Exercise

Helmets provide protection, but they get a bad rep. How can adults encourage kids to wear them?

Summertime and bike riding go hand in hand. The pleasant weather invites cyclists of all ages, and for kids, bikes grant independence. They can get from place to place using environmentally friendly transportation and without relying on Mom or Dad for rides. This can be especially important during long summer days because, unfortunately, most parents and/or caretakers don’t get a summer vacation from work. Moreover, they are free to use! Even if the initial investment is a financial burden, many cities offer free or subsidized bike-sharing programs.

CHIL encourages kids to take advantage of this prime bike-riding time. At the same time, we support the use of bike helmets as they improve safety. We know they’re hot and sweaty, they give you helmet hair, and the chances of getting in an accident, statistically, are small. We get it. Wearing a helmet requires taking on a short-term cost with an unknown reward.

In fact, one of the major fears of policy-makers considering requiring helmet usage is that the reluctance to wear a one will actually reduce bike-riding popularity altogether. This would be an unwanted consequence given biking is such an accessible form of exercise. Nonetheless, the research gathered on helmets, bike accidents, and fatality are in largely in agreement. In her review of bicycle helmet research, including five well conducted case‐control studies, Dr. Rebecca Ivers found that “helmets provide a 63–88% reduction in the risk of head, brain and severe brain injury for all ages of bicyclists” and “the review authors concluded that bicycle helmets are an effective means of preventing head injury.”

Ivers makes it clear that wearing a helmet is good for your health—so much so that some health insurance companies even offer monetary incentives (both positive and negative) to helmet-wearing, like covering the cost of helmet or revoking coverage in accidents where the rider is without helmet. We want to emphasize that wearing a helmet while bike riding makes an already-healthy activity even more healthy.

When it comes to children, the bike-riding beginners, it’s important to instill the habit of helmet-wearing perhaps before they even think of it as a short-term cost. We’ve gathered the following tips to incentivize kids to wear helmets:

  • Encourage good habits. From the first time they start riding with training wheels, have them where a helmet. Make it clear that putting the helmet on and getting on the bike should happen simultaneously, just like putting on a seatbelt in the car.

  • Let them pick out the helmet they would like. Many retailers carry a plethora of options with different colors and décor. Stickers are also fair game. The helmet can become a fun accessory, and unlike clothes, kids won’t outgrow them every year!

  • Set an example for them by always wearing a helmet when you ride.

  • Point out celebrity cyclists (or other admirable figures in their lives) wearing helmets.

  • Be sure to use positive reinforcement—praise children when they do wear their helmets rather than only scolding when they don’t.

Bike riding should be fun, but it also should be done safely—especially when it comes to younger riders. Wearing helmet should not have to compromise the enjoyment of biking for kids, and with the right encouragement, it doesn’t have to.

 

Being Mindful: Coping with the Stresses of a Student’s Life

Students may face a different kind of stress compared to people who work. Before college, the school day ends at a certain time, but with homework, studying, and projects, there doesn’t really seem to be a definitive end to the school day. After high school, the division between the school day and the rest of the day blurs even further when there is always something we could be studying or reading for.

 

In this kind of environment, it can be easy to feel overwhelmed with work and stress. On top of that, students of all ages might feel competition among their friends, further complicating the school and social life balance. What are some tips for managing these stressors?

 

Get Organized. Juggling all our commitments in our head is unnecessarily stressful. There are many physical planners and productivity apps available to help us manage deadlines and test dates. Choosing one that works for you might take some time, but will definitely pay off in the long-run! The key is not to let the planner/organizer stress you out further. Each day can begin or end with a recap of things to do, and crossing off accomplished tasks can be really satisfying! Planners can also help you avoid overbooking yourself.

 

Get Help, If You Need. This could simply mean asking a friend or teacher for help on understanding a new concept covered in class. This could also mean asking a trusted adult or advisor for help navigating changes difficult to face alone: a parent, a doctor, or a teacher are all great starting points for questions about politics, gender and sexuality, or social phenomena we see everyday. The internet is full of information and can be a tempting go-to but it’s easy to get lost in a sea of opinions out there.

 

Breathe. This is meant both literally and figuratively - we need to relax! In our fast-paced lives, it takes effort and planning to do so. Taking a few minutes each day (such as signing up for the eMindful Challenge) to try some meditation techniques can help us clear our mental clutter, which can make facing the next task easier. If meditation isn’t for you, that’s okay - there are other ways to relax productively such as putting down your smartphone for at least a few minutes. Some of our friends use cooking, baking, exercising, reading, writing, just to name a few, as ways to decompress. The point is to challenge yourself to do something that you might continue to benefit from. For example, if you make a healthy snack now, it means you’re less likely to go grab fast food later. If you read a book by your favorite author now, you can remember it later and enjoy it then too.

 

Sarah is CHIL's lead blogger and currently a student at UPenn with plans to attend medical school in the future. To decompress, Sarah likes to go running or do crossword puzzles.

