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TV Linked to Kids' Eating Problems

U.K. Imposes Strict New Standards; U.S. Takes Hands-Off Attitude

February 28, 2007

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The more a 3-year-old watches television, the more he or she consumes sugary drinks and extra calories, Harvard researchers said at the American Heart Association's 47th Annual Conference on Cardiovascular Disease Epidemiology and Prevention.

"For every one-hour increase in TV viewing per day, we found higher intakes of sugar-sweetened beverages including juice (one extra serving per week) and total calories (46.3 more kcal/day)," said Sonia Miller, B.A., lead author of the study and a student at the Harvard Medical School.

Meanwhile, in the United Kingdom, television ads for foods high in fat, salt, or sugar will be reduced by up to 50 percent on programs viewed by children under 16 under tough new regulations promulgated by Ofcom, that country's quasi-governmental telecommunications regulator.

Consumer advocates say the British rules are "far superior" to those in the U.S., where regulators have largely taken a hands-off approach.

In the Harvard study, Miller and her colleagues based their research on questionnaires from mothers of 1,203 children enrolled at birth in Project Viva, a study of childhood nutrition in Massachusetts funded by the National Institutes of Health.

Just as more TV watching was associated with increased intakes of less healthful foods and nutrients, the researchers said it was also associated with decreased intakes of more healthful foods and nutrients, including fruits and vegetables, calcium and dietary fiber.

"Although 46 calories a day doesn't sound like much, it can make a difference in weight over time," said Matthew Gillman, M.D., S.M., senior author and associate professor of ambulatory care and prevention and director of the Obesity Prevention Program for Harvard Medical School and Harvard Pilgrim Health Care.

"Studies estimate that you can explain the amount of excess weight gain in the U.S. adolescent population over the past 10 years or so with the addition of only 150 calories a day. If this "energy gap" also applies to younger children, then each hour of daily TV or video watching could explain about 1/3 of that increase," Gillman said.

This study shows that poor dietary habits -- both more adverse practices and fewer healthy ones such as fruit and vegetable intake -- are associated with increased TV or video viewing, patterns associated with obesity and cardiovascular problems, he said.

Furthermore, these trends were found after researchers controlled for possible confounders such as maternal sociodemographic factors and parental body mass index (a measure of degree of overweight). Of the 1,203 children, 87 percent came from families with incomes greater than $40,000/year and 72 percent of their mothers had at least a college degree, researchers said.

The average amount of TV/video viewing for the group was 1.7 hours per day, so most children in this study were in line with the American Academy of Pediatrics recommendation of zero hours of screen time up until age 2 and no more than two hours per day after age 2.

"We don't really know from this observational study whether kids are substituting unhealthful foods for the more healthful ones. All we can say is that we see a pattern of less healthful foods and nutrients with increased TV use," Gillman said.

Children can get a lot of physical activity even if they watch a lot of TV or get little physical activity even if they watch little TV. So most people think the strong relationship between TV viewing and overweight is due to the eating side of the obesity equation rather than the exercise side, Gillman said.

That equation is energy in (calories from food) minus energy out (calories burned from exercise). After taking into account what kids need to grow, if the energy in exceeds the energy out, excess weight gain results.

"TV seems to affect the 'energy in' side," Gillman said. "Whether it is due to kids snacking in front of the TV or the advertisements causing kids to eat more of the food that's advertised, we don't know.

"The most important thing to note is that the obesity epidemic in this country involves not just adults, not just adolescents, not just school-age children, but all the way down to infants. No age groups are spared. And once a child is obese, it is very hard to treat. So obesity prevention is the way to go."

The American Heart Association recommends children limit sedentary behaviors, with no more than 1 to 2 hours per day of video screen/television and no television sets in children's bedrooms and encourages 60 minutes of moderate-to-vigorous play or physical activity daily.

British Crackdown

In the U.K., consumer groups say they will press the British parliament to enact even tighter TV standards, while in the U.S., the nonprofit Center for Science in the Public Interest (CSPI) urged multinational food companies to behave at least as well in the U.S. as they'll soon be required to behave in the U.K.

"The new British regulations are far superior to the situation here, where the Federal Trade Commission continues to support a failed self-regulatory system," said CSPI legal affairs director Bruce Silverglade. "If food companies and the advertising industry can survive under the new British standards, they could certainly survive under similarly tough standards in the United States."

In the U.S., the industry-funded Children's Advertising Review Unit enforces a set of narrow technical guidelines, which unlike the new British rules, do not consider the nutritional quality of foods.

Notably, CARU's web site emphasizes that it works to preserve advertisers' "freedom to direct their messages to young children." Similarly, the National Advertising Review Council, CARU's parent organization, states that its top goal is to "minimize governmental involvement in the advertising business."

The Council of Better Business Bureaus, which oversees both organizations, is promoting a new initiative that merely requires food companies to pledge that 50 percent of their ads contain a message encouraging healthy diets or physical activity.

Since the Federal Trade Commission has indicated it won't restrict food advertising on children's television, CSPI has threatened litigation to protect kids from junk-food ads. Last year, CSPI, the Campaign for a Commercial-Free Childhood, and two Massachusetts parents announced that they might sue Kellogg and Viacom, owner of the kid-friendly Nickelodeon network, over their marketing practices.

The potential plaintiffs are in negotiations with Kellogg, but not Viacom. Litigation is likely if agreeable settlements with one or both parties are not reached.

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