Exercise as Medicine: What Does This Really Mean?

“Currently, physical inactivity is ranked as the number four cause of death. 5.5% of deaths are due to physical inactivity which is totally preventable and treatable,” says James MacDonald, MD, MPH, a physician for Nationwide Children’s Sports Medicine.

The question at large is how much do people really know about the level of physical activity that children should be getting to live a healthy lifestyle?

Over the years Dr. MacDonald has been prescribing exercise to patients in addition to medicine, and he believes that this prescription should be the most significant for younger kids: “We are going to be inherently responsible for the future of these children when they end up developing chronic illnesses because of their lack of physical activity now.”

A commonly recommended format for the exercise prescription is known as “FITT” : Frequency, Intensity, Type, Time. The FITT mnemonic is used to help explain to parents what the specific physical activity requirements for their child may look like. The American Academy of Pediatrics consensus recommendation is 60 minutes of moderate vigorous physical activity (MVPA) for kids each day. This recommendation leaves out the “type” of exercise a child may do, and so using the FITT mnemonic a pediatrician can help a parent and child decide on the exercise or activity that is most suitable for them.

Resistance training is one of those activities that is suitable for kids, however, many parents have become apprehensive of their children partaking in resistance training and many myths surround what this type of exercise does to their bodies. Dr. MacDonald counters this by noting, “It is a myth that resistance training for kids is dangerous and that they have to wait until they’re an adolescent. With the proper supervision, lifting weights can be safe for kids. There is no evidence to support the idea that lifting weights will stunt growth.”

Resistance training often takes place when young kids partake in various competitive sports. However, the lack of long-term sport involvement often prevents the weight and resistance training from truly helping these children. Dr. MacDonald states that although overall participation in sports is increasing between young kids, 75% of these kids dropout of their organized sports by the time they reach age 13. He says it is important to detect risk factors for life-long sedentary behaviors that begin before school age and the inactivity trends that increase in middle/high school.

On the other hand, adolescents can “overdose” on sports and do too much. Dr. MacDonald notes, “A previous study found that if your hours of organized sport per week exceeded your age in years in a certain age group, you have doubled, if not tripled, your risk of an overuse injury.”  At the end of the day, families may need to make a choice about which sports a child should do, and urge them to not do too many.

Many steps can be taken to help growing children become fit, strong and build a healthy lifestyle. The list below outlines some of the ways pediatricians and primary care providers can help:

• Advocate for physical education and recess in school
• Ask about physical activity at well-visits
• Educate parents on what the appropriate level of exercise is for their child’s age group
• Encourage sports or activity, including free play and resistance training

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