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Doctors Asked to Monitor Patient Activity

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CHICAGO (AP) _ The American Academy of Pediatrics wants to turn children's doctors into activity police, encouraging them to routinely monitor how active patients and even their parents are each day to help conquer obesity.

Boosting daily physical activity from infancy through the teen years is a key to fighting fat, and parents need to set good examples by also adopting active lifestyles, the group says in a new policy statement.

It is published in May's Pediatrics, for release Monday.

The policy says pediatricians should ask patients and parents at regular office visits how active they are. They also should document how much time patients spend each day on sedentary activities and urge them to follow AAP guidelines recommending no TV for children under age 2 and no more than two hours daily of TV, video games and other ``screen time'' for older children.

Also, schools should reinstate mandatory daily physical education from kindergarten through high school. These classes should allow participation by all children, including the disabled. Overweight and obese children should be encouraged to participate in activities such as water-based sports and strength-training rather than weight-bearing activities, including jogging, that may be more difficult for them, the policy says.

Parents are encouraged to ``become good role models by increasing their own level of physical activity'' and to make active pursuits a part of the family lifestyle starting when children are infants, with regular walks to the park or zoo and by routinely engaging in physical play with them.

Preschoolers should take part in unorganized outdoor activities and begin walking ``tolerable distances'' with family members. Older children and adolescents should be physically active for at least an hour daily, and organized sports may be started when children are school-age, the policy says.

``I've been giving this advice for a long time. Most of the time parents don't feel that it is an imposition,'' said policy co-author Dr. Jorge Gomez, a pediatrician at the University of Texas Health Science Center in San Antonio.

For parents who say busy work schedules and other lifestyle factors make it hard for the family to be active, ``we sit down and troubleshoot,'' Gomez said. ``A little is better than nothing. You don't have to play with your child every day, but on your day off, make a point of doing something outside with your child,'' including taking a walk, flying a kite, or playing ball.

``It doesn't have to be strenuous, it doesn't have to be organized,'' just ``something to promote the habit of being outdoors and active,'' he said.

Angie Dixon, 38, a writer in Little Rock, Ark., agreed that physical activity is important, but said the recommendations ``certainly could become intrusive'' if doctors aren't sensitive to families' constraints.

``With two kids, there's not much time when I don't have somebody bothering me,'' Dixon said. Still, she said she tries to walk for exercise several times weekly and encourages her 8-year-old daughter and 10-year-old son to be active, too.

She said she supports having pediatricians voice the same recommendations.

``I'm not sure how effective it will be, but I think it's worth a try,'' Dixon said.

Government figures published in April show that more than one-third of U.S. children are overweight and about 17 percent are obese.

Dr. Peter Belamarich, a pediatrician with Children's Hospital at Montefiore in New York, said the academy is right to be urging doctors to intensify their efforts to curb the problem.

``I think it's fantastic. I think we should be taking a leadership role in this area,'' Belamarich said. ``This is a national health problem that is going to just overwhelm us as a society if we don't attend to it.''

Dr. Claire LeBlanc, a policy co-author and pediatrician at Children's Hospital of Eastern Ontario in Ottawa, Canada, said rising obesity rates affect children globally and prevention ``is really the key.''

``Physical activity is certainly one of the pieces of the puzzle that could be an effective part of the solution,'' LeBlanc said.
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