Kids, TV a weighty blend of trouble

Washington -- Couch potatoes get their start as tiny spuds, said researchers examining the role of television, videos and computer games in the rise in childhood obesity -- a role that is likely more complex than previously thought.

Young children sitting transfixed by the TV or computer for many hours each day are not only substituting a passive activity for more vigorous calorie-burning physical movement but are also being exposed to thousands of hours of food ads.

The recent surge in childhood obesity has been mirrored by an explosion in media targeted to children: shows and videos, specialized cable networks, video games, computer activities and Internet Web sites, according to a new Kaiser Family Foundation report, "The Role of the Media in Childhood Obesity."

Today, about 10% of 2- to 5-year-olds and 15% of 6- to 10-year-olds are overweight, according to the Centers for Disease Control and Prevention, and the medical complications common in overweight children include hypertension, type 2 diabetes, respiratory ailments, orthopedic problems and depression.

The U.S. surgeon general has identified the high incidence of obesity among young people as the greatest threat faced by public health today, an alarming statement that prompted the foundation to produce its report.

"While media is only one of many factors that appear to be affecting childhood obesity, it's an important piece of the puzzle," said Vicky Rideout, vice president and director of the KFF's Program for the Study of Entertainment Media and Health.

Thomas Robinson, MD, MPH, associate professor of pediatrics and medicine at Stanford University School of Medicine, examined that puzzle piece in several experiments and found that children's reduced television viewing resulted in less weight gain. He presented his findings at a Feb. 24 discussion.

Dr. Robinson discovered that, over a seven-month period, a group of third- and fourth-graders who watched one-third less television than normal gained two fewer pounds than did classmates who viewed their usual amount. "That's a fairly large change when you're talking about normal school kids," he said. "Not all the kids were overweight."

In addition, he found that the children who watched less failed to gain the extra inch that the TV-viewing controls, who watched their usual amount of television, added to their waist circumferences. And it is abdominal fat that's associated with metabolic disorders, Dr. Robinson noted.

He also observed that the nonviewers ate fewer meals in front of the television and he noted trends among this group of being exposed to less high-fat food and experiencing improved physical fitness, although there was no difference in reported physical activity.

Increased exposure to TV, videos and computer games also increased contact with advertisements that enlist the help of children's favorite TV and movie characters -- from SpongeBob cheese snacks to Scooby-Doo cereals and Teletubbies fast-food kids' meals, according to the report. The typical child sees about 40,000 ads a year.

And children younger than 8 are much more susceptible to those advertising messages, according to a study by an American Psychological Assn. task force. "They aren't very sophisticated, and they can't grasp the persuasive intent," said APA member Dale Kunkel, PhD, professor of communication at the University of California, Santa Barbara. "A 5-year-old will see the ads as good information."

"This is a critical concern, because the most common products marketed to children are sugared cereals, candies, sweets, sodas and snack foods," said the panel's chair, Brian Wilcox, PhD, director of the Center on Children, Families and the Law at the University of Nebraska in Lincoln.

Turning off the tube

Despite the growing evidence that media are at least part of the reason for childhood weight gain, the Kaiser report found scant evidence that children's use of media displaced more vigorous physical activities, a common assumption.

Even though the jury is still out on exactly what role television plays, turning the set off is a good first step for controlling childhood obesity, Dr. Robinson said. "As physicians worried about health outcomes, we know that the interventions to reduce TV viewing really do work, and that's evidence enough to move forward and promote reduction in exposure to TV."

And the tube is not the only enemy, noted several Kaiser panelists. For example, millions of dollars are being spent on product placement in videos.

But television also can be an agent of change for the better, said Marva Smalls, an executive vice president at Nickelodeon and at other television networks. "Let's Just Play," a recently launched Nickelodeon multimedia campaign is one example of programming designed to get children moving. Another, "Share More Than Meals," is intended to get families back around the dinner table.

"Kids will lead the way," Smalls predicted. "They like to be smarter than their parents."