Is there a link between screen time and childhood obesity?

We live in a digital era where the nature of our lifestyles makes it near-impossible to get away from digital screens. While we used to celebrate the breakthroughs of technology and the convenience that digital devices brought to our lives, there is an increasing body of research pointing towards the negative effects of too much screen time on our mental and physical health.

Children and toddlers face more severe health consequences because of the fact that their bodies and brains are still developing and that they have poorer impulse control. In particular, childhood obesity is one of the repercussions of excessive screen time amongst young children that we simply cannot afford to ignore due to how prevalent it has become.Photo: Active Health

What is excessive screen time?

Screen time is the total amount of time spent facing digital screens in a day. Young children these days are well-acquainted with a number of devices. While TV and computers used to be the only digital screens that kids spent hours staring at, the rise of mobile devices has drastically increased the means of possible exposure. Smartphones, tablets and console games make it easy for children to clock more screen time anywhere they are � children watching videos or playing games on a smartphone are common sights on buses and trains and even in restaurants.

It�s hard to tell when screen time is considered excessive because most experts can�t agree on a fixed duration spent on screens that qualify as �too much�. This is because of the complexity of the effects of screen time � productive screen time (such as creating content, playing educational games and chatting with others) should be viewed differently from passive screen time (such as mindless consumption of content or social media feed). As such, the general guideline in determining when screen time borders on the excessive is to consider not just the duration spent, but also how the time was spent.

How too much screen time can cause childhood obesity

The link between screen time and obesity has been proven using findings from numerous research studies. Too much screen time causes a shift in a child�s lifestyle from an active to a largely sedentary one, which is the main cause of obesity. The rise in incidence of childhood obesity from excessive screen time can be attributed to a number of reasons:

� Physical inactivity

Watching videos and playing games on digital devices are stationary activities. When children spend too much time indoors with their devices rather than going out to play or explore their environment, they lose precious exercise time. A decrease in physical activity doesn't just mean that fewer calories are being burned � the metabolic rate is affected as well.

� Increased incidences of snacking

TV-time is always seen as a good opportunity to open a bag of chips or guzzle some soft drinks. The indulgent nature of screen usage means there are more opportunities for children to reach for snacks while they are engrossed in their screens. The snacks that children love are often addictive, high-calorie and low in nutrient density.

� More exposure to food advertisements

TV programmes and commercials can be insidiously enticing your child to eat more. When children view advertisements related to food or when TV programmes feature food products, they tend to want to eat more. These findings are supported by research studies � according to a Harvard University study, food advertisements can increase snacking habits by 45%.

� Getting less sleep

Screen time can eat into a child�s sleep time, and when this happens the child�s metabolism can be affected. Like how it is with adults, lack of sleep upsets hormonal balance causing a slowdown in the metabolic rate. This, in turn, can lead to weight gain and obesity.

Too much screen time can indeed cause child obesity, but a reverse in the trend has the opposite effect in that reducing screen time can help kids to lose weight. An American study found that children of primary school age benefited from a reduction in screen time as well as a regulation of the content they consumed. These kids got more sleep, behaved better, were more sociable with other children, performed better academically but most pertinently, gained less weight and were less likely to be obese.

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The problems of obesity

In a child�s world, being obese can mean being teased by other children and having low energy levels. But these are just superficial consequences. What makes childhood obesity such a serious problem is the long-term chronic health conditions it can lead to.

� Heart disease

Obesity is related to high cholesterol levels and high blood pressure. These create a heightened risk of developing heart disease and experiencing other heart-related problems like heart attacks and strokes later in life.

� Diabetes

In Singapore, children as young as five years old are suffering from diabetes. There is an upward trend of childhood diabetes cases, especially in type 2 diabetes which has been strongly linked to obesity. This condition occurs when the body is unable to break down and absorb glucose properly and can be fatal.

