Developing Physically Active and Sporty Kids - Benefits and Barriers

Introduction[edit | edit source]

Physical activity is distinct from exercise. Physical activity refers to any movement, such as walking, cycling, wheeling, sports, active recreation and play. Individuals of any skill level can enjoy physical activity.[1]

Exercise is a specific subcategory of physical activity. It is planned, structured, repetitive and purposeful, and it ultimately aims to improve or maintain physical fitness.[2]

Physical activity improves children’s health and reduces risk factors for poor health.[3]

Obesity[edit | edit source]

Since 1997, the World Health Organization (WHO) has considered obesity a major public health problem and a global epidemic.[4] The prevalence of obesity has increased significantly over the last 40 years. It is predicted that, if this trend continues, the majority of adults will be overweight or obese by 2030.[4]

Globally, 38.3 million children under the age of 5 (or 5.6 percent) are considered obese.[5] The longer children are overweight or obese, the more likely they will be obese when they are adults.[5]

  • Since 2000, the number of children aged under 5 who are overweight has increased by nearly 24 percent in Africa[6]
    • In South Africa, childhood obesity may be related to cultural beliefs and practices[7]
  • In 2019, almost half of all children under 5 who were overweight or obese lived in Asia[6]
  • In some settings, there can be a double burden of malnutrition:[6]
  • Children in low- and middle-income countries are more likely to be:[6]
    • Vulnerable to inadequate pre-natal, infant and young child nutrition
    • Exposed to diets that are micronutrient-deficient, energy-dense, but which include high-sugar / high energy foods

When combined with a lack of physical activity (see below), these dietary factors can cause obesity in children.[6] There is also an association between socioeconomic status and adiposity (i.e. fat levels),[8] with obesity more common in low-income groups.[3]


Physical Activity[edit | edit source]

Many children and adolescents are not sufficiently active. In particular, physical activity levels often decrease in children aged between 9 and 15 years.[10]

Decreasing levels of physical activity may be due to:[3]

  • The shrinking backyard
  • The perceived / real danger of letting children play outside
  • Increased use of technology
  • Decreased levels of incidental exercise

There are also high dropout rates from organised sports, which is discussed in more detail here.

Moreover, according to the Chartered Society of Physiotherapists,[11] only 20 percent of parents know how much physical activity / exercise their children should be getting each day.

Physical Activity and Injury Prevention Campaigns[edit | edit source]

Many campaigns have been developed to encourage physical activity, including:

Developing partnerships between the health and education sectors could help to achieve physical activity goals in children. Physiotherapists can also help to empower parents and teachers to encourage physical activity in children.[3]

Exercise Recommendations[edit | edit source]

The following are general exercise recommendations:[3]

  • Children should aim for one hour of physical activity every day
  • Their heart rate should increase, but conversation should still be possible
  • Exercise / activity can be spread out over the day
  • Adults should aim for 30 minutes of exercise most days

More information on recommended levels of physical activity for children is available here.

Benefits of Exercise[edit | edit source]

Physical activity has many benefits for children.[12] It increases cardiovascular health, strengthens bones, muscles and connective tissue and enhances fitness and athleticism.[13]

Exercise and the Brain[edit | edit source]

Exercise also has a positive impact on the brain.[14]

  • Memory and learning are improved in children who are more active[15]
  • Reading and mathematics scores are better in children who are more active,[3] including those with attention deficit hyperactivity disorder (ADHD)[16]
  • Top-down control (i.e. executive function) improves following exercise[17][18]
    • This has positive implications for children with ADHD[3]
    • Pontifex and colleagues[19] found that moderately intense aerobic exercise can improve neurocognitive function and inhibitory control in children with ADHD


Why Does Exercise Affect the Brain?[edit | edit source]

  • Physical activity improves learning and hippocampal neurogenesis (i.e. the growth of new nerve cells in the hippocampus)[13][21] [22]
  • Physical activity and a diet high in natural products may:[13][22]
    • Encourage the growth of new blood vessels
    • Enhance chemical messengers and growth factors

Thus, it may be beneficial to encourage exercise in the morning to increase a child’s focus at school. Children could be encouraged to walk to school, or their teachers could schedule a walk / run around the field at the start of each school day.[3]

What Type of Exercise is Best?[edit | edit source]

Different types of exercise have been found to have different effects.

  • High-intensity training (HIT) in adults improves insulin sensitivity[23][24] and top-down attentional control[17]. According to Leahy et al.[25] high-intensity interval training (HIIT) can positively effect cognitive function and mental health in children and adolescents.
  • Winter et al.[26] found that in healthy subjects, vocabulary learning was better after high impact anaerobic sprints when compared to low impact aerobic running or rest
  • Vaisto et al.[27] concluded that:
    • Total physical activity is inversely proportional to cardiometabolic risk and directly proportional to high-density lipoprotein (HDL) cholesterol
    • The strongest association was for unstructured physical activity and recess activity
      • Other studies[28][29] have also noted the benefits of incidental exercise / recess activities for children
    • Rest and screen time increased cardiometabolic risk
  • Aerobic and resistance training are also beneficial:
    • Colcombe and Kramer[30] and Hall et al.[31] found that aerobic exercise training is associated with improvements in cognition, particularly executive control processes (planning, multi-tasking, working memory and dealing with ambiguity)
    • Hillman et al.[18] determined that moderate- to vigorous-intensity exercise can improve cognitive performance and brain function in children aged 7 to 9 years during tasks that require greater executive control
      • Participants in Hillman et al.'s[18] study intermittently engaged in at least 70-minutes of moderate-to-vigorous physical activity


