On April 15, the Centers for Disease Control and Prevention held a media conference at the National Press Club in Washington, D.C., to announce the release of a new report on school-based physical activity and its association with academic performance.
The report -- a review of 50 studies published in 43 articles -- reached a conclusion that is no great surprise to those of us who know kids well (I have five), and work to promote their health (both physical, and intellectual). Physical activity is good for body and brain, alike. As often seems to be the case, modern analytic methods and systematic review of evidence landed us right in the middle of Grandma's common sense counsel: sound mind, sound body.
The fundamental findings of CDC's 129-page report were that diverse interventions for kids of various ages produced a net improvement in academic performance more often than not. Over 50 percent of the studies analyzed improved some measure of cognition or academics. An additional 48 percent of the interventions contributed to fitness and health without compromising academics.
The benefits of physical activity probably need no introduction. Being active, in combination with eating well, is both the first, and only truly reliable, line of defense against the clear and omnipresent danger of childhood obesity. Even when physical activity is not preventing overweight, it is promoting vitality and helping to prevent disease. Independent of weight control, exercise can help keep diabetes at bay.
But while fitness, vitality, the avoidance of disease and the pleasures and glories of athletics might make a totally persuasive argument for routine exercise, the benefits don't stop there. The mind and body are genuinely connected, and the soundness of one redounds to the other.
Just consider that rates of behavioral disorders in childhood -- attention deficit disorder in particular -- are at an all-time, unprecedented high. How do we account for that? Certainly, there has been no radical shift in the genes that oversee the construction of children in the last generation. Children are much the same as they ever were. Their typical day is as it never was before.
Children used to play outside. They used to have physical education and recess during the school day. More and more, we take naturally rambunctious children, send them to schools from which recess and Phys Ed have been all but banished, bolt them to chairs all day long, and then watch them grow into adults we can't get off couches with crowbars! And, alas, along the way we medicate more and more of them for attention disorders. Could it be that WE are the ones who have not been paying sufficient attention to the natural, healthy restlessness of children?
Some years ago, when my son, Gabriel, was five, he joined the rest of my family in attending an evening talk I gave at Dartmouth. Whereas my daughters, all older than Gabe, were able to sit attentively as my talk began, Gabe was fidgeting out of his seat and tormenting his poor mother within minutes.
The story that ensued -- one I have told many times -- is that I interrupted my talk to intervene on my wife's behalf. I asked Gabe to run a lap around the large auditorium in which I was speaking. He did, completed it, then popped up from his seat and took off for another. As he came around at the end of lap two and kept on going, three other kids took off after him. When the four of them came around and kept going, several dozen children joined in!
As the ruckus played out, I noted to my audience that what we were observing was more important than anything I might be saying. I presumed all of the kids running laps around us were healthy. My son, certainly, was healthy -- although, lord knows, if you were cooped up with him at that age for any length of time you'd be tempted to medicate either him or yourself! But he was, and is, healthy. Rambunctiousness in children is normal.
And it should be treated with recess, not Ritalin! Gabriel had shown me how.
The result of Gabe's fidgety disruption was a program called ABC for Fitness (Activity Bursts in the Classroom), ultimately crafted not only by my research staff, but by experts in physical education, notably Marvin Christley with the New Haven, CT, Public Schools, and experts in education from the CT Department of Education. The program, available to all for free at http://www.davidkatzmd.com/abcforfitness.aspx, not only allows for intermittent bursts of activity throughout the day whenever kids 'need' one, but matches aerobic routines to grade level and subject matter. Teaching time actually goes up!
The program has rapidly spread to thousands of schools, because it's so easy, costs nothing, and works so well. We've analyzed the results in over 1,000 children and found not only improvements in fitness, but stable academic performance, and significant declines in medication use for both asthma, and ADHD. This report has been accepted for publication, and will be out soon.
The traditional three 'R's -- reading, writing, and 'rithmetic- remain as important as ever. Our own work, CDC's review of 50 studies, and every parent's experience with children indicate there is a strong case to add back a fourth that contributes its own benefits, while supporting the time-honored three. It is variations on the theme of recess- not Ritalin!
-fin
Dr. David L. Katz; www.davidkatzmd.com
Follow David Katz, M.D. on Twitter: www.twitter.com/DrDavidKatz
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David Katz rocks!
This article is great. The completely obvious connection between exercise and well-being is so often forgotten.
I have ADHD i have since I was David's son Gabes age.
