Tuesday, March 15, 2011

Do after school sports help fuel childhood (and adult) obesity?

No study to talk about today, just some thoughts.

Society often likes to revert to the, "when we were kids we used to play outside" speech to help explain away childhood obesity.

I've blogged about that one before but in short, I think it's a ridiculous argument on two fronts.

Firstly, how active were we when we were leisurely riding our bikes, climbing trees or playing in parks? Were we active enough to burn boatloads of calories? Not me.

Secondly I think it's ridiculous because like it or not, this world is full of electronic wonders, and not only are they all here to stay, but as time goes by they'll become further and further enmeshed in society. Video games will provide more, not less entertainment and engagement, and the internet and our social media connectivity is likely to become indispensable parts of even our children's lives.

We mustn't forget that children are also consumers of time. Consequently they're going to spend their free time on the activities that they enjoy the most. When we were kids that meant spending time at home with our parents and 12 crappy channels of TV vs. playing outside. Now? It's a whole new ball game.

What all of this means is that even if you subscribe to the argument that in fact our when we were kids leisure time activities were in and of themselves protective against obesity by virtue of either the calories they burned or in some indirect fashion, on calories consumed, it doesn't change the fact that time changes all, and we're not likely going to find ways to make outdoor leisure activity as comparatively attractive to kids as it once was.

So what does this have to do with after school sports? Just those first few words, "When we were kids".

When we were kids after school sports weren't a big deal.

Sure I remember a summer soccer league and some swimming lessons, but for the most part, sport was had at school and usually in the form of intramurals. Leagues ran before school, during lunch and after school, and everyone, not just the elite athletes, were involved. Looking at schools nowadays it would seem that not only have phys-ed classes disappeared, but so too has a great deal of that inclusive, in-school competition.

But even if your kids' school has great intramurals and phys-ed, I'd be willing to wager you're spending a great many more evenings shuttling your children out to hockey, dance, soccer and gymnastics than your parents did with you when you were a kid. While these classes may well improve our children's health through fitness, I can't help but wonder whether or not they fuel obesity through shifts in prioritization, dietary choice, and learned behaviour.

What do I mean?

I can't tell you how many of my patients describe their late afternoon and early evening lives as child carrying convoys. They'll describe only having a few brief moments after they return home from work to bundle their kids up before driving them to their various events. And what's suffering as a consequence? Food. Family meals disappear, and if they still have them, they end up being something that can be whipped together exceedingly quickly at home (and quick isn't usually synonymous with healthy or low calorie), or food is bought on the run in a drive through or on site in places like arenas.

In turn these quick-serve, express-organized, fitness evenings do a great deal of harm to go along with the exercise they provide. Firstly they help to teach children that fitness is a more valuable priority than food in terms of available time - better to exercise than pack a lunch or cook a meal. Secondly, after school exercise may feed entire families rapidly prepared highly processed junk food (either reheated boxes at home or fast food bought on the run). Thirdly, they help to make the cook together, sit together, eat together meal the exception, rather than the rule. And while the children may not yet be suffering as a consequence of this type of lifestyle, no doubt they're also internalizing it as the example by which they'll likely organize their future adult lives.

I don't have an easy solution to offer. Tightly squeezed schools may no longer have the means or the money to fund and organize rigorous intramural programs and as the father of 3 young girls, I know how much they enjoy their after school activities, and how important I think they are to their physical development and health. However we aim our household priority on the family meal, not the fitness, and we try to schedule after school activities accordingly.

Do take a moment to consider your weekday after school arrangements. Ask yourself if you're taking any nutritional shortcuts that you can change, and at the very, very least, why not make at least one weeknight weekly, a sacred, activity free evening, and together as a family, cook a healthy meal from scratch, and sit, talk and enjoy each others' company?

[And while there's no study yet that I've seen to look at this, my friend and colleague Dr. Sara Kirk and her team out East have recently been awarded a grant to study this very phenomenon. May the statistical power Gods smile on them all, and stay tuned to this blog in 2015 or so to see her results]

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  1. I agree, however, I also think that w/ 2-income families, this will continue to be a problem. I have stayed home with our kids since they were born and I know people say that they can't afford to do that- but it was a choice. We are not wealthy by any means, we have chosen to do without a lot of things (holidays, fancy foods, going out for dinners, cable etc.) which in turn have helped our famiy to not only be strong together, but to also be healthy together. Since we don't have cable, there aren't as many exciting choices - BUT there are zillions of movies that could be watched (libraries have them free - so we still have an issue) -- and video games (I have older kids - DS purchased a system) - and computers w/ games and lots of sit-down things to do - it has to do with parental supervision and guidance and education - from PARENTS ... a rule all along was (1) the kids can't put the TV on w/o first choosing what they will watch from the TV guide (no surfing) - that has lessened now that they're older; and (2) they may watch TV when it's raining or inclement weather only...that changes things for sure! We have the same rules for ourselves - it has become a way of life. We walk as a family (even with older kids - not all the time) and I also find that they choose healthy things to do w/ their friends, i.e. they go on hikes together, play hockey 1x per week and soccer 1x per week, we have a volleyball net set up year round - it gets used. Yes they sit, but they also MOVE! Part of that has been teaching at home. There really are no valid excuses IMO! They don't always make the best food choices, but I have educated them about food and nutrition...they KNOW! When I used to babysit a neighbours kids they used to get sooooo excited to walk to the store - it was a novel concept for them, no kidding! If we drove, I parked & we all walked to the stores that we needed to go to. My kids found it funny how exciting this was to my neighbours kids. We all need to be a little more old-fashioned I think!

