Kids TV health warning?

Kids channels strive to have a positive impact on the lives of their young viewers, but new research suggests that too much viewing can have a detrimental effect on their health. Medical writer Joanna Lyford speaks to experts in the field.

New studies from North America and Europe cast light on the impact on children’s health of electronic media

Link between having TV in the bedroom and weight gain

No evidence-based UK guidelines for ‘safe’ viewing times

American Academy of Pediatrics recommends an upper limit of two hours per day, with no TV for children under two

4- to 15-year-olds spends 2hrs 23 minutes a day watching TV

Judicious use of interactive media considered acceptable for children aged under two, up to a limit of one hour a day

Children’s use of electronic media can have a detrimental impact on their physical health and psychological wellbeing, according to a series of articles published in medical journal JAMA Pediatrics last month.

Key findings from the studies include a negative impact of TV viewing time on children’s sleep duration, an association between electronic media use and emotional problems, and a link between having a TV in the bedroom and weight gain. The research adds to growing evidence of harm associated with excessive TV and electronic media use by children, according to Paediatrician Dr Robert Scott-Jupp, from the Royal College of Paediatrics and Child Health.

“At present there is no UK-wide guideline for what constitutes a ‘safe’ amount of screen time, and any such limit would be arbitrary rather than evidence-based” Dr Robert Scott-Jupp, Royal College of Paediatrics and Child Health

“While the studies do not prove ‘cause-and-effect’ they nevertheless support a general policy of restricting access to TV and other media devices among young children,” Dr Scott-Jupp says. “At present there is no UK-wide guideline for what constitutes a ‘safe’ amount of screen time, and any such limit would be arbitrary rather than evidence-based.”

Any attempt to limit screen time among children could be a challenge. According to TV Licensing’s recently published TeleScope 2014 report into UK viewing habits, 4- to 15-year-olds spent two hours 23 minutes a day watching TV on average. Furthermore, more than half of children in the survey had a TV in their bedroom.

One of the studies in JAMA Pediatrics looked specifically at the health impact of bedroom TVs among US boys and girls aged 10-14 years. Having a TV in the bedroom per se – rather than the amount of TV viewing time – was associated with excess weight gain among the children. The authors speculate that the association could be due to disrupted sleep patterns or greater exposure to child-targeted food advertising. “Removing bedroom televisions may be an important step in our nation’s fight against child obesity,” they conclude.

“Removing bedroom televisions may be an important step in our nation’s fight against child obesity” JAMA Pediatrics

Another study, also conducted in the US, found that the extent to which mothers – but not fathers – monitored their children’s electronic media use was strongly associated with the child’s weight at age seven. The researchers suggest that interventions “aimed at parental supervision and control of child media exposure may promote healthy child weight development during middle childhood.”

Another of the studies examined TV viewing time among Spanish children aged 2-9 years. It found an inverse relationship between TV time and sleep time, such that the more TV a child watched at a given age, the less he or she tended to sleep two or three years later. The researchers conclude that parents “should consider avoiding long periods of daily television exposure among preschool and school-aged children.”

Professor Kevin Fenton, national director of Health and Wellbeing at Public Health England, says that there are well-established links between everyday behaviours and children’s wellbeing. “The amount of time children spend looking at screens including TVs is important: increased screen time is associated with attention difficulties, increased feelings of loneliness, emotional distress, anxiety and depression,” he says.

“Increased screen time is associated with attention difficulties, increased feelings of loneliness, emotional distress, anxiety and depression,” professor Kevin Fenton, national director of Health and Wellbeing at Public Health England

A large European study examined the emotional consequences of excessive screen time in very young children. Use of electronic media at age 2-6 years was associated with poorer wellbeing two years later. TV seemed to be worse than electronic games or computers, and the risks of emotional problems and poor family functioning increased for each additional hour the children spent using electronic media.

Linda Pagani, Professor of Psychoeducation at the University of Montreal, Quebec, Canada, says: “Between 0 and 5, children’s brains best learn by contact with humans, and excessive screen time, especially passive TV watching, creates a time debt that generates deficits in teachable moments for social interaction skill-building. These deficits could later translate into emotional distress.”

While the UK does not have any national guidelines on screen time for children, in the US, the American Academy of Pediatrics (AAP) recommends an upper limit of two hours per day, with no TV whatsoever for children under two years old. However, this advice is questioned by an AAP advisory panel member, Dimitri Christakis, a physician and associate editor of JAMA Pediatrics.

Judicious use of interactive media is acceptable for children aged under two, up to a limit of 30 minutes to one hour a day, Dimitri Christakis, associate editor of JAMA Pediatrics

Dr Christakis notes that touch-screen devices – although not TV – share many attributes with traditional children’s toys, such as reactivity and portability, while offering additional features such as interactivity. On this basis, he argues that “judicious” use of interactive media is acceptable for children aged under two, up to a limit of 30 minutes to one hour a day; “admittedly, an arbitrary number.”