ISPO NEWS: What have you observed at your practice? When did children and youths begin to exhibit a lower level of physical fitness?
Stefan Renz: We have observed this development for the last fifteen years during preventative check-ups. Many children and youths have problems with their gross motor skills and physical coordination. They are incredibly stiff and cannot even touch the floor with their fingertips when doing a forward bend; they hardly make it to their knees. Quickly jumping back and forth with both feet or balancing backwards often doesn’t work at all. We are also seeing dramatic increases in the secondary effects of lack of exercise, such as excess weight and high blood pressure.
Where do these kids come from?
Of course, this development has a social component, as usual; this is one of our society’s problems. An above average percentage of these children are from educationally deprived households.
What are the consequences of lack of physical activity?
It enhances what the medical field calls the metabolic syndrome: the dangerous combination of obesity with ensuing joint problems, high blood pressure, as well as dysfunction of the lipometabolism and glycometabolism.
Do you diagnose these conditions in children?
Yes, we are finding them in children. We meet eight- and nine-year-olds who are excessively overweight. My laconic statement is that if a child in seventh grade weighs less than 100 kilograms, he or she is lucky.
I What kind of therapy can be used?
What we do at a therapeutic level? Well, at first we try to wean our patients step by step off medication and motivate them to exercise more. If the children are, quote, only, unquote, overweight, we help them regain the balance between calorie intake and calorie use. There are a number of programs, which – if all works as planned – only have a 20 or 25 percent success rate, no more than that. In any case, the young person has to be motivated, and want to change something, because he or she is suffering due to their excessive weight. We waste a massive amount of money on therapies that are based nowhere near everyday life. To really succeed we have to start in the social environment of the patients and offer motivation for change. This applies to physical activity as well as healthy nutrition.
Please describe the concept.
Stefan Renz: I believe that today the priorities are set incorrectly as early as in kindergarten. According to the motto: on Monday we teach science, on Tuesday we work on some project, Wednesdays we teach English, and if we have any time in between, maybe we’ll take the kids outside to play. Exercise is shortchanged all the time in our everyday life.
... and continues to decline until puberty hits.
Absolutely, I agree. It is a lot cooler to get a new cell phone than to exercise at a sports club. To hang out and chill is much more in trend than jogging through the park.
How high is the probability that this behavior will change when these children become adults?
We do not have any significant research on this. Our best guess is that inactive youngsters will continue this lifestyle even as adults. On the other hand we have to state that our society has been getting progressively older, despite the appearance that people are getting sicker. Medical science is constantly improving.
What are the causes for the lack of physical activity?
Clearly the increasing media consumption. This is not a new insight, yet it still accurate. In general, there are many four-year olds in all levels of society who are still very agile, because they just love to romp around. And they won’t get stuck in front of the television for hours either, no matter, how interesting the program. But at age five the program on TV becomes so attractive that kids rather watch than go outside to play. This is where the cultural background also has an impact: there are people who state that if the outdoor temperature is less than 20.5 degrees and there is a more than 20 percent chance of rain, they will not step outside.
Isn’t that a very extreme statement?
Stefan Renz: The adults don’t exercise enough, either. Even stairs are only used in an emergency. Yesterday, there was a huge line in front of the elevator in our medical complex. I thought maybe it was out of order. A woman said to me, no, it is not, but there is no way we’ll climb the three flights of stairs on foot.