Researchers have shown that overweight children age 4 to 7 have reduced sedentary behavior, lower calorie intake, and a lower body mass index after using a monitoring device to reduce television viewing and computer use time by 50 percent over a two-year period. The study – conducted by Leonard H. Epstein, Ph.D., of the University at Buffalo, the State University of New York, and colleagues – is published in Archives of Pediatrics & Adolescent Medicine.
It is known that obesity is related to television viewing behavior: “Television viewing is related to consumption of fast food and foods and beverages that are advertised on television,” clarify the authors. “Viewing cartoons with embedded food commercials can increase choice of the advertised item in preschoolers, and television commercials may prompt eating. Television viewing or related sedentary behavior may prompt eating by the association of these behaviors with eating, and television viewing and related behavior may impair the development of satiety by interfering with habituation to gustatory and olfactory cues.”
To test the impact of a device to monitor television and computer usage, the authors conducted a randomized controlled clinical trial. Participating in the study were 70 children between the ages of 4 and 7 with body mass index (BMI) measurements at the 75th percentile or higher for their age and sex. The children regularly spent at least 14 hours per week watching television or playing computer games. A monitoring device was installed on each television and computer monitor, and each family member received an individual code that activated the electronic devices.
The researchers randomly assigned 36 children to an intervention group whose codes had a set weekly time limit. The weekly screen time for these children was reduced by 10% each week until it was reduced by half. Intervention group children also received incentives such as money and stickers on a chart it they watched less than the available amount each week. The 34 children assigned to a control group did not have restricted TV or computer use. Every six months for two years, researchers acquired measurements of body mass index, television viewing times, caloric intake, and physical activity.
After two years, children in the control group reduced TV and computer usage by about 5.2 hours per week and children in the intervention group reduced usage by about 17.5 hours per week. Adjusted for age and sex, BMI measurements were lower in the intervention group. Additionally, the intervention group had lower calorie (energy) intake measurements than the control group children, but there was no significant difference between the two groups in the amount of physical activity.
The authors conclude: “Using technology to modify television viewing eliminates parental vigilance needed to enforce family rules and reduces the disciplinary action needed if a child exceeds his or her sedentary behavior limits.” They point to child choice as a crucial factor. “Perhaps most important, the device puts the choice of when to watch television in the child’s control, as opposed to a rule such as no television time until homework is completed,” suggest the researchers.
In an accompanying editorial, Steven L. Gortmaker, Ph.D. (Harvard School of Public Health, Boston) posits that, “One of the more useful aspects of the article by Epstein et al. is its clear documentation of an innovative and effective strategy that parents and caretakers can use to set screen time limits in children and youth.” Commenting on the current recommendations that call for children older than age 2 to watch a maximum of 2 hours of TV per day and those younger than age 2 to not watch TV at all, Gortmaker writes: “New innovations that assist parents may help make these recommendations a reality.”
A Randomized Trial of the Effects of Reducing Television Viewing and Computer Use on Body Mass Index in Young Children
Leonard H. Epstein; James N. Roemmich; Jodie L. Robinson; Rocco A. Paluch; Dana D. Winiewicz; Janene H. Fuerch; Thomas N. Robinson
Archives of Pediatrics & Adolescent Medicine. (2008). 162(3):239-245.
Written by: Peter M Crosta