1. Smith-Miller, Cherie A. MEd, BSN, RN, C, NCSN, CORLN

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How is television viewing affecting our children? The answers terrify me.


For one thing, television remains under considerable suspicion for its possible role in the obesity epidemic in this country. Although the media have been reporting on this for some time now, the figures continue to astonish. According to the Centers for Disease Control and Prevention, the number of young people ages six to 19 years old who are overweight or obese has more than doubled in 20 years. About 15% of all children and adolescents-9 million young people-are now considered overweight or obese. The percentage is even higher in certain populations: for example, 27% of Mexican American boys and nearly one-fourth of non-Hispanic black girls ages six to 19 are overweight or obese. Yet little is being said about the role adults may have played in this development, and even less about how nurses can be catalysts for change.


Evidence shows that excessive television viewing is one reason for the lack of physical activity reported by many children. The American Academy of Pediatrics, citing Nielsen Media Research data, has noted that the typical school-age child spends almost three hours a day watching television; yet that child spends one hour daily doing homework, according to research cited by the Vanier Institute of the Family. A study published in the Journal of the American Medical Association in 1998 found that children who reported watching four or more hours of television per day had higher body mass indexes (BMIs) and more body fat than those who reported watching fewer than two hours per day. And although the association between television watching and level of physical activity level was not clear, children who watched more television and were less physically active had higher BMIs.


Other signs indicate that television viewing is changing how children spend their leisure time. Televisions are no longer confined to the family or living room; in many homes, nearly every room has a television. A recent study by the Kaiser Family Foundation reported that 36% of children up to age six have a television in their bedrooms, including 26% of children younger than age two. The study also found that one-third of children up to age six live in homes where the television is left on "always" or "most of the time" (termed "heavy TV households"); these children are slower to learn to read and likely to read less than children in homes where televisions were turned off more often. And although causality couldn't be demonstrated, four-to-six-year-olds living in "heavy" viewing homes also spent less time playing outside.

FIGURE. The notion t... - Click to enlarge in new windowFIGURE. The notion that these devices are innocuous couldn't be more wrong.

The family car is the latest frontier-sales figures for "rear-seat video entertainment" such as DVD players reportedly reached $419 million in 2002 and have continued to rise as prices have dropped. As a mother of three, I understand a parent's desire for a peaceful excursion. But these mobile entertainment systems train children to be passive recipients rather than involved participants-just as the television does inside the home.


This electronic incursion into our homes and vehicles has gone largely unchallenged; indeed, parents are the primary purchasers. But the notion that these devices are innocuous couldn't be more wrong.


Nurses need to understand how the pervasive use of television and similar products contribute to the obesity epidemic, especially in children. I believe pediatric obesity to be one of the most easily preventable conditions we face today. People often lament the expanding girths and reduced activity levels of children. But talk, no matter how heartfelt, isn't enough. Parents and others who care for children need to stop using television as an electronic babysitter and start setting a good example by being more physically active themselves. Pushing that "off" button just might add years to a child's life.