An investigation of children's fitness levels, published recently in the medical journal Archives of Disease in Childhood, makes worrying reading for parents. Sport experts from the University of Essex in Britain staged fitness tests on 300 10-year-old boys and girls in 1998 and another 300 in 2008. The second group came up markedly less fit, with the researchers concluding that an average 10yearold child in 1998 could have beaten 95 per cent of today's youngsters in running contests.
One of the most significant findings was that sedentary lifestyles - with children slumped on the sofa watching television or glued to their games consoles - were making children less fit, even among those who are not obese. The research team focused on Chelmsford, an affluent town in Britain with traditionally low levels of obesity, to illustrate the point that being a normal or healthy weight does not necessarily equate to being fit.
Gavin Sandercock, a lecturer in clinical physiology at the University of Essex and the study's lead author, said: "We focused on Chelmsford because you typically don't have high levels of obesity in affluent areas, so that wouldn't overly influence the results. "For the test, we looked at the kids' cardiorespiratory fitness to see how well they could run, using the 20-metre shuttle run - a widely used measure of fitness - and were taken aback by the results."
Sandercock says that globally, over the 10-year period, children's fitness has declined by about four per cent. This is commonly blamed on rising obesity, because the children's extra weight makes it difficult for them to run. "The surprising thing was that our children didn't put on weight over that period - girls actually got a bit thinner in this population. But their fitness still dropped, by seven per cent in boys and nine per cent in girls, which was double the rate we expected."
The danger, says Sandercock, is that our focus on obesity is obscuring the long-term health risks of declining fitness levels, which are "large and worrying". Although children in the UAE face slightly different health challenges from their counterparts in the UK and US, there are many similarities, too. A study carried out by local researchers last year, published in the WHO Eastern Mediterranean Health Journal, found that 48.8 per cent of pupils attending private secondary school in Dubai had a "poor level of sporting practice", with 21.2 per cent doing no sport at all. This lack of activity, allied to alarming obesity levels, is potentially bad news for children in the Emirates.
In contrast to the situation in Sandercock's study, obesity is a major factor in the UAE, which has one of the highest rates of childhood obesity in the world. About 22 per cent of children are classed as overweight, and 14 per cent as obese. One of the main risk factors for both obesity and poor fitness levels is diabetes, as Dr Maha Barakat, medical and research director at the Imperial College London Diabetes Centre, in Abu Dhabi, confirms: "Type 2 diabetes is mainly brought on by an unhealthy, inactive lifestyle and weight gain," he says. "In recent years, we have seen a rapid spread over all age groups. Recent studies show a rise in obesity cases among schoolchildren and young adults.'
Clearly, no parents would wish ill health upon their children. In fact, as any mother or father who has endured sleepless nights by a feverish child's bedside knows, we will do anything in our power to keep them safe and well. The problem is, if all your children's friends are sedentary, TV/PlayStation/junk-food-loving creatures, it's a real struggle to drag them off the sofa or out of their bedrooms and get them running around.
So, what's the solution? Barakat feels that progress is being made. "We believe the UAE is taking steps in the right direction by planning various nutrition and physical activity programmes, in addition to driving public-awareness campaigns. Diabetes is now top of the country's list of health concerns and is being tackled through awareness and lifestyle changes." However, Barakat argues that more can be done. "Schools can definitely help by supporting healthy-eating messages," he says. "All schools should serve nutritious, balanced meals and should encourage the children to be physically active, even outside the allocated school time for physical exercise."
One of the key messages to parents is that, when it comes to children's fitness, "screen time" is the enemy. This encompasses television, video games, computers, hand-held consoles and even smartphones like BlackBerries or iPhones. Dr Alya Ahmad, the UAE spokeswoman for the American Academy of Paediatrics (AAP) and a paediatrician at the City Hospital in Dubai, believes parents must encourage their children to take regular exercise and limit their daily screen time to a couple of hours.
"The AAP recommends that kids should do an hour of activity every day," she says. "This can be running, walking, swimming or free play for younger children. It's part of the AAP's 5.2.1 rule for healthy children: five pieces of fruit and vegetables, two hours of sedentary or screen time and one hour of activity per day." This echoes the advice of UK experts such as Dr Charmaine Griffiths, of the British Heart Foundation. "Physical activity is good for your child's mind, body and soul," she says. "While you may have to drag your son or daughter away from their latest computer game, allowing them to lead a sedentary lifestyle could have long-term implications for their health."
Griffiths points out the many health benefits enjoyed by active children, which include strengthening the heart, muscles and bones, reducing the risk of chronic disease later in life, reducing body fat, raising self-esteem, improving their social development while reducing anxiety and stress, and increased opportunity to mix with other children and make friends. "Children and young people should aim to participate in physical activity for 60 minutes a day," says Griffiths. "They need to do moderate-intensity activity like walking, dancing, games, swimming, cycling, sport or active play. And they should take part in activities which enhance and maintain muscular strength, flexibility and bone health at least twice a week, such as skipping, jumping, climbing or gymnastics."
Of course, there's a vicious cycle here, in that it's harder for obese or overweight children to take part in these activities, and heavier kids may be embarrassed or unwilling to join in with team sport or other group activity. However, a groundbreaking Swedish programme may offer a solution. The Mandometer is a hi-tech device developed by researchers at the Karolinska Institute in Stockholm and comprises a portable electronic scale connected to a small computer, which generates a graphic representation of a patient's eating rate during a meal. With the help of feedback from the Mandometer, a patient can learn to eat normally by adapting his or her eating speed.
The device was recently tested on overweight children at the Bristol Royal Hospital for Children, with great success. Per Södersten, a professor of neuroendocrinologic behavioural science, who helped to develop the Mandometer, explains how it works: "The Mandometer provides real-time feedback on a computer screen that guides the patient to eat a proper amount of food in the right period of time. It's especially effective for people with 'binge-eating disorder', but can be used with any kind of problematic eating."
What was the thinking behind it? "There is nothing wrong with someone who becomes obese," Södersten says. "Our biology allows us to eat more than needed when food is in abundant supply - people get obese when food is easily and cheaply available. Humans are not equipped to regulate their body weight automatically; they need external support. That is where the Mandometer comes in." While technology offers innovative ways to deal with the epidemic of obesity, Sandercock remains concerned about falling fitness levels among children. He thinks we all share responsibility for our children's health and urges action to halt the decline. "I think we need a cultural shift at every level, from parents to schools and right up to government level."
One problem that he identifies is "that we're so risk-averse now". He adds: "There are more hospital admissions for kids with RSI, from overusing video-game controllers, than for broken wrists. Obviously, no one wants their child to break an arm, but this shows how unwilling we are to let kids climb trees or play outside." It is not easy being a parent, and it's certainly not easy to raise active offspring in a world that seems designed to foster poor eating habits and sedentary leisure. But children naturally have bags of energy and love to run around and play - all we really need to do is encourage them.
