ABSTRACT
Over the past three decades the number of obese children ages 6 to 11 years has tripled and the prevalence of obese preschool-age children has doubled (Singh, Siahpush, & Kogan, 2011). Furthermore, approximately 17% or 12.5 million of U.S. children and adolescents ages 2 to 19 years old are obese. Physical inactivity has been recognized as a major contributing factor to the obesity epidemic, yet a large portion of the U.S. child and adolescent population do not engage in the recommended moderate and vigorous physical activity (MVPA) (Hills, King, & Armstrong, 2007; Tomporowski, Lambourne, & Okumura, 2011). is observation is due to several factors, including a lack of opportunity to participate in physical activity (Curtis, Hinckson, & Water, 2012); an overemphasis on academics, which promotes extended periods of sedentary time during the school day (Kalish & Sabbagh, 2007; McCurdy et al., 2010; Milteer et al., 2012); and diminished safe outdoor environments because of increased crime, overdevelopment, and blighted properties (Molnar et al., 2004; Singh et al., 2011). ese challenges lead to an obesity-promoting environment, which negatively aects multiple sectors of society that struggle to identify solutions (Huang, Grimm, & Hammond, 2011; Sothern et al., 1999a). us, promoting the addition of daily physical activity into the lives of obese children continues to be a frustrating experience for most families and pediatric health care professionals (Kiess et al., 2001; Sothern et al., 2010). Further adding to this negative state of aairs is a lack of consistent professional guidelines for exercise therapy. Recently, general physical activity guidelines were established for sedentary youth, which in many cases includes overweight and obese children and adolescents (Strong et al., 2005; U.S. DHHS, 2008) and the American Heart Association included broad-based suggestions for tailoring exercise to obese populations in a recent publication (Daniels et al., 2009). In addition, Brambilla, Pozzobon, and Pietrobelli (2011) recently published an extensive review paper concerning the favorable impact of exercise to metabolic disease prevention in youth, which included suggestions for exercise intensity and modality. To date, however, no one professional medical or scientic organization has provided specic recommendations for intensity, duration, frequency, or modality of exercise for the management of pediatric obesity (American Academy of Pediatrics [AAP], Committee on Sports Medicine, 1990; American College of Sports Medicine [ACSM], 2010; Daniels et al., 2009; Eisenmann, 2011; Faigenbaum et al., 2009; Ganley et al., 2011; Kitzmann et al., 2010; Sothern, 2001; Sothern et al., 2006; U.S. Preventive Services Task Force, 2010; Washington, Bernhardt, Gomez, Johnson, et al., 2001). Pediatric health care professionals, thus, must rely on the available scientic literature when determining initial exercise recommendations for overweight and obese children and adolescents with varied family and medical histories.
