Taking It Outside

IT’S A SCENE THAT FOR MOST PARENTS is frustratingly familiar:  Outside  blooms a perfect summer day, while inside kids drape themselves on furniture, calling out occasionally for snacks or to announce, “I’m bored!” The languor is broken only by trips to the cupboard or refrigerator. And then there is the bewitching power of “screen time,” a force few kids can resist. “TV, texting, Internet chatting, video gaming,” says physician Alexandra Adams, a professor of family medicine with the UW-Madison School of Medicine and Public Health (SMPH). “You name it, they’re doing it.”

As a childhood obesity expert, Adams knows another fact about today’s kids of summer: Many of them are at serious risk of packing on pounds. The children she treats at her practice in the UW Pediatric Fitness Clinic already struggle with weight gain and low fitness levels, and now 90 percent of them are coming back 5 to 10 pounds heavier after the three-month summer break, she says, without an associated increase in height. For young kids and teens, it’s a devastating amount to gain, especially since statistics say those excess pounds may never come off again. And her patients are hardly alone. According to the American Heart Association, one in three American children are now overweight or obese, putting them squarely on the path to adult obesity and at risk for adult diseases, including diabetes, heart disease, arthritis and kidney stones.

“We have kids in our clinic who are type 2 diabetics and hypertensive and on cholesterol medication in their early teens. They look like mini-adults,” Adams says. “They’re physiologically much older in their bodies than they should be. And that’s tragic.”

“There is no more ‘free range’ childhood,” says Dennis

These troubling trends have led doctors, nutritionists and health advocates to introduce a multitude of anti-obesity programs, including the national “Let’s Move!” campaign started by First Lady Michelle Obama last year. Educational initiatives, healthier school lunch programs, and kid-tailored fitness regimens are all being tried. But amid these carefully orchestrated interventions, a team of CALS and SMPH researchers is now wondering if we’ve missed an obvious part of the prescription, especially for children in summer.

With kids staying indoors in record numbers, what if we just got them to go outside?  This doesn’t mean shuttling them to weekly soccer games or other activities by car; kids today get plenty of that, says Sam Dennis, a CALS landscape architect who specializes in children’s environments and collaborates frequently with Adams. What Dennis has in mind are the outdoor experiences children used to have in the past—the type that 50- and 60-something adults describe when asked to explain how they played as children.

“They’ll say, ‘We didn’t have any equipment and we didn’t have organized teams. We would just go out into the woods and build forts or make mud pies,’” says Dennis, who collects these accounts to inform his design of children’s play spaces. “And they get very caught up and animated in telling stories of how they played in nature as kids.”

These children of 40 and 50 years ago not only played outside more; they were also only one-third as likely to be overweight as their counterparts today. Being outside obviously removes kids from the indoor temptations of snacking and screen time. Plus, research shows that kids who spend more time outdoors are also more likely to be physically active, Dennis says.

Yet like many seemingly simple solutions, this one, too, has a catch. Earlier generations of kids played outdoors and were slimmer for it not because they were somehow healthier or more capable of making good choices than children are today—even though some grownups like to think so.

“It’s not that we were so much smarter,” says SMPH physician and pediatrics professor Aaron Carrel, with a smile. Kids have always been kids. The difference was the environment.

“Obesogenic” is what the  Centers for Disease Control and Prevention calls the American landscape today, meaning it promotes unhealthy eating, a sedentary lifestyle, too many calories—and extra pounds. The more fattening aspects of our surroundings are easy to spot: a fast food hamburger and super-sized fries, for example. But what makes obesity so hard to prevent nowadays is that many things that foster weight gain have become part of our everyday lives, says Carrel. We take elevators instead of stairs, we drive instead of walk, we lift our garage doors with the press of a button. As a result, we probably expend 100 to 300 fewer calories each day than people did 30 years ago, while also taking in 100 to 300 more. And those added calories … well, they add up.

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