11 Ways to Encourage Your Child to Be Physically Active

Did You Know?

• Only 1 in 3 children are physically active every day.
• Less than 50% of the time spent in sports practice, games, and physical education class involves moving enough to be considered physical activity.
• Children and teens spend more than 7 hours per day on average using TVs, computers, phones, and other electronic devices for entertainment.
• About 1 out of 3 children is either overweight or obese in the United States.
• Overweight teens have a 70% chance of becoming overweight or obese adults.

Getting Started

Parents can play a key role in helping their child become more physically active.

Here are 11 ways to get started:

1. Talk with your child's doctor. Your child's doctor can help your child understand why physical activity is important. Your child's doctor can also suggest a sport or activity that is best for your child.
2. Find a fun activity. Help your child find a sport that she enjoys. The more she enjoys the activity, the more likely she will continue it. Get the entire family involved. It is a great way to spend time together.
3. Choose an activity that is developmentally appropriate. For example, a 7- or 8-year-old child is not ready for weight lifting or a 3-mile run, but soccer, bicycle riding, and swimming are all appro­priate activities.
4. Plan ahead. Make sure your child has a convenient time and place to exercise.
5. Provide a safe environment. Make sure your child's equipment and chosen site for the sport or activity are safe. Make sure your child's clothing is comfortable and appropriate.
6. Provide active toys. Young children especially need easy access to balls, jump ropes, and other active toys.
7. Be a role model. Children who regularly see their parents enjoying sports and physical activity are more likely to do so themselves.
8. Play with your child. Help her learn a new sport.
9. Turn off the TV. Limit TV watching and computer use. The American Academy of Pediatrics recommends no more than 1 to 2 hours of total screen time, including TV, videos, computers, and video games, each day. Use the free time for more physical activities.
10. Make time for exercise. Some children are so overscheduled with homework, music lessons, and other planned activities that they do not have time for exercise.
11. Do not overdo it. When your child is ready to start, remember to tell her to listen to her body. Exercise and physical activity should not hurt. If this occurs, your child should slow down or try a less vigorous activity. As with any activity, it is important not to overdo it. If your child's weight drops below an average, acceptable level or if exercise starts to interfere with school or other activities, talk with your child's doctor.

Remember

Exercise along with a balanced diet provides the foundation for a healthy, active life. This is even more important for children who are obese. One of the most important things parents can do is encourage healthy habits in their children early on in life. It is not too late to start. Ask your child's doctor about tools for healthy living today.

Ballet and Dance

Dance is an artistic, athletic, expressive, and social form of physical activity that appeals to a wide variety of individuals. The physical aspects of dance can be both a valuable source of exercise as well as a cause of injury. For young people who take dance classes, have formal training in dance, or perform as dancers, they typically do so in one of the following dance disciplines: ballet, jazz, modern, tap, hip hop, Irish, or lyrical.
There are many forms of dance that have unique physical demands and specific injury risks. There are also some physical demands that are common to a wide variety of dance forms. For example, many types of dance involve jumping, turning, toe pointing, back arching, and lifting. These activities can produce tendinosis, stress fractures, ankle sprains, ankle impingement, or low back pain.
The following is information from the American Academy of Pediatrics about common ballet and dance injuries and their symptoms. Also included are 3 common questions from dancers.

