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Getting children to be more physically active seems as if it should be so simple. Just enroll them in classes and programs during school or afterward that are filled with games, sports and other activities.
这篇综述发表在上周的《英国医学杂志》(BMJ)上，英国半岛医学及牙科学院(Peninsula College of Medicine and Dentistry)的研究人员们收集了1990年1月到2012年3月期间全球范围内发表的30个与儿童活动干预有关的研究数据。 To be included in the review, the studies had to have involved children younger than 16, lasted for at least four weeks, and reported objectively measured levels of physical fitness, like wearing motion sensors that tracked how much they moved, not just during the exercise classes but throughout the rest of the day. The studies included an American program in which elementary school-age students were led through a 90-minute session of vigorous running and playing after school, three times a week. Another program involved Scottish preschool youngsters and 30 minutes of moderate physical playtime during school hours, three times a week. 要被收入综述，研究需涉及16岁以下的少儿，持续至少4周，并报告客观测量的体适能水平，如佩戴运动传感器追踪他们的运动量，而且不仅限于体育课上，还应包括一整天的情况。其中一项收录的美国研究，小学生进行了一周三次的课后活动，每次从事90分钟的激烈跑步和游戏。另一项研究是关于苏格兰学前幼儿的，他们有每周三次，每次30分钟的课间中等强度运动。 In each case, the investigators had expected that the programs would increase the children's overall daily physical activity. 在各个案例中，研究者期待活动计划能增加儿童每日整体活动量。 That didn't happen, as the review's authors found when they carefully parsed outcomes. The American students, for instance, increased their overall daily physical activity by about five minutes per day. But only during the first few weeks of the program; by the end, their overall daily physical activity had returned to about where it had been before the program began. The wee Scottish participants actually became less physically active over all on the days when they had the 30-minute play sessions. 事与愿违，这就是综述的作者们仔细分析结果后的发现。比如美国学生，他们的整体活动时间每天增加了5分钟，但这仅限于活动计划的前几周；最终，他们的整体活动时间回落到了计划干预开始前的水平。苏格兰的小参与者们在进行30分钟的课间活动后，实际上整体活动时间还减少了。 The review authors found similar results for the rest of the studies that they perused. In general, well-designed, well-implemented and obviously very well-meaning physical activity interventions, including ones lasting for up to 90 minutes, added at best about four minutes of additional walking or running to most youngsters' overall daily physical activity levels. 综述作者在他们研读的其他研究中也发现了相似的结果。总体来说，设计精良、安排合理、用意良好的活动干预，包括那些长达90分钟的，相对少儿的整体日常活动水平，最多也就是增加了大约4分钟的步行或跑步时间而已。 The programs "just didn't work," at least in terms of getting young people to move more, said Brad Metcalf, a research fellow and medical statistician at Peninsula College, who led the review. 领导这次综述的研究人员、半岛学院的医疗统计员布拉特·麦特卡夫(Brad Metcalf)说，活动计划“行不通”，至少在驱使青少年多多活动方面是这样。 Why the programs, no matter their length, intensity or content, led to so little additional daily activity is hard to understand, Dr. Metcalf said, although he and his co-authors suspect that many children unconsciously compensate for the energy expended during structured activity sessions by plopping themselves in front of a television or otherwise being extra sedentary afterward. It is also possible, he said, that on a practical level, the new sessions, especially those taking place after school, simply replace time that the youngsters already devoted to running around, so the overall additive benefit of the programs was nil. 为什么这些计划无论持续时间、活动强度或运动内容如何，都没怎么增加少儿的日常活动量？麦特卡夫博士说，这确实很费解，但他和他的合作者们怀疑，很多儿童无意识地为活动计划期间消耗的能量做出了弥补，弥补方式就是瘫坐在电视机前或活动后久坐。他说，另一种可能是，从试验的实际层面来说，新的活动时间，尤其是放学后那些课外活动，仅仅是取代了孩子们原本跑来跑去的时间，所以活动计划整体的附加益处为零。 But the broader and more pressing question that the new review raises is, as the title of an accompanying editorial asks, "Are interventions to promote physical activity in children a waste of time?" 然而，新的综述提出了更为广泛和急迫的问题，正如编者按的标题所说：“促进儿童运动的干预计划是在浪费时间吗？” Thankfully, the editorial's authors answer with an immediate and emphatic "no." If existing exercise programs aren't working, finding new approaches that do work is essential, they say. 庆幸的是，编者按的作者立刻斩钉截铁地回答：“不是。”他们说，如果现有的活动计划行不通，寻找新的途径就至关重要。 They point out that active children are much more likely to be active adults and that physically active children also are far less likely to be overweight. A convincing, if separate body of scientific evidence has shown that the most physically active and fit children are generally the least heavy. 他们指出，活跃的儿童更可能生长为活跃的成年人，运动多的儿童也更不容易超重。一项令人信服的科研证据表明，大多数运动多、体能好的儿童体重较轻。 So if structured classes and programs are not getting children to move more, what, if anything, can be done to increase physical activity in the young? "It's a really difficult problem," said Frank Booth, a professor of physiology at the University of Missouri-Columbia, who was not involved with the review. 如果有组织的班级和课外活动不能让儿童多运动，那么还能采取什么行动让青少年动起来？“这确实是个难题，”弗兰克·布斯(Frank Booth)说。他是美国密苏里大学哥伦比亚分校(University of Missouri-Columbia)的生理学教授，并未参与综述研究。 Determining the most effective placement of classes and programs, so that they don't substitute for time already spent running around and instead augment it, would help, he said. 他说，需要找准校内外活动最有效的定位，不必占用原来的跑步时间，而是在原有的基础上加大活动量，这样可能管用。 But a more vital element, he said, "involves mothers and fathers," who can encourage children to leave the couch, subverting their drive to compensate for energy expended earlier by sitting now. 但是他认为，更重要的因素是“让父母参与进来”，他们能鼓励儿童离开椅子，不让他们通过久坐来补偿早先消耗的能量。 A welcoming setting may also be key, the authors of the accompanying editorial wrote, pointing to a 2011 study of same-sex twins, ages 9 to 11. In that study, the most important determinant of how much the youngsters moved -- or didn't -- was their local built environment. Children with more opportunities to be outside, in a safe, well-designed space, were more likely to be outside, romping. 友善的环境可能也很重要，编者按的作者认为，根据2011年一项针对9到11岁同性别双胞胎的研究，影响少儿们活动或不活动的一项重要因素是当地的建筑环境。如果儿童在环境安全、设计合理的地方外出的机会更多，则更容易外出嬉戏。 But none of these suggestions will be easy to put in place, Dr. Booth said, or inexpensive, and all will require scientific validation. No one expected, after all, that well-designed exercise interventions for children would prove to be so ineffective. 但布斯博士说，这些建议都不太容易实施，所需资金不菲，而且都需要科学验证。毕竟没有人希望完善设计的儿童活动干预被证明效率如此低下。 Ultimately, he continued, the best use of resources in this field may be to direct them toward unearthing the roots of childhood inactivity. "Kids naturally love to run around and play," Dr. Booth said. "But they're just not doing it as much now. And we don't know why. So what we really need to understand is, what's happening to our kids that makes them quit wanting to play?" 最后，他说，对这方面资源的最佳利用是直接发掘儿童不爱活动的原因。“孩子的天性喜欢奔跑玩耍，”布斯博士说，“但他们现在不如从前爱动了。我们不知道原因。所以我们真正需要了解的是，孩子们怎么了，为什么不想玩了？” 本文最初发表于2013年10月3日。 翻译：Skandha |
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