Healthcare Costs and Exercising Children

An article in the New York Times describes a new study that used complex models to imagine what the health landscape of American children would look like if children exercised every day. The study found that the United States could save more than $120 billion a year in healthcare costs alone if all children exercised every day.

Researchers at the Global Obesity Prevention Center at Johns Hopkins University used computerized models that created avatars for each of the 31.7 million children in the United States currently between eight to 11-years-old. In keeping with real-life statistics, they programmed two thirds of these children to rarely exercise. The researchers then modeled each child’s calorie intake and “virtual body change” day by day, year by year, and tracked these simulated childhoods into adulthood. After these avatars reached adulthood, their health was modeled based on the predictive risk for heart disease, stroke, high blood pressure, etc.

The results were sobering. The models predicted that if eight to 11-year-olds were as inactive as predicted almost $3 trillion in medical expenses would be spent on this population. Furthermore, they would have lost productivity each year once they reach adulthood.

Even if this estimate is not perfectly precise, it is undeniable that the social price tag of physical inactivity is significant - inactive kids will grow to be sedentary adults whose health problems are not only expensive to treat but also cost the economy in lost wages and productivity. Childhood obesity and Type 2 diabetes are only some of the many risks associated with a lack of exercise.

The same researchers also looked at the counterfactual and model of  how society would benefit if these children did exercise regularly. If half of the children in the U.S. were able to receive at least half an hour of exercise three times a week (the recommendation by the Centers for Disease Control and Prevention), childhood obesity would fall and the societal costs of obesity-related disease would drop by $32 billion. 

The numbers are undeniably compelling. The societal burden of disease stemming from lack of exercise would impact us all, regardless of how healthy we imagine ourselves to be. Today’s adolescents live with an unprecedented amount of distractions that might make physical activity seem less appealing, but getting proper exercise is not only a short-term benefit but also a long-term investment.

Setting Good Activity Goals

Today we’re continuing our segment on technology and our efforts to be less sedentary. In trying to be more physically active, it’s often most effective to set goals and work towards them each day. Goals can be individual ones or benchmarks for groups of friends or family members. But how do we set goals that work best for us?

 

A popular goal for daily physical activity is 10,000 steps per day. It’s become a catchphrase for the makers of exercise gadgets and wearable technology, but the number “10K a day” is not one that has a lot of scientific research behind it. In fact, a recent New York Times article says that a better goal might be 15,000 steps per day. Studies that arrive at approximate numbers like these often look at certain populations at a time - the study described in this article looked at postal-service walkers, many of whom were older and walked a lot each day. Also, the benefits of this sort of exercise look at health conditions that often do not manifest themselves until later in life (e.g. risk of heart disease).

 

Universal goals like these numbers only offer a simplistic approach to quantifying adequate exercise. (15,000 steps a day is apparently the equivalent of walking briskly for two hours at a 4mph pace.) What does this number mean for children who often need to be very active, but also must spend hours sitting at school each day in class? And even among children, different individuals have different needs or circumstances that might make walking 15, 000 a day a tricky goal.

 

Future research could have real potential for impact if it looks at what ideal exercise for children looks like. Federal guidelines already recommend brisk activity nearly every day for young children, but since many children and teenagers are eager to take advantage of new technology to monitor their activity, researchers should investigate what activity levels are ideal and safe for these users.  


 

Wearable Tech and Meaningful Changes in Health

Recently, our blog posts have discussed the role of technology in children’s lives today - specifically, smartphones and Internet safety. At CHIL, we’re also working with students to incorporate technology into their physical activity via our pedometer program.

 

“Wearable technology” like Fitbits and Apple Watches have exploded in popularity in recent years. Their popularity especially among students has inspired several extensive studies into the effectiveness of such devices for goals like weight loss. These studies have been published in influential publications like the Journal of the American Medical Association, suggesting their importance and relevance today. Many of these studies showed mixed results in the effect of having a Fitbit-like device on weight loss over time.

 

But it’s important to remember that while weight loss is potentially an easy, objective measure for researchers, it is not the only potential health benefit that comes from tracking day-to-day activity. It’s also not the only goal that students should have for themselves. Simply tracking physical activity can be a huge help for those who need to increase their daily activity levels - and that applies to many of us, and to students as well. Despite the federal recommendation that teens get at least one hour of exercise (moderate or rigorous) each day, 2012 data showed that only one in four teens get that hour, according to an article recently published by NPR.  The  Center for Disease Control and Prevention (CDC) also reports that nearly half of American youths aged 12-21 years are not vigorously active on a regular basis.

 

Another article in NPR weighs some of the factors that could influence the effectiveness of wearable technology for fitness or activity. For example, while meeting daily fitness goals and step counts (the popular “10K a day”) could really motivate one person, failing to meet the same goal could discourage another from continuing to wear the device altogether. Also, meeting a daily goal could actually cause a person to “reward” him/herself with more calories. How, then, can we make these gadgets more effective? According to Dr. Mitesh Patel, who was interviewed in the NPR article, these devices are basically most effective when the people using them are “already dedicated to tracking their fitness.” Beyond the initial cost of an expensive device, there has to be a motivator that continues after the novelty of the gadget wears off.