  2. Roberta10:26 am

    As we live in a fairly central location in Edmonton, it has always been a priority for us that kid activities be found within a 3km or so radius of the house. We simply don't sign up for anything where we have to drive - if we can't walk or bike, we pick something else. That way we get the transportation exercise as well as the actual activity. Mealtime is still a challenge but if you're not in the car going past the McDonald's, you're not going to eat a Happy Meal. I also bike year-round to my own activities. We are very fortunate to be able to live in such a well-situated location with a plethora of activities available.

  3. I will second I Will Lay Down...'s comments regarding two-income families -- or at any rate, families without a supervisory adult at home to clean, cook, and "lay down the law" so to speak. Unfortunately, the number of single-parent households without nearby family support and the cost of living in many areas makes the idea of a "stay at home" parent (or grandparent) financially impossible, and home cooking temporally difficult. That said, parents should be able to spend some weekend time with their children "cooking ahead" and storing in portions, so that there is always a stash of "homemade TV dinners" (usually soups and stews) that can be pulled out of the freezer and heated up when a meal is needed in a hurry.

    The other issue with this is that Home Economics classes -- in which generations of girls (and later on, boys as well!) were taught basic cooking skills -- have been considered "electives" and first-up for budget cuts. Home Ec included practical cooking, baking, and sewing skills -- something very useful if one's parents couldn't, or didn't want to, take the time to teach their kids.

  4. I stay at home. It was a choice we made, too, to have a less hectic lifestyle. The kids don't participate in too many activities as we don't have a second vehicle. We eat at home every night of the week: once a week we may have a store bought pizza we cook at home. Nonetheless, in the last five years, both my son (13) and I have become obese. My husband has become quite thin and my daughter (10) is "normal."--and just naturally active.

    I don't know what I did wrong. And I don't know how to fix it, either.

  5. Anonymous3:17 pm

    Using the excuse of being a 'two-income' family as the reason for poor family eating habits should be lumped together with exactly what Yoni is talking about with using '..when we were kids...'.

    My family is two income. We have two active boys who participate in some after-school activities, as well as two adults who also participate in 'after-work' fitness activities. Some activities are done individually and some as a family. I cook all our meals and my husband makes the lunches for everyone. Not because we can't afford to eat out, but because we recognize the nutritional importance of real food as well as the psychological benefit of having family meals together. It just takes motivation and planning. Planning for both what the family is going to eat for the week, but also with choosing activities that are close to the home.

    This whole situation is far more complicated that just whether one parent stays at home or not. Trying to point the blame for childhood obesity at a single simple cause is exactly the point that Yoni is trying to make. It is not that simple!


  6. Anonymous4:09 pm

    Yeah, just what I expected. First comment in and it was "Women, get back in the kitchen". Everything is always blamed on the mothers.

    Brenda, your comment comes across as though you think 2-income or single parent families lack supervision, which simply isn't true. It's not like parents just leave their kids to fend for themselves, and you are perpetuating a negative stereotype.

    In reality, it's not that hard to make healthy food quickly, especially if you plan ahead. I'm mostly vegetarian so I don't have to deal with things like whole roast turkeys, and honestly I just can't think of anything else that would take hours to make. 98% of the food I eat takes half an hour or less to make, and that includes prep time as well as cooking time. I realize that plenty of families don't have that half an hour, but this is where the idea of balance matters. If the activities can just be scaled back a little bit, it can make a big difference.

  7. I admit I do kind of subscribe to the "when we were kids" theory. I agree that when we were playing outside we weren't always engaging in "fitness" activities by today's standards, but we were moving almost constantly.

    But I also agree that we can't go back to that time, and that sedentary distractions, like video games, internet, etc., are here to stay. I also believe that diet plays a far bigger role in the childhood obesity epidemic than lack of movement, but the lack of movement doesn't help. (And when you're schlepping your kids to activity after activity, they're still spending an awful lot of time on their behinds--in the car!)

    But I'd never thought of how parents' privileging of after-school activities over healthy eating factored into the equation. I think this is an excellent point, one which should give us all pause. Why not cancel a few activities, and spend the time teaching kids to cook instead? It will do them more good in the long run than team sports, the majority of which will eventually be dropped by most kids anyway.

    By the way, I don't see any real decrease in intramural sports in schools. What I do see are many, many more parents who are extremely
    ambitious for their kids. For these parents, intramurals just don't cut it.

  8. I'm just not going to respond to the "blame it on working moms" theory (which is often the insidious message behind "I stayed home and we made the sacrifices yada, yada). I value my BP.

    As far as "when we were young", let me tell you about my experience. When I was young, I rode my bike to school, I walked a fair bit, I was spectacularly unathletic (always last to be chosen for team sports) and I was chubby. Always have been, always will be.

