Childhood obesity prevention is a complex issue. Over the past 10 years, obesity prevention and treatment efforts have focused on interventions aimed at reducing the amount of time kids spend in front of the television or computer. In a new study, researchers at The Hospital for Sick Children (SickKids) tested a behavioural intervention aimed at preschool-aged children in the primary care setting to see if it would be effective at reducing screen time, or reducing the number of meals in front of the television.
The study, published in the November 5 online edition of Pediatrics, found that a 10 minute conversation between a parent and a paediatrician was effective at reducing the number of meals spent in front of the television by more than two meals a week. However, overall it did not result in a reduction of screen time or reduced body mass index (BMI) among preschoolers.
“Making lasting behavioural changes, like cutting back on screen time, can be a challenge for people of all ages,” says Dr. Catherine Birken, senior author of the study and Staff Paediatrician and Associate Scientist in Child Health Evaluative Sciences at SickKids. “This study tells us that obesity prevention and screen time reduction may require repeated reinforcement, and flexible, developmentally appropriate approaches across settings that change as the child ages.”
Birken adds that we should continue to focus prevention efforts on young children, because parents have control over feeding and activity at this age. She says it’s a prime time to learn healthy behaviours and children who adopt healthy habits early are more likely to continue on this path as adults.
The amount of time spent in front of a screen, like watching TV and playing video games, is associated with important health outcomes in children including delayed language development, aggressive behaviour, cigarette smoking and obesity. Meals in front of the TV are particularly linked to obesity as it has been associated with increased caloric intake and alterations in satiety signals.
This current study complemented SickKids research done in 2011. A meta-analysis of 13 studies focused on screen time interventions found that the interventions aimed at reducing screen time among children had no overall effect on the reduction of BMI in children. There were few studies in young children, and none in the primary care setting. In this current study, the research group conducted a randomized control trial of their own to evaluate screen time interventions among preschoolers in primary care.
One hundred and sixty families participated in this randomized control trial through TARGetKids!, a primary care research network for children in Toronto. Half of the parents were in the intervention group and received a 10 minute counseling intervention, which provided parents with information on the health impact of screen time in children and offered strategies to decrease screen time, such as removing the TV from the bedroom, eating meals without TV, budgeting screen time, and suggesting activities for the child that did not involve TV. The outcome was measured one year later.
A joint initiative between SickKids and St. Michael’s Hospital, TARGets Kids! partners with primary care practices across Toronto to develop the evidence to promote healthy nutrition, activity, and good health in young children and families through the primary practice setting.
This study was supported in part by a Paediatric Consultants Research Grant, The Hospital for Sick Children. The Paediatric Outcomes Research Team is supported by a grant from SickKids Foundation.
About The Hospital for Sick Children
The Hospital for Sick Children (SickKids) is recognized as one of the world’s foremost paediatric health-care institutions and is Canada’s leading centre dedicated to advancing children’s health through the integration of patient care, research and education. Founded in 1875 and affiliated with the University of Toronto, SickKids is one of Canada’s most research-intensive hospitals and has generated discoveries that have helped children globally. Its mission is to provide the best in complex and specialized family-centred care; pioneer scientific and clinical advancements; share expertise; foster an academic environment that nurtures health-care professionals; and champion an accessible, comprehensive and sustainable child health system. SickKids is proud of its vision of Healthier Children. A Better World.™ For more information, please visit www.sickkids.ca.
About SickKids Centre for Research and Learning
The SickKids Centre for Research and Learning will bring together researchers from different scientific disciplines and a variety of clinical perspectives, to accelerate discoveries, new knowledge and their application to child health — a different concept from traditional research building designs. The facility will physically connect SickKids science, discovery and learning activities to its clinical operations. Designed by award-winning architects Diamond + Schmitt Inc. and HDR Inc. with a goal to achieve LEED® Gold Certification for sustainable design, the Centre will create an architectural landmark as the eastern gateway to Toronto’s Discovery District. The SickKids Centre for Research and Learning is funded by a grant from the Canada Foundation for Innovation, the Government of Ontario, philanthropist Peter Gilgan and community support for the ongoing fundraising campaign. For more information, please visit www.sickkidsfoundation.com/bepartofit.
For more information, please contact:
The Hospital for Sick Children
The Hospital for Sick Children
Phone: 416-813-7654 ext. 1436