PHYSICAL ACTIVITY RECOMMENDATIONS FOR OBESE CHILDREN

Exercise alone is not typically accepted as a tool for promoting the achievement of a healthy weight
in youth. A large quantity of physical activity is required to reduce body fat [8]. For example, to
metabolize just 1 pound of fat, which is equivalent to 3500 calories of energy expenditure, a healthyweight
adult male or an obese child with equivalent body mass must run approximately 30 miles.
But the benefits of exercise to the management of pediatric obesity are cumulative. Over time,
consistent physical activity will result in a multitude of metabolic and physiologic benefits [36,52].
In particular, frequent vigorous physical activity periods are shown to be associated with decreased
abdominal fat in male adolescents [53]. And the adult research literature indicates that regular
exercise training (> 6 months) improves fat oxidation (increased oxidative enzymes), glucose
metabolism (increased number of glucose transporters and glucose into triglycerides), mitochondrial
function, sympathetic nervous system activity (improved catecholamine stimulation response), and
lipoprotein lipase activity, which may, indirectly, positively affect metabolic profiles [36,54–56].
Together, these changes and resulting benefits will not only enhance dietary efforts during weight
loss but also promote long-term weight maintenance. Unfortunately, the positive effects of exercise
training will only be realized if the obese child complies with the prescribed physical activities.
Therefore, it is imperative that careful consideration be given to selecting the most appropriate
intensity, frequency, duration, and modality of exercise for each obese child. Table 6.2 provides
physical activity recommendations for obese children that may be safely and effectively used in
the pediatric clinical setting