Childhood obesity has become a public health concern in recent years. The Centers for Disease Control and Prevention estimates that approximately 12.5 million children and adolescents are obese. This number accounts for approximately 17% of children and adolescents between the ages of 2 and 19 in the United States. Worse, it estimates that the obesity rate among children and adolescents has tripled since 1980.

Many factors likely play a role in the trend for increasing childhood obesity in the United States. These factors include the consumption of fast food and soft drinks, lack of physical activity, and increased time spent watching television or playing video games.

While preaching better nutrition and physical activity to kids is essential, that message will likely prove far more effective if parents serve as better examples of good health.

What can parents do to lead healthy lifestyles and demonstrate those lifestyle behaviors to their children?

Teach better nutrition

Not only should kids eat healthier foods and drink healthier beverages, they should also learn to make better nutritional choices themselves. Getting rid of junk food and soft drinks can be good start for a healthier family, but children should learn how to choose healthier foods and beverages.

One idea that parents can consider for instilling proper nutrition involves taking the kids to the grocery store. Walk up and down the aisles and teach them why certain foods are more nutritious than others. Then allow them to select some of the foods and drinks themselves, perhaps for a family meal. If they can bring their own lunches to school, allow them to choose foods for their daily lunches.

By teaching nutrition at an early age, it's more likely these youth will make healthier food choices as they get older and more independent.

Limit screen time

The amount of time that kids spend staring at a screen is staggering. When parents consider how much time their children perform these activities, they need to consider how often their kids spend time watching TV, using computers, playing video games, watching movies, or looking at cell phones.

Studies show that kids between the ages of 8 and 18 watch television for an average of 4.5 hours per day. When other forms of screen time are included, this average jumps to 7.5 hours per day.

This screen time can increase the chances that a child becomes obese. Kids are likely to snack, especially on junk food, while watching TV. Also, these young kids will likely see hundreds of advertisements for unhealthy foods and beverages during the television programs. More importantly, some of that 7.5 hours could be spent engaging in regular physical activity.

The American Academy of Pediatrics recommends that parents limit their children's total media consumption to no more than one to two hours per day. While this guideline is critical for children and adolescents to follow, parents should use it as well. It is hard to preach limits on screen time if the parents come home and watch TV too.

Engage the family in physical activity

The 2008 Physical Activity Guidelines for Americans recommends that children and adolescents perform at least 60 minutes of physical activity each day. Parents can play a large role in helping their kids achieve these daily recommendations by engaging them in fun activities involving physical exertion. Jogging, walking, taking bike rides, hiking, and many other activities can be both fun and physically beneficial. To keep the kids enthusiastic about exercise, allowing them to bring their friends or encourage them to pick the activities.

If children see their parents exercising regularly, they are also more likely to accept it as a normal part of their own lives. They might look forward to exercising rather than perceiving it as some sort of punishment.

If parents commit to becoming healthier themselves - making better nutrition choices and performing regular physical activity - their children are much more liekly to emulate these behaviors.

What are you doing to engage your family in fitness?

They say two things are guaranteed in life: death and taxes. I would like to add a third... aging.

We age from the moment we are born until the moment we draw our last breath. We all experience this natural life process; some of us just experience it for a shorter time than others. Today, our longer life spans are creating challenges and opportunities as we enter unknown territory.

Among these challenges is the aging population's continual fixation on staying young and on top of its game. This desire to discover the fountain of youth has spawned numerous million-dollar industries. Whether its Viagra, nutraceuticals, or tummy tucks, these markets are being driven by aging Boomers who want solutions and want them now. Just look at celebrity Boomers Randy Jackson of American Idol and Al Roker of NBC's Today Show; both had gastric bypass surgery. After a lot of nip and a little tuck, they are thin again. But these celebrities took a major risk when undergoing their operations, as three out of every 200 people die after weight loss surgery.

The Hunt is On

Plastic surgery has gone mainstream. So, too, have the cosmetic companies that claim to offer solutions for wrinkles, age spots and cellulite. Of course, let's not forget the so-called medical breakthrough of a few years ago: the World's First Anti-Aging Pill. The pill's dramatic press release stated that the "promising discovery has been proven to quickly reverse the aging process by repleneshing the body's own production of youth hormone to normal 25-year old levels." Hard to believe, I know, but let's try to image what such a product could mean.

If we can lose weight by having surgery and build muscle by taking a pill, why spend time sweating off those pounds and building that noteworthy physique? If we can take "elixirs of life" that promise to recapture the vitality of youth, why get out of bed to walk or run on a dark, cold morning in winter? These are good questions to ask, but the fact is that all the surgeries, pills and elixirs have a downside, whether their claims are ture or false. About 40% of Americans age 50 and older believe anti-aging products are basically "hogwash," while another 36% are "curious, but skeptical." Although more than 20% of people in this age group say these products can "work sometimes," just 3% say they like them a lot.

