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Are Physically and Mentally Healthier

Research shows what many parents have long known, that children who learn and play in nature are healthier both mentally and physically. Active, unstructured play outdoors helps build a child’s physical strength and also helps children build social and emotional skills such as problem solving and self-esteem.

Children today are spending seven to 11 hours per day sitting with media and only minutes per day playing outdoors. With that sedentary lifestyle we’ve found a rise in childhood obesity, depression, near-sightedness and ADHD. The good news is this is a situation that everyone can improve by taking the kids in their life outside. Families who make a plan to be active in nature are helping their children build skills that will contribute to a healthier life.

Unstructured Free Play Brings Cognitive, Social and Health Benefits

Unstructured free play in the out-of-doors brings a host of benefits to children-from being smarter to more cooperative to healthier overall. This well-documented article by two physicians builds a strong case for the importance of unstructured free play in the out-of-doors for all age groups, and especially young children. While concerned about the "obesity epidemic" in young children, the authors say that the health benefits from outdoor play are only one aspect of the overall benefits. They suggest that the concept of "play" is more compelling and inviting to most adult caregivers, parents and guardians than "exercise." The authors cite cognitive benefits from play in nature, including creativity, problem-solving, focus and self-discipline. Social benefits include cooperation, flexibility, and self-awareness. Emotional benefits include stress reduction, reduced aggression and increased happiness. Children will be smarter, better able to get along with others, healthier and happier when they have regular opportunities for free and unstructured play in the out-of-doors. (Synthesis)

Burdette, Hillary L., M.D., M.S.; and Robert C. Whitaker, M.D, M.P.H. "Resurrecting Free Play in Young Children: Looking Beyond Fitness and Fatness to Attention, Affiliation and Affect." © 2005 American Medical Association.

Childhood Obesity

The prevalence of obesity among children aged 6 to 11 more than doubled in the past 20 years, to 17 percent of children in this age group. The rate of clinically obese adolescents (aged 12-19) more than tripled, to 17.6 percent. The Centers for Disease Control concludes that a major missing ingredient is an hour per day of moderate physical activity.

Study: CDC's National Center for Chronic Disease Prevention and Health Promotion. Division of Adolescent and School Health. Childhood Obesity. 20 Oct. 2008.

Lack of Vitamin D

Many children in the U.S., especially minorities, need more Vitamin D. Spending time outside raises levels of Vitamin D, protecting children from bone problems and other health issues.

Study: American Academy of Pediatrics. “Many Children have suboptimal Vitamin D Levels,” Pediatrics. October 26, 2009.

Cognitive Development

Natural Settings and Cognitive Behavior: Children who are exposed to natural or outdoor settings receive benefits to their cognitive health, such as reduction of ADHD symptoms.

Study: Wells, N.M. (2000). At Home with Nature: Effects of “greenness” on children’s cognitive functioning. Environment and Behavior (32), 6, pp 775-795.

Anxiety, Rumination, Mood

This study investigated the impact of nature experience on affect and cognition. We randomly assigned sixty participants to a 50-min walk in either a natural or an urban environment in and around Stanford, California. Before and after their walk, participants completed a series of psychological assessments of affective and cognitive functioning. Compared to the urban walk, the nature walk resulted in affective benefits (decreased anxiety, rumination, and negative affect, and preservation of positive affect) as well as cognitive benefits (increased working memory performance). This study extends previous research by demonstrating additional benefits of nature experience on affect and cognition through assessments of anxiety, rumination, and a complex measure of working memory (operation span task). These findings further our understanding of the influence of relatively brief nature experiences on affect and cognition, and help to lay the foundation for future research on the mechanisms underlying these effects.

