Promoting physical activity among overweight and obese children – a challenge in health care

The prevalence of childhood obesity and overweight has increased rapidly worldwide in recent years. As obesity tracks from childhood to adulthood and childhood adiposity is a strong predictor of obesity and other metabolic risk factors later in life, preventive actions are urgent. A Cochrane Review (1) from 2009 concludes that interventions combining physical activity and dietary intake and other behavioral factors appear to be effective. Furthermore, the review stated that family-based lifestyle interventions that include behavioral approaches aiming at changing physical activity and dietary patterns provide clinically meaningful decrease in overweight and obesity among children. In this issue of Advances in Physiotherapy , B ä cklund and co-workers present two papers from a randomized controlled trial, including a 2-year family-based lifestyle intervention among overweight and obese children, 8-12 years of age. The fi rst year included 14 group sessions and the second year 12 internet-based sessions with assignments. During both years, four of the sessions had focus on the importance of increasing the children ́ s physical activity. The physical activity was measured using Sensewear Armband at baseline and at 1-year and 2-year follow-ups. When comparing the intervention and control groups no signifi cant differences were found in the physical activity outcome variables. However, during the 2-year intervention, the intervention group had an unchanged screen time while the control group increased their screen time with 15%. The authors conclude that despite limited effects shown in these studies, interventions concerning physical activity are of importance. More intense interventions regarding physical activity focusing on reducing sedentary activities, such as screen time, rather than increasing physical activity, could be a future focus. For the pediatric physiotherapist this might be an important message. An interesting study by Bergstr ö m and co-workers shows that back extensor muscle training in postmenopausal women have positive effects on maintaining muscle strength, height and thoracic expansion. Thirty-six women having at least one vertebral fracture, kyphosis and osteoporosis, were