From the Guidelines
The recommended approach for this 9-year-old boy is to proceed with strength training as planned (option E). Supervised strength training programs are considered safe and beneficial for children as young as 7-8 years old when properly designed and supervised. The father's plan includes appropriate elements: direct supervision, individualized exercises, light weights, low resistance, and an every-other-day schedule to allow for recovery. Contrary to outdated concerns, properly supervised strength training does not damage growth plates or stunt growth in children. In fact, it can improve muscular strength, enhance motor skills, potentially reduce sports-related injuries, and help with weight management, which may be beneficial given the child's BMI above the 85th percentile, as defined by the CDC growth charts 1. The child's enthusiasm for the program is also a positive factor for adherence. No cardiac testing is required before starting strength training in an otherwise healthy child. The program should emphasize proper technique, appropriate progression, and variety to maintain interest while ensuring safety.
Some key points to consider:
- The American Heart Association guidelines recommend promoting achievement of appropriate weight and reducing sodium in the diet, emphasizing increased consumption of fruits and vegetables 1.
- For children who are at risk of overweight (85th percentile) or obesity (95th percentile), a weight management program should be initiated with appropriate energy balance achieved through changes in diet and physical activity 1.
- Lifestyle modification therapy, including family-based behavioral weight management, is indicated as the initial intervention for severe pediatric obesity, and may be beneficial for this child given his BMI above the 85th percentile 1.
- Young children (aged 6–9 years old) with severe obesity may experience larger reductions in BMI standard deviation score with lifestyle modification therapy, making early intervention crucial 1.
Overall, the benefits of strength training, combined with a healthy lifestyle and weight management, can have a positive impact on the child's overall health and well-being, reducing the risk of morbidity, mortality, and improving quality of life.
From the Research
Exercise Recommendations for a 9-Year-Old Boy
- The boy's father, a certified personal trainer, has created a detailed strength training plan with direct supervision, individualized exercises, and low resistance every other day 2.
- The plan seems to be well-structured, and the child is eager to begin strength training, which is a positive aspect for his overall fitness and development.
- However, the mother's concern about safety due to the child's age is valid and should be addressed.
Safety Considerations for Strength Training in Children
- There is no evidence to suggest that strength training should be deferred until adolescence due to cognitive immaturity or until after puberty due to risk of growth plate injury 3, 4.
- In fact, resistance training has been shown to have numerous benefits, including improved physical performance, movement control, and functional independence, as well as potential benefits for cardiovascular health and bone development 3, 5.
- The child's BMI is above the 85th percentile for age, but this does not necessarily mean that strength training should be avoided; instead, it may be beneficial for reducing body fat percentage and increasing lean mass 4.
Proceeding with Strength Training
- Given the lack of evidence suggesting that strength training should be deferred, and considering the potential benefits of resistance training, it is recommended to proceed with strength training as planned 2, 3, 4.
- The child's eagerness to begin strength training and the father's supervision and expertise are positive factors that support proceeding with the plan.
- It is essential to continue monitoring the child's progress and adjust the plan as needed to ensure his safety and optimal development.