I use exercise and diet as my main tools to keep focused. It has worked for me for years. I write about ADHD all the time and about ADHD and Excercise here:http://www.adhdaction.com/adhd-and-exercise.html.
Any kid or any person will benefit from exercise. So to use the famous slogan
"Just Do It!"
Beatings at school were common in our day to "correct" the "inappropriate" behavior we couldn't help. My husband is ADD, I'm ADHD. My husband avoided it (good schools and parents). I wasn't so lucky. It didn't fix the AD(H)D for me either - I just had more bruises and fractures.
The author doesn't mention beating as a method of "control" because he is writing about what happens today. 40 years ago, beating a child was considered an acceptable method of "focusing a child's attention and correcting "bad" behavior.
It was child abuse. DUH!
I wish exercise was the answer. For those of us who suffer from this disorder, sadly it isn't. Our brain chemistry is different. We process medications differently. "Speed" acts as a depressant on our bodies, and depressants act as amphetamines. It's the key diagnostic differential - if you give someone amphetamines and they bounce off the walls, they are NOT ADD or ADHD.
It really is that simple.
No, it does NOT go away in "adulthood."
This GENETIC disorder is masked by normal childhood activity. The laziness of docs and parents-who shouldn't have had children if all they wanted was "peace and quiet"-means that the disorder is OVERDIAGNOSED. Believe me, it DOES EXIST!
Thank you Dr. Katz, reminding us the value of recess.
The fact is, just because a child is fidgety or restless, does not mean they have ADHD.
It is true that some General Practitioners have over-prescribed medication for ADHD. The best treatment for ADHD includes therapy, exercise, proper diet and (sometimes) medication.
Ritalin and drugs like it is a stimulant. It is used to reinforce the executive functions of the brain. The reason that ADHD patients appear calmer with it is that it gives them the means to better control themselves.
The classification for ADHD did not exist before 1980. Because of the novelty and the nature of ADHD, it should not be surprising that some people saw ADHD everywhere. Fortunately, we're beyond that. The fact remains that some people have ADHD and require treatment for it.
In my youth my parents called it "ants in your pants"...now they wanted to give it a fancy name and a chemical to young, developing brains that they even admit were not sure how it worked. I thought it was ridiculous at the time and have railed against doing this to kids for years. I believe it stemmed from overworked parents and teachers who wanted these active boys to "sit still". Then there's all the chaos in families that didn't help. So people believed these "experts" and drugged their kids for years and years. Many of them at adolescence had terrible times adjusting to their changing hormones and needs. They were also now addicted to a substance that was starting to have the opposite effect. I think it's a travesty that we did this to a generation of kids. I realize there are some truly mentally challenged kids that need help...but certainly not in these numbers. It was the drug of the day. And then we tell our teenagers they shouldn't use drugs after we've plied them with substances their whole life.
that is being enforced.
You could argue that ADHD results from some sort of biological difference, and is ameliorated or exacerbated by the child's experiences, but there are so many conditions that mimic ADHD that we have a lot more research to do. True ADHD is something parents often observe from day one.
http://www.sensorysmartparent.wordpress.com
It's frustrating that people are prescribed Ritalin when they do not have ADHD. I think it should be mandatory that these evaluations that I went through in order to be prescribed stimulant medication. I am frustrated with the idea that it doesn't exist because I have struggled in my life so much. My freshman year of college I rebelled and did not take my medication-- I failed 2 classes. Now on a regiment along with behavioral therapy and strategies my GPA sophomore and junior year was a 3.86.
Certainly, my growth has been slowed by meds and I am not creative when I am on it. But in order to be the first from my family to graduate from college and get my masters I need it. My life would be so much more difficult without it.
My little boy was orignially diagnosed with ADHD. After testing, it turned out he had over 30 food allergies and elevated levels of various environmental metals (mercury, lead, copper, etc.). When we removed the allergens from his diet - his behavior improved dramatically. We've also done some chelation - focusing on "natural" methods (reducing future environmental exposures, using supplements, dietary changes, etc.) - and only rarely using prescription chelators.
I don't believe my son's issues are genetic...or we would have generations of relatives with symptoms like his. In my opinion, this is largely the result of environmental assaults (vaccines, lead/copper in tap water, mercury/aluminum in the air, etc.). As we've "cleaned up" my son's environment (changed his diet, switched to natural products in our home, eliminated vaccine use, etc.) - he's become better able to focus and behave appropriately. We've never used stimulant medication with him...and he's doing so much better - he even qualified for gifted classes (he's now able to stay on task long enough to actually excel).
