Association between Duration of Watching Television and Obesity in Children
CHAPTER
I
BACKGROUND
In this era, the concern about nutrition problem in
children not only talk about the malnutrition but also in the
over-nutrition. This over-nutrition
problem cause an obesity trend in children. There are several factors that can
cause childhood obesity, such as daily diet, lack of physical activity, and
genetic factor.[1] Most research only focused in the unbalanced food
consumption as the risk factor of obesity. Thus, there is not much observation
that discuss about the modern children lifestyle.
One of the modern
children lifestyle to be discussed is watching television (TV). The habit of
watching TV for a long time can cause side effects for the child.[2] These effects affect the both the physic and
psychology of the children directly or indirectly. Watching TV in a long time
limits the physical activity of the children. The time that is supposed to be
used for outdoor activities is allocated into watching TV. It is accounted that
a long time in TV viewing is closely related to the increase of Body Mass Index
(BMI). Eating snacks while watching the TV also contributes to the increase of
calorie intake. The increase of calorie intake that is not balanced with
appropriate physical activity will cause fat accumulation
in the child’s body.[3]
Obesity is one of the more widely discussed
examples of television’s negative health consequences. There is extensive
literature on associations between television viewing habitsand childhood
obesity, including observational studies with cross-sectional and prospective
designs.[2] Some studies
have already done in some countries, such as Saudi Arabia and European, with
the aim to examine the association between the television viewing habits and
obesity in the children of school-age. The studies are given with the
case-control design, with the data taken by questionnaires. The children
selected for the data are mostly aged between 2-14 years, and the study
considered some aspects such as children’s habitual television exposure time,
television during meals, and having television in their bedrooms. All studies
brought out the same result, that watching TV represents an important risk
factor for obesity in children with school-age.
CHAPTER II
CONTENT
2.1 Method
Our
objective was to assess association of television habit in relation to Obesity
and overweight in children. To do this, We searched journals about the topic.
We performed a literature search on PubMed and JFConline on May 2014. We use the following keywords: Children,Obesity,and
television. We also use other
relevant articles to help us understand more about this topic.
Journal have PICO design below
P
= Children
I
= Duration Viewing Television
C
= Watching television less than
1-2 h/day
O
= Obesity and overweight
The Journals Publish between
2010 until 2015, Abstracts of each
journal were assessed for applicability and suitability with our topic.
We do the critical appraisal for know the Validity , Importance and
Applicability (VIA) of the journal.
There’s three journal we used for this topic
1.
Braithwaite, Irene et al. The Worldwide Association
Between Televison Viewing And obesity in Children and Adolescents : Cross
Sectional Study’ PloS ONE 8.9 (2013)
In
this paper , the researcher focus on reported time spent viewing television
relationship to their BMI. The researcher use Environmental Questionnaire /ER
(available on webside isaac.auckland.ac.nz) . The EQ included question on
height and weight reported by parents for the children. The model of the paper
is cross sectional with any criteria (exclusion and inclusion) to minimize the
bias. BMI was assessed separately for each
age group using a general linear mixed model with centre as a random effect and
age, sex,television watching and measurement type as fixed effects.
2.
Lauren
Lissner et al. Eur J Epidemiol (2012) 27:705–715. Television habits in relation
to overweight, diet and taste preferences in European children: the IDEFICS
study
This report is
based on data from the IDEFICS, is a multi-center cohort and intervention study
with a focus on diet-related health outcomes. Participants were between 2 and 9
years old and recruited via their daycare centers or schools. The examination
protocol included a detailed questionnaire in which parents and physical
examination of all children. During the baseline
survey, 16,864 children were examine, 16,220 met basic inclusion criteria of
complete information and repeat after 2 years.
The
researcher was collected data of weight and height to calculate BMI, television viewing habits, dietary habits of
high-fat and sweet foods and beverages. They also
included parental education as a covariate and do taste
preference tests. For analysis, logistic models were used to calculate
prevalence odds ratios for overweight and logistic regression was used to describe
odds of each television habit in relation to fat or sweet propensity after
adjustment for age, sex, socioeconomic status and survey country studied.