Common injuries

Injury	Description/Cause	Symptoms
Flexor hallucis longus tendonitis	Inflammation of tendon that flexes big toe; tendon is stressed with releve, jumps, pointe work.	Pain, tightness, and/or weakness along the tendon in arch or behind the inner part of the ankle.
Symptomatic os trigonum	Extra piece of bone behind ankle joint (found normally in 20% of individuals) gets pinched when the toes are pointed and ankle is flexed downward.	Pain, tightness, and occasional swelling behind ankle associated with releve, pointe work, and going up on toes.
Anterior talar impingement	Pinching of soft tissues in front of ankle with ankle bending upward.	Pain, tightness, pinching sensation in front of ankle with plié, preparing to jump, and landing from jump.
Ankle sprain	The ankle inverts (collapses inward) most commonly when dancers are on their toes while jumping, landing, or turning.	Pain, swelling on outer ankle; sense of instability with sideways movement; sprains are more common if there has been a previous sprain.
Stress fracture	Repetitive impact stress can cause weakening of bone; often without a visible crack seen on x-ray. Common in metatarsals (forefoot), tarsals (midfoot), tibia, and fibula (leg) and occasionally femur, pelvis, and spine.	Persistent, deep, bony pain associated with high levels of impact activity; more common in dancers with calcium or vitamin D deficiency, eating disorders, and menstrual irregularities.
Patellofemoral pain syndrome	Pain under the kneecap from pressure associated with knee bending, pliés, jumps; can lead to softening or thinning of cartilage behind the kneecap.	Dull, achy anterior knee pain that increases with knee bending, pliés, and jumps.
Snapping hip	Multiple causes including tendon snapping over front or side of hip; associated with active hip movement; occasionally due to torn cartilage lining the hip socket but very unlikely due to dislocating hip.	Snapping sensation that may or may not be painful; occasionally, dancer has a sense that the hip is going out of place; occasionally, there is a catch or pinching sensation deep in joint when hip is bending.
Pars injury	The pars interarticularis is a part of the spine that is stressed with back extension (arching); pain or weakening of the pars most commonly occurs during periods of rapid bony growth. Injuries to this area may be referred to as spondylolysis, or stress fracture of the spine.	Tightness, achiness in central part of the low back that is worse with arching, jumping, running, and lying prone; better with forward bending; nerve symptoms and radiating pain are rare with this condition.
Disc injury	Weakening or bulging of lumbar disc; due to repetitive trunk bending, twisting, or lifting. Athletes may also get a vertebral end plate (growth plate) injury.	Low back pain that extends to the flank or buttock; may spread to thigh; occasional numbness or tingling; worse with sitting, bending, lifting, and lying down with face up; better with arching and lying down with face down.

Frequently asked questions

Q: When can I begin pointe work?

A: En pointe refers to performing dance steps on the tips of the toes. This technique is used only by female dancers. Trying pointe work too soon can lead to risk of sprains, fractures, and growth plate injuries. Most experts believe that a dancer is ready to try pointe work when the following criteria are met:

• Age range 9 to 15 years; 12 is average (assuming other criteria below are met)
• Three or more years of classical ballet training; 2 or more classes/week of preprofessional training (Instructors who have trained professional dancers can usually determine when a dancer has the necessary experience, technical skill, and strength to go en pointe.)
• Sufficient bony maturation
• Adequate strength in arch, ankle, leg, hips, trunk muscles
• Adequate balance and control
• Adequate supervision and training, including carefully graded skill progressions and monitoring

Q: Can I improve my turnout?

A: Turnout refers to the ability to externally rotate the hip. Not all dancers can achieve optimal turnout because they may be limited by their bony anatomy. For example, the depth and angle of a dancer’s hip socket may affect how far he or she can rotate his or her hip. However, most dancers can improve their turnout with appropriate exercises. For example, turnout can be improved by stretching the hip joint and the muscles on the inner side of the hip joint.
Optimal turnout allows dancers to stand with their feet pointing opposite directions while their knees are positioned directly over the feet. If turnout is not done correctly, dancers are either unable to hold this position or they “cheat” by twisting their knees or forcing their lower legs to the outside. When the hip, knee, and foot are not in alignment, leg and low-back injuries can occur.

Q: How can I safely lose weight?

A: Dancers of all ages face tremendous pressure to be thin. The pressure may be based on aesthetic or performance requirements. At times, targeted weight goals may be unhealthy. Not getting enough calories and nutrients can contribute to less energy, impaired brain functioning (like poor concentration), and increased risk of illness and injury. When unsafe weight loss practices are used to reach a desired appearance, health risks can include serious illness, hospitalization, and even death.
Dancers who want to lose weight should use a medically supervised strategy. This includes working with a medical professional to determine how much weight loss is safe, how quickly the weight can be lost and how nutritional and energy requirements will be met. It may also be helpful to work with a registered dietitian. It is essential to have regular medical monitoring to evaluate the safety and efficacy of the weight loss program.
For answers to additional questions about injuries, injury prevention, and safe training practices, talk with your doctor or a physical therapist.

All About Eggs

All eggs sold in stores are grade A, so the “choice” of grade is a no-brainer. But these days, you’ll find plenty of other labels on eggs, intended to make you buy one particular product or another. Because the choices can be dizzying and unclear, it can be difficult to know what is best for your family. To help you sort things out, here are some terms and a little information about what each means—or doesn’t mean.

