Front Page  health

Monday, August 1, 2005

TV is linked to overeating, not exercising

By Lance Chilton
For the Journal
    YOUR CHILD'S HEALTH:
Q. People keep mentioning obesity and television in the same sentence. TV doesn't give anyone too much to eat! What is the connection, if any?
    A: Recent studies show that watching too much television is associated with behavior problems, including attention deficit/hyperactivity disorder (ADHD). And in a study that came out in a recent pediatric journal, watching television was associated with lower educational attainment and a lower chance of getting into college.
    The study, done in New Zealand, took into account other factors that might have contributed to these children's poorer school results. It did not allow for the value of the TV watched— presumably documentaries about world history are better than "Sex in the City" episodes.
    TV, along with fast food, smoking and all-terrain vehicles, are among my favorite whipping boys— you may have seen the connection between excessive weight gain and excessive television watching made in this column before.
    There are three reasons for the proven association: (1) Time spent watching TV is time not spent in exercise, (2) TV ads regularly tout the wonderful tastes of high-calorie, low-nutritional-content foods, and (3) There IS one form of exercise associated with TV: hand moving to mouth, carrying many calories.
    I toe the line advocated by media experts at the American Academy of Pediatrics, who urge that "youngsters under age 2 not watch any television, that older children watch no more than two hours daily of 'quality' programming, and that televisions be kept out of children's bedrooms."
    With regard to obesity, a reader writes, "My sister is very upset with her long-term pediatrician. Why? Because he told her very athletic son that he needed to lose a bit of weight and to develop a "six pack.
    "So the 10-year-old is pushing her to exercise with him daily. Clearly he feels he has to comply with his doctor's ideas of a good body, but a six-pack?
    "I agree exercise is a good idea (and some good is coming of this in that my sister decided to get ice cream and cookies out of the house)."
    A: I'm not sure why a doctor would push for a "six-pack" (well-defined abdominal muscles), and I'm not sure how he presented the subject to your nephew.
    I find it very difficult myself to figure out just what to say when I note that a child is overweight. I want to be sure to be sensitive to children who are themselves very sensitive about their weight. Some overweight children in my practice appear to feel that there's something "bad" about them for being chubby.
    I try to emphasize that their being overweight and my not being able to see without glasses are not faults.
    On the other hand, I'm not willing to just avoid the subject. The outcome, both for individuals and for the population at large, is just too important. Obesity is a major risk factor for being teased and having lower expectations in school and later in work. Overweight children are much more likely than the lean to become overweight adults, and overweight adults are at considerably increased risk of diabetes, heart disease, high blood pressure, and even cancer.
    I like the approach championed by Envision NM, a new organization that is working with pediatricians, family physicians, and school-based health centers to improve our approach to weight and nutrition issues. Envision uses a poster developed by California Kaiser-Permanente pediatrician Scott Gee and his team. I display the poster prominently in my office exam rooms and refer to it many times each day. Its four points are:
   

Exercise vigorously 30-60 minutes a day (find something you like to do).
   

Cut down on TV and video game use.
   

Eat five or more servings of fruit or vegetables daily (make them taste good and they'll replace foods higher in calories).
   

Drink very little soda or fruit drinks (water or reduced-fat milk instead).
    By the way, one doesn't have to have "six-pack abs" to make a dent in the risks of diabetes and heart disease. Evidence shows that regular exercise helps, regardless of whether weight is lost or not.
   
Lance Chilton is a pediatrician who has practiced in Albuquerque for the past 28 years. He is past president of the New Mexico Pediatric Society. Send your questions about children's health to Chilton by mail, Lovelace Pediatrics, 5400 Gibson SE, Albuquerque, NM 87108, or by e-mail to lancekathy@yahoo.com.