Exercise and the obese child

Obesity in children has been associated with lower levels of physical activity and fitness. Physical activity and exercise are essential elements in obesity treatment. Consensus recommendations for obesity prevention recommend that children and adolescents accumulate 60 minutes or more of at least moderate physical activity daily. In addition to obesity, risk for decreased physical activity also includes being an ethnic minority, living in poverty, having a disability, living in an apartment or public housing, adverse climate, and perceived or actual lack of neighborhood safety. The combination of decreased fitness and decreased physical activity can magnify metabolic changes. Regular physical activity has also been shown to lessen the burden of obesity-related comorbidities, including reductions in blood pressure, increased insulin sensitivity, and decrease in hepatomegaly. Exercise prescriptions for obese children should involve family support, activities which are doable, fun and develop participatory skills. Children with congenital heart disease are also at risk for obesity and represent a group of children that requires focused attention on obesity prevention and treatment.