Mental Wealth

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An Overlooked Factor in the Childhood Obesity Epidemic

Is an overlooked source of childhood obesity staring us in the face?

By Krysteena Stephens, M.A., IMFT and Victoria Dunckley, M.D.

screen-time & obesity
According to the American Heart Association, 1 in 3 children are considered overweight or obese, topping issues like smoking and substance abuse as the number one pediatric health concern today in the United States.  Why is it that childhood obesity has tripledin the last 30 years? When considering this question, factors like larger portion sizes, growing fast food chains, the decrease of nutritional value in food, and lack of physical activity come to mind. But is there another environmental issue being overlooked? One that’s relatively easy to modify?  

Trends in the obesity rate began a steady upward climb in the early to mid-seventies. Likewise, the first home gaming systems were released in the early 1970’s and we’ve been flooded with new screen developments ever since.  Today, children and adolescents spend an average of nearly 8 hours a day using devices such as computers, televisions, video game consoles, cell phones, and tablets—time that could easily be replaced with outdoor play, sports, and interpersonal activities. An emerging body of research points toward a strong association between screen-time and the development of obesity and other metabolic changes. Let’s take a look at some potential explanations behind this relationship:

 1.     Screentime is associated with metabolic syndrome in adolescents, regardless of physical activity.  The Journal of Public Health published a study on 1803 adolescents aged 12-19 years and found a positive correlation between screen time and likelihood of metabolic syndrome, independent of the amount of physical activity reported.  These children showed higher levels of triglycerides, fasting blood glucose, blood pressure, and larger waist circumference the more hours of screen time per day they reported.  To help prevent the risk of metabolic syndrome, the American Academy of Pediatrics  recommends that parents limit their child’s screen time to 2 hours per day, and encourages alternate activities such as outdoor play or sports, reading, socializing with peers, or hands-on creative activities such as crafts or playing an instrument.

 2.     Watching television during meals may attribute to poorer dietary habits among adolescents.   A study published in the The Journal of Nutrition Education and Behavior found that children who watch television during family meals consumed less vegetables, whole grains, and calcium-rich food sources than children who ate family meals away from the television.  Another study questioned the parents of over 1,700 two-to-four-year olds and found that children who watched more television on average were twice as likely to consume soft drinks or other sweetened beverages every week. The article also reported a 50 percent increase in soft drink consumption for every additional hour of television the child watched.  The American Academy of Pediatrics recommends keeping your child’s room free of a television, computer, or other electronic devices and eating family meals away from a television to lessen the likelihood of overconsumption of sugary drinks, snacks, and other unhealthy foods.

 3.     Parental role modeling plays a predominant role in the health and weight of a child.  One study found that health-centered intervention strategies directed toward parents showed better results in regards to children’s weight than interventions directed solely toward the child.  Not surprisingly, parents who engage in higher levels of screen-time and sedentary behavior also have children who engage in more screen-related activities and sedentary behavior.  Results from a similar study encourage parents to reduce their own screen time, lessen family television watching, and place restrictions on their children’s screen exposure per day.

 4.     Excess screen time exhibits direct as well as indirect effects on younger children’s physical and mental health.  Although the American Academy of Pediatrics discourages the use of any screens for children 2 and under, approximately 38% of 2-year-olds are reported as using a smart phone or tablet within the last year.  During this critical time, children learn a great amount of information through live social and physical interaction, and research shows screen usage may actually hinder cognitive growth and worsen executive functioning.  Another study reported that preschoolers who watched 2 or more hours of television per day had a greater chance of being overweight than children who did not.  Since self-discipline, motivation, and impulse control depend on executive functioning, indirect effects from screen-time may include dysregulated eating habits, being out-of-tune with bodily hunger and fullness cues, and lack of motivation to direct one’s energy physically.

5.     Insomnia—a known risk factor for weight gain—has become an epidemic in teens. Weight gain has been linked to chronic poor sleep. A growing number of children and teens report sleep issues, and screen-time at night may be to blame. Artificial light from the screen suppresses melatonin, and both visual and psychological stimulation induce fight-or-flight reactions, keeping the brain alert. Screen-time at night may contribute to obesity by inducing chronic sleep deprivation and stress reactions, conditions that lead to weight gain over time via insulin resistance. Kids may sneak electronic devices into bed, text after lights out, play games or surf the internet—both as part of a bedtime routine as well as during periodic awakenings througout the night. (Parents are frequently unaware of this!) Additionally, daily fatigue from disturbed sleep dampens the innate drive to be physically active, creating a vicious cycle.  

This eye-opening research implies that reducing the amount of time your child spends on a computer, watching television, or playing on a smartphone or tablet may prove to be a more powerful intervention to treat and prevent childhood obesity and related health concerns than previously realized.  Not only does it allow a child’s natural tendency to engage in physical play to emerge, but it also reduces the likelihood of developing cognitive symptoms such as inattention and poor executive functioning--symptoms which are themselves risk factors for obesity.  Playing an active role in our children’s lives by placing restrictions on screen time, encouraging physical activities, and fostering interpersonal interactions is crucial in order to tackle the costly obesity issue. Our society created the problem, and our society can reverse it.  

References:

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Golan, Moria, and Scott Crow. 2004. “Targeting Parents Exclusively in the Treatment of Childhood Obesity: Long-Term Results.” Obesity Research 12 (2) (February 1): 357–361. doi:10.1038/oby.2004.45.

He, Meizi, Leonard Piché, Charlene Beynon, and Stewart Harris. 2010. “Screen-Related Sedentary Behaviors: Children’s and Parents’ Attitudes, Motivations, and Practices.” Journal of Nutrition Education and Behavior 42 (1) (January): 17–25. doi:10.1016/j.jneb.2008.11.011.

Jordan, Amy B., James C. Hersey, Judith A. McDivitt, and Carrie D. Heitzler. 2006. “Reducing Children’s Television-Viewing Time: A Qualitative Study of Parents and Their Children.” Pediatrics 118 (5) (November 1): e1303–e1310. doi:10.1542/peds.2006-0732.

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Morrison, D N, R McGee, and W R Stanton. 1992. “Sleep Problems in Adolescence.” Journal of the American Academy of Child and Adolescent Psychiatry 31 (1) (January): 94–99. doi:10.1097/00004583-199201000-00014.

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Olafsdottir, S, C Berg, G Eiben, A Lanfer, L Reisch, W Ahrens, Y Kourides, et al. 2013. “Young Children’s Screen Activities, Sweet Drink Consumption and Anthropometry: Results from a Prospective European Study.” Eur J Clin Nutr (November 20). http://dx.doi.org/10.1038/ejcn.2013.234.

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Victoria L. Dunckley, M.D., is a board-certified child and adolescent psychiatrist specializing in treating children with complex diagnoses and/or treatment-resistant conditions.

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