We'd all be farmers, and their extra energy would go well back in the fields.
People with ADHD just march to a different drummer, and the only reason people see this as a problem, is because many of their symptoms will interfere with them making money when they grow up. If our civilization could figure out a way to exist without money, ADHD would just be another color in the rainbow. Think about it.
Sorry, it's the middle of the night. My bad.
Because of the widespread idea that AD/HD=hyperactivity, we end up with every child who has a behavior problem being labeled AD/HD, while introverted children with the disorder are seldom treated. This confusion discredits the validity of the diagnosis, because some children are labled AD/HD and recomended for medication when their real problem is too much sugar, not enough excersize, and abusive homelife, etc. It also means that children who are daydreamy and withdrawn, but otherwise well-behaved, good students, fall through the cracks and may never get appropriate treatment.
I would point out that 1) the condition can affect an adult drastically, unless he/she finds a career which can utilize or conceal it, 2) "AD/HD" is a clumsy DSM term causing great confusion to laymen (I prefer the older "ADD with/without hyperactivity"), 3) there are many girls and women affected (my group was about half women), 4) sure, there is plenty of misinformation, misdiagnosis and abuse, but the condition is real and treatable, 5) it comes in many forms, and diagnosis/treatment is an art as well as a science, 6) Dr. Katz is no doubt right about many children but one cannot generalize or stereotype, 7) there are many medications and natural treatments available - not just Ritalin - and one has to find what works, and 8) accurate diagnosis/treatment by knowledgeable professionals, and understanding and support by parents, educators and the public, can be liberating and not labeling.
Eventually though, I "snapped out of it" and learned to function reasonably well in school. Due to my continued disdain for homework, my grades were middling, but I eventually graduated from an advanced math and science (ironic, since those are among my worst subjects) boarding school, with a 3.6 GPA and a 30 ACT (without studying, something I rarely did). In college, I have a 3.6 as well, and made the dean's list last semester (hopefully this one too). I secretly quit taking the medication when I was 17, due to the cardiovascular (My blood pressure runs a bit high as is, and Concerta raises my blood pressure by about 20/20.) side effects, and it making me feel agitated and unable to calm down (before crashing when it wore off), and I felt 100% better, like a new person. I've know people for whom medication was a saving grace, but for me it wasn't. Later one, while trying to pull an all nighter, I took one of my (Concerta 54) pills, and I felt awful; my mind went crazy, stuck going a thousand miles an hour. I suppose an apt description would be "manic" (This has happened again since, without taking the medication, so it may have been pure coincidence, though it is doubtless that I feel better without the medication.).
Put plainly, the medication never did much for me. I never noticed a difference, though on some days, I perhaps felt a bit tired and subdued. I did have trouble sleeping though. My problems continued unabated. We (back in the 90s; I'm 19) still had comprehensive PE and real recess where I lived, so it wasn't an issue of no exercise.
"Coulter considers the relationship of vaccination to autism, hyperactivity, allergies, autoimmune diseases, and learning disabilities. He carries his argument into the social realm, suggesting a connection between neurological damage and the present high level of criminality in American society."
http://www.amazon.com/exec/obidos/ASIN/1556430841/shirlswellncafen
You may want to consider reading this book. It may help - when making future medical choices for yourself (and your future children).
"Physicians have always known that encephalitis, or inflammation of the brain, ...can be caused by traumatic injury to the head, a severe burn, infectious illnesses such as measles, mumps, German measles, chicken pox, or whooping cough, and — last but not least — the vaccines against these same diseases: 'post-vaccinal encephalitis.'"
"Coulter talked about encephalitis having physical, neurologic, mental, and emotional symptoms."
"Some of Coulter's most disturbing statements are that there are not only physical manifestations of post-encephalitic syndrome. There are also intellectual and moral manifestations. Even those people who have only been mildly affected many times exhibit the following symptoms: anxiety, paranoia, impatience with criticism, rage, suicidal impulses, impulsiveness, alienation, egotism, ego weakness, narcissism, or erotic self-love, and emotional instability."
"The vaccination program greatly increases the likelihood that a person will have encephalitis because nearly everyone is given the vaccine that contains the pertussis toxin, which incidentally, is used in laboratory experiments to induce encephalitis in animals."
http://www.vaclib.org/chapter/lecture.htm