Friends may make the difference in keeping children active

Children being physically active with a friend may accomplish more than hearing encouragement or being active with a parent, according to a new study presented at the American Heart Association's Epidemiology/Lifestyle Scientific Sessions 2015.

This suggests that a peer-to-peer approach may be an effective way to increase physical activity among children.

"We speculate that the social network of friendships is increasingly important in influencing behaviors as children get older," said Jessica Graus Woo, MHSA, Ph.D., lead study author and an associate professor of pediatrics at Cincinnati Children's Hospital Medical Center in Cincinnati, Ohio. "Having physically active friends may make it easier for obese children to get involved with activities and lower the perceived barriers for doing so, while having a physically active family may not be as inspiring."

Regular physical activity is key to managing weight for both children and adults, but little is known about whether children and adolescents see benefits or barriers to getting the exercise they need. The issue is critical since about one in three American children and teens are overweight or obese, putting them at risk for high blood pressure, high cholesterol, diabetes and heart disease, according to the American Heart Association.

Researchers interviewed 104 children and adolescents as part of the Biorepository of Environment, Activity and Nutrition to Prevent Obesity-related Disorders (BEANPOD) study, asking their opinions on the benefits of and barriers to physical activity. Among the participants, 74 percent were female, 47 percent were white and the average age was 12.5 years.

All the participants ranked 10 potential benefits and 15 potential barriers to physical activity. They noted the extent friends and family got involved with them, encouraged physical activity but did not get involved, and the amount of time spent playing sports each week. The study did not address what activities the children performed.

Among the researchers' findings:

• The most commonly-cited barriers were feeling self-conscious (29 percent); lack of enjoyment (22 percent); poor health (22 percent); lack of self-discipline (21 percent); and lack of energy (21 percent).
• Family encouragement was high at 78 percent, but family and friends doing physical activities with kids was far lower, between 36 and 48 percent.
• A friend getting involved was associated with significantly lower perceived barriers, including lack of interest, energy, enjoyment, equipment, skill, health and knowledge, where family participation or encouragement did not have this effect.
• Children age 12 and older were more likely to cite lack of time, lack of enjoyment and fear of injury than younger children. They were also more likely to recognize the value in being physically active to reduce the risk of disease.
• Among those who reported that friends never or were almost never physically active with them, 38 percent were in the highest physically active category, but if friends joined in, 76 percent reported being in the highest physically active category.

More research is needed to confirm these findings, but researchers aren't surprised that friends being physically active together can make the activity more fun and, therefore, reduce barriers.

"Clinically, much of the focus on increasing physical activity involves engaging the family and encouraging the patient to be more active, but this study suggests that encouragement may not be sufficient," Woo said. "Clinicians may also need to consider how to get children to be active with their friends."