The value of outdoor play as a way to manage obesity, anxiety, and behavioural issues is often underestimated, writes Dr Maraschin, an expert paediatrician. In today’s digital age, many children spend hours indoors, leading to health concerns like obesity and mental health struggles such as anxiety. However, simply stepping outside can be a game-changer. Outdoor play allows children to be active, social, and engaged, providing both physical exercise and emotional relief. These activities can help manage obesity by promoting movement, reducing anxiety by calming the mind, and addressing behavioural issues through natural, unstructured play.
The statement “the value of outdoor play as a way to manage obesity, anxiety and behavioural issues” is being found more and more in academic papers. In fact, a United Nations Convention, in 2023, reiterated that a child’s right to play is as fundamental as the right to be cared for and to be protected from violence. Our own Children’s Act of 2005 emphasises the rights and well-being of children, including the right to play. Wow, to think that our society has reached a stage where we have to declare play as a right is concerning. I want to stress that they are referring to free play. This means that children need to be allowed and encouraged to play outside, in the sunshine, where their imaginations run wild. Their play must be initiated and directed by themselves without adult interference or excessive supervision. It is not a structured sports activity or extramural.
Why has this concept of play become such an issue?
- In the early 1980s, only 7% of children met the criteria for obesity. In 2025, 33% of children in the United States will be obese. In South Africa, 13% of children under 5 years old are obese, and this number jumps to 22% by the time our children are between the ages of 10 and 14 years old. Obesity leads to many long-term, irreversible health issues like diabetes, heart disease and asthma.
- Children are spending up to 7 hours a day staring at screens. This can be in the form of a cell phone, laptop, television or tablet. The recommendation from the American Academy of Paediatrics is that children between the ages of 2 and 5 years should have no more than 1 hour of screentime, and children aged 6 to 12 years should have a maximum of 2 hours. Excessive screentime is associated with disturbed sleep patterns, eye strain, obesity, behavioural issues, as well as anxiety and depression.
- We know that anxiety and depression are caused by a combination of factors ranging from a genetic predisposition, traumatic events, social pressures and family disruptions. What is of concern is the rise in “toxic” stress. This is where a child is exposed to stress over a prolonged period. In South Africa, this may be as a result of our high crime rates, unemployment, broken homes, excessive academic expectations and a lack of freedom. Children naturally begin to feel unsafe, insecure, overwhelmed and caged in. In fact, the rate of anxiety, depression and suicidality has increased dramatically over the last 10 years. The amount of free play shows a trend in the opposite direction of anxiety and depression. Free play is becoming less and less common, and this awful affliction of anxiety, depression and suicidality has spiked.
All of this is starting to sound a lot like the title of this article. Instead, what is being proposed is something so simple. Provide opportunities for children to play freely outside, and you will be providing the antidote to obesity, anxiety and behavioural issues.
How does free play provide such wonderful benefits to our children?
OBESITY
Have you ever observed children playing outside on the playground?
- Games usually involve running, climbing, skipping and kicking or catching a ball. Without even realising it, these children are burning calories, thereby promoting a healthy weight.
- Children in the age group 5 to 17 years need a minimum of 60 minutes of moderate to vigorous physical activity per day. Due to such an increase in screentime, this is often difficult to achieve, but if you get a child outside and allow for free play, studies indicate that they achieve this very easily.
- Free play and outdoor activities usually require the child to make use of the large muscles. This movement builds muscle, increases the metabolism, improves blood flow and digestion. These are essential to combat obesity, and it’s fun!
ANXIETY AND DEPRESSION
The number of children suffering from anxiety and depression has increased dramatically over the last 10 years. There are several reasons for this, including school and extracurricular demands. Getting children outside, into green areas, can have a dramatic effect.
- A child who is allowed to play on the grass after school has been shown to be able to focus better, manage their emotions and have lower stress levels. Imagine homework after a play session! So much more can be achieved.
- A study looked at the effect of replacing a tiny piece of asphalt with some grass. The children who played on the grass were way less aggressive and showed increased happiness.
- A 2019 study found that children in urban areas were at a much higher risk of developing psychiatric disorders. The study showed that children who spent less time in a green space were 55% more likely to develop psychiatric disorders. Even if we live in a city, we need nature to nurture our little ones and ensure good mental health.
- The Restoration theory states that spending time in nature allows a child to mentally relax. This, in turn, increases the ability to focus and concentrate. Imagine how critical this is for children with ADHD.
- I am sure you have heard about cortisol. Adults know it as the stress hormone. Unfortunately, this hormone also affects our little ones negatively, especially when they face exams, intense homework loads, strict sports schedules and limited unstructured, free time. Playing outside freely, even for short periods, lowers cortisol levels and, in turn, anxiety. One of the recommended “treatments” for toxic stress is to allow for safe, free play.
- Children living in urban areas where they have fewer opportunities to get dirty are missing out on a unique, good bacteria found in soil. I know that COVID made many of us germaphobes, but here’s the thing: Mycobacterium vaccae is a friendly bacteria found in soil. Allowing a child to make mud pies, plant seeds and get grubby will expose the child to the happy bacterium. This alters serotonin levels in the brain, improving the child’s mood and making him or her more resilient to stress.
BEHAVIOURAL ISSUES
When we talk about behavioural issues, we are referring to those children who constantly cause chaos at school, home or in social settings. This behaviour negatively impacts the child’s relationships and impacts a child’s ability to succeed at school. Many children with ADHD and the associated disorders do often have behavioural issues, but we are seeing an increasing number of children with behavioural issues that do not fit the criteria for ADHD. Here are some examples of behavioural issues:
- A child who acts out his or her distress by becoming aggressive, defiant or impulsive.
- A child who cannot express what he or she is feeling and, as a result, withdraws, becomes anxious or is unable to cope with frustration.
- A disruptive child usually interferes with others. They are likely to bully, argue, disrupt conversations or refuse to follow instructions and rules.
In 2014, Dr S. Brown (psychiatrist) wrote a paper in which he stressed the consequences of limiting children’s free play. He warned that play deprivation would lead to emotional dysregulation. This means that children who have a tendency toward depression, cannot self-regulate, are more aggressive, have poor impulse control and struggle with interpersonal relationships. In other words, they have behavioural issues. The lack of free play has become a much bigger problem since COVID.
How can free play help?
- When adults don’t interfere in disagreements, children must find ways to compromise. This also teaches courage, negotiating skills and self-confidence.
- When playing with peers, a child must learn to wait his or her turn, regulate impulses and control their reactions. This is part of emotional intelligence.
- When playing freely, children learn to understand others’ feelings, become empathetic and encourage social awareness.
- Children who engage in quiet play that involves all the senses and physical movement relax. This releases stress and regulates emotions.
- Studies have shown that unstructured, free play in a green space dramatically improves the concentration and behaviour of even severely ADHD children. A 20-minute walk is just such an activity.
In a nutshell, allowing children to play freely equips them for life. Emotional intelligence and good social skills are key factors in leading a successful adult life.
In our crazy, busy world, where both parents usually work, schools are demanding, and competition gets tougher, it may seem daunting to have yet another thing to do. The beauty of free play, however, is just the opposite. It is providing parents with the opportunity to let go, allowing children to do what they are wired to do and thereby achieving incredible results in their children’s overall well-being. We have discussed obesity, anxiety, depression and behavioural issues. These words were not part of the vocabulary used to describe children 50 years ago. The difference is that childhood used to mean playing outside until you were called in for dinner. Society has changed. Screens are a reality, and urban spaces have made access to green spaces more difficult.
So, how do we get children playing more?
- Make it a priority that your child has daily opportunities to play freely outdoors.
- The play doesn’t have to be big and elaborate. If your child isn’t used to playing outdoors, then allow for short opportunities where you are close enough to create a sense of safety but not interfere.
- Get excited about being outdoors. This doesn’t mean you have to become a triathlete, but you do need to show enthusiasm for getting out into the sunshine. Put your phone away and lead by example.
- Plan activities that ensure success. A game or activity that involves little movement and a definite outcome won’t keep a child busy for long. Let the child build an obstacle course with the garden chairs or practise balancing on a beam. It is all unpredictable, and the skill can improve with each try.
- Outdoor play without adult supervision encourages risky play. It is all about chance and fate. This risky play does not mean that we ignore safety measures like bicycle helmets, life jackets and gum guards. It means allowing a child to assess an activity within their comfort level and ability. The child may decide how high he wants to climb or how fast he wants to ride that little black motorbike down the driveway. Such risky play increases physical abilities. It also has positive effects on mental and socio-emotional health. Allowing children to rough and tumble, race one another and compete informally builds resilience and conflict resolution. It is good for them to push the boundaries and to test their capabilities.
- Boredom is healthy! It encourages imagination and is the master of creation. Leave the child to explore and invent activities. Make sure that you don’t interrupt the play or try to supervise.
- Encourage friendships, then set the children free to play. The children will inspire and challenge each other to try harder, climb higher and run faster. Generally, they have way more fun outside if they have someone to play with.
- Get the cooperation of your child’s school. Discuss the amount of homework versus free time. Assist in building playgrounds. Limit the number of formal extra-murals but ensure that the child then uses the time to play and not to sit in front of the television.
ALSO READ: Encouraging Independence Without Anxiety
Conclusion
In 2014, Dr S Brown sounded the alarm bells on the negative effects that play deficit was having on children. Now, more than a decade later, the situation is getting worse. Three-year-olds are attending maths lessons, pre-schoolers are expected to sit in desks, and children are spending so much time on the couch with devices that they have poor eyesight, posture issues and low tone.
Adults are key to changing all of this. Let the children play. If we do not, then the classic quote from developmental psychologist Brian Sutton-Smith will become synonymous with this generation: “The opposite of play is not work, it is depression”
References
- (UNICEF Innocenti Research Centre, UNICEF Canada. Not There Yet: Canada’s Implementation of the General Measures of the Convention on the Rights of the Child. Florence, Italy; 2009 (Accessed September 7, 2023).)
- https://www.pnas.org/doi/10.1073/pnas.1807504116
- https://pmc.ncbi.nlm.nih.gov/articles/PMC5458530/
- https://www.communityplaythings.com/resources/articles/play-deprivation-is-a-serious-problem
- https://cps.ca/en/documents/position/outdoor-risky-play
- https://www.unicef.org/eca/stories/importance-outdoor-play-and-how-support-it
- https://nifplay.org/books/play-for-life-play-theory-and-play-as-emotional-survival/
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