Prevalence odds ratios (OR) are reported with 95 % confidence intervals.
Analyses and figures were done with the Statistical Analysis System, SAS,
version 9.2.
3.
Sameer H. Al‑Ghamdi. The association between watching television and obesity
in children of school‑age in Saudi Arabia
In
this journal the author use case control study and was performed to the
students between nine and 14 years of age who attendded a school health clinic.
The case were children that have obese, and the control were non-obese, but if
there secondary cases to medical illnesses or chronic drug use were excluded.
Then the data collection method, the estimation of sample size was based on the
prevalence of exccessive watching of TV of children. The study was conducted by
enrolling children who made unscheduled visits to the school health clinic. The
data information which collected were demographic data, TV watching, physical
activity, meals, and anthropometric measurements. For
antropometric measurements of weight andd height a well trained nurses were
collected and for all study
participants was calculated with Body
mass index (BMI), which is weight in kilograms divided by height in meters
squared (kg/m2).
2.2 Result
According to journal “The Worldwide Association between Television Viewing and Obesity in
Children and Adolescents: Cross Sectional Study”, there was a significant
positive association between higher levels of television watching and BMI
(p<0.0001)with an apparent dose response effect.
In this journal shows estimated BMI (SE) in kg/m2 for
short television viewing and the increase in BMI (SE) for each television
viewing category by age and sex. In the adolescent females, data were available
for 104,712 adolescent females. The mean BMIs in the short viewing category
were 18.9, 19.1, 19.6 and 20.0 kg/m2 for ages 12, 13, 14 and 15 respectively.
In the female children, data were available for 38,272 female children. The
mean BMIs in the short viewing category were 15.3, 15.3, 15.6 and 15.8 kg/m2
for ages 5, 6, 7 and 8 respectively. In male children, data were available for
38,731 male children. The mean BMIs in the short viewing category were 15.9,
15.6, 15.9 and 16.0 kg/m2 for ages 5, 6, 7 and 8 respectively. After
controlling for centre, age, and measurement type, there was a positive
association between higher levels of television watching and BMI (p<0.0001)
with an apparent dose response effect. Relative risks and confidence intervals
by sex in each age group for overweight or obesity in each television viewing
category relative to the short television viewing category are shown in table
2.
There are similar result in other design study. One of
them is an journal entitled “Television habits in relation to overweight, diet
and taste preferences in European children: the IDEFICS study”, television were
significantly related to increased odds for overweight. Eating while watching
television was significantly associated with overweight, with prevalence odds
ratios of 1.20 (95 % CI 1.04–1.40) for boys and 1.35 (95 %CI 1.17–1.55) for
girls in fully adjusted models. Having a television in the bed- room showed
similar associations: OR 1.39 (1.19–1.61) in boys and 1.23 (1.06–1.42) in
girls. Finally, watching 60 min a day or more on weekdays and/or weekends was
associated with overweight to a similar degree in both sexes: OR 1.20
(1.05–1.38) in boys and OR 1.21 (1.06–1.38) in girls. These estimates were all
derived from statistical models that adjusted for age, survey country, parental
education, dietary propensities, parental reports of physical activity, and the
other two television variables. However, there is no independent associations
between high-risk TV behaviors and taste preferences per se (data not shown).
Beside European there
is other design study that conduct in other region that had some similar result
about relation watching television and obesity. According to journal “The
association between watching television and obesity in children of school age
in Saudi Arabia”, obesity was significantly associated with the number of TVs
available at home. Of the students who had more than three TVs at home, 83.6%
were obese compared to only 33.3% of students with only one TV at home
(P=0.001). Children who watched TV late at night were more likely to be obese
than those who watched television at other times (P=0.026). There was no
significant association between a history of eating while watching TV and
obesity (P=0.893).
