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Time for a view on screen time

  • Dr Aric Sigman


In Britain today, children by the age of 10 years have regular access to an average of five different screens at home. In addition to the main family television, for example, many very young children have their own bedroom TV along with portable handheld computer game consoles (eg, Nintendo, Playstation, Xbox), smartphone with games, internet and video, a family computer and a laptop and/or a tablet computer (eg, iPad). Children routinely engage in two or more forms of screen viewing at the same time, such as TV and laptop.1 Viewing is starting earlier in life. Nearly one in three American infants has a TV in their bedroom, and almost half of all infants watch TV or DVDs for nearly 2 h/day.2 Across the industrialised world, watching screen media is the main pastime of children. Over the course of childhood, children spend more time watching TV than they spend in school.3 When including computer games, internet and DVDs, by the age of seven years, a child born today will have spent one full year of 24 h days watching screen media. By the age of 18 years, the average European child will have spent 3 years of 24 h days watching screen media; at this rate, by the age of 80 years, they will have spent 17.6 years4 glued to media screens. Yet, irrespective of the content or educational value of what is being viewed, the sheer amount of average daily screen time (ST) during discretionary hours after school is increasingly being considered an independent risk factor for disease, and is recognised as such by other governments and medical bodies but not, however, in Britain or in most of the EU. To date, views of the British and European medical establishments on increasingly high levels of child ST remain conspicuous …
Time for a view on screen time
Aric Sigman
In Britain today, children by
the age of 10 years have
regular access to an average of
ve different screens at home.
In addition to the main family
television, for example, many very young
children have their own bedroom TV
along with portable handheld computer
game consoles (eg, Nintendo, Playstation,
Xbox), smartphone with games, internet
and video, a family computer and a
laptop and/or a tablet computer (eg,
iPad). Children routinely engage in two
or more forms of screen viewing at the
same time, such as TV and laptop.
Viewing is starting earlier in life. Nearly
one in three American infants has a TV
in their bedroom, and almost half of all
infants watch TV or DVDs for nearly
2 h/day.
Across the industrialised world, watch-
ing screen media is the main pastime of
children. Over the course of childhood,
children spend more time watching TV
than they spend in school.
When includ-
ing computer games, internet and DVDs,
by the age of seven years, a child born
today will have spent one full year of
24 h days watching screen media. By the
age of 18 years, the average European
child will have spent 3 years of 24 h days
watching screen media; at this rate, by
the age of 80 years, they will have spent
17.6 years
glued to media screens.
Yet, irrespective of the content or edu-
cational value of what is being viewed,
the sheer amount of average daily screen
time (ST) during discretionary hours
after school is increasingly being consid-
ered an independent risk factor for
disease, and is recognised as such by
other governments and medical bodies
but not, however, in Britain or in most of
the EU. To date, views of the British and
European medical establishments on
increasingly high levels of child ST
remain conspicuous by their absence.
This paper will highlight the dramatic
increase in the time children today spend
watching screen media. It will provide a
brief overview of some specic health
and well-being concerns of current
viewing levels, explain why screen
viewing is distinct from other forms of
sedentary behaviour, and point to the
potential public health benets of a
reduction in ST. It is proposed that
Britain and Europes medical establish-
ments now offer guidance on the average
number of hours per day children spend
viewing screen media, and the age at
which they start.
Children of all ages today, are watching
more screen media than ever before.
Excluding any viewing time outside the
home, such as hand-held screen activities,
the average ST in the home for young
British adolescents is 6.1 h/day, and this
is rising signicantly.
Canadian children
spend 7.8 h/day, and American children
7.5 h: 55% of their waking lives.
ongoing EU ToyBox study group has just
reported, In general, parents had no
formal rules about TV viewing
Remarkably, in most countries, parents of
a low SES had almost no rules regarding
watching TV. Children can watch TV all
day long or whenever they want.
However, ST is no longer merely a cul-
tural issue about how children spend
their leisure time, nor is it conned to
concern over the appropriate/inappropri-
ate content of what is on the screen. It
has become a medical issue, often exhi-
biting a dose-response relationship with
disease risk.
The US Department of Health and
Human Services now cites reducing STas
one of its key health improvement prior-
itiesin achieving its national 10-year
health promotion and disease prevention
objective:to increase the proportion of chil-
dren aged 0 to 2 years who view no television
or videos on an average weekday, and increase
the proportion of children and adolescents
aged 2 years through 12th grade [18 years]
who view television, videos, or play video
games for no more than 2 hours a day.
