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Dr. Becki Battista and Dr. Scott Collier share an interest in the benefits of regular physical
activity for children and adolescents.
Photo by Marie Freeman

Originally published: 2012-11-26 13:47:28
Last modified: 2012-11-26 13:47:28

Exercise is medicine; play is insurance

by Susan King

Dr. Becki Battista and Dr. Scott Collier are associate professors in the exercise science program in the Department of Health, Leisure and Exercise Science, housed in the College of Health Sciences at Appalachian State University. 

Battista's concentration is growth and motor development. Collier is a clinical cardiovascular physiologist. What element of this broad field of study links Battista and Collier in their current work? In a word, play. 

According to the Centers for Disease Control and Prevention, childhood obesity has more than tripled in the past 30 years. In 2008, more than one-third of children and adolescents in the United States were overweight or obese. North Carolina ranks in the Top Five states with high-risk adolescent populations due to obesity, and Watauga County has one of the largest percentages of at-risk adolescents in the state.  

Battista and Collier share an interest in the benefits of regular physical activity for children and adolescents.

Research sites

"My interest in working with young children began after I came to Appalachian, when I became aware of the declining emphasis on motor skill development and the decrease in opportunities for unstructured play in early childhood," Battista said. 

With funding from the CDC, administered by the Appalachian District Health Department, Battista began working with child-care centers in Watauga, Ashe and Alleghany counties through a program called Communities Putting Prevention to Work. Because they serve so many families, child-care centers have become pivotal settings where established patterns and behaviors can be modified for the better. 

Battista said, "Our goal was to improve the practices and policies surrounding healthy eating and physical activity in child care. First, we had to determine whether or not centers were meeting evidence-based recommendations for providing healthy environments for nutrition and physical activity. The child-care centers were very receptive and willing to participate in our study."

The project required center directors to self-evaluate their practices based on state and federal guidelines. The "healthy" in healthy eating is determined by cooking practices, such as whether or not butter is added, and serving methods (family style or portions). Children's physical activity was evaluated also, as were the available play equipment and spaces. 

Each center then created a site-improvement action plan based on its self-evaluation. 

Most centers were meeting expectations, although additional resources are needed to improve the quality of meals and snacks and to enhance the environment for physical activity.

With funding from the health department, centers purchased new play equipment, improved access to water and educated parents about how to be active with their children.  

 "We hope to continue to assist area child-care centers in finding ways to improve daily physical activity of the children. We also want to provide the state policy makers with results from the project to reinforce the impact child-care centers have on promoting positive, healthy behaviors," Battista said. 

In six months, Battista evaluated 33 child-care centers that served 1,300 children who may have benefited from some of the changes resulting from the centers' participation in this project.  

For more information about Battista's scholarship and research, visit

Obesity, children, activity

Schools provide opportunities for children to learn about and practice healthy eating habits and physical activity. However, they become much less active during summer break. Collier used this time period to research the effectiveness of structured physical activity. 

His research was supported by a grant from the Be Active -- Appalachian Partnership in conjunction with BLAST (Building Lively Active Strong Tweens) through the Wellness Center of the Appalachian Regional Healthcare System. 

The research compared the effects of four or eight weeks of play-based activity versus an unsupervised summer break on the cardiovascular and metabolic function in adolescents. 

Children either participated in an activity group or in a control group that was engaged in any activities and had no plans for changing typical activity levels throughout the summer.

"Our hypothesis was that eight weeks of play-based activity would cause the greatest beneficial shift in metabolism and cardiovascular function," Collier said. 

The active group performed a supervised, play-based physical activity program for four hours a day, five days a week, with alternating sport and recreational activities. The program allowed children to experiment with a wide variety of activities (hiking, dodge ball, swimming, resistance bands, yoga, fun runs, etc.) aimed at increasing strength, flexibility and cardiovascular fitness.  

"The data revealed that eight weeks of play-based physical activity caused a beneficial shift in metabolic markers," Collier said. "Positive changes were noted in arterial and metabolic health. Fat oxidation and arterial remodeling were more efficient. Combined, the results exhibited a preventive effect on metabolic and cardiovascular diseases." 

Increased blood pressure is no longer a disease of an older population, Collier said.

"The age at which blood pressure begins to rise is slowly decreasing," he said. "Drugs are prescribed to treat the disease, but many current treatments will become ineffective if obesity and sedentary lifestyles continue to increase.  Also, if more individuals need medicine, our health-care system will be burdened by additional costs."  

The immediate and long-term effects of childhood obesity on health and well-being include heightened risk of high blood pressure, high cholesterol, pre-diabetes, bone and joint problems, sleep apnea and low self-esteem. To be effective, the intervention of exercise as medicine must be at an early age. 

Collier reported, "Exercise is medicine."

The results of the study have been published in international journals.

For more information about Collier's scholarship and research, visit