    Can we please admit that normal people come in a variety of heights and weights?

    I am so sick of the assumption that overweight people are all neurotic couch potatoes and everyone starts out life being slim. I was never slim and it didn't come from being brought up on cheeseburgers and being chauffeured everywhere. In fact, my mother was into healthy, unprocessed foods when everyone around me was eating Wonder bread. Oh, and we didn't have a car. It was public transit or walk.

    Yes, that's how it was when I was young.

  9. Hi NewMe,

    I know you've been a reader for a long time and imagine that you know that I don't think there is any one particular cause for any of the obesities.

    My point in writing this post was to put a different spin on the typical, "When we were young" rant, not to try to explain away obesity as the sole function of anything in particular.

  10. I agree with many of you when you say that mothers moved away from being the home executive to a more business mom and rightfully so. I do believe that women need that independence. I also believe there is ways to work around the I work I cant pick up the kids. We all should encourage kids to be more active when they are young as this will add to the value of their life in the longrun.

  11. I think we have romanticized how active we once were and exaggerated how sedentary we are now. In the 1960s you didn’t need today’s sophisticated athletic shoes, because you could do your Jack Lalanne leg lifts in Keds or ballet slippers. At the Figure Salon you wrapped a canvas strap around your butt and attach both ends to a machine that looked like a motorcycle engine on a stick, and when you flipped the switch it would “shake your flab away.” Exercise now is much sweatier.

    Regarding less formal exercise, if the “obesity epidemic” is the result of decreased outdoor play for children, then wouldn’t girls be less affected than boys? In the US, the Women’s Sports Foundation reports that high school girls’ participation in sports has increased 904% since 1972, the enactment of Title IX. Shouldn’t the increase in soccer and basketball for girls have mitigated the effects of the obesity epidemic for them by comparison to boys (who eat the same on-the-run diet that you describe, Yoni)? Yet some research says girls are more affected, and also entering puberty earlier.

    I also reject the theory that we historically ate such “pure” and small foods. We misremember those "homecooked" meals, that featured canned fruit salad, Spam, Velveeta, baked potatoes with sour cream and butter (not salsa or nonfat yogurt) and casseroles. In the 1960s, a steak was bigger than a deck of cards and nobody ate hummus and sprouts on multigrain tortillas.

    Don't get me wrong, I think something has gone wrong in the past three decades, and that has moved our average weight upwards, but I think blaming a decrease in exercise and "healthy" homecooking doesn't explain it. I especially think that making parents feel more guilty is unproductive. I think we need to look at myriad obesogenic factors that have emerged since 1960 -- livestock hormones and other endocrine disruptors in our food and environment, transfats, the proliferation of HFCS, anti-bacterials killing our gut flora, among dozens of other factors. With regard to kids and parents, the rule should be: do what makes you a stronger, happier, saner family. Obesity should not figure into the equation.

  12. Dr. Freedhoff,

    Just so you know: I wasn't ranting against you. It was more a general rant (lol). I didn't get any insidious messages from you post.

  13. Anonymous11:55 pm

    This article is definitely food for thought, pardon the pun:). With regards to intramural activities look at the food options being offered to children in arenas, soccer fields, or even to children who have been active outside. Kids can be physically active which is wonderful but I know for a fact thatthe choices they and/or parent choose to fuel their bodies after being active is disturbing.

    I have a real difficult time understanding why our society presumes that children = junk food/treats!!! Do they not see the damage...obviously not!! I am the one who looks like a terrible parent b/c I disagree that my children should have hot chocolate with marshmallows after active play outside in the winter (aka: what my neighbors kids always have to offer).

    Very frustrating but I will keep fighting!!!

  14. Well, that's definitely something new to think about. Like northTOmom, I've never explicitly paired excessive activities and outings with a lack of time to eat well. Yet it makes simple sense. If we use up our time doing other things, the time left for healthy food preparation and family mealtimes is cut short.

    Now that I AM thinking about it, I agree that there should be a balance between focusing on healthy eating and keeping our bodies moving. (Let's not forget that there are other reasons to stay fit and strong than avoiding obesity.) Consciously allocating time to cook and eat as a family unit (whatever it's configuration) makes sense as it's so important for building short-term and long-term healthy eating habits.

    To be honest, although I cook with my kids and eat with my kids, we rarely do the whole lot together as a sequential process. I plan to follow through on your suggestion and do this at least once a week. My kids are 3 and 4 years old now and although our days are getting busier the older they get, their capabilities in the kitchen are also so much more advanced! We should be able to manage it with enjoyment - as long as we make the time!

  15. Taylor(:3:49 pm

    I'm going to be honest; I think you should add the percentage that obesity would more than likely increase if sports were taken out of school activities. I'm 13 & I have looked absolutely everywhere for this sort of information for my Language Arts class. & I cant find it anywhere.

  16. Damn,

    This article completely nailed my families eating habits. I have 5 brothers and sisters and all are involved in highly competitive sports programs after school. There is definitely something to be said for not taking the time to make healthy time consuming dishes.

    Great article.