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The factors that influence body image and strategies to either lose weight or increase muscle among children are studied. Health risk related to eating and exercise among children is also discussed.

Increased physical activity results in a decrease in blood pressure and may prevent the development of high blood pressure or hypertension in young people at risk. It was estimated that as many as half the adolescents in the US do not exercise enough to maintain a healthy cardiovascular system. The relation between exercise, blood pressure and other cardiovascular risk factors was examined in 6,000 adolescents between the ages of 12 and 17. Exercise tolerance was assessed by treadmill test performance, which involves measurement of heart rate and estimation of oxygen consumption during a five-minute walk at a speed of three-and-a-half miles per hour. The results show that oxygen intake increased with age in the boys, but decreased with age in the girls. Oxygen intake was higher in boys than girls and similar among both black and white subjects. Exercise heart rate was correlated with blood pressure in white subjects and with obesity in both black and white children. Because of its positive effects upon obesity and cardiovascular fitness, aerobic exercise in adolescents may be beneficial in the prevention of adult hypertension.

Distance running has become popular among children, and young athletes often run 10 to 15 miles daily or participate in marathons which require distance races of about 26 miles. Long-distance running is associated with certain health problems involving the muscles, endocrine glands, blood, body temperature, and even psychosocial health. The American Academy of Pediatrics recommends that physicians should become aware of these health risks and help to prevent them. Overuse injury, the most common skeletal muscle injury, develops in relation to the distance covered. Such injuries may lead to chronic disability such as growth deformity or chronic arthritis, the inflammation of the joints, and early prevention or treatment is essential. Female distance runners often experience a delay in menarche, the start of menstruation, although menarche will occur after cessation or reduction of intensive exercise. The cause of delayed menarche in adolescent female runners is not known. Iron depletion is also common among adolescent runners, and may be related to poor diet, the mechanics of running, bleeding from the gastrointestinal tract, or the presence of blood in the urine. Children have less efficient body temperature control than adults, and young runners are at risk for heat-stroke, hypothermia (abnormally low body temperature), and dehydration. Psychosocial problems may result from spending long hours in training and having unrealistic expectations. The total mileage and duration of running are associated more directly with health risks than the distance run on the day of competition. Children should be allowed to participate in endurance running if they enjoy the activity and have no adverse symptoms. However, pediatricians should consider the health risks associated with long-distance running when counseling families of young runners. (Consumer Summary produced by Reliance Medical Information, Inc.)