In the logistic analysis, as the child’s age decreased
by one year, there was a 32% reduction in obesity (OR=0.68, P=0.003). The
presence of only one TV at home was associated with a 42% reduction in the risk
of childhood obesity (OR=0.58, P<0.001). The child`s personal ownership of
TV was associated with an increased risk of childhood obesity (OR=1.75,
P=0.002). As the number of hours of watching TV at weekends decreased by one
hour, there was a 19% reduction in the risk of obesity (OR=0.81,P=0.009)
2.3 Association watching television and obesity
in children
All journals that are included in this review stated
that watching television in long hours every day increase the risk of obesity.
This result is obtained by comparing patient’s BMI to hours spent on television
every day.
According to journal, “Television habits in relation
to overweight, diet and taste preferences in European children: the IDEFICS
study”, it did a research using young European children as sample to determine
the relationship of weight status and propensity of types of foods consumed to
the risk of getting obesity. Increasing of viewing television(TV) time, having
TV in bedrooms and having meals while watching TV will increase the risk of
overweight in young children.
This imply that taste preferences and TV habits may be
independent determinants of weight status in children. For instance, despite
standardization of the food frequency questions and some confirmation of their
validity and reliability the representativeness of the food frequencies
vis-a-vis children’s whole diets may vary due to differences in school meal
practices in the different survey settings. It is possible that complex
reporting errors are distorting the role of diet as a mediating factor in the
TV-overweight association. In this context, an important source of error
derives from the fact that all television viewing and dietary data are by
necessity reported by parents or guardians of these young children; in addition
to being imprecise, these estimates may be influenced by desire to report
healthy habits
In journal, “The association between watching
television and obesity in children of school‑age in Saudi Arabia,” watching television during childhood is associated
with an increased BMI. In this study, watching TV for more than three hours per
day, especially over the weekend, was significantly associated with childhood
obesity. However, the evidence suggests that a reduction in the watching of TV
could significantly reduce the prevalence of obesity..
There is other design study that show the similar
result. Based on journal, “The Worldwide Association between Television Viewing
and Obesity in Children and Adolescents: Cross Sectional Study” there was a
positive association between longer periods of television viewing and BMI in
both adolescents and children worldwide. There was a dose response effect in
both age groups. There was a 10 to 27% increased risk of overweight or obesity
in adolescents and children watching 1–3 hours of television per day, with
adolescent females having a 45% increased risk when watching more than 5 hours
of television per day. The strength of these associations are consistent with
those found in previous studies. The associations are consistent with
longitudinal studies that demonstrate a temporal sequence between television
viewing and the development of overweight and also with intervention research
that shows that reducing viewing time can slow the increase in BMI in
adolescence.
CHAPTER III
CONCLUSION
Several
genetic and lifestyle factors have been recognized to induce obesity, sedentary
behaviors, including watching TV, have attracted a great deal of attention as
potential risk factors for obesity since any child can be sedentary. Duration
of watching television and obesity in children appear strong relation in many
design of study whether cross sectional, case control or cohort and other present
results support the widely held assumption that television plays a role in
childhood obesity, while underscoring the complex and multifactorial
nature of the
problem.
REFERENCES
1.
Braithwaite, I., Stewart, A. W., Hancox, R. J.,
Beasley, R., Murphy, R., & Mitchell, E. a. (2013). The Worldwide
Association between Television Viewing and Obesity in Children and Adolescents:
Cross Sectional Study. PLoS ONE, 8(9). http://doi.org/10.1371/journal.pone.0074263
2.
Lissner, L., Lanfer, A., Gwozdz, W., Olafsdottir, S.,
Eiben, G., Moreno, L. a., … Reisch, L. (2012). Television habits in relation to
overweight, diet and taste preferences in European children: The IDEFICS study.
European Journal of Epidemiology, 27(9), 705–715.
http://doi.org/10.1007/s10654-012-9718-2
3.
Al-Ghamdi, S. H. (2013). The association between
watching television and obesity in children of school-age in Saudi Arabia. Journal
of Family & Community Medicine, 20(2), 83–9.
http://doi.org/10.4103/2230-8229.114767
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