• More than 18 percent (!) of the four-year-olds were obese.
• About half the families had a family dinner routinely.
• A little over a half of the four-year-olds got what the study considers enough sleep.
• 40 percent of four-year-olds had their TV time limited to less than two hours a day on weekdays.
• One in seven kids had all three household routines (family meals, enough sleep and limited TV time) and one in eight kids had none of these routines in place.
• Each of the routines was associated with significantly lower obesity rates. Kids who had all three routines had 40 percent less prevalence of obesity even after adjusting for maternal obesity and other socioeconomic characteristics.
Anything surprising in this data?
Unfortunately we’re getting used to seeing 18 percent obesity—yes, obesity, defined as a Body Mass Index (BMI) above the 95 percentile—not merely overweight in four-year-olds. That’s nearly one in five young kids!
Yet I still cringe whenever I see these numbers.
The finding that 60 percent of four-year-olds log more than two hours a day in front of the TV on weekdays is especially troubling to me. And I suspect these TV viewing times are an underestimate since parents tend to give socially desirable responses when asked about their habits, and only TV viewing at home and on weekdays was figured-in into this study.
Most large studies show that the more TV kids watch, the more likely they are to be overweight. How does TV contribute to obesity? Although common sense would say that TV displaces more active pursuits, that point isn’t well proven, as of yet.
What is very clear is that when our kids watch TV they are exposed to billions of dollars’ worth of well-crafted food ads, most of them for junk-foods: fast-food, sugary cereals and candy. These ads are so slick, and the marketing is so clever and entertaining that some toddlers have been known to sing the tunes and repeat the message after being exposed to some ads just once.
Most toddlers can’t tell programming and advertising apart—furry, cuddly friends and super-heroes abound in both—and it takes maturity and training to teach kids how to counteract the impact or to even notice the persuasive intent of advertising.
That’s why marketers want to get kids while they’re young; it’s like shooting fish in a barrel, and they’ll be loyal to the brand forever. That’s also why we parents should want to keep marketers away from our kids, especially when they’re very young and impressionable.
These days some food companies participate in a self-regulatory program but self-regulation doesn’t seem to be doing much to ensure responsible advertising to children. I actually don’t think there is such a thing as fair and responsible advertising to toddlers.
The American Academy of Pediatrics recommends limiting “children's total media time (with entertainment media) to no more than 1 to 2 hours of quality programming per day” and “discourage television viewing for children younger than 2 years”. TV is a babysitter every parent might want resort to every once in a while (we all need a break!) but common sense suggests that the upper limit should be lower than the Academy’s guide, and unfortunately, even quality programming is often flanked by ads.
Should we adopt these three habits?
This study is cross-sectional and observational, meaning it looks at a population at a certain point in time and proves an association between family meals, good sleep and limited TV and lower rates of childhood obesity. It cannot prove causality, nor did the study examine the key influencers of obesity—diet and physical activity levels. It very well may be that these three habits are the habits of families who eat better and move more.
Yet even without further proof that these three habits curb obesity, I would absolutely recommend them to families, mainly because family meals, good sleep and limited TV-time make so much sense. There are other reasons to adopt these habits (for example, eating together is simply a good way to keep family ties strong), and there’s very little downside to embracing them.
But there are possible drawbacks. Your kids may suffer some arguments over the dinner table, have occasional bad dreams while they sleep, and miss some educational and entertaining stuff on TV.
On the other hand, they’ll be learning the pleasures and skills of dining in company rather than gulping down food, they’ll get enough sleep to sustain growth and health, and I’m pretty sure that most alternatives to TV (playing, reading or even being bored) offer better stimulation and sustenance to a child’s developing brain. If these three habits also protect young children from obesity, that’ll be a nice added bonus.
I’d take the risk.
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