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INTRODUCTION

“Do it, move it, make it happen. No one ever sat their way to success.”

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The United States continues to struggle with the medical and economic consequences of physical inactivity and obesity. Despite evidence that trends in rising rates of obesity are slowing, declines in physical activity over the past several decades have largely mirrored the rise in obesity among children and adolescents. Longitudinal data from the National Health and Examination Surveys (NHES) show that the percentage of overweight and obese adolescents in the United States has increased from 5% to 18% since the mid-1980s. Obese youth are less likely to engage in physical activity and are much more likely to report chronic health problems compared with peers of normal weight. Obese adolescents are also more likely to struggle with orthopedic problems and behavioral health issues and to be obese as adults.1

During adolescence, levels of spontaneous physical activity drop significantly from high points in childhood. The number of US adolescents meeting recommended activity levels is low, and this figure has not changed significantly over the past 10+ years (Table 10-1). Adolescents spend much of their time engaged in sedentary activities. Most adolescents engage in ≥1 hour of technology-related behavior (TV, Internet, videogaming, etc) per day. In contrast, adolescents currently average a mere 12 minutes per day of vigorous physical activity. One-third of the US high-school students are not regularly active; one-half of high school seniors are not enrolled in physical education classes, and 70% of all high school students watch ≥1 hour of TV every day of the week. For students who are enrolled in physical education, the actual amount of class time devoted to physical activity is often insignificant. Students often spend most of their time in physical education class standing around, waiting for instructions, or socializing. Teens active in school sporting activities are also more likely to be active as adults. Health-related behaviors, such as dietary habits and physical activity patterns, solidify during adolescence and persist into adulthood. Recognition of individuals who are insufficiently active, overweight, or obese during adolescence is key to promoting lifelong healthy behaviors.

Table 10–1.Trends in moderate-to-vigorous physical activity and sedentary behavior among US High School Students, 2011 national overview.

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