What does this mean for students who are using less-pricey tools like those in our pedometer programs? These students can probably derive most of their long-term motivation not from the promise of weight loss but from the support they get from their school, friends, and family to be more active. The CDC agrees, pointing out that “well designed school-based interventions” and “social support from family and friends” are key in increasing physical activity for all teens. Our pedometer program seeks to do just that. For more information about our pedometer program, please click here.

Forming New Year's Resolutions to Keep

Happy New Year! Many of us want to start off on the right track in the new year by making resolutions. These resolutions aren’t limited to adults; kids can make them too along with their parents and siblings! Resolutions don’t have to be notoriously difficult to keep either.

 

Many families may strive to eat healthier and get more exercise. Dr. Thomas McIerny, the former president of the American Academy of Pediatrics (AAP), pointed out the importance of these goals - they improve health and they establish healthy habits that will stay with children throughout their lives..

 

Check out the AAP’s tips for parents and kids to help you formulate healthy resolutions this year. Let’s break them down and take a look:

 

Eating:

  • Focus on developing healthy attitudes about food and where it comes from by avoiding a “clean your plate” mentality that discourages conversation about food.

  • Establish a “regular routine” of meals and snacks, and always eat meals at the table. As mentioned in our previous blog post, children who eat with family tend to experience a diverse range of foods and avoid overeating.

  • We also talked about picky eaters who can pose as a challenge to parents. But we should keep two truths in mind: when a child rejects a certain food, it’s always a good idea to try again later; parents also remain their children’s best role models.

Play:

  • Anything can become physical activity such as a walk around the neighborhood, or going out to the yard. Take advantage of this as a group.

  • Limit screen time for children. Each day brings new research that further proves that devices can distract from good sleep or ruin concentration. Televisions, phones, and video games are all ubiquitous in our daily lives, but we can take steps to limit their influence in our lives.

  • Encourage your children to participate in sports and dance teams that can introduce them to new friends while also providing physical activity.

 

Here are some tips from Stanford University’s Children’s Hospital on how to achieve these goals:

  • Make small goals: these are easier to keep, so it won’t be as discouraging if you fail to meet a very ambitious goal about a habit that takes time to develop. Establishing one activity to do each week is a great start.

  • Have roles and a buddy system: Family members can remind each other about their goals and help each other stay on track. Encourage kids to be active participants in choosing their next goal.

  • Have a rewards system: Small, non-food rewards can accumulate to bigger awards, which kids can choose for themselves (e.g. a trip to the beach or playing a favorite game).

  • Practice simple journaling: It can build awareness, according to Cindy Zedeck, director of the Pediatric Weight Control Program at Lucile Packard Children’s Hospital Stanford. Journaling can help you think about the choices you’ve made that day.

Study: Children’s Obesity Risks Increase During the Summer

This week’s topic may seem a bit funny in the weeks leading up to Thanksgiving, but it is very relevant any time of the year. 


Summer vacation is far away, but there’s reason to think about it ahead of time. A new national study (described here in the NYTimes) found evidence that obesity risks in young children are  higher when they are out of school than when they are in school. The fundamental question in debate surrounding obesity and children’s health is this: Does the cause of obesity exist primarily in school or outside of school? Recently, schools have updated their lunch menus, physical education classes ,and nutrition curriculums to reflect a growing awareness of obesity risks in  children. However, the findings of this study suggest that even with these improvements, healthy habits can be forgotten when they are not continued outside of school. 


Researchers hypothesized that if children's body mass index (BMI) grows the fastest during the school year, factors found in school environments could be a culprit for obesity risks. Conversely, they hypothesized that if BMI grows the fastest during the summer, that would mean the major risk factors could exist outside of school. They examined the weight gain of more than 18,000 children from the time they started kindergarten through when they finished second grade. The authors found that the prevalence of overweight or obese children increased between these years. A more striking finding was that the prevalence of being overweight or obese increased during summer vacation months, but did not increase during the school year. 


Intuitively, we can think of a few reasons why summertime might pose some weight control challenges for children. Children may go to sleep later and get less sleep during the summer, which could increase the risk for weight gain, according to another study in the New York Times. During summer breaks, students may also be prone to snacking and sedentary behaviors because recess and physical education classes are not scheduled into their daily routine.  Maintaining a healthy weight can be as challenging as maintaining reading and writing skills over the summer. Experts recommend that schools begin conversations with parents well before the school year ends to make plans for students’ diets and physical activity over the summer. These preemptive measures may be especially useful for students who may receive healthier meals at schools, but do not have access to nutritious food in their homes. 


Due to the holiday season, November and December is a time when young children spend more time at home with their families. Forming healthy behaviors during shorter breaks from school might help establish healthy habits that will last beyond long summer months.