Monday, February 20, 2012

After School Sports Increase Junk Food and Total Calorie Consumption

That's the conclusion drawn by a recent meta-analysis of the impact of after school sports on pediatric obesity and diet.

Weight wise, despite what between the lines reading of the paper suggests the authors wanted to find, they were unable to conclude that after school sports had a beneficial impact on weight status.  While there were some studies that suggested benefit, there were many others that did not, leading the authors to ultimately state,
"there is not sufficient evidence to conclude that sport participation protects against the development of obesity"
So why might that be? After all, it may be fair to assume that kids who play after school sports are more active than kids who don't and consequently burn more calories. In fact according to this review paper, that'd be true in that to date the data would suggest that kids in after school sports are in fact more active overall than kids who aren't (they cite one study that used accelerometry to suggest a 30minute daily difference in physical activity due to organized sport).

But if they're burning more calories, why aren't they lighter?

Well, if they're burning more but aren't lighter, it'd probably follow they're eating more. And indeed, that's what the research also suggests with extra calories in after school sports participants coming from sugar sweetened beverages (can you say, "Gatorade"?) and from fast food (can you say, "Drive-Thru"?).

Now bear in mind the review didn't have that many papers to draw upon, and the results consequently aren't the most robust, but if my patients' and my family's experiences are anything to base things on - many families will hit drive-thrus or take out so as to allow for rapid transit to after school sports and it seems as if a child simply setting food on a blade of grass buys him or her some sort of sugar sweetened treat at game's end.

Who said fixing this problem was going to be simple?

Nelson TF, Stovitz SD, Thomas M, LaVoi NM, Bauer KW, & Neumark-Sztainer D (2011). Do youth sports prevent pediatric obesity? A systematic review and commentary. Current sports medicine reports, 10 (6), 360-70 PMID: 22071397

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  1. Lowell5:55 am

    Makes sense to me. Based on a sample size of one (my highschool self...), I ate junk food almost every day on the way home from practice, but on days I didn't have practice I'd ride the bus home without an opportunity to buy said junk food.

    You are spot on in suggesting the problem isn't simple.

  2. You know, people do tend to get hungry when they're physically active. It's perfectly natural. And our bodies tend to seek out the type of build they're predisposed to have. But if someone's on the heavier end of the bell curve and is active and healthy, then I'm not convinced that there's anything wrong with that. True, it would be better if teenagers got their calories from something other than fast food and sugared drinks. But if they're active, they're going to need to get the calories from somewhere. If they were eating trail mix instead on MacDonalds but were still the same size, would you applaud that? I would.

    1. Anonymous8:54 am

      If they were eating good trail mix (without the sugar coated yogurt pieaces and extra dried fruit and M&M's ) instead of MacDonalds and were still the same size they would be healthier because they are eating real food and I would indeed applaud that. The reality is that if everyone were doing that less of them would be that "same size" because it is not the vast majority of people that will make healthy choices, be active and still maintain a larger body size. That is the difficult balance isn't it? Accepting that not everyone can be small but not allowing that to be an excuse for those who could be making healthier choices.

    2. Doesn't most trail mix contains dried fruit. Regardless, what I imagine as trail mix is still a calorie dense food

    3. Yes, Fleur. Trail mix is made out of nuts and dried fruit and it is indeed high protein, high fat and calorie dense. Exactly what a someone who has just been doing something very tiring will find satisfying. If you feed them a carrot, they will still be hungry.

  3. Let's not throw the baby out with the bathwater. The after-school exercise should be encouraged. The issue is the crappy food choices and its overly easy access. Would love to know the body composition data on these kids as that would be a more substantive marker of health and risk than weight/BMI.

  4. Just wanted to share this in light of Dee Calarco's comments: Michael Phelps' 12,000 calories-per-day meal plan -

  5. Anonymous8:58 am

    It was like reading about my family in this post.

    I fed my kids the healthiest (home cooked and home grown in our garden) foods...until they hit elementary school. When they were preschool I had sworn I would never be oe of those parents who took my kids to fast food restaurants.

    Wow, did that change.

    There was no time to make them dinner after school before their sports activities.
    They came in the door, had time for a snack and then out the door again to get to their basketball/swimming/karate/air cadets/skiing.

    (I was active myself, playing tennis 3-4 times per week...until the tennis club closed, I stopped being active and become 'mom the chauffeur').

    That meant three times a week we were going to one of the fast food restaurants for drive thru dinner. (Plus, of course the obligatory one night of the week we were ordering pizza).

    It wasn't just after school... don't forget the schools pizza day, Subway day, and McDonalds day...I had no idea at the time what I was setting up my family for in their future!

    Sure, we had healthier snacks at home (yogurt, fruit), and the three nights we weren't doing drive thru or pizza, I made good home cooked meals...made my own trailmix and fruit leathers from our own garden.