• Organic. If an egg is US Department of Agriculture–certified organic, the hens have not been given antibiotics and their feed is free of pesticides, fertilizers, and other chemicals. But if the organic label carries a state agency’s name, the standards may be different.
• No Antibiotics. The Food and Drug Administration (FDA) does not allow routine use of antibiotics, but they can be used if the chicken is ill. No antibiotics have been used if the eggs are part of the National Organic Program.
• No Hormones. This terminology is meaningless because the FDA does not allow any hormone products in egg production. Every egg should already be hormone-free.
• Natural or Naturally Raised. This label has no meaning other than what egg producers want it to mean.
• Cage-free. Hens that provide these eggs are kept out of cages. They have access to food and water but are not necessarily allowed outdoors.
• Free Range. These birds have access to the outdoors but still may be allowed only on concrete areas.
• Pasture-raised. Hens in this category get part of their food from outdoor sources (eg, bugs, greens), which may increase some vitamins and omega-3 fatty acids and reduce saturated fats. There is no regulation on the use of this term.
• Vegetarian-fed. The hens are fed only vegetarian foods. Chickens are not naturally vegetarian; they enjoy the occasional grub or caterpillar.
• Pasteurized Eggs. These eggs are heated just enough to destroy bacteria but not hot enough to cook them. They are increasingly found in supermarkets and are a good choice for people who are susceptible to infection (such as those undergoing chemotherapy or who have AIDS) or who like their eggs undercooked. Remember that the risk of infection from eggs these days is quite small and is almost completely eliminated if they are cooked adequately before eating.
• Omega-3 Eggs. Producers of eggs carrying this label claim that their product has higher levels of omega-3 fatty acids, which may be beneficial for heart health and brain development. However, they are not inspected by the FDA for their omega-3 content unless there is a complaint.
• Animal Welfare Approved. This term is given to independent farmers whose hens are in small flocks of fewer than 500, spend all of their time outside in pesticide-free pastures, and are not fed animal by-products.
• American Humane Certified. This category is similar to the previous one, but these hens also are not subjected to forced molting, which increases egg production.
• United Egg Producers Certified. This term is applied to a coalition of egg producers with lower standards, such as each hen being provided space only equivalent to a letter-sized piece of paper.

Bioengineered Foods

Bioengineering has pushed farmers beyond the age-old practice of selective breeding, whereby one animal or plant strain was crossed with a related one to bring out desirable characteristics and suppress less useful ones. Now, scientists can manipulate genes and create new strains out of unrelated species. Foods, ingredients, and additives produced by bioengineering must meet the same FDA safety standards as traditional products. The total acreage of bioengineered crops is still small, but it represents a growing practice.

Safety 

Food producers are responsible for ensuring that the foods they sell are safe. The US Department of Agriculture has the authority to remove meat, poultry, and egg products produced in federally inspected plants, and the FDA has the authority to remove all other foods from the market if they pose a risk to public health.

Risk of Allergic Reactions

One area of concern related to the transfer of genetic material is the possibility that proteins introduced from one food into another could cause allergic reactions in people sensitive to the first food. For example, a tomato bred to produce a protein normally found in peanuts could cause potentially life-threatening symptoms when eaten by someone allergic to peanuts. For this reason, the FDA requires clear scientific proof of safety from developers working with foods to which people are commonly allergic, such as milk, eggs, wheat, fish, tree nuts (eg, walnuts, pecans), and legumes (eg, beans, peanuts). It’s impossible to predict allergic reactions to proteins derived from plants or other sources if they are not recognized causes of allergy. Nevertheless, scientists can test a bioengineered protein to see whether its structure resembles that of a known allergen. If it does, further tests show whether an allergic cross-reaction is likely.

Fat, Salt and Sugar: Not All Bad

Forcing children to eat food doesn’t work. Neither does forbidding foods. When children think that a food is forbidden by their parents, the food often becomes more desirable.
It’s important for both children and adults to be sensible and enjoy all foods and beverages, but not to overdo it on any one type of food. Sweets and higher-fat snack foods in appropriate portions are OK in moderation.
The following is information about fat, sugar, and salt and dietary recommendations based on recommendations from the US Department of Agriculture and the US Department of Health and Human Services.

