Obesity linked to inactivity

By KRISTI EATON

VIEW ON HEALTH

As the assortment of video games, computer games, television shows and movies marketed to kids continue to grow, so too do their waistlines.

No longer are kids coming home from school to play outside until dinner. Now, kids, some as young as toddlers, head straight to the Xbox and TV for hours on end, all the while forgoing basic activity and exercise.

In the past 30 years childhood obesity has tripled. In 1980, 6.5 percent of children ages 6 to 11 were obese. In 2008, the number increased to 19.6 percent. Likewise, it increased for adolescents during the same time period -- from 5 percent in 1980 to 18.1 percent in 2008, according to the Centers for Disease Control. Obesity is defined as having a Body Mass Index -- a measure comparing height and weight -- of 30 or higher. A healthy range is from 18.5 to 24.9. A BMI of 25 to 29.9 is considered overweight. In Nevada, 34.2 percent of kids aged 10 to 17 are overweight.

While maintaing a healthy weight is a complex issue and has many components, a sedentary lifestyle influenced by our increasing use of technology can play a large role in the expanding waistlines.

"Childhood obesity is clearly multi-factorial, but that's definitely part of it," said Anissa Gustafson, a registered dietician with Las Vegas' Children's Heart Center, about technology.

She added: "There are a lot of studies that show that too. Over the last two to three decades, video games and more accessibility to computers -- as all that increased -- childhood obesity increased."

A 2004 study showed a connection between sedentary activities such as playing video games and overweight children. Researchers from The Children's Hospital of Philadelphia and the University Hospital Zurich measured 872 children in first, second and third grades enrolled in 10 schools in northeastern Switzerland. The students were asked a variety of questions, including the television programs they regularly watched, the amount of time they spent playing electronic games, their breakfast consumption, if they watched television during meals, and if they snacked while watching television. The researchers discovered that children of foreign nationality living in Switzerland were about twice as likely to be obese as Swiss children. Non-Swiss children watched more television and had less physical activity.

Gustafson noted that The American Academy of Pediatrics recommends no more than one to two hours of screen time -- TV, computers or video games -- per day. In reality, though, she said most children get five or more hours per day.

"So that's a lot of sitting still," she said. "They're (TV, video games and computers) replacing the kids going outside being active. Less activity leads to gaining weight."

And the trend is starting at a younger and younger age. Gustafson said she sees toddler patients who are already watching too much television.

"It's definitely more a problem in the adolescent patient. But it's not unheard of for toddlers to watch two hours or more of TV a day," she said.

Starting the behaviors early mean children are becoming overweight and obese at an increasingly early age. A survey conducted earlier this year by the Nevada Institute for Children's Research and Policy at UNLV showed that 25 percent of kindergartners in the state are considered obese.

James Zervios, a spokesman for the Obesity Action Coalition, said it's not coincidence that obesity rates have increased during the the past decade; the same time when video game consoles like the Xbox and PS3 became widely available and popular.

And it's not just children who are impacted by technology, Zervios said. Adults are greatly affected as well.

"Look at the dichotomy of obesity and you see a trend even in the adult population with technology," he said. "You could pretty much stay home and get pretty much every single thing you need. You can shop online and you do everything you need to do without leaving the house."

For many children, technology has changed the way they communicate, which in turn changes the way they live. No longer do they play outside with friends. Instead, kids are spending their time on social networking sites.

"Now you have kids that can come home from school and, without parental involvement, can be on Facebook for five or six hours before the parents come home," Zervios said. "In the past, those hours may have been spent doing other things like going outside or riding the bicycle."

However, both Zervios and Gustafson believe technology can play a healthy role in a child's life, if used properly.

"Don't get me wrong. Technology is not some evil demon that has brought on obesity," Zervios said. "I think all around, individuals have become more reliant upon technology, and maybe its contributing to it. Technology doesn't get you up out of bed every morning and get you to work or get you to school. Maybe the alarm clock does. But at the end of the day, the person still has to engage technology in order for technology to have an effect on them. We have to go to technology. Technology doesn't come to us. We have to go to the computer and turn it on and go to Facebook and MySpace. We have to go to the video game console and turn it on. We have to go to the cell phone and use it."

He said technology can be a part of a child's everyday life if a parent chooses that.

"But it should definitely not be a part of all of what is considered an activity for a child," he said. "Maybe a portion of the evening they can play on the video console but the other part of the evening be outside playing with friends or getting more activity."

The video game industry was well aware of its bad wrap, and several years ago Nintendo created Wii Sports for its Wii game console. The games offered are tennis, baseball, bowling, golf and boxing. Nintendo also created Wii Fit, an exercise game.

Both are becoming more popular among children and adults alike, but Gustafson cautions against relying on them too much.

"Again, it comes down to parents kind of overseeing that as well," she said. "Parents may be getting the Wii for the kids with the intentions of 'oh it'll help them be active by playing the Wii Fit.' But are they also getting them the other Wii games that don't encourage physical activity? So you have to be careful with that."

"A lot of time people forget the simple stuff, like going outside and playing. I just think it's bad to rely on that for your physical activity," she added.

But since it looks like the popularity of video games will not be waning any time soon, researchers are looking into the effectiveness of games like Wii Sports on keeping kids active.

"We know if kids play video games that require movement, they burn more energy than they would while sitting and playing traditional screen games. That's pretty obvious even without our data," said Lorraine Lanningham-Foster, a Mayo Clinic obesity researcher who let a study in 2007 on the issue. "The point is that children very focused on screen games can be made healthier if activity is a required part of the game."

Lanningham-Foster and a group of scientists studied 25 children; fifteen children were of normal weight for their height and frame and 10 were mildly obese. The children were tested while sitting and watching TV, playing a traditional video game, playing two types of activity-required video games, and watching television while walking on a treadmill.

The results showed that when the children played one of the activity-required games, their energy expenditure, or calories, tripled compared to sitting and watching TV, or playing a traditional video game.

WHAT PARENTS CAN DO

Both Gustafson and Zervios said the solution to the obesity epidemic is simple: Exercise more and eat less, which means parents need to take an active role in monitoring how much screen time their kids get each day.

"Parents, the biggest thing is set boundaries and rules," said Gustafson. "When the two hours are up, we find something else to do."

She admitted that this can be hard for parents who work a lot and aren't always home with their kids.

"But it's kind of a matter of being more involved and realizing there are other things to do, like rec centers and YMCAs with swimming pools," she said, adding: "And parents need to do it with them; go to the center with them. As a parent, it's just taking an active role and finding other things for them to do."

But if parents don't take on an active role, the federal government might take their place. A bill introduced in Congress this month would require federal and state governments to track the Body Mass Index of children ages 2 to 18 in order to receive certain grant funds.

"Making the healthy choice the easy choice for our families is essential to ensuring our quality of life," said Rep. Ron Kind, one of the authors of the legislation. "Easier access to the tools and education to prevent and treat obesity; affordable, nutritious food to promote a balanced diet; and an increased emphasis on physical activity to maintain our overall health is critical to achieving a healthy lifestyle. I am pleased to work on legislation that helps provide the opportunities that meet the needs of busy American families."