Andre Picard
Globe and Mail

One of the world's leading obesity researchers is lashing out at the sedentary nature of schools, saying the lack of physical activity in the curriculum is "unethical" and "uncivilized" and at the root of the childhood obesity epidemic.

"Schools, it's time to wake up," Jean-Pierre Despres said yesterday in a fiery keynote speech to the Canadian Cardiovascular Congress in Quebec City.  "It's totally unethical to keep our kids prisoners of a sedentary lifestyle," he said in calling for daily physical education classes and more playtime.

Dr. Despres, the scientific director of the International Chair on Cardiometabolic Risk at Laval University, said the  number of obese and overweight children is frighteningly high and the chief culprits are inactivity and poor nutrition.

While stressing that he doesn't want to "let parents off the hook," he said it is no coincidence that children spend the bulk of their waking lives in schools, where physical activity is minimal, nutritional education is virtually non-existent and food choices are often poor.  He described that environment as "toxic."

Dr. Despres said not only are children inactive, they are losing the ability and the will to move.  "Kids can't run any more.  They can't even run a quarter-mile," Dr. Despres said.  "I don't accept that, in a civilized society, this is tolerable."

In an interview after the speech, Dr. Despres said physical actitivty and nutrition education should be integrated into teaching.  He said kids could, for example, learn to count by skipping and be taught chemistry by way of cooking class.

"Good health is not incompatible with a good education," he said.  In fact, he said, research clearly shows that physically active children do better academically.

A landmark study conducted in 1951 in Vauves, France, found that the school day that maximizes learning consists of two-thirds classroom time, one-third physical education and no homework.

That research has been replicated, with slight permutations, time and again, and always with the same result, said Graham, Fishburne, a professor in the faculty of education at the University of Alberta.

He said physical activity doesn't make children smarter, but it makes them less agitated, less stressed and in better condition for learning.

Dr. Despres is renowned for his research demonstrating that waist size is a far better predictor of the risk of heart disease than the traditional measure of obesity, body-mass index.  (BMI is an approximation of body fat based on weight and height.)

He took up that cause again yesterday, calling on physicians to make the measuring tape an essential tool in their clinical practice, and bemoaning the fact that so few carry out the simple measure.

"It's a dismal statistic to hear that three-fourths of physicians don't measure waist size," Dr. Despres said.

He also stressed that the research has become much more precise over the years and that, in addition to waist size, the type of fat a person is carrying influences their risk of hear disease. His more recent research has focused on the fact that measuring triglycerides (part of a standard blood test) along with waist size can single out, quite precisely, people who are at greatest risk.  For example, a man with a waist in excess of 90 centimetres and triglycerides in excess of 2 millimoles a litre should be considered very high risk.

In many cases, these seemingly slim people are actually more at risk of heart disease than people who are considered very obese, with a BMI of 40 or more.

"We need to go beyond body weight and beyond BMI and look at what really matters," Dr. Despres said.

More than 3,500 delegates, including physicians, nurses and researchers are attending the Canadian Cardiovascular Congress.