The physical activity, fitness and health of children.

It is clear that, despite their natural tendencies, children have become less physically active in recent decades, with children today expending approximately 600 kcal days' less than their counterparts 50 years ago. Although the health consequences of a reduced energy expenditure in adults is well documented, there is little direct evidence linking sedentariness with health in children. However, three main benefits arising from adequate childhood physical activity have been postulated. The first is direct improvements in childhood health status; evidence is accumulating that more active children generally display healthier cardiovascular profiles, are leaner and develop higher peak bone masses than their less active counterparts. Secondly, there is a biological carry-over effect into adulthood, whereby improved adult health status results from childhood physical activity. In particular, childhood obesity may be a precursor for a range of adverse health effects in adulthood, while higher bone masses in young people reduce the risk of osteoporosis in old age. Finally, there may be a behavioural carry-over into adulthood, whereby active children are more likely to become more active (healthy) adults. However, supporting evidence for this assertion is weak. Given this background, recent health guidelines suggesting that children should accumulate 60 min of moderate-intensity physical activity every day--supplemented by regular activities that promote strength flexibility and bone strength--appear to be justified. Future developments should include the implementation of large-scale, longitudinal studies spanning childhood and young adulthood, the further refinement of tools for measuring physical activity accurately in young people, and research into the relative strength of association between fitness--as well as activity--and health in children.