American Academy of Pediatrics Urges Physical Activity Prescriptions at Doctor Visits

​A new clinical report outlines ways that pediatricians can get their patients moving – and why it’s so important to health.

Itasca, IL – To help children grow healthy minds and bodies -- and prevent many chronic diseases -- parents need not look far to find a treatment that is free and does not come in the form of a pill or a shot.

Physical activity plays a significant role in children’s health, yet only one in four children report meeting the daily recommended guideline of 60 minutes of activity per day. The American Academy of Pediatrics, in a new clinical report, calls on pediatricians to assess their patients and write a prescription for physical activity, as needed.

The report, “Physical Activity Assessment and Counseling in Pediatric Clinical Settings,” will be published in the March 2020 Pediatrics (published online Feb. 24). The report includes tables highlighting national recommendations by the 2018 US Physical Activity Guidelines for Americans by age group, as well as tools for integrating assessment and counseling in practice.

“As pediatricians, we diagnose children with illnesses such as obesity, fatty liver disease, prediabetes and depression every day,” said Natalie D. Muth, MD, MPH, FAAP, FACSM, coauthor of the clinical report, written by the AAP Council on Sports Medicine and Fitness and AAP Section on Obesity. “Research tells us that physical fitness can and should be part of an overall treatment plan for every patient, from infant to adult, including those with special health care needs.”

According to the 2017 Youth Risk Behavior Survey, only 26% of American teens report that they are meeting the nationally recommended amount of activity per day, and 15% reported not being physically active for at least one hour on a single day in the prior week.

The typical preschooler spends more than six hours in sedentary activity, according to research. More than 40% of children watch three or more hours of television per day on school days, and the average 8-18-year-old spends more than seven hours daily in front of a screen, studies have shown.

The AAP recommends that physicians assess and document children’s motor skill development, physical literacy and physical activity levels at all health supervision visits. The pediatrician can help identify barriers and strategize with the family on how to overcome them.

A prescription detailing the recommendations can be shared with other medical providers, therapists and caretakers to help put the plan into action.

“We know that parents are powerful role models,” said Blaise A. Nemeth, MD, FAAP, a coauthor of the report. “When parents engage in active play with their children, they are not only helping their children learn new skills, they are strengthening their relationships and helping kids learn to enjoy moving their bodies.”

AAP recommends that families strive to meet these national guidelines:

• Infants need 30 minutes throughout the day of physical activity. This could be tummy time while awake.
• Toddlers should be active three or more hours daily, or about 15 minutes every hour they are awake. Neighborhood walks or free play outside are examples.
• Elementary and middle school students need 60 minutes of physical activity most days, including vigorous muscle- and bone-building activities three days a week. Free play and organized sports are good options. For middle school students, focus on ways to encourage socialization, and avoid specializing only in one sport.
• Teens also need 60 minutes of daily physical activity most days, including three days that include activities that build muscle and bone strength. Encourage activities that encourage socialization and competition, when appropriate.

AAP encourages pediatricians to discuss the benefits of physical activity with families on their children’s physical and mental health, social growth, and development at well-child and sick visits. They can also model -- and encourage parents to model -- a physically active lifestyle. It’s important to advocate for increased opportunities for physical activity at childcare and preschool, school, home, in the community and elsewhere.

The health impacts of physical activity are immense, with strong evidence that moderate to vigorous activity improves cardiovascular and muscular fitness, bone health, weight status and cardiometabolic risk factor status. Less widely appreciated, according to AAP, are the benefits of physical activity on how children behave, focus on tasks and perform academically.

“Ideally, every child will leave their pediatrician’s office with specific instructions and goals on how to become more active,” Dr. Muth said. “Physical activity is a potent medicine for the whole family’s health and wellbeing.”

As an additional resource, AAP offers a 30-second PSA, in which pediatrician Dr. Shelly Flais urges parents to find ways to help their child find activities they enjoy, while keeping the focus on fun, rather than winning. The PSA, "Keep Kids Active," can be accessed at https://www.youtube.com/watch?v=x4f9sdSMyjM or shared from AAP Facebook pages at @AmerAcadPeds and @HealthyChildren.

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The American Academy of Pediatrics is an organization of 67,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults.