In this third installment of how to solve childhood obesity we will be talking about the problem of ‘screen time.’ Screen time is the amount of time that a child spends in front of a television, computer or other similar device. Thus far in this series we have talked about how breastfeeding and chemical exposure is related to obesity. These ideas are not my own. They are from the Let’s Move Campaign spearheaded by Michele Obama. I am simply discussing them here.
In my practice I see many children with a wide variety of conditions. Most of these conditions respond favorably to reducing screen time. A child who is watching television or playing video games is not active. This reduction in activity level not only leads to obesity but complicates ADHD and other learning disorders.
The American Academy of Pediatrics (AAP) recommends that children two years old and under should not be exposed to television, and children over age two should limit daily media exposure to only 1-2 hours of quality programming. In contrast to these recommendations, one study found that 43% of children under age two watch television daily, and 26% have a television in their room!
Children this young are not opting to watch television. Their parents are using it as a cheap babysitter unfortunately. It may be easy to sit your child in front of the TV and let them ‘entertain themselves’ but it is not healthy. Children that young need to be up and about learning and exploring the world. Not only is it important for maintaining a healthy weight, it’s how their brain develops. The input from the muscles and joints provides enormous amounts of information to the brain. The brain uses this information to develop. If a child is seated and is not active a large portion of this input is lost.
Secondly, Physical activity assists children in obtaining and improving fine and gross motor skill development, coordination, balance and control, hand-eye coordination, strength, dexterity, and flexibility—all of which are necessary for children to reach developmental milestones.
Thirdly, allowing a child to watch too much TV or play too many video games sets up bad habits. Habits that we form when we are young are hard to break. Just like eating poorly as a child leads to poor eating habits as an adult, watching too much TV as a child leads to the same as an adult.
Preschool aged children are also watching more television than recommended. Ninety percent of children ages 4-6 use screen media for an average of two hours per day. Over 40% of children in this age group have a television in their bedroom, a third have a portable DVD player, and a third have a portable handheld video game player.
The choices for children are just about endless. The list below is just a sample of the devices that children have access to these days.
- DVD/Blu-Ray player
- Nintendo DS
- Playstation 3
- XBox 360
Not only do they have all the above options, but the gaming systems come with hundreds of games that could keep a child entertained for a life time. This list above doesn’t mention cellular phones (except the iPhone) either. I’ve seen children as young as 8 with cell phones. Who are they calling?
Also the online world has changed how children are entertained as well. Kids go home, get online and chat with their friends instead of actually getting outside and moving.
It’s one thing to talk about all these forms of entertainment, but do they actually lead to obesity. The research says they do. Studies show an association between television viewing and risk of being overweight in preschool children, independent of socio-demographic factors. Specifically, for each additional hour of television viewing, the odds ratio of children having a BMI greater than the 85th percentile was 1.06. Having a television in the bedroom had a stronger association, with an odds ratio of 1.31. One study noted that preschool children who watched television for more than two hours a day were more likely to be overweight than children who watched television two hours or less daily.
Television viewing is also linked to dietary intake. Another study found that television exposure was correlated with fast-food consumption in preschool children, even after adjusting for a variety of socio-demographic and socio-environmental factors.
So how do we solve the problem? I often tell the parents of my young patients that their child needs to be limited to no more than 2 hours of total screen time per day. If the child wants to get up and watch 1 hour of cartoons before school, they only have one hour for the rest of the day. Also, they are not permitted to watch television during meals. That should be for family time. When children get home from school they should get outside and enjoy an activity that makes them move. Ride a bike, play a sport or get involved with an after school program. Kids that come home and plop down in front of the television are much less likely to be healthy. Do your kids a favor and get them moving!