What Exercises Are Most Beneficial for Overweight and Obese Elementary-Aged Children?

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The increased prevalence of childhood obesity has been known for over three decades. Despite this awareness, the obesity rate in children has increased two- to three-fold during this same time period. The current child obesity rate in the United States appears to be leveling off but obesity prevalence still remains high and above national goals (Farris et al, 2011). Based upon the National Health and Nutrition Examination Survey (NHANES) data, the current national prevalence of child obesity is estimated as follows: ages 2-5, 12.4%; ages 6-11, 17%; and ages 12-19, 17.6% (Farris et al , 2011). An excessive increase in BMI during early childhood may be related to the development and acceleration of adverse cardiovascular and metabolic risk factors (Pedrosa et al, 2011). The current national goal for the obesity rate in children is 5% of all children who are obese have an increased risk of cardiovascular disease when compared to their normal weight peers the risk of being obese as an adult is greater if a child’s weight status tracks into adolescence (Farris et al , 2011). Because of the increased prevalence of cardiovascular disease risk factors observed both in children who are overweight and in children who are obese, there is a need for interventions that effectively reduce the degree of obesity. Physical inactivity is one of the leading causes of major chronic illnesses tracking from childhood and adulthood. Overweight and obese children are four times more likely to become overweight as adults. In 2010, The World Health Organization (WHO) stated that physical inactivity is the fourth leading risk factor for global mortality (Laframboise & deGraauw, 2011). It is known that increasing physical activity to increase total energy expenditure and reducing caloric intake is the theoretical basis for management of obesity. Thus increasing aerobic physical activity may be the foundation for decreasing childhood obesity and making the first steps towards behavioral change (Laframboise & deGraauw, 2011). A recent study of healthy children ages 4 to 18 years found that 60% to 80% had fitness levels below the 25th percentile (Ohtake, 2005). Aerobic Fitness is a component of cardiovascular fitness and relates to the child's ability to engage in and sustain participation in physical activities requiring a consistent and reliable supply of energy to working muscles (Darrah & Kelly, 2006). For short-term activities, the body can produce energy without using oxygen by means of an anaerobic process. For longer-term activities, the energy-producing process requires oxygen, that is, an aerobic process. Aerobic exercise refers to a repeated movement produced by skeletal muscles at a specific intensity, duration, and frequency with the goal of improving the child's ability to supply oxygen to the working muscle (cardiorespiratory fitness) as measured by at least one physiological parameter (Darrah & Kelly, 2006). This definition distinguishes aerobic exercise programs from more general recreational activity programs that do not attempt to monitor the intensity of the exercise program or physiological changes (Darrah & Kelly, 2006). The physiologic outcome measures of aerobic function most frequently cited in the literature are peak oxygen consumption (peak VO2) and heart rate (HR) (Darrah & Kelly, 2006). Evaluation of HR is used during exercise testing and prescription to evaluate the level of intensity of the exercise or task being performed. Both submaximal HR and maximal HR are higher in children than in adults. Maximal HR In children varies from 195 to 210 beats per minute and decreases by 0.7 to 0.8 beats per minute per year (Darrah & Kelly, 2006). In addition, a child's ability to engage and sustain participation in physical activities requires a consistent and reliable energy supply to working muscles through the splitting of adenosine triphosphate (ATP); small amounts of ATP are available in muscles at...
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