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Are children and adults less active today?

Are children and adults more overweight/ obese today? Is there a physical activity ~ health link? Fitness components:
1. 2. 3. 4.

Cardiovascular endurance Body composition Flexibility Muscular strength and endurance

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A form of muscular endurance Efficiency of the heart, lungs, and vascular system in delivering oxygen to working tissue The bodys ability to deliver oxygen to the muscle is affected by

Heart rate Stroke volume Cardiac output Maximal oxygen consumption

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The number of times the heart beats each minute (bpm) Changes over the lifespan
Fetal HR is rapid and irregular Birth HR is below fetal level with periods of

bradycardia (HR < 60 bpm)

120-140 bpm

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Maximal HR declines with maturity To predict maximal HR

220-age = HR max HR max = 195-220 bpm Decline = 0.8 bpm/year of age

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Work and HR
Linear relationship As workload increases, HR increases

HR

Workload

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The volume of blood ejected from the heart with each beat (ml/beat) Size of SV affected by
Heart size Contractile force of the heart muscle

Vascular resistance to blood flow

Venous return
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SV is lower in children
Due to smaller heart

Lifespan changes
Birth ~ 3-4 ml/beat Adolescence ~ 40 ml/beat Male adult ~ 70-90 ml/beat Trained male adult ~ 100-120

ml/beat

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Maximal SV during exercise

Untrained male ~ 100-120 ml/beat Untrained female ~ 80-100 ml/beat Trained male ~ 150-170 ml/beat Trained female ~ 100-120 ml/beat

Differences between male and female values due to smaller heart in female (25%)

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 Stroke volume and age

Between the ages of 25-85 yr, SV can fall

by 30%
Lifespan activity can minimize the SV

decline with age

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 Amount of blood pumped in 1 minute

HR x SV = CO or Q (flow)

At rest, CO equals ~5 liters/min

70 beats/min x 70 ml/beat = 4900 ml/min

or 4.9 liters/min

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CO and exercise
Affected by physical condition Age

Untrained male ~ 20-25 liters/min Trained male ~ 30-35 liters/min Because HR and SV decline with age, so does CO

Decline of 1 % / year after age 25

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The largest amount of oxygen that a human can utilize at the tissue level (VO2 max ) This is the best measure of physical work capacity (ability to do work without fatigue)
Very little data exist on children under 6 years of age
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 For boys ages 6 to 16 years, VO2 max 50

to 53 ml/kg/min For girls at 8 yr, VO2 max = 50 ml/kg/min, on average Must correct for weight (kg), so boys/men can be compared with girls/women
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There is a gradual decline in maximal oxygen consumption in young girls as maturity approaches due to
Increases in body fat
Lower blood hemoglobin concentrations A decline in large muscle development Many girls become less active during adolescence

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 With age there is a decline in VO2 max

and a concomitant decline in physical work capacity

Rate of decline is 1% per year
An active lifestyle across the lifespan

can alter this decline

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Information is fragmented and limited Are changes in the cardiovascular values in children due to training or maturation? Some researchers question the value of endurance training in preadolescent children

Some will argue that training will improve

performance

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VO2 max changes in children are small to moderate Prepubertal children can follow the standard prescription used by adults

Frequency = 3 days per week Intensity = 60%-80% HR max

Time = 25-30 min

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Field test data involve non-laboratory devices capable of testing large numbers of children
Practical

Inexpensive

Most popular field test for children

Timed distance run

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Prescription ~ FIT
Frequency = 3 to 5 days/week Intensity = 60-90% HR max

Time = 20-60 min

Mode of activity is any large muscle group movement (walking, biking, running) A program of this sort will increase physical working capacity

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Physiological changes during submaximal work

SV will increase HR will decrease

CO will increase
HR recovery is quicker Therefore, work is easier after training

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It has been suggested that as much as 50% of the functional declines in the factors affecting physical performance are due to disuse and not aging
What effect does a physical exercise training program have on physical work capacities of elderly people?
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If an older individual can improve VO2 max by 20%, that is like 20 years of rejuvenation!

