PRIMARY PREVENTION OF PEDIATRIC OBESITY: DECREASE SEDENTARY ACTIVITY

Sedentary time for children has increased in the past few decades. This shift from active to passive play has resulted in fewer calories expended, and more of these unused calories stored as fat. Studies have shown that children spent more time in physical activities and less time watching TV in the 1950s than they did in the 1990s.

• In the 1950s, children spent only 86 minutes per day in front of the TV or engaged in sedentary activities.
• In the 1990s, children’s TV watching time (used as a surrogate for sedentary time) tripled, averaging 4 - 4.5 hours of TV watching per day!

Although no quantitative data that is comparable to TV watching across decades was found to document the generally accepted idea that there has been a progressive decline in children’s physical activity, comparing children’s daily routines in the 1950s to those in the 21st century amply supports this notion.

The American Academy of Pediatrics (AAP) has produced guidelines for children's TV viewing:

• Children younger than 2 years old should watch no television.
• Children 2 years and older should watch < 2 hours of television per day.

However, the reality is that these AAP-recommended viewing hours are exceeded by 17% for ages 0-11 months and 48% for ages 12-23 months. Unfortunately, children's TV viewing increases from age 3 to age 8, at which point the AAP guidelines are exceeded by twice the limit.

Longitudinal analysis12 shows that the amount of TV viewing in early childhood is directly proportional to that viewed at school age. Thus, preventive measures against excessive TV watching must begin before the age of 2 as other studies" suggest a causal relationship between school-age TV viewing and obesity and aggression. Remarkably, in 10 to 15-year-old children/adolescents, the odds of being overweight quadruple and the odds of regaining lost weight are eight times greater with excessive TV viewing. Thus, reductions in TV viewing time could significantly decrease childhood obesity.

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