� Asthma

Asthma in young children isn�t rare, but obesity can be a contributing factor to asthma in children who don�t naturally suffer from it. Asthma is caused by an inflammation of the lung�s airways and there is a high correlation between chronic asthma and obesity.

� Sleep disorders

Obesity can cause sleep disorders because it increases the chances of blocked airways when sleeping. This leads to chronic conditions like snoring and sleep apnoea, which can disrupt the quality and quantity of sleep a child gets at night. This then goes on to affect his or her energy levels and concentration in the day.

� Joint pain

Being obese puts additional pressure on the joints and can cause them to hurt due to them being insufficiently developed enough to support the body's weight. As a result, obese children tend to be less physically active, and this sets up a vicious cycle of obesity and physical inactivity.

Other consequences of excessive screen time

Besides the huge problem of childhood obesity, excessive screen time in children can also cause other problems in the following two areas.

� Impaired social development

Children learn how to socialise through interacting with their parents, relatives and other children. When they spend more time interacting within a virtual environment, their social skills can be adversely affected, as do their ability to interpret non-verbal cues.

� Mental health

Games and videos are highly enjoyable, but social media can be detrimental to a child�s mental health. Social media has been widely found to lead to lowered self-esteem levels in youth, which increases the risk of depression and other related mental health issues. Cyberbullying is also another danger in the digital world that can severely impact a child�s mental health. In fact, as many as 3 in 4 local youth aged 13-19 have experienced some form of cyberbullying so this is definitely a relevant problem to worry about.

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Fight obesity by reducing and regulating screen time

It�s clear that too much screen time causes childhood obesity and that obesity is a serious problem that shouldn�t be ignored. However, banning children from using digital devices altogether won�t be a good solution as your children can lose out on the inherent benefits. Besides, most experts agree that some amount of screen time is beneficial to children. Therefore, a more practical solution is to reduce the duration of screen time and to regulate the usage, and parents have an indispensable role to play in this regard.

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� Set limits to screen time

Parents have the authority to impose rules on screen time usage, so make use of it. Set clear boundaries on how much screen time your child gets a day, and when your children can use the digital devices. It�s good to specify time frames when devices can be used and to limit these to one device at a time. For example, children can get one hour of TV time after mealtime and half an hour of smartphone time after completing their homework.

It would also be a good idea to set off-limit timings where no device usage is allowed (this applies to adults too!). In particular, screen time shouldn�t be allowed during mealtimes and an hour before bedtime due to its disruptive effects on eating and sleeping patterns.

� Join in the kids� screen time sessions

The best way for a parent to regulate their child�s screen time and to ensure that this time is spent productively and not passively is to join in when your child is using digital devices. Watching TV and playing computer or smartphone games with your child can help you see if your child is fully engaged and learning from the content. You can also engage your child�s cognitive processing centres by asking thought-provoking questions related to what's being shown on the screen.

� Choose appropriate content

While you can�t be there all the time to monitor your child�s screen usage, you can help to curate appropriate content for your child to consume. Create a child-friendly video playlist or download only games that you believe are educational and beneficial to your child.

� Help your child find a healthy hobby

Lack of outdoor hobbies can make it easier for your child to stay in and dabble in more screen time, so help your child find an interest outside of their digital lives. Sports activities make great hobbies so help your child discover a sport that he or she loves � you can visit our Active Health Labs to find out more about physical activities that are kid-friendly. Even if the hobby doesn�t work out, your child can make new friends and spend time socialising with other kids instead of hanging out with digital devices.

� Plan family activities

Give your child a chance to go outdoors and spend more time with people by planning regular family activities. Explore new places and go for community events like art classes or child-friendly museum exhibitions. Family activities will remind your child that there�s an entire world outside of the digital realm!

Overcoming obesity caused by too much screen time is all about balance and parental involvement. Screen time should be viewed as a lifestyle activity but not one that takes up all your child�s time. Get your child used to living with regulated amounts of screen time from a young age - this not only prevents childhood obesity but also ensures good long-term physical and mental health.

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