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INTRODUCTION

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

  —Unknown

The United States continues to struggle with the medical and economic consequences of physical inactivity and obesity. Declines in physical activity over the past several decades have mirrored a rise in rates of obesity among children and adolescents. Longitudinal data from the National Health and Nutrition Examination Surveys (NHANES) show that the percentage of overweight and obese adolescents in the United States has increased from 5% to 21% since the mid-1980s. Overweight and obese youth are less likely to engage in physical activity and are more likely to report chronic health problems compared with peers of normal weight. Overweight and obese adolescents are more likely to struggle with orthopedic problems and behavioral health issues. They are also more likely to be obese as adults.

During adolescence, levels of spontaneous physical activity drop significantly from high points in childhood. This likely correlates with increased rates of obesity among adolescents (21%), compared with children ages 6–11 (18%) and ages 2–5 (14%). The number of US adolescents meeting recommended activity levels also remains low and has not changed significantly over the past decade (Table 10–1). Adolescents spend much of their time engaged in sedentary activities. In 2010, children and adolescents (ages 8–18 years) were reported to spend an average of >4 hours watching television, >2 hours listening to music, and >2 hour using computers or playing video games each day. With the recent proliferation of smartphone technology, most teens now have access to a smartphone. In this context, 95% of teens report daily internet use, and 45% of teens report that they are online “almost constantly.” In contrast, adolescents currently average a mere 12 minutes per day of vigorous physical activity. Data continue to suggest that one-third of US high school students are not regularly active and one-half of high school seniors are not enrolled in physical education classes. Interestingly, 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. Recognizing adolescents who are insufficiently active, overweight, or obese can help to promote a lifetime of healthy habits.

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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