The benefits of nature experience: Improved affect and cognition Gregory N. Bratmana,∗, Gretchen C. Dailyb, Benjamin J. Levyc, James J. Grossd

a Emmett Interdisciplinary Program in Environment and Resources, Stanford University, 473 Via Ortega, Suite 226, Stanford, CA 94305, United States

b Center for Conservation Biology (Department of Biology) and Woods Institute for the Environment, Jerry Yang & Akiko Yamazaki Environment & Energy Building – MC 4205, Stanford University, 473 Via Ortega, Stanford, CA 94305, United States

c Department of Psychology, College of Arts and Sciences, University of San Francisco, 2130 Fulton Street, San Francisco, CA 94117, United States

d Department of Psychology, Stanford University, 450 Serra Mall, Stanford, CA 94305, United States

Video- This video is of Gregory N. Bratmana speaking on the topic at the Health and Nature Summit in Houston, TX

Childhood Obesity and Equity

Currently, obesity affects 17% or 12.5 million of America’s children and adolescents aged 2-19 years. According to the Institute of Medicine, the prevalence of obesity has doubled over the past 30 years for preschoolers and adolescents, and more than tripled for children aged 6-11. Disparities in childhood obesity are also rising. While obesity prevalence increased by 10% for all US children from 2003-2007, children of lower socioeconomic status from high unemployment households saw a 23%-33% increase in obesity. Among Hispanic children, obesity prevalence increased by 24% from 2003-2007, and odds of obesity and overweight were twice as high for black and Hispanic children than white children. Furthermore, obese children are more likely to grow up with a negative self-image, lower levels of advanced education, lower family income, and a lower rate of marriage as adults[1].

Leyla E. McCurdy, MPhila, Kate E. Winterbottom, MPHa, Suril S. Mehta, MPHb, and James R. Roberts, MD, MPHc. May 2010. Using Nature and Outdoor Activity to Improve Children’s Health. Current Problems in Pediatric and Adolescent Health Care (5). [July 2010; 21 June 2018]; Volume (40):Washington D.C.

Type 2 Diabetes

Type 2 diabetes is being diagnosed with increasing frequency in children. Due to the increase in prevalence over the past few decades, the definition has now changed from its previous title, “adult-onset” diabetes. According to the CDC, 1 in 3 children born in 2000 will eventually develop diabetes mellitus if present rates of obesity continue.

Leyla E. McCurdy, MPhila, Kate E. Winterbottom, MPHa, Suril S. Mehta, MPHb, and James R. Roberts, MD, MPHc. May 2010. Using Nature and Outdoor Activity to Improve Children’s Health. Current Problems in Pediatric and Adolescent Health Care (5). [July 2010; 21 June 2018]; Volume (40):Washington D.C.

Hypertension

Hypertension in children has increased because of the childhood obesity epidemic, with 10% of obese children having elevated blood pressure. Sedentary behavior may influence the development of hypertension in children. For example, high blood pressure in children age 3 through 8 years old has been associated with high periods of television viewing and screen time.

Leyla E. McCurdy, MPhila, Kate E. Winterbottom, MPHa, Suril S. Mehta, MPHb, and James R. Roberts, MD, MPHc. May 2010. Using Nature and Outdoor Activity to Improve Children’s Health. Current Problems in Pediatric and Adolescent Health Care (5). [July 2010; 21 June 2018]; Volume (40):Washington D.C.

Cardiovascular Disease and Metabolic Syndrome

Overweight adolescents are at an increased risk of coronary heart disease and premature death. Most overweight and obese children have at least one risk factor for cardiovascular disease, including higher cholesterol levels, abnormal glucose tolerance, high blood pressure, and elevated triglycerides.

Leyla E. McCurdy, MPhila, Kate E. Winterbottom, MPHa, Suril S. Mehta, MPHb, and James R. Roberts, MD, MPHc. May 2010. Using Nature and Outdoor Activity to Improve Children’s Health. Current Problems in Pediatric and Adolescent Health Care (5). [July 2010; 21 June 2018]; Volume (40):Washington D.C.

