Northwest Health | SUMMER 2007 By Linda Thomas

Summer in the Northwest is an ideal time for kids to be outside having fun — swimming, cycling, shooting hoops, rollerblading, and learning to love physical activity. But a growing number of children spend their free time frozen in place. Adolescents sit in front of TV, computer, or video-game screens at least four hours every day, according to the American Academy of Pediatrics.

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"Children aren't as active year-round as they used to be, and I'm shocked at the number of my patients who are overweight or obese," says Deb Harper, MD, a pediatrician at Group Health Riverfront Medical Center in Spokane. An estimated 15 percent to 25 percent of schoolchildren are overweight or obese, and poor diet and sedentary behavior are the main culprits.

Pediatricians recommend two hours of physical activity for kids each summer day, and at least half an hour of exercise every day during the school year. Children who are active for 30 minutes or more a day, 5 days a week, can cut their risk of getting type 2 diabetes in half, says Dr. Harper.

Inspiring Physical Activity
So how do you get your child in motion? Dr. Harper, who has been a pediatrician for 23 years and has three teenage sons, shares her solution. "Make the inside of your house boring and the outside more interesting," she says.

The Harper family has a basketball hoop and a fenced backyard with a grassy area for playing soccer or tossing a ball around. Inside the house they have one small TV in the master bedroom. "If the boys want to watch TV, they have to sit on the floor in our bedroom," Harper says with a laugh. "Who wouldn't prefer being outside?"

Parents should set rules at the beginning of the summer about how much screen time children can have each day, says Peggy Braile, MD, a pediatrician at Group Health Tacoma Medical Center. Two hours is more than enough. She suggests these subtle ways for parents to reduce TV viewing time:

Don't use the TV as background noise. Only turn it on if someone wants to watch a specific show.

Avoid using the TV as a way to wind down at the end of a day. Instead, take a walk around the neighborhood, play catch with the kids, or get the whole family out for a bike ride.

If your child is having a friend over to play, keep the TV turned off.

"It's important to help your children find activities they can enjoy for life," says Dr. Braile. "If it's not fun, they won't stick with it. If it's fun, they'll incorporate that activity into their lifestyle as an adult." Some lifelong sports that Dr. Braile encourages young people to try include swimming, bicycling, hiking, running, and walking. Tennis, golf, and skiing are also great sports, but those activities require a partner or specialized equipment.

What about team sports? An estimated 41 million American kids participate in team sports — another way to boost your child's activity level. Dr. Harper advises signing your children up for sports when they express an interest in playing. They'll likely stick with a sport longer if they're self-motivated, rather than participating to please a parent. She also recommends waiting until children are at least 6 years old.

"I didn't let my boys play team sports until they were in fourth grade," she says. "My husband — who was a coach — and I both believe that young children get a better sense of coordination through free play." Even when your child is ready for competitive sports, it's still important to look for a coach and program that emphasize the importance of safety and teamwork, rather than winning at all costs.

Being a Good Role Model
Group Health physicians agree that parents' attitudes about physical activity and fitness play a big role in the attitudes their children develop. "Kids learn by watching what their parents do or don't do," says Group Health's David Lisle, MD, a family and sports medicine physician at Everett Medical Center. "If you want your kids to be active, then you need to be active."

"My teenage boys and I lift weights together at the gym," says Dr. Harper. "They think it's hysterically funny how little weight I lift."

Is Your Teen Due For a Physical?
Group Health's new wellness guidelines for kids recommend that adolescents aged 13 years and older come in for a comprehensive, preventive well-care visit once a year. If it's time for your child to have a checkup, a well-care visit can incorporate any physical exam requirements that may be needed before your child can participate in sports activities in the fall.

Well-care visits are a chance to make sure your child's immunizations are up to date, answer kids' questions about their health, and get them involved in their own preventive care. Sports-specific checkups may include evaluating any past injuries or chronic conditions such as asthma that may be concerns as your child becomes more active, and listening for cardiac abnormalities. "Detecting a problem can actually save a life," says David Lisle, MD, family physician.

If your child needs a physical before the school year begins, it's a good idea to schedule the appointment now before the back-to-school rush begins.