exercise for children

Teach kids to stay fit

Your Health DR GITA MATHAI

Summer vacations have started. Earlier children would “go to the grandparent’s village” for a month of playing in the fresh air and sunshine. It was a welcome annual ritual, an antidote to the structured drudgery of school days. This is no more the case. Now grandparents too live in towns or cities where there are few playgrounds. The heat makes everyone lethargic; summer sports coaching is available but inaccessible to the majority of children. The stress on academic excellence often means that from a young age children are sent to coaching classes during the holidays. Parents say “my son /daughter plays everyday.” They mean computer games, video games or running around in the house or apartment complex. Others bemoan the number of hours spent watching television. This is often coupled with unhealthy snacking -- packaged foods washed down with sweetened aerated drinks. Naturally the children gain weight. But, the weight gain is unhealthy and the child is over and above the recommended weight for age. The formula (age +3)X5 = ideal body weight in pounds. This divided by 2.2 gives the weight in kilograms. Alternatively the height in metre squared multiplied by 23 provides an approximate value of the ideal body weight. The extra fat is usually deposited in the abdomen producing an unsightly paunch. The accompanying fat thighs mean the children look knock kneed and have an ungainly waddling gait. An hour is the minimum recommended amount of exercise required for physical and mental health of children. Today, the majority of children and adolescents do not get the required one hour of aerobic activity (running, swimming or cycling) a day either during school days or during the holidays. Their muscles are often weak and flabby. As sunlight exposure is minimal, their bones too lack strength, predisposing them to calcium deficiency and osteomalacia in adult life. Studies have shown that around 70-80 per cent of children and adolescents in India are vitamin D deficient despite our abundant sunshine. Obesity and vitamin D deficiency are two of the factors that predispose to the development of diabetes. The lifestyle and habits that result in progression to diabetes are established in childhood. One out of five Indians is either frankly diabetic, prediabetic or has gestational diabetes (diabetes during pregnancy). Many of these people are unaware that they have a problem. They go about their daily activities without any symptoms at all. Some may feel tired, notice extra hunger or thirst, have frequent visits to the toilet, lose weight, or develop urinary tract infections, boils, skin lesions that do not heal, fungal infections on the skin or vagina or urinary tract infections. It is important to recognise a predisposition to develop diabetes. Children who are inactive and obese grow into adults who are the same. They learn by observation. They watch sedentary adults (often their role models) in the family, snacking and watching television assiduously. During adolescence, boys may develop breasts and a paunch. This makes them self-conscious and often undermines their self-confidence. In girls, hormonal imbalances develop. The periods become irregular. Attractive girls grow into teenagers with pimples, a hairy face and scanty hair on the head. Urgent action is needed now, when parents and children have time and energy and are not under the stress of examinations. • Search for a government sports complex near your home. These are well run and provide training in a variety of sports. Even if they do not express an interest and show a reluctance to go, eventually interaction with athletic peers will cultivate a competitive spirit and interest in the sport. • If nothing is available, get up at 5AM, wake up the children and ask them to run/walk outside the house for 40 minutes. The traffic is usually not heavy at that time but supervision is needed. You cannot really sit in the house and tell children “go and run.” • Appropriate footwear is needed. Shoes and socks need to be provided. Running in slippers and sandals is not advisable as it predisposes to injuries of the foot. • Flexibility and core strength is important. This prevents injuries and backache, arthritis and knee pain in adult life. Yoga can be learnt and practiced at home. Martial arts training is also a good alternative. Especially for girls, it provides flexibility, confidence and personal security. Although you may have a strong family history of diabetes, and you may eventually succumb to your genes, regular exercise, and maintenance of a healthy lifestyle and ideal body weight with good muscle mass will go a long way in delaying the onset of the inevitable. It is never too late to start, even if you are technically past your childhood. Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in