Children’s physical activity and health—Chronic disease in children and young adults

Editorial

Children’s physical activity and health—Chronic disease in children and young adults

The previous Special Issue was devoted to physical activity (PA),physical fitness,diet,and health in young people.1The content of this second Special Issue will focus on PA and chronic disease in children and young adults.

The first paper written by Durstine et al.2considers the problem of chronic diseases becoming a public health concern worldwide with estimates of trillions of dollars in annual health care costs and causing more than 36 million deaths a year.Their review first focuses on physical inactivity as a lifestyle factor which is heavily correlated with the development of many chronic diseases which provides physiological disadvantages that ultimately lead to poor health and increased likelihood for the early onset of chronic disease;whereas PA continues to gain recognition as an important lifestyle intervention in primary and secondary prevention.The authors contend that a lifetime of PA and exercise reduces the negative economic and social impact of chronic diseases,and that more emphasis in primary prevention is necessary to reduce disease risk in youth and young adults.Additionally,similar emphasis is necessary for secondary disease treatment in those children and adults already inflicted with a chronic disease.

In the second paper,Riner and Sellhorst3examine the recent decline in the PA levels among children.This change in children’s lifestyle is likely responsible for the increase in many chronic diseases to include cardiovascular risk,obesity,and ariseindiabetesamongchildrenwhoareotherwisehealthy.The authors report that such lifestyle changes present even more of a problem when chronic diseases such as congenital heart disease,asthma,and cerebral palsy already affect the child. Because of medical limitations and contraindications,greater careisnecessarytomakecertainthatthesechildrenareinvolved inanappropriateexerciseprogramthathassuitablesupervision. Further complications are either caused or exacerbated when there is insufficient PA or lack of proper direction.Riner and Sellhorst conclude that once the concern for safety,risk of injury,or medical condition is satis fied,the priority is to focus on ensuring the highest quality of life possible.

Liese and coauthors4report diabetes as the leading childhood and adolescence chronic disease.In past years the autoimmune insulin-dependent diabetes mellitus(type 1 diabetes) was the primary form of this disease found in children,but in the last several decades an emergence of type 2 diabetes which was previously found only in adults has developed in children and adolescents.Liese et al.4discuss the importance of including PA and exercise as a primary component of a diabetes management plan.They review the epidemiologic and interventionevidenceforthehealthbene fitsofPAandphysical fitness and report that the data is quite consistent.The authors establishthatthesebene ficialeffectsofincreasedPA,exercise, and decreased sedentary behavior are extremely important in youth with diabetes because of the markedly increased longterm risk of cardiovascular disease in this population when compared to children without diabetes.

In this fourth paper,Williams and Stevens5present some perceptive insights and data regarding children with cystic fibrosis(CF).In young people with this condition low levels of PA are always seen despite clinicians and their support teams acknowledging the importance of daily PA.In addition to drug therapies,exercise programming is considered a positive treatment strategy and an important component for long-term management.Unfortunately,detailed information about prescribingexerciseandspecialconsiderationsforCFpatientsto optimize clinical outcomes are lacking.For example,little information isavailable concerning the effects of regular PA and exercise on bone health and CF related diabetes.The authors report that the impact of exercise training on other physiological outcomes such as patient symptoms,nutritional status,bacteria colonization,andqualityoflifearenotknown.Mostimportantly strategies to achieve greater adherence to exercise training in children with CF are needed in order to gain the full potential of PA and exercise programming as therapeutic interventions.

The last paper by Pitetti et al.6provides a review concerning children and adolescents with Down syndrome(DS). These individuals possess a set of health,anatomical,physiological,cognitive,and psycho-social attributes predisposing them to limitations for developing their physical fitness and PA levels.The authors provide an insightfulreviewsummarizing a relatively large existing body of literature for youth and adolescence having DS and report a variety of limitations they possess:1)low cardiovascular and muscular fitness/exercise capacity;2)a greater prevalence of overweight and obesity;3)a large proportion do not meet the recommended amount of daily aerobic activity;and 4)their PA likely declines through childhood and into adolescence.They conclude their paper by stating that effective PA and exercise programming should be used in a multi-factorial approach and the programming should be flexible enough so as to be individualized to meet the physiological,cognitive,and psychosocial pro files of each youth with DS.

The purpose of this second Special Issue is to increase awarenessfortheprevalenceofchronicdiseasesworldwideand the association with PA.The high rate of these diseases is not only reported for adults but is now being found in children and adolescents.Authors for all five papers feel strongly that a lifetime of PA and exercise can reduce the harmful physical and financial impact of most chronic diseases,and that primary prevention should focus on reducing disease risk in youth and youngadults.Atthesametime,similaremphasisshouldalsobe placed on the secondary disease treatment in those children and young adults already in flicted with a chronic disease.

1.Armstrong N,Cheng S,Durstine JL.Physical activity,physical fitness,diet and the health in young people.J Sport Health Sci 2012;1:129—30.

2.Durstine JL,Gordon B,Wang Z,Luo X.Chronic disease and the link to physical activity.J Sport Health Sci 2013;2:3—11.

3.Riner WF,Sellhorst SH.Physical activity and exercise in children with chronic health conditions.J Sport Health Sci 2013;2:12—20.

4.Liese AD,Ma X,Maahsc DM,Trilk JL.Physical activity,sedentary behaviors,physical fitness,and their relation to health outcomes in youth with type 1 and type 2 diabetes:a review of the epidemiologic literature. J Sport Health Sci 2013;2:21—38.

5.Williams CA,Stevens D.Physical activity and exercise training in young people with cystic fibrosis:current recommendations and evidence.J Sport Health Sci 2013;2:39—46.

6.Pitetti K,Baynard T,Agiovlasitis S.Children and adolescents with Down syndrome,physical fitness and physical activity.J Sport Health Sci 2013;2:47—57.

J.Larry Durstine,Guest EditorDepartment of Exercise Science, The University of South Carolina,Columbia,SC 29208,USA

E-mail address:ldurstin@mailbox.sc.edu

Neil Armstrong,Guest EditorChildren’s Health and Exercise Research Centre, University of Exeter,Exeter EX4 4QJ,UK

E-mail address:N.Armstrong@exeter.ac.uk

Sulin Cheng,Guest EditorDepartment of Health Sciences,University of Jyva¨skyla¨, FIN-40014 Jyva¨skyla¨,Finland

E-mail address:shulin.cheng@jyu.fi

14 December 2012

Peer review under responsibility of Shanghai University of Sport

2095-2546/$-see front matter Copyright©2012,Shanghai University of Sport.Production and hosting by Elsevier B.V.All rights reserved. http://dx.doi.org/10.1016/j.jshs.2012.12.002