TELEVISION VIEWING AND CHILDHOOD OBESITY
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HYPOTHESIZED MECHANISMS
Three potential mechanisms have been suggested to link television viewing and obesity:
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Reduced energy expenditure from television viewing displacing physical activity. Evidence for this displacement of physical activity has come from natural experiments documenting the initial introduction of television into small communities in Canada43 and Scotland,4 in which subsequent participation in physical activities decreased. Other epidemiologic studies among children and adolescents have been
EPIDEMIOLOGIC STUDIES
A substantial number of epidemiologic studies have examined the association between television viewing and childhood obesity. In general, these studies consistently have found relatively weak, positive associations.32 In the first of these studies, Dietz and Gortmaker9 examined data from more than 13,500 children and adolescents in the National Health Examination Surveys. They reported statistically significant associations between hours per day of watching television and prevalence of obesity.
EXPERIMENTAL STUDIES
Several experimental studies of reducing television viewing have been completed recently. Epstein et al now have performed two experimental studies of reducing sedentary behavior as part of an intensive, family-based weight loss program for obese children. In the initial study,15 61 families with obese 8- to 12-year-old children were randomized to treatments that targeted increased activity, decreased sedentary behaviors, or both, in addition to a comprehensive, family-based, dietary and
SUMMARY
Children spend a substantial portion of their lives watching television. Investigators have hypothesized that television viewing causes obesity by one or more of three mechanisms: (1) displacement of physical activity, (2) increased calorie consumption while watching or caused by the effects of advertising, and (3) reduced resting metabolism. The relationship between television viewing and obesity has been examined in a relatively large number of cross-sectional epidemiologic studies but few
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Address reprint requests to Thomas N. Robinson, MD, MPH Stanford Center for Research in Disease Prevention 1000 Welch Road Palo Alto, CA 94304 e-mail: [email protected]
This work was supported in part by grants from the National Heart, Lung, and Blood Institute, National Institutes of Health (R01 HL54102, R01 HL62224, U01 HL62663) and a Robert Wood Johnson Foundation Generalist Physician Faculty Scholar Award.
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Division of General Pediatrics and Stanford Center for Research in Disease Prevention, Stanford University, Stanford, California