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Minimal muscular strength is important for human movement How much strength does a toddler need to walk? How much strength does it take for an elderly individual to get up from a chair? Lacking minimal strength can limit an individual's freedom of movement

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 Strength is the ability to exert a

muscular force Static or isometric force muscular force exerted against a non-moveable object Dynamic force muscular force exerted against a moveable object

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Laboratory test
Grip strength

Field tests
Pull-up test ~ upper body strength/endurance Chin-up test ~ upper arm strength/endurance

Modified bent-knee sit-up test ~ abdominal

strength/endurance

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 Grip strength test is a common test

among children
Easy to administer Reliable
Changes in strength are tied to

changes in body weight

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In boys, the strength spurt lags a year behind the height spurt
Boys tend to outgrow their strength just prior to

puberty May explain why some boys experience a period of clumsiness

Boys fastest increase in muscular strength occurs 1 yr after peak height velocity

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In girls, the strength spurt occurs during the same year as peak height velocity In general, boys are 10% stronger than girls Gender differences are most apparent after puberty

Total body strength in women is 63.5% of men

Absolute upper-body strength in women is 50% less

than men Absolute lower-body strength in women is 20-30% lower than men
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Aging
Between 25-50 yr there is a slow loss in muscle

mass of about 10% Between 50-80 yr there is an accelerated loss of muscle mass of about 40% Therefore, one can lose approximately 50% of total muscle mass by the age of 80 yr

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 Abdominal strength/endurance

Little differences exist between boys and

girls ages 6 to 9 yr After age 10 yr, boys outperform girls Performance for both boys and girls levels off between 16 to 18 yr

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Upper-body strength/endurance
30% of boys age 10-11 yr failed to perform 1 chin-up

during the NCYFS I Modified pull-up test developed for the NCYFS II
Modified Pull-up Test

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 Upper-body strength/endurance

Little differences exist between boys and

girls ages 6 to 9 yr After age 10 yr, boys outperform girls After age 10 yr, girls are not capable of performing any chin-ups

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Prepubescent
Controversy exists regarding strength training for

this population Can children increase strength through a resistance training program? Can these strength gains improve athletic performance? How does strength training affect flexibility, blood pressure, anaerobic fitness, and body composition?
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Prepubescent individuals are capable of significantly increasing strength following a resistance training program
Are these gains in strength accompanied by gains in performance?

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Prepubescent
Skills showing improvement Long jump Vertical jump Running speed Agility Specificity ~ greatest skill improvement was for

those activities in which the children were involved

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Prepubescent
Professional organizations publishing position

statements for prepubescent strength training

American Academy of Pediatrics National Strength and Conditioning Association American College of Sports Medicine

All recognize the value of weight training

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Prepubescent
Weight training involves the use of various

resistance exercises to increase muscular strength, endurance, and power for fitness or sport Weight/power lifting is a sport incorporating maximal lifts
Not recommended for youth until physically mature (Tanner Stage 5)

Body building is a competitive sport Muscle size, symmetry, and definition are important
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 Prepubescent

1 RM (repetition maximum) in boys and

girls ages 6.2-12.3 yr is safe when conducted in the presence of adult supervision

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Adolescence/early and middle adulthood

Programs of progressive resistance training will

result in improved muscular strength/endurance Concerns for these populations

Valsalva Maneuver ~ breath holding (straining) during a lift Anabolic steroid use
Averages 4-6% among high school males Averages 1-2% among high school females

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Males
Baldness Prostate changes Gynecomastia Impotence/sterility

Females
Breast shrinkage Clitoral enlargement Increased facial/body hair Menstrual irregularities Premature hair loss Deepened voice

Males & Females

Acne Aggression Brittle connective tissue Cardiovascular disease Cerebrovascular incidents Dependency Headaches Hypertension Liver disease Psyche and behavior changes Short stature (premature epiphyseal closure)

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 Minimal training standards (ACSM)

Frequency ~ 2 times per week Intensity ~ 60% of 1 repetition maximum Amount ~ 1 set
1 set of 8 to 12 exercises 8-10 repetitions per exercise

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Late adulthood

Can strength training in

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late adulthood alter, delay, or allow one to avoid the physiological deterioration associated with aging? Even though decreases in muscular strength can be expected with age, the rate of decline can be significantly slowed

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Late adulthood
It is never too late to start a resistance-training

program
1.9% to 132% improvements in strength

For the elderly, it is the intensity of the training and

not the initial level of fitness that determines the response to training

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Late adulthood
Strength training also decreases the number of falls

experienced by this population Strength training positively influences activities of daily living
Improved walking speed Improved functional index of mobility

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Prepubescent children do not gain muscle mass