Encouraging Healthy Eating for a Healthy Heart

Childhood is the best time to start heart healthy eating habits, but adult goals for cutting back on total fat, saturated fat, trans fat, and cholesterol are not meant generally for children younger than 2 years.

Fat is an Essential Nutritent for Children

Fat supplies the energy, or calories, children need for growth and active play and should not be severely restricted.

Dangers of High Fat Intake

However, high fat intake—particularly a diet high in saturated fats—can cause health problems, including heart disease later in life. Saturated fats are usually solid at room temperatures and are found in fatty meats (such as beef, pork, ham, veal, and lamb) and many dairy products (whole milk, cheese, and ice cream).
For that reason, after age 2 children should be served foods that are lower in fat and saturated fats.

Healthier, More Low-Fat, Low-Cholesterol Foods for Children Over Age 2:

• Poultry
• Fish
• Lean meat (broiled, baked, or roasted; not fried)
• Soft margarine (instead of butter)
• Low-fat dairy products
• Low-saturated fat oils from vegetables
• Limiting egg consumption

The General Rule on Fats

As a general guideline, fats should make up less than 30% of the calories in your child’s diet, with no more than about one-third or fewer of those fat calories coming from saturated fat and the remainder from unsaturated (polyunsaturated or monounsaturated) fats, which are liquid at room temperature and include vegetable oils like corn, safflower, sunflower, soybean, and olive.
Some parents find the information about various types of fat confusing. In general, oils and fats derived from animal origin are saturated. The simplest place to start is merely to reduce the amount of fatty foods of all types in your family’s diet.
_{Note: Whole milk is recommended for children 12 to 24 months of age. However, you child's doctor may recommend reduced-fat (2%) milk if your child is obese or overweight or if there is a family history of high cholesterol or heart disease. Check with your child's doctor or dietition before switching from whole to reduced-fat milk.}

Serve Children Foods Low in Salt

Table salt, or sodium chloride, may improve the taste of certain foods. However, researchers have found a relationship between dietary salt and high blood pressure in some individuals and population groups. High blood pressure afflicts about 25% of adult Americans and contributes to heart attacks and strokes.

Take the Salt Shaker Off the Table

The habit of using extra salt is an acquired one. Thus, as much as possible, serve your child foods low in salt. In the kitchen, minimize the amount of salt you add to food during its preparation, using herbs, spices, or lemon juice instead. Also, take the salt shaker off the dinner table, or at least limit its use by your family.

Check Sodium Levels in Processed Foods

Processed foods often contain higher amounts of sodium. Check food labels for levels of sodium in:

• Processed cheese
• Instant puddings
• Canned vegetables
• Canned soups
• Hot dogs
• Cottage cheese
• Salad dressings
• Pickles
• Certain breakfast cereals
• Potato chips and other snacks

Sugar in Your Child's Diet: More Than Just a Sweetener

Caloric sweeteners range from simple sugars, like fructose and glucose, to common table sugar, molasses, honey, and high fructose corn syrup. Although the main use of sugar is as a sweetener, sugar has other uses. For example, sugar can be used as a preservative, can change the texture of foods, and can enhance flavors and add color.

Sugar Supplies Energy

Sugars in foods, whether natural or added, provide calories—the fuel that supplies energy necessary for daily activities. And if given the choice, many children would probably request sugary foods and beverages for breakfast, lunch, and dinner—research shows that humans are naturally drawn to sweet tastes.

Too Much Sugar Means Too Many Calories

Parents should keep in mind that calories from sugar can quickly add up and over time can lead to weight gain, and sugar also can play a role in the development of tooth decay.

Cholesterol Levels in Children and Adolescents

The American Academy of Pediatrics (AAP) recommends cholesterol testing for the following groups of children:

• Those whose parents or grandparents have had heart attacks or have been diagnosed with blocked arteries or disease affecting the blood vessels, such as stroke, at age 55 or earlier in men, or 65 or earlier in women
• Those whose parents or grandparents have total blood cholesterol levels of 240 mg/dL or higher
• Those whose family health background is not known (eg, many adopted children), or those who have characteristics associated with heart disease, such as high blood pressure, diabetes, smoking, or obesity

For children in these categories, their first cholesterol test should be after 2 years but no later than 10 years of age.
A child may have high cholesterol for a variety of reasons such as obesity, diabetes, liver disease, kidney disease, or an underactive thyroid. If an initial test shows high cholesterol, your pediatrician will check your child’s blood again at least 2 weeks later to confirm the results. If it is still high, the doctor will also determine if your child has an underlying condition.
A recent government report indicated that there is good evidence that children with cholesterol problems become adults with high cholesterol. So it is important to monitor the cholesterol of children who may have an increased risk of elevated cholesterol.

