Increased media usage among children and young people is fuelling higher obesity rates, according to consultant paediatrician and president of the Malta Paediatric Association Thomas M. Attard.
Chances are that as you’re reading this, your child is staring at a screen. But it’s not television or video games anymore. With ever more sophisticated entertainment on smartphones, the emergence of tablets and the ever-present computer, we now talk of screen time – the time your child’s eyes are fixed on any screen, big, small, indoors, outdoors, interactive, or passive.
One of the most obvious steps to curb the growing childhood obesity epidemic in Western countries is to curb screen time
It’s also, to a certain extent, the time that a screen, usually a television, is in the background, offering serious competition to the most interesting book or engaging conversation, and certainly eclipsing any homework.
Any way you cut it, screen time is bad. The amount that is tolerable at different ages is subject to academic jousting, but the overriding principle is that less is better.
The statistics, however, are not encouraging. Even back in 2004, media usage – including handheld video games among children and adolescents, already on the increase in Western countries – was as much as 35 to 55 hours a week. The impact of newer technologies, including tablets and smartphones, has predictably worsened the outlook.
Curiously, a socioeconomic divide has emerged in how screen time is meted out as more socially advantaged children are gaining more access to interactive screen devices.
Television viewing among infants and toddlers has also increased – a study published in 2002 reported 17 per cent of infants and 41-48 per cent of toddlers through 35 months were watching more than two hours of television daily.
Studies have also repeatedly shown an increase in the proportion of children in Western countries, with televisions and access to unsupervised PCs with internet connectivity in their bedroom. How often do you see a parent on their smartphone oblivious to their tablet-wielding toddler safely strapped in their stroller – everyone doing what they like, but at the cost of interaction, activity and eroding on quality time? We are all to blame.
But why the fuss? Mainly because paediatricians almost universally believe that media usage in children impacts negatively on many aspects of their development, including their physical activity levels, eating patterns, risk of obesity, aggressive and high-risk behaviour and school performance.
This is supported by tomes of research articles on every aspect of the negative impact of screen time. In fact, it seems that one of the most obvious steps to curb the growing childhood obesity epidemic in Western countries is to curb screen time.
Malta is not immune to the childhood obesity phenomenon. Several published studies in children have shown the proportion of pre-obese and obese school-aged children to be among the highest in Western societies. These studies have also shown a higher prevalence in the more socially disadvantaged harbour area, although no segment of society is spared.
With the increased prevalence of obesity comes an increased preoccupation with the negative consequences of obesity starting in childhood.
Aside from the social and psychological impact, including stigmatisation, poor self-esteem and depression, obese children are also at risk of diseases that traditionally have been thought of as adult illnesses. These include early onset heart disease, high blood pressure, high blood cholesterol and diabetes.
Overweight children are more likely to have sleep apnoea, asthma, severe heartburn (gastro-oesophageal reflux disease), as well as fat accumulation in the liver and, eventually, liver disease. Obese children are even more likely to do badly in hospital for whatever reason they are admitted.
We are unfortunately at the threshold of an era when, in developed societies, parents can anticipate that their children will enjoy a poorer health-related quality of life than their own because of the impact of obesity-related diseases.
Where to start addressing the issues? The current recommendations by leading professional bodies include guidelines on limiting media time to less than two hours of quality programming per day for older children and less in infants and toddlers.
Parents are discouraged from allowing background television exposure during play and mealtimes and are urged to limit the use of smartphone apps as distraction for children and toddlers when outside the home. Enticing as these might be as quick fixes for the fidgety child, they do not promote the development of normal interaction patterns.
A more holistic approach towards obesity is also required – this includes changes on a societal, indeed political, level that may include a robust national healthy food policy. Preventive strategies have to focus on both active measures to limit childhood obesity and aggressive, multidisciplinary steps to treat obesity in children through the input by exercise specialists, nutritionists and family therapists coordinated by trained medical specialists.
Efforts geared towards sustained weight loss in obese children can result in improved health as well as psychosocial outcomes. The outlook is less than rosy – current research does not have any panacea to offer on what is truly a global health priority, but this cannot deter us from doing our utmost to safeguard our children’s health and quality of life.
Act now
Parents should discourage television viewing for children under two years of age and should encourage more interactive activities that promote proper brain development, such as talking, playing, singing and reading together.
Parents should limit children’s media time (with entertainment media) to no more than one to two hours of quality programming per day for older children.
Parents should also monitor programming, view with their children and adolescents, and encourage alternative forms of entertainment, such as reading, athletics, hobbies and creative play.