Low level of circulating androgens, but does not provide a complete answer because young adult women can gain muscle mass

Elderly
Sarcopenia results in loss of muscle strength With loss of strength and increase in frailty, falls are

more common
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Range of motion with a joint Flexibility is joint specific

There is no one good test for overall flexibility

A typical flexibility test

Sit-and-reach test / back saver sit-and-reach test Tests the hamstring, back and hip flexibility

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Sit and reach test

Back saver sit and reach test

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Flexibility declines with age due to changes in

Connective tissue (tendons, ligaments) ~ less

resilient and may crack or fray Synovial fluid ~ less viscous Cartilage ~ may be damaged from injury or lifelong wear and tear Osteoarthritis (joint disease)

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Declining flexibility and aging

Osteoarthrosis is common in 80% of adults between

the ages of 55 and 64 yr

Regardless of process or causes, physical activity is necessary to maintain joint mobility

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Defining obesity
Three Popular Definitions: Social: Many define obesity based upon appearance

alone or the number of pounds one is overweight Statistical: Based on estimates established from normative studies of population Operational: Based on criteria tied to rates of Mortality and Morbidity BMI a widely used operational measure
Body composition
Amount of lean body tissue vs. fat tissue
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Weight Status Underweight

BMI <18.5 kg/m2

Waist Circumference

Normal
Overweight Obese

18.5-25.9 kg/m2
25-29.9 kg/m2 >30 kg/m2 >100cm

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Growth trends in adipose tissue

Birth ~ 11% fat in boys and 14% in girls Fat at birth is stored in ~5 billion adipocytes

The number of fat cells continues to increase in

childhood Body fat declines at the onset of walking

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Two growth spurts in fat tissue

1st yr: fat increase in boys ~26%; in girls ~28% Puberty for boys; prepuberty and puberty for girls Greater fat mass in girls during the second growth spurt

With age, fats contribution to overall body composition depends upon the size of fat cells, not the number of cells
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 General growth trends

Body weight reaches its peak at about 45

years of age
Body weight is not a good indicator of body composition

A sedentary lifestyle lends to the

observed decrease in lean body mass and an increase in fat mass

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Optimal Health Optimal Fitness

Men Women

10-25% 18-30%

12-18% 16-25%

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Prevalence of obesity in the US ~ age

Children 6-11 yr = 15% are overweight* Adolescents 12-19 yr = 15% are overweight*

Adults = 64% are either overweight or obese

*NHANES 1999-2000

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Prevalence of obesity in the US ~ race

Mexican American and black non-Hispanic women

exhibit higher rates of overweight and obesity compared non-Hispanic white women Mexican American men exhibit higher rates of overweight and obesity compared to non-Hispanic blacks and non-Hispanic whites

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Prevalence of obesity in the US ~ income

Low socioeconomic status (income < 130% of the

poverty level High socioeconomic status (income > 130% of the poverty level

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Prevalence of obesity in the US ~ income

Men in both groups are likely to become

overweight and obese Women in low socioeconomic groups are more likely to become overweight or obese compared to women in high socioeconomic groups

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 Health consequences

High blood lipid levels Elevated blood pressure

Diabetes
Cardiovascular disease

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Association between childhood and adulthood obesity

Children with a BMI value at the 95th tile for their

age and gender have a greater than 60% chance of being obese at age 35 yr

Association between childhood and parental obesity

Parental obesity more than doubles the likelihood

that a child will be obese in adulthood

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Field test measures of body fat

Hydrostatic weighing Bod Pod

Dual energy X-ray absorptiometry (DEXA)

Skinfold calipers

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Hydrostatic weighing has been the preferred method for determining percent body fat This test is not practical as a field-test measure Calculations based upon water displacement

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The Bod Pod is quickly becoming the new standard in body composition measurement Calculations are based upon air displacement Everyone can be tested ~ disabled, children, elderly

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Relationship of obesity to motor development and performance

In general, greater amounts of fat are negatively

related to activities where the body has to be projected or lifted (tests of vertical jumping, running/walking, running)

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During the ages of 4-18 yr

Strong negative correlation between BMI and

endurance performance Boys outperform girls in the distance run, chin-up, and sit-up tests Girls outperform boys in the sit-and-reach test

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 Childhood health status is not

associated with adult health status Athletic participation in youth is not associated with coronary risk factor status in middle age

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