Empowering teens key to improve future health

Research showing that for every year of growth, children gain an extra 25 minutes of sedentary time each year is a reminder of the important role GPs can play in empowering older kids to look after their health, an expert suggests.
 
Published in PLOS One, the study used data pooled from international and Australian research that collected accelerometer statistics on the movement of children and teens.
 
This includes information about physical activity, demographic, behavioural, anthropometric and metabolic data in a sample of 6567 young people.
 
Findings show that for each year of age, low-level physical activity (LPA) decreased by about 22 minutes a day while moderate to vigorous physical activity (MVPA) decreased by three minutes a day during childhood and adolescence.
 
‘In this large, multi-country pooled analysis, we found consistent evidence for an age-related decline in LPA and MVPA and a concomitant increase in time spent sedentary,’ the authors wrote.
 
‘This overall pattern of findings was consistent across days of the week and in selected demographic subgroups.
 
‘Given the known benefits of physical activity throughout the life-course, findings support the development and implementation of public health policies and interventions to maintain or increase activity during childhood.’
 
Exercise during childhood is linked with aerobic and muscular fitness as well as improved cardiometabolic markers and mental health.
 
The World Health Organization recommends that young people aged 5–17 years, including those living with a disability, accumulate an average of 60 minutes of moderate to vigorous intensity physical activity daily and limit time spent sedentary.
 
Despite this, the researchers note that surveillance data suggests a large portion of children and adolescents are not reaching their target.
 
RACGP Specific Interests Child and Young Person’s Health Chair, Dr Tim Jones, said it is not surprising to see that children in this study had reduced their physical activity.
 
‘As kids move into being teenagers and young adults, we are seeing an increase in sedentary behaviour at a time when we know exercise and self-care habits for life are often formed,’ he said.
 
‘It’s a missed opportunity for early preventive care.
 
‘I believe there are a multitude of reasons why young people are more sedentary. We see decreased engagement in peer sport, reduced modelling of family-based exercise by busy and stressed parents, online socialisation (which is sedentary) substituting for in-person activities and the general busy-ness of work/study commitments as all playing a role.’
 
But Dr Jones said this also presents an opportunity for GPs to engage with older children and empower them to look after their health.
 
‘We know that young people [aged] 15–24 are the group of Australians most avoiding contact with a GP due to cost,’ he said.
 
‘This means that as GPs we need to find time to engage young people, whenever they make it into our consulting room, around preventive care and setting realistic health goals that empower them regarding their health.
 
‘We also need to make sure we are connecting with families with younger kids as there is good evidence that healthy family-based physical activity routines formed before a child turns 12 tend to continue through adolescence and into adult life.’
 
Along with experiencing reduced physical activity, adolescence is also a key time of identity formation, and this can come alongside concerns about the world around them, such as climate change, political polarisation, and widening social inequity, Dr Jones added.
 
‘As GPs, we won’t help our young patients through heavy handed paternalistic recommendations around diet, exercise and screen time. We need to find ways of showing our young patients that we care and that we are invested in a professional relationship with them that seeks to empower them as agents for their own health.
 
‘Every minute we spend doing this will pay massive dividends into the future.
 
‘I spend a lot of my consults asking curious and non-judgemental questions about a young person’s identity, beliefs and values. It is through that shared understanding that actual health-based goals can be made together and then achieved.’
 
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adolescents child health children lifestyle physical activity preventive health