Media's Effect on Obesity in KidsThe AAP recommends that pediatricians ask parents of children and adolescents about media use at every well-child visit.
The American Academy of Pediatrics (AAP) recent policy statement on Children, Adolescents, Obesity, and the Media addresses the emerging evidence base linking increased media time with childhood obesity. Highlights of the statement include the following:Many longitudinal and correlational studies link excessive television viewing and obesity. Watching TV can contribute to obesity by promoting sedentary activity and decreasing physical activity, teaching unhealthy eating patterns, increasing snacking behavior, and interfering with normal sleep patterns. Further, increasing physical activity, reducing media time, and improving nutritional practices have been shown to prevent the onset of obesity and reduce the prevalence of existing obesity.Effects of advertising on unhealthy eating habits: Children and teens who watch more TV consume more calories, eat higher-fat diets, drink more soda, and eat fewer fruits and vegetables. In addition, advertisements for foods high in fat, salt, and sugar and low in nutritional content encourage children to choose unhealthy foods.
More than 80% of advertisements during children's TV programming are for fast foods or snacks — that's at least 10 advertisements per hour. Currently, nearly 40% of children's caloric intake comes from solid fat and added sugars, and soda or fruit drinks provide nearly 10% of total calories.Effects of media on sleep habits: Among adolescents, TV viewing for 3 hours per day doubles the risk for having difficulty falling asleep compared with TV viewing for <1 hour per day (JW Pediatr Adolesc Med Jul 27 2011). Some evidence suggests that later bedtimes and less sleep increase risk for obesity. In addition, sleep deprivation leads to fatigue and increases sedentary behavior.Recommendations for pediatricians:Ask parents the following two questions about media use: (1) How much screen time does the child or adolescent spend per day? (2) Is there a TV or unrestricted, unmonitored Internet connection in the house, including in the child's bedroom?Encourage parents to discuss food advertising with their children as they monitor children's TV viewing and use shared viewing time to teach their children about appropriate nutrition.
Counsel parents to limit total noneducational screen time to 2 hours per day, avoid putting TV sets and Internet connections in children's bedrooms, limit nighttime media use to improve children's sleep, and try to avoid screen exposure in infants younger than 2 years.Work with community groups and schools to implement media education programs in child care centers, schools, and community-based programs. Programs that teach children how to understand and interpret advertisements have the potential to immunize young people against harmful media effects.Comment: Excess TV viewing has proven adverse effects on sleep and eating habits of children. Pediatricians should actively discourage parents from allowing TVs in children's bedrooms. Like watching TV, playing video games is largely a sedentary activity, although some video games do involve physical activity (JW Pediatr Adolesc Med Jul 27 2011). Like incremental increases in calories (e.g., from butter and soda), incremental increases in screen time might lead to significant weight gain over time. Pediatricians can educate patients and parents about how increased media watching contributes to obesity.
Martin T. Stein, MDPublished in Journal Watch Pediatrics and Adolescent Medicine July 27, 2011