Exercise and Motor Ability[edit | edit source]

There is strong evidence that fundamental motor skill (FMS) proficiency is associated with physical activity, obesity, cardiorespiratory fitness and ball skills.[3][33][34][35] Poor motor proficiency is negatively associated with:[36]

  • Body composition
  • Fitness
  • Muscle strength and endurance
  • Anaerobic capacity
  • Power
  • Physical activity

Moreover, children with poor motor proficiency are more likely to be overweight or obese.[37][38]

  • Developmental coordination disorder (DCD) may be a specific risk factor for poor cardiovascular health in children[39]
  • De Waal et al.[40] found that motor proficiency in children can be affected by increased weight, but this effect can be countered by weight loss

Exercise Interventions for Motor Ability[edit | edit source]

There is limited evidence about which interventions are best for children with poor motor proficiency. However, according to Cliff et al.[41]:

“Physical activity programs designed for children with overweight/obesity need to address deficiencies in FMS proficiency as part of an overall strategy to promote physical activity participation”.

A 2009 longitudinal study by Barnett et al.[42] found that:

  • Being competent at object control skills (e.g. catching, throwing and kicking) in childhood may help young people develop a positive perception of their sports competence
  • This perception might increase engagement in physical activity and enhance fitness levels in adolescents

Barnett et al., therefore, conclude that:

“Teachers should be encouraged to teach motor skills using a mastery learning environment where the child is able to succeed and is encouraged to personally improve which can lead to higher levels of enjoyment and greater levels of perceived competence.”[42]

Thus, interventions that aim to improve physical activity and participation in children should focus on:[3]

  • Weight control
  • Training motor proficiency
  • Enhancing intrinsic motivation
  • Sport and physical education curricula must also cater for all students' needs


A Child’s Body Make-Up[edit | edit source]

Connective tissue is found in muscle, ligaments, surrounding organs and bone. It supports, anchors and connects various body parts. Low connective tissue tone may mistakenly be called “low muscle tone” or hypotonia.[3]

Figure 1. Beighton scale.

Low connective tissue tone (i.e. hypermobility or increased laxity in connective tissue) can impact a child’s participation in physical activity. It may increase a child’s predisposition to injury,[44] and it is associated with coordination or strength deficits.[3]

Low connective tissue can be assessed using the Beighton scale (Figure 1). More information on low connective tissue tone is available here and a detailed discussion of benign joint hypermobility syndrome (BJHS) is available here.

Summary[edit | edit source]

  • Physical activity levels are declining, but obesity is increasing in children and young people
  • The benefits of maintaining a healthy weight and participating in regular exercise are well-known
  • Participation in exercise may be associated with motor ability and specific conditions such as low connective tissue tone

References[edit | edit source]

  1. World Health Organization. Physical activity. Available from: (accessed 4 October 2021).
  2. Caspersen CJ, Powell KE, Christenson GM. Physical activity, exercise, and physical fitness: definitions and distinctions for health-related research. Public Health Rep. 1985;100(2):126-31.
  3. 3.00 3.01 3.02 3.03 3.04 3.05 3.06 3.07 3.08 3.09 3.10 3.11 Prowse T. Developing Fit and Sporty Kids - Physical Activity, Obesity, Cognition and Motor Ability Course. Plus , 2021.
  4. 4.0 4.1 Haththotuwa RN, Wijeyaratne CN, Senarath U, Chapter 1 - Worldwide epidemic of obesity. In: Mahmood TA, Arulkumaran S, Chervenak FA editors. Obesity and Obstetrics (Second Edition). Elsevier, 2020. p3-8.
  5. 5.0 5.1 Narzisi K, Simons J. Interventions that prevent or reduce obesity in children from birth to five years of age: A systematic review. Journal of Child Health Care. 2021;25(2):320-34.  
  6. 6.0 6.1 6.2 6.3 6.4 World Health Organization. Obesity and overweight. Available from: (accessed 4 October 2021).
  7. Mamabolo RL, Alberts M, Steyn NP, Delemarre-van de Waal HA, Levitt NS. Prevalence and determinants of stunting and overweight in 3-year-old black South African children residing in the Central Region of Limpopo Province, South Africa. Public Health Nutr. 2005;8(5):501-8.
  8. Vazquez CE, Cubbin C. Socioeconomic status and childhood obesity: a review of literature from the past decade to inform intervention research. Curr Obes Rep . 2020;9:562–70.
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  19. Pontifex MB, Saliba BJ, Raine LB, Picchietti DL, Hillman CH. Exercise improves behavioral, neurocognitive, and scholastic performance in children with attention-deficit/hyperactivity disorder. J Pediatr. 2013;162(3):543-51.
  20. Harvard Health Publishing. How to keep your brain healthy through exercise. Available from: [last accessed 07/10/2021]
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