Nonalcoholic Fatty Liver Disease

Nonalcoholic fatty liver disease refers to the fatty infiltration of the liver without excessive alcohol consumption. It is closely related to obesity and insulin resistance. A population-based study estimated that the prevalence of nonalcoholic fatty liver disease among children aged 2-19 at nearly 10%, and that the prevalence of fatty liver among obese children at 38%.

Leyla E. McCurdy, MPhila, Kate E. Winterbottom, MPHa, Suril S. Mehta, MPHb, and James R. Roberts, MD, MPHc. May 2010. Using Nature and Outdoor Activity to Improve Children’s Health. Current Problems in Pediatric and Adolescent Health Care (5). [July 2010; 21 June 2018]; Volume (40):Washington D.C.

Obstructive Sleep Apnea

Obesity is a well-documented risk factor for the development of obstructive sleep apnea in adults, and it may be a risk factor for sleep apnea in children as well. Obesity may also increase a child’s risk for the consequences of obstructive sleep apnea. For example, obstructive sleep apnea was found to be an independent predictor of nocturnal hypertension.

Leyla E. McCurdy, MPhila, Kate E. Winterbottom, MPHa, Suril S. Mehta, MPHb, and James R. Roberts, MD, MPHc. May 2010. Using Nature and Outdoor Activity to Improve Children’s Health. Current Problems in Pediatric and Adolescent Health Care (5). [July 2010; 21 June 2018]; Volume (40):Washington D.C.

Asthma

Approximately 7 million American children (9.4%) have asthma, a percentage that has doubled since the 1980s. Children who are overweight or obese are more likely to have asthma symptoms. Of the 7 million children reported to have asthma in 2003-2006, black and Puerto Rican children have the highest prevalence. Furthermore, asthma is more prevalent in urban environments; factors contributing to this disparity include indoor and outdoor air pollution, housing and neighborhood conditions, poverty, health care inequities, and social and psychosocial stressors. These circumstances support the notion that black children are 1.6 times more likely to be diagnosed with asthma when compared with white children. However, Puerto Rican children have the highest prevalence of asthma of all racial and ethnic groups; they are 2.4 times more likely than white children to have asthma. Along with the factors of living in an urban environment, television viewing has also been associated with asthma. A population-based study investigated the relationship of BMI with wheezing and asthma in 20,016 children. The authors found that subjects who spent 5 or more hours a day watching television were more likely to experience wheeze and asthma in comparison with those who watched television less than 1 hour a day.

Leyla E. McCurdy, MPhila, Kate E. Winterbottom, MPHa, Suril S. Mehta, MPHb, and James R. Roberts, MD, MPHc. May 2010. Using Nature and Outdoor Activity to Improve Children’s Health. Current Problems in Pediatric and Adolescent Health Care (5). [July 2010; 21 June 2018]; Volume (40):Washington D.C.

Vitamin D Deficiency

Children continue to demonstrate evidence of vitamin D deficiency, as noted in an analysis of the 2001-2004 NHANES. It is indicated that 9% of the pediatric population, or 7.6 million US children and adolescents had insufficient levels of vitamin D. Additionally, low levels of vitamin D may lead to osteoporosis, cardiovascular disease, metabolic syndrome, hypertension, diabetes, myocardial infarctions, and peripheral arterial disease. Spending time outside raises levels of Vitamin D, protecting children from bone problems and other health issues. Historically, the main source of vitamin D comes from synthesis in the skin after exposure to UVB light. In a cohort study conducted in Japan in 2003, authors evaluated the degree of association between vitamin D and lifestyle factors in Japanese women aged 19-25. Lifestyle factors included nutrient intake, physical activity, and duration of sunlight exposure. Two main findings of the study were that daily energy expenditure and numbers of steps taken per day were positively associated with vitamin D. Furthermore, the average amount of time per day spent in sedentary activity was negatively associated with vitamin D. Asthma may also be related to vitamin D deficiency. Twenty-eight percent of the children with asthma had insufficient levels of vitamin D.