Cholesterol Levels in Children and Adolescents

Classification	Total Cholesterol*	Low-Density Lipoprotein (LDL)*
Acceptable	<170	<110
Borderline	170-199	110-129
High	>200	>130

*Milligrams per 100 mL of blood

Teens and Acne Treatment 

I'm starting to get pimples! What can I do to get rid of them?

The bad news—There's no cure for acne. The good news—It usually clears up as you get older. In the meantime, there are a few things you can do to help keep those zits under control.

Types of treatments

Benzoyl peroxide

Benzoyl peroxide wash, lotion, or gel—the most effective acne treatment you can get without a prescription. It helps kill bacteria in the skin, unplug oil ducts, and heal pimples. There are a lot of different brands and different strengths (2.25% up to 10%). The gel may dry out your skin and make it redder than the wash or lotion, so try the wash or lotion first.
How to use benzoyl peroxide

• Start slowly—only once a day with a 5% wash or lotion. After a week, try using it twice a day (morning and night) if your skin isn’t too red or isn’t peeling.
• Don’t just dab it on top of your pimples. Apply a thin layer to the entire area where pimples may occur. Avoid the skin around your eyes.
• If your acne isn’t any better after 4 to 6 weeks, try a 10% lotion or gel. Use it once a day at first and then try twice a day if it doesn’t irritate your skin.

Stronger treatments

• Retinoid. If benzoyl peroxide doesn’t get your zits under control, your doctor may prescribe a retinoid to be used on the skin (like Retin A, Differin, and other brand names). This comes in a cream or gel and helps unplug oil ducts. It must be used exactly as directed. Try to stay out of the sun (including tanning salons) when taking this medicine. Retinoids can cause your skin to peel and turn red.
• Antibiotics, in cream, lotion, solution, or gel form, may be used for “inflammatory” acne (when you have red bumps or pus bumps). Antibiotics in pill form may be used if the treatments used on the skin don’t help.
• Isotretinoin (brand names are Accutane, Amnesteem, Sotret, and Claravis) is a very strong medicine taken as a pill. It’s only used for severe acne that hasn’t responded adequately to other treatments. Because it’s such a powerful drug, it must never be taken just before or during pregnancy. There is a danger of severe or even fatal deformities to unborn babies. Patients who take this medicine must be carefully supervised by a doctor knowledgeable about its usage, such as a pediatric dermatologist or other expert in treating acne. Isotretinoin should be used cautiously (and only with careful monitoring by a dermatologist and psychiatrist) in patients with a history of depression. Don’t be surprised
  if your doctor requires a negative pregnancy test, some blood tests, and a signed consent form before prescribing isotretinoin.

Remember

The following are things to keep in mind no matter what treatment you use:

• Be patient. Give each treatment enough time to work. It may take 3 to 6 weeks or longer before you see a change and 12 weeks for maximum improvement.
• Be faithful. Follow your program every day. Don't stop and start each time your skin changes.  Not using it regularly is the most common reason why treatments fail. 
• Follow directions. Not using it correctly can result in treatment failure or troublesome side effects.
• Only use your medicine. Doctors prescribe medicine specifically for particular patients. What's good for a friend may not be good for you.
• Don't overdo it. Too much scrubbing makes skin worse. Too much benzoyl peroxide or topical retinoid creams can make your face red and scaly. Too much oral antibiotic may cause side effects.
• Don't worry about what other people think. It's no fun having acne, and some people may say hurtful things about it. Try not to let it bother you. Most teens get some acne at some point. Also remember that acne is temporary, and there are a lot of treatment options to keep it under control.

Last Updated

8/20/2015

Source

Acne - How to Treat and Control It (Copyright © 2010 American Academy of Pediatrics, Updated 12/2013)

The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.