Top Things to Know: Sedentary Behaviors in Today’s Youth: Approaches to the Prevention and Management of Childhood Obesity

Published: August 06, 2018

  1. This statement discusses sedentary behavior and its relationship to obesity and other cardiometabolic outcomes in youth. Adolescents are the most sedentary of pediatric populations and are engaged in the most total recreational screen-based media.
  2. The deleterious effect of sedentary behavior on cardiometabolic health is most notable for screen-based behavior and adiposity.
  3. Increasing trends of screen time are concerning; the portability of screen-based devices and abundant access to unlimited programming and online content may be leading to new patterns of consumption that are exposing youth to multiple pathways harmful to cardiometabolic health.
  4. Discussed in this paper are the implications for practice, research, and policy, what emerges is the importance of understanding the context in which sedentary behaviors occur. There is also a need to capture the nature of sedentary behavior more accurately, both quantitatively and qualitatively, especially with respect to recreational screen-based devices.
  5. School-aged children are sedentary for ≈8 of their daily waking hours on average; most are engaging in excessive screen time, which increases substantially with age, most notably during preadolescence. Where traditional television viewing has declined in the past 10 years, use of other screen-based devices for viewing television and other recreational content is on the rise, leading to overall net increases in screen time.
  6. Screen time is associated with adiposity and often persists after adjustment for diet and physical activity. Associations between screen time and adiposity are more consistently observed in cross-sectional than in longitudinal studies; associations between screen time and other cardiovascular risks have been observed infrequently. Objectively measured sedentary behavior generally is not associated with adiposity or with other cardiovascular risks.
  7. The effectiveness of interventions designed to reduce sedentary behavior appears to vary by weight status and appear to be more effective in younger school-aged children, possibly because of their reduced autonomy and control over their environment.
  8. School-based interventions that use screen-based technology can reduce overall screen time. Effective strategies to reduce sedentary behavior include structural changes to the environment, the involvement of family, and the use of electronic television monitoring devices. Removing televisions and other recreational screen-based devices from bedrooms and during meal time supports limiting screen time.
  9. Parents/guardians should be supported to devise and enforce appropriate screen time regulations and to model healthy screen-based behaviors.
  10. Effective strategies to limit screen time include structural changes to the environment, the involvement of family, and the use of electronic television monitoring devices as well as removing televisions and other recreational screen-based devices from bedrooms and during meal time. It is important for parents to monitor screen time in children and youth in order to prevent obesity and other cardiometabolic effects of a sedentary lifestyle.

Citation


Barnett TA, Kelly AS, Young DR, Perry CK, Pratt CA, Edwards NM, Rao G, Vos MB; on behalf of the American Heart Association Obesity Committee of the Council on Lifestyle and Cardiometabolic Health; Council on Lifelong Congenital Heart Disease and Heart Health in the Young; and Stroke Council. Sedentary behaviors in today’s youth: approaches to the prevention and management of childhood obesity: a scientific statement from the American Heart Association [published online ahead of print August 6, 2018]. Circulation. DOI: 10.1161/CIR.0000000000000591.