    After school sports activities + snack + sports drink + drive thru meals eaten in a car = poor decision making skills in food/lifestyle choices and the eventual weight gain.

    What I thought was good parenting skills, turns out to have set up my family for future failure in making healthy food choices in their lives.

    Our kids are now grown and left the house...but I watch our son struggle with his weight and makes choices which are poor - still eating at fast food restaurants and a job as a pilot with erratic hours, his choices during his workdays are vending machines filled with junk food (he tried taking his own food, but that didnt' last long), resulting in his gaining 20 lbs since he finished university.
    Our daughter is still at a university working on her Masters degree. She is active... runs several times per week, plays basketball twice a week and loves to cook her own meals. There are no fast food restaurants in her downtown living area, so when she does go out to eat a few times a week, her choices are from healthier style restaurants.
    Me, well after being a chauffeur mom, becoming less active after my local tennis club closed, getting used to eating at fast food restaurants meant while out during the day running around and I would get hungry - it was okay to stop and pick up a quick nuggets/fries/diet coke...I gained over 40 lbs in 15 yr. (love how we order a diet drink with our fries :-) )
    Now in my later fifties I am weight lifting three times a week, not dieting but watching what I eat - why would I want to blow all the hard work I put in at the gym on a lousy food choice - but, wow is it hard! Still have 30 lbs to lose.
    IT IS HARD and now wish I had made better choices for my family and myself!!!

  6. Alexie9:31 am

    I remember when Gatorade began advertising its presence heavily in the 1990s. I was a university student at the time, not earning very much, but the drink appealed to me because of the way it was marketed as a sports drink. At the time, it wasn't as common knowledge that anything marketed as an 'energy drink' means it's high in sugar. So I honestly believed that Gatorade would give me the pick-me-up I needed to get through my studies and was a healthy choice at the same time. How could it not be, with all those images of sports people slamming it back, not to mention marketing that mentioned 'electrolyte replacement' - woah, honest to goodness medicine!

    The taste didn't appeal to me initially, but I got used to it and drank it instead of water.

    My weight ballooned. It was only in looking back that I was able to pinpoint where my weight troubles began. Damn Gatorade and their marketing that co-opted sports images.

  7. Thank you for being just about the only person who isn't parroting the line that kids need to sign up for organized sports for their health.

    Sure it's fun, it teaches sports skills, teamwork and so on. But from the aggressively-marketed sugar water sports drinks and hot dogs sold at the concession stands to the junk-food fundraisers and drive-thru fast food meals, they do nothing to teach good eating habits.

    Just look at any pro football or baseball game to see how sports affect obesity...yeah, not an ounce of fat to be seen on those players...

  8. My son plays initiation hockey twice a week; one hour long practice and one hour long game. These kids are 4,5 and 6 years old. The amount of them who get fries and gravy and burgers from the concession stand after is ridiculous. It's gross. I have the benefit of having kids with an intolerance for gluten and poor digestion so I have the excuse not to stop at fast food just takes a helluva lot of planning to pack healthy on-the-go meals :)

  9. Cindy Shearer11:27 am

    This post (and subsequent comments) resonates with work we're doing out of the Atlantic Health Promotion Research Centre at Dalhousie University. Prior work led us to realize that for today's time-crunched families, nutritious home-made meals are often sacrificed in order to accomodate children's physical activity schedules (much like some of the commenters above have described). We're now in the process of developing a multi-level intervention, including a smart phone application, to help families negotiate these challenges. Here is a link to the fact sheet, if it is of interest:

  10. Anonymous12:48 pm

    I had this experience last year when my two were in so many activities we only had Tuesdays with no scheduled activities. Pair that with two full-time working parents and we ate out and ate PB a lot. We skipped the hamburger joints, but I could not manage meals the way I wanted. This year we got wiser and had the kids choose their favorites and let the rest go. Now they only have activities twice a week. I cook a lot and we have time to go to the park and play with toys. I think sports, music etc. are great for kids. They have so many opportunities to try so much. But when my 8 year old son tells me, "I hated last year". I know I've made the right choice for my family. I was trying to keep up to my friends, by giving my children all the opportunities I could. But you lose family time in the process. For parents struggling like I was last year, have your kids make some choices. They may surprise you with which activities they choose. I know mine did!

  11. Well, I think this is a place where parents could get together and find ways to either eliminate the gatorade etc. when it isn't really necessary, or find ways to provide healthier snacks.

    When I was an athlete in high school there was definitely times where I did snack, and snacked on unhealthier things, only because it was what I had the most access to. I certainly was exercising enough that I could afford the calories. Now that we know better maybe this could be a place where we could improve nutrition.

    While I certainly believe that kids might be snacking on unhealthy foods, I hope the takeaway message isn't to discourage kids from organized sports.