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Can Youth Sports Reverse the Obesity Epidemic?


Before the pandemic, nearly one in five children and adolescents ages 2–19 were obese. This proportion varied by race, ethnicity and other socioeconomic factors, from fewer than 1 in 10 to as many as 1 in 4 children. Lockdowns during the first year of the pandemic exacerbated the obesity epidemic. As public health officials called for changes in daily behaviors to prevent transmission of the SARS-CoV-2 virus, children adopted different dietary habits and reduced physical activity. When childcare centers closed, children had less access to healthy meals, may have snacked more while using smartphones and laptops for school and recreation, and were less active playing with peers.

This perfect storm — increased screen time and reduced physical activity — led to weight gain, eating disorders and mental health crises. The body mass index (BMI) of children and adolescents doubled according to one US study conducted in 2020. Another study conducted in Philadelphia during the same early pandemic period in 2020 reached similar conclusions, finding that weight gains were concentrated in children ages 6 to 9 years living in lower-income households. Those who were overweight prior to the pandemic experienced the fastest weight gains, amounting to about 6 to 7 pounds over a six-month period.

The dual epidemics of obesity and COVID-19 have set today’s children up for a lifetime of health challenges unless we help them reverse these trends. Helping children resume healthy lifestyle habits matters: childhood obesity is a risk factor for COVID-19 hospitalization and sets them up for lifelong cardiovascular and metabolic health challenges. Getting involved in youth sports can help overcome pandemic-associated inertia.

What factors are associated with inactivity?

Prior to the pandemic, the American Heart Association (AHA) published a comprehensive review of sedentary behaviors and ways to prevent childhood obesity. Several factors can influence a child’s likelihood of being sedentary: having a TV, phone or other electronic device in the bedroom, living in a community with few green spaces, a perception that the community is not safe for outdoor play, and maternal depression or distress.

As families lost access to youth sports, community parks and after-school activities, kids spent more time at home with anxious, overworked parents. Removing access to video games and screens is one important way to increase activity, but this is easier done with younger children than adolescents.

Do sports improve health habits?

The literature was surprisingly mixed on this question about a decade ago, finding that participation in sports improved fruit and vegetable consumption as well as time spent in physical activity, but sports had little correlation with obesity. This may be because the children still consumed too many calories overall, possibly due to sugary sports drinks and other rewards for activity. Now sports drinks come in a wide variety of options, including zero sugar. Rewards need not undue the benefits of exercise.

Can children who are obese safely participate in sports?

Yes, as with any health condition it is wise to check with a pediatrician before starting a new, vigorous activity. However, getting children actively engaged in sport is a very worthwhile goal and can be encouraged through informal and formal activities. The European Childhood Obesity Group encourages the “joyful” participation in sports such as basketball and handball, which can be adapted to suit a child’s ability.

Is exercise ever prescribed by doctors?

Yes, pediatricians can recommend healthy lifestyle changes for the family to improve nutrition and physical activity. Some children will benefit from structured, supervised activity as they gain fitness. Classical sports such as basketball, gymnastics and martial arts are all excellent ways to get children involved in developing friendships and new skills, attention, self-discipline and lifelong habits.

Which sports are best to start with?

As their comfort with exercise increases, team sports are an excellent choice because they allow children to move in and out of play as they are able. Fostering enjoyable interactions with peers makes exercise fun instead of a chore, increasing longer-term participation. Parents need to throttle their competitive streak, though. Try not to make winning the only goal.

What precautions should parents take?

During a consultation prior to beginning the activity, the pediatrician or sports medicine doctor will assess the child’s overall health and any limitations which should be considered. For instance, how much exercise tolerance the child might have at the outset of the program, and which sports might be best suited to the child’s ability. Parents should be cautious about heat and exertion, particularly in sports requiring a lot of protective gear, such as football.

Rolling back screen time can help

Families may have dropped out of youth sports during the pandemic, and during this time the children may have picked up screen time habits strikingly different from their pre-pandemic norms. Excess screen time is linked to overweight and obesity because inactivity is often coupled with poor dietary choices. Making changes to reduce screen time can increase physical activity as well as improve sleep and nutrition. Rest assured, your family is not alone in this effort to shift back to healthier routines.

Key takeaways

Youth sports provide a fantastic opportunity to reconnect with the children and our neighbors while improving the family’s fitness.

Children also benefit from interactions with other young people of various ages as they engage in “clan battles” and made-up strategy games.

Highly imaginative role-playing games offer them a chance to gain experience problem-solving and negotiating conflicts.

It is important that parents provide supervision and support during these interactions—children may be somewhat out of practice after two years of relative social isolation.

Resources:

When Pandemics Collide: The Impact of COVID-19 on Childhood Obesity - PubMed (nih.gov)

CDC: Children, Obesity, and COVID-19 | Overweight & Obesity | CDC

CDC MMWR: Longitudinal Trends in Body Mass Index Before and During the COVID-19 Pandemic Among Persons Aged 2–19 Years — United States, 2018–2020 | MMWR (cdc.gov)

Underlying Medical Conditions Associated With Severe COVID-19 Illness Among Children - PubMed (nih.gov)

Obesity in Children and Adolescents during COVID-19 Pandemic - PubMed (nih.gov)

Pediatric obesity and body weight following the COVID-19 pandemic - PubMed (nih.gov)

AAP: COVID-19 and Changes in Child Obesity | Pediatrics | American Academy of Pediatrics (aap.org)

Do youth sports prevent pediatric obesity? A systematic review and commentary - PubMed (nih.gov)

Associations between sports participation, adiposity and obesity-related health behaviors in Australian adolescents - PubMed (nih.gov)

European Childhood Obesity Group: Could sport be part of pediatric obesity prevention and treatment? Expert conclusions from the 28th European Childhood Obesity Group Congress - PMC (nih.gov)

Extracurricular Sports Participation and Sedentary Behavior in Association with Dietary Habits and Obesity Risk in Children and Adolescents and the Role of Family Structure: a Literature Review - PubMed (nih.gov)

American Heart Association: Sedentary Behaviors in Today's Youth: Approaches to the Prevention and Management of Childhood Obesity: A Scientific Statement From the American Heart Association - PubMed (nih.gov)

Identifying effective intervention strategies to reduce children’s screen time: a systematic review and meta-analysis | International Journal of Behavioral Nutrition and Physical Activity | Full Text (biomedcentral.com)

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