Pediatricians are raising the alarm on the negative effects of screens and online media on children’s health.
With the rise of social media and sophisticated and targeted online advertising, screen time has become increasingly engaging and pervasive, said Natalie D. Muth, MD, MPH, RDN, FAAP, FACSM. Screentime has greater risk to negatively impact the knowledge, attitudes, and beliefs of children and adolescents as well as their behaviors.
Screen time and media use can be harmful in a few ways, said Dr. Muth. These include:
- Sedentary time spent on screen and media can displace time that could otherwise be spent engaging in physical activities like outdoor play or sports, for example.
- Screen time is often when mindless eating and snacking occurs, contributing to worsened nutrition.
- Advertisements and other screen time exposures have been shown to negatively impact nutrition and food choices.
- Growing research shows the potential negative effects of social media and screen time exposure on a child and adolescent’s mental health and well-being.
“Not all screen time is harmful, but it is important to consider potential risks and benefits and monitor screen time activity and usage carefully,” said Dr. Muth, who is a spokesperson for the American Academy of Pediatrics, primary care pediatrician and obesity medicine specialist in the WELL Clinic at Children’s Primary Care Medical Group in San Diego.
Currently, families and social media may harbor myths or misinterpret definitions of “healthy.” Pediatricians and other primary pediatric health care providers have a crucial role in helping to promote lifestyle factors beneficial for the health of children of all weights, shapes, and sizes.
Environmental triggers
Screen time is one of several pitfalls to healthier lifestyles for children growing up in today’s society. Alarmingly, few children and adolescents meet federal nutrition or physical activity recommendations, according to “The Role of the Pediatrician in the Promotion of Healthy, Active Living”, a clinical report published this year by the AAP. The report updates recommendations last made in 2015 and overviews ways to lower risks of illnesses such as obesity or disordered eating.
The AAP states that practical strategies to promote healthy, active living are urgently needed. “Few children and adolescents meet federal recommendations for nutrition or physical activity, and rates of poor or inadequate sleep, negative health effects from screen use and social media, and mental health concerns in children and adolescents have increased,” researchers said in the report. Childhood obesity and disordered eating, including binge eating disorder and atypical anorexia nervosa, remain complex biopsychosocial illnesses with many genetic, environmental, and social drivers; healthy lifestyle remains an important component of both prevention and treatment, the APP said.
“We are most likely to make healthy ‘recommended’ choices when the healthy choice is the easy choice,” said Dr. Muth, lead author of the clinical report. “The environment in which we live makes it challenging to eat a diet rich in whole grains, fruits and vegetables and low in ultra-processed, sugary/salty foods. At the same time, for many kids the built environment makes it challenging to reach the recommended 60 minutes of physical activity per day. If we are serious about supporting kids and families in achieving good health and meeting nutrition and activity guidelines, we need to make the healthy choice the easy choice.”
Difficult discussions
According to the Centers for Disease Control and Prevention, approximately 1 in 5 U.S. children and adolescents have obesity. During childhood, obesity can put children at risk for physical conditions such as type 2 diabetes, high blood pressure, and liver disease, and psychological conditions such as bullying, low self-esteem, and anxiety. Young children who are overweight in kindergarten are four times more likely to have obesity by 8th grade than those who are not overweight in kindergarten. If current trends continue, the CDC forecasts that by 2050, the majority of today’s children and adolescents (57.3%) are projected to have obesity by age 35. “Action is needed so our children grow up healthy and strong,” said Dr. Mitch.
Obesity has an impact on medical costs. Compared to children with healthy weight, the CDC estimates that total medical expenditures for children with severe obesity are $909 higher each year.
Despite all these warning signs, obesity is difficult to discuss with younger patients and their families for several reasons, Dr. Muth said. One is a long-standing stigmatization and weight bias. This includes a “blame” mentality. There is also risk of negatively impacting a child’s self-esteem and body image or having the discussion in a way that prompts a child or adolescent to engage in dieting or other harmful behaviors.
“People come in all shapes and sizes and one is not necessarily better than another, and there is a strong genetic or inherited component of body size,” Dr. Muth said.
Health is the primary focus. While health risks can be associated with obesity, they do not necessarily go hand in hand. “Also, many environmental factors that are outside of a child’s control can impact behaviors,” Dr. Muth said. “This is complicated and complex, making discussion on an individual level more challenging, as the many social determinants of health play a powerful role.”
The pediatrician’s role
Dr. Muth believes pediatricians are a trusted source of information and guidance. They see children frequently over a long period of time and are best positioned to monitor growth trends, identify challenges, and sensitively and credibly speak with a child and family in exploring strategies to help optimize a child or adolescent’s health and well-being. They also provide recommendations based on science which is particularly important in this day of misinformation and rampant sharing of bad and potentially harmful advice.
Practitioners must communicate in a way that is sensitive and supportive with a focus on health. This includes listening to understand where a child and family currently are, what their goals or desires are, and working together to develop a plan that supports healthy, active living across domains of nutrition, activity, sleep, screen and media use, and social emotional wellness. It also includes advocating for community and environmental changes that help support the healthy choice as an easy choice.
“This takes into account social determinants of health and where a child or adolescent lives, learns, and plays,” Dr. Muth said.
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Key factors
In an article for healthychildren.org, Dr. Muth listed the following things that affect a child’s health and weight:
Nutrition. Setting regular meal and snack times can support healthy weight. Another key: having healthful foods such as fruits, vegetables and whole grains on hand while minimizing highly processed foods and sugary drinks.
Physical activity. Kids need physical activity built into every day – whether that’s playing sports, playing outdoors, helping with family chores, walking or biking to school, engaging in physical education, taking a family walk or any other physical activity they enjoy.
Sleep. When kids (and adults) don’t get enough sleep, their bodies release stress hormones to help them get through the day. These biological patterns affect appetite and the way our bodies burn (or store) excess calories.
Healthy tech use. This issue is closely related to sleep, since screen time before bed disrupts sleep cycles. But it’s also a factor in making time for healthy activities that get us moving.
Emotional and social issues. Feeling loved, seen and appreciated are just as central to your child’s health as nutrition and exercise. The brain and the body are one system – so when kids feel safe and secure, their bodies function well.
Read the full article at: https://www.healthychildren.org/English/health-issues/conditions/obesity/Pages/obesity-prevention-aap-policy-explained.aspxelping Kids Build Healthy Active Lives: AAP Policy Explained – HealthyChildren.org