A new diagnosis is gaining popularity among pediatricians: "exercise deficit disorder" or EDD.

Spurred on by the success of attention deficit disorder, or ADD, which has become respected as a learning disability requiring intervention, pediatric providers are hoping to draw the same attention to children who are not getting enough exercise. EDD is defined as "reduced levels of moderate to vigorous physical activity inconsistent with public health recommendations."

Now that we have a name for this, what are we going to do with it?

Statistics show exercise rates decline by 5 to 10 percent every year a child lives. While reductions are expected after age 10, the fact that these reductions are showing up from the beginning of life worries epidemiologists.

Specific guidelines exist for the older-than-6 crowd: at least 60 minutes of moderate to vigorous activity per day. We are still working on guidelines for younger children, but they will likely include active, unstructured play for 15 minutes every waking hour. In this world of "Toddler TV," that goal is getting harder to reach.

The urgency in addressing the EDD epidemic is not just motivated by concerns related to weight. Yes, 17 percent of American 6-to-10-year-olds are dangerously overweight, but you do not have to be overweight to have EDD. Besides weight problems, children who do not get regular exercise face problems with bone density, motor coordination, balance, decreased lung capacity and a higher incidence of mood disorders. Addressing EDD will help our children with much more than just weight control.

It is important to point out that the recommended exercise should be moderate to vigorous. Many children spend a great deal of time at organized sports activities. The exercise value of these activities can be quite diminished. Moderate activity means jogging, playing baseball, participating in yoga or riding a bike; vigorous activity includes soccer, singles tennis, karate or running.

To judge, you can check your child's heart rate during physical activity. A person’s maximum heart rate is 220 beats per minute minus his or her age. Moderate activity should allow exercisers to achieve 50 to 60 percent of their maximum heart rate, and vigorous activity should reach about 70 to 80 percent.

Health care providers need to be more aggressive in identifying children who need more exercise. Screening should be done at all wellness visits. Then there need to be well-thought-out treatment plans.


If you think your child has EDD, begin by having your health-care provider assess if there is anything making exercise more difficult for your child, such as asthma, motor skill delays or muscle weakness. Once such problems have been addressed, you can start your child on exercise therapy.

Have an open discussion with your health care provider and your child about increasing his or her activity level. Make this a family project; do not single out one person, regardless of need.

The solution does not need to be fancy or expensive. A younger child can easily reach goals at your local playground. Your older child may need a little more inspiration, like a hike, bike ride or even training for a 5K. Take it slow, stay focused on the positive, and get everyone moving … every day.

The good news is that EDD is a reversible problem in most children. And the earlier you start accustoming your children to daily exercise, the easier it will be for them to be healthy adults. From a public health standpoint, merely recognizing that EDD exists is a big step toward a healthier population. However, we must now direct our energy toward solutions that make sense for parents.

I wish I could just write a prescription for more exercise, but it is not as easy as that. Each child is different, and parents, health care providers and community members need to work to find the right exercise to get each child moving.