It’s nearly impossible to avoid screen time these days; between smartphones, TVs, computers, and tablets, almost everyone’s daily routine revolves around time spent on screens. That includes children. The average child aged 8-18 spends approximately 7.5 hours on entertainment media, 4.5 hours watching TV, and 1.5 hours on a computer each day.
While technology has the potential to enhance learning, entertainment, and communication, there is also a direct link between increased screen time and pediatric obesity. Screen time greater than 2 hours daily is associated with increased rates of obesity, and studies show that teens who spend 5 hours or more watching TV are five times more likely to become overweight. This association is due in part to increased sedentary behavior, but it is also associated with poor sleep—particularly within 4 hours of bedtime—and with mindless eating behaviors and intake of sugar-sweetened beverages. More than 2 hours of daily screen time is associated with decreased executive function, decreased inhibition, and increased impulsivity, inattention, cognitive changes associated with ADHD, binge eating, and loss of eating behavior control.
As healthcare professionals, we must be hyper-aware of this correlation and provide families with education and resources to limit screen time and promote healthy habits that will set children up for happy, healthy lives.
Screen Time & Sleep
Good-quality sleep is important for the well-being of children, as sleep affects memory, mood, learning, and academic performance. Exposure to light from screen devices can disrupt sleep and lead to poor quality of sleep, and children who sleep with their mobile devices are at increased risk of insomnia. A study published in the Journal of American Academy of Pediatrics highlighted that 50% of children experienced some level of sleep curtailment and concluded that chronic sleep deprivation from infancy to school age was directly associated with a higher overall rate of childhood obesity.
It’s important to understand how sleep and weight are dependent on each other at different levels. Poor sleep quality and obesity may both manifest altered brain functions that control sleep and hunger. The parts of the brain that regulate the circadian rhythm also regulate hunger and satiety. Other possible mechanisms for weight gain are sleep deprivation, making children more likely to consume more calorie-dense foods, snack, and eat at nighttime.
The Physical & Psychological Consequences of Screen Time
Screen time exposure is one of the well-documented causes of obesity in the tech-centric modern world. From physical problems like eye strain to psychological problems like ADHD-like behavior, a wide gamut of health issues are caused by excessive screen time. Neuropsychological changes in the mind lead to addictive behavior toward gadgets that is similar to substance abuse behavior. Growing evidence points to increased screen time in children as hampering the development of a healthy and strong mind. An immature, anxious, or depressed mind is more vulnerable to emotional eating, increasing the likelihood of weight issues.
How Families Can Limit Screen Time
How can we help patients and their families reduce screen time in our virtual world? The first step is educating parents about the impact of screen time on their children’s health and providing tips and activities to limit screens in the home, such as:
- Limit exposure to screen time in very young children by not having TV time and computer games available to them.
- Engage children in creative playtime and encourage outdoor exploration.
- Read to children regularly.
- Provide music or conversation rather than screens for driving time in the car.
- Wait until children are in 8th grade or older to provide a cell phone.
- Do not allow cell phones, television, or other devices in the bedroom, particularly after bedtime.
- Do not allow screens at the meal table.
- Use an app to track and limit children’s screen time use on gaming devices.
- Set rules about the amount of video game time and television time children can have each day.
- Do not allow food or beverages other than water during gaming or computer time.
- Create dedicated family time each day without any electronic devices.
- Set a curfew for gadget use in the house.
Resources to Reduce Screen Time
Screen time reduction tools are available to help families make meaningful use of media time without hurting their health:
- Designed by APP, Family Media Plan helps customize a family’s media plan.
- S.M.A.R.T. (Student Media Awareness to Reduce Television), a curriculum for youth by NIH, is a program to motivate children to spend less time on TV.
- WE CAN! (Ways to Enhance Children’s Activity & Nutrition) is a national movement designed to give parents and caregivers a way to help children aged 8-13 maintain a healthy weight by increasing physical activity and decreasing screen time.
The Obesity Medical Association (OMA) also provides a wealth of resources for healthcare professionals, including the Pediatric Obesity Algorithm, a set of guidelines to help healthcare professionals make informed decisions when treating children with obesity. The algorithm includes age-specific recommendations and a staged treatment approach to guide clinicians’ treatment recommendations or help when referring patients to childhood obesity specialists. Together, we can continue to promote our pediatric patients’ health and well-being and set them up for success in the future.