Leyla E. McCurdy, MPhila, Kate E. Winterbottom, MPHa, Suril S. Mehta, MPHb, and James R. Roberts, MD, MPHc. May 2010. Using Nature and Outdoor Activity to Improve Children’s Health. Current Problems in Pediatric and Adolescent Health Care (5). [July 2010; 21 June 2018]; Volume (40):Washington D.C.

Depression and Anxiety

Children and adolescents are increasingly being prescribed medication for depression, anxiety, or behavioral difficulties. Six percent of adolescents 14-18 years old have been diagnosed with depressive disorders, as well as 3% of children younger than 13 years old. Stress is also a top health concern for adolescents in the USA, according to a 2009 survey by the American Psychological Association. The survey found that nearly half of the adolescents in the USA said that their level of stress had increased in the past year, and the 14% of adolescents categorized their stress as extreme. The prevalence of ADHD has increased considerably in recent decades, labeled by the CDC as “a serious public health problem.” The results of the National Health Interview Survey showed that 9% of children have ADHD. Another study in 2005 found that 5% of US children between the ages of 4 and 17 were prescribed medication for difficulties with emotions or behavior, and 90% of these were treatment for symptoms of ADHD[2].

Leyla E. McCurdy, MPhila, Kate E. Winterbottom, MPHa, Suril S. Mehta, MPHb, and James R. Roberts, MD, MPHc. May 2010. Using Nature and Outdoor Activity to Improve Children’s Health. Current Problems in Pediatric and Adolescent Health Care (5). [July 2010; 21 June 2018]; Volume (40):Washington D.C.

Children’s Health and Sedentary Lifestyle

In the US in recent decades, there has been a nationwide shift to a sedentary lifestyle, leaving children vulnerable to the negative effects of inactivity. Physical activity is known to reduce the risk of premature mortality, coronary heart disease, hypertension, diabetes mellitus, osteoporosis, colon cancer, depression, and anxiety. Nonetheless, in 2006, approximately 40% of US adults reported no participation in any leisure-time physical activity. Inactivity has also been measured in children and adolescents. While research shows that adolescents who are physically active are more likely to be active during adulthood, only 35% of high school students met currently recommended levels of physical activity in 2005. Children’s lack of physical activity and their growing disconnect with the natural environment have been influenced by the rise in electronic media, decreased time for unstructured free play, and environmental barriers. Per capita visits to US national parks have decreased since 1987, coincident with the rise in electronic entertainment media, video game, and internet use. Young people spend roughly 7.5 hours a day consuming some forms of electronic media – an hour more than was reported 5 years ago. Additionally, each added hour of television significantly increases the odds of having social or emotional problems such as low self-esteem. Free, unstructured play also affects the amount of physical activity children engage in each day.

According to the AAP, play allows children to use their creativity and imagination while building dexterity and physical strength. Unstructured play is also important for healthy brain development; children learn how to work in groups, share, negotiate, resolve conflicts, and learn self-advocacy skills.

Since the 1970s, children have lost roughly 12 hours a week of free time, including a 25% decrease in play and a 50% decrease in unstructured outdoor activities. In fact, children now spend more time in vehicles being transported from one indoor activity to another than in nature. This statistic speaks to the important role of parents in raising healthy children. Parents’ encouragement and presence are actually key predictors of the amount of time children spend outdoors; authors of a 2009 ecological study observed that older children who had less adult supervision after school spent less time outside. Not only does the parents’ role in raising a child affect his/her health, but the built environment is another important factor, speaking to racial and ethnic issues. Differences in the built environment also may contribute to racial and ethnic health disparities in the USA. Minority children and those from lower socio-economic classes generally have less access to recreational facilities, which is linked to decreased physical activity and overweight. Neighborhoods with large minority populations, on average, have fewer supermarkets and produce stores. Therefore, they must rely on convenience stores and fast food restaurants that carry food high in fat, sodium, and sugar that are also associated with a higher body mass index (BMI).