’s in it for them? Family-centered care is of utmost importance so that realistic outcomes are explained simply and effectively to participants. Exercise should be promoted as a gateway for improving overall health rather than focusing on weight loss alone in youth with obesity.

The recommendations in this paper can be used at the individual, community, provincial and federal level with the hope of increasing adherence and increasing the health benefits of physical activity participation in youth. This paper serves as a practical guide for parents, community members, educators, exercise specialists, exercise facility managers, clinicians, future investigators and policy makers. The practical application of this paper has the potential to help health professionals better cater exercise programs to youth and to influence public policy to help maintain the health and physical activity of children throughout the lifespan.

Reference

Angela S. Alberga, Emily R. Medd, Kristi B. Adamo, Gary S. Goldfield, Denis Prud’homme, Glen P. Kenny, and Ronald J. Sigal. Top 10 practical lessons learned from physical activity interventions in overweight and obese children and adolescents. Applied Physiology, Nutrition, and Metabolism. 38: 249-258, 2013.

This article is a summary of an article published in Applied Physiology, Nutrition & Metabolism. If you intend citing any information in this article, please consult the original article and cite that source. This summary was written by Ms. Angela S. Alberga for the Canadian Society for Exercise Physiology and it has been reviewed by the CSEP Knowledge Transfer Committee.

The CSEP Knowledge Translation Committee supports the translation of research-based knowledge for the practical application of improving the health of Canadians through the publication of this article.