To Age or Not to Age

As we hear stories about increasing numbers of Boomers and older adults having their stomachs stapled or taking expensive remedies, we must recognize that most of these new industries focus on physical beauty rather than on internal health. Think about it. We can have a great exterior, but still develop heart disease, hypertension, osteoporosis, diabetes and depression. But by making healthier lifestyle choices, eating properly, and exercising, we can prevent, control or retard much of the damage. Even today, physicians can prescribe pills to treat diabetes, depression and hypertension. However, we can address these health issues as well and if not better - and for much less money - through exercise, proper nutrition, and lifestyle modifications.

The reality is, we don't live in a perfect world. And the pursuit of the perfect exterior, whether young or old, while neglecting the perfect interior, could have a major impact on the health of aging Boomers. Our goal must be to help these individuals achieve their ideal self, both inside and out. By broadening the focus to include the internal, we can help our members - and our businesses - enjoy better health.

Expanding the Message

To accomplish this lofty task, take a step back and think of the market as your child. What advice would you give to your child, who you love dearly, and who you want to see grow up healthy and living a long life. Would you put them in front of a mirror and critique them, testing their body fat to see how they compare with the rest of the population? Not most parents. You are more likely to talk to them about what it means to be healthy, from the inside out, offering the support they need to grow and accomplish a healthy lifestyle.

Now think of members in your community. Do you help people you care about to be better from the inside out? Do you give them the support they need to be succesful?

What we in the field of physical activity and exercise offer the world is the ability to lead a high quality life, and there is no better time to start a physical activity program than during National Physical Fitness and Sports Month.

So, how will you help your community members shift their focus from perfection to prevention?

With the recent activities of the American Public Health Association's "Safety is No Accident: Live Injury-free" campaign during the week of April 4-10, we would like to continue to raise awareness about falls prevention. Falls are a major health concern among older adults. More than one-third of older adults fall each year, and fall rates increase with advancing age.¹ Falls are the leading cause of injury deaths, the most common cause of non-fatal injuries, and the most common reason for hospital admission due to trauma in older adults.² Every hour, there is one death and 183 emergency department visits for falls-related injuries among older adults and more than 95% of hip fractures are caused by falls.³

These facts are a scary reality; however, we know the most common risk factors⁴ of falling. They include the following:

• Conditions associated with aging
• Muscle weakness
• Difficulty with balance or walking
• Vision problems
• Pre-existing medical conditions that limit mobility, such as Parkinson's disease, stroke or diabetes
• Conditions that cause confusion
• Being on more than four medications at the same time
• Use of assistive walking device
• Environmental hazards (e.g. throw rugs or pets)
• Difficulty completing daily living activities
• Low blood pressure
• Fear of falling
• History of fears

We also know that maintaining physical activity is critical in helping to prevent falls and can have a significant impact on many of the risk factors listed above. Performing physical activities of any fitness level - including programs, Tai Chi, aerobics and yoga - can help improve balance, strength and flexibility, and get patients moving again. In fact, effective interventions to prevent falls in community-dwelling older adults included exercise-based interventions provided in the home or group setting.⁵ Exercise interventions that appear to have the greatest impact are balance activities performed in standing (limit upper-extremity support), and exercise programs that are progressed based on the individual person. General exercise programs on the other hand, which do not focus specifically on balance and strength, are not as effective as individually tailored exercise.⁶ Finally, there has been strong evidence that supports a multifactorial approach to preventing falls with programs that include not just exercise but also appropriate screening, gait training and environmental assessments.⁷

According to the American Geriatrics Society's (AGS) Clinical Practice Guidelines, all should be screened for risk of falling. The AGS recommends a brief screening tool that includes three questions:

1) Have you ever fallen in the past year?

2) Has the patient had an acute fall?

3) Does the patient have difficulty with walking or balance?

If inviduals aged 65 years and older state that they have experienced two or more falls or has sustained an injury from a fall, they are considered to be at risk for falling. Likewise, if the person has difficulty with balance or walking, they may be at higher risk.

All professionals working with older adults should be aware of the risk for falls and the factors associated with a higher risk. With greater vigilance, we can prevent the injuries related to falls in older adults, as well as the related loss of function and participation in daily activities.

Are you screening older adults for falls? What community fall prevention programs are available for older adults in your community?

You can find more consumer resources about risk factors, testing balance, and where to find a physical therapist by visiting Move Forward.