Australian Department of Health and
Ageing has issued similar guidelines, as
has the American Academy of Pediatrics
(AAP), adding: mediaboth foreground
and backgroundhave potentially nega-
tive effects and no known positive effects
for children younger than 2 years.
11 12
The Canadian Paediatric Society has gone
further, No child should be allowed to
have a television, computer or video game
equipment in his or her bedroom.
French Government prohibits French
channels from airing all TV programmes
educational and otherwiseaimed at
children under 3 years of age.
What is the basis for this concern?
Numerous well designed prospective
cohort studies continue to nd a highly
signicant dose-response association
between ST and risk of type 2 diabetes,
cardiovascular disease (CVD) and all-
cause mortality among adults, with ST
identied as an independent risk factor
with biological plausibility.
Wijndaele et al
recently reported
that every 1 h/day increase in television
viewing was associated with a 6%
increased hazard for total fatal or non-
fatal CVD, and an 8% increased hazard
for coronary heart disease, independent
of gender, age, education, smoking,
alcohol, medication, diabetes status, CVD
family history, sleep duration and phys-
ical activity energy expenditure.
At the same time, others report that
for participants engaging in 4 h/day of
recreational ST (eg, TV, computers) rela-
tive to <2 h/day, there was a 48%
increased hazard for all-cause mortality,
and a 125% increased hazard for CVD
events of which 25% was explained by
cardiometabolic biomarkers.
In children and adults, ST has also
been found to have an unfavourable
dose-response association with a range of
biomarkers for CVD, type 2 diabetes and
metabolic syndrome (MetS) including
LDL/HDL/total cholesterol, triglyceride,
brinogen, systolic/diastolic blood pres-
sure (BP) and C-reactive protein.
16 19
Examining television/DVD/video and
computer use and metabolic risk, Hardy
et al
found that adolescent boys who
exceed 2 h/day of STwere more than twice
as likely to have abnormal levels of insulin
and homeostatic model assessment of
insulin resistance (HOMA-IR), suggesting
an increased risk of insulin resistance.
Another study involving 1318.5-year-olds
in ve Spanish cities found those watching
more than 3 h of TV per day had signi-
cantly less favourable levelsof HDL-
cholesterol, glucose, apolipoprotein A1 and
overall CVD risk scores.
Nevertheless, the association between ST
and health risk appears not as simple as
ST merely being a sedentary behaviour.
First, sedentary behaviour as a risk factor
Correspondence to Dr A Sigman, Ofce 444, 91
Western Road, Brighton BN1 2NW, UK; aric@
Arch Dis Child Month 2012 Vol 0 No 0 1
Leading article
is distinct from too little moderate-to-
vigorous physical activity (MVPA) in all
age groups, with the two possibly being
separate constructs involving different
metabolic pathways contributing to
19 20 22 23
Prolonged ST elevates
health risk independent of the level of
MVPA people routinely engage in.
recent analysis of the ongoing US
National Institutes of Health Diet and
Health Study observed that even among
people with high levels of MVPA, high
amounts of television viewing remain
associated with a 47% increased risk for
all-cause, and a 100% increased risk for
cardiovascular mortality.
Another study
of body composition and abdominal
obesity in children across 10 European
cities has recently concluded that phys-
ical activity does not attenuate the
obesity risk associated with ST.
Moreover, childrens ST may be some-
what distinct from other forms of seden-
tary behaviour in its inuence on
biological risk factors for disease.
23 25 26
For example, examining a range of seden-
tary behaviours, screen activities and BP
in young adolescents, Gopinath et al
reported a dose-response relationship,
each hour per day spent in screen time,
watching TV and playing video games
was associated with a signicant increase
in diastolic BP of 0.44 ( p=0.0001), 0.99
(p<0.0001) and 0.64 mm Hg ( p=0.04),
respectively. By contrast, each hour per
day spent reading was associated with a
decrease…’ In prepubertal children, TV
viewing and total ST, but not computer
use, have been found to be positively
associated with both systolic and dia-
stolic BP, while painting or sitting were
Additionally, different screen activ-
ities may have differing independent
associations with biomarkers and chronic
disease risk in youth.
23 26 27
A cross-sectional study of a large
sample of overweight and obese adoles-
cents concluded that time spent playing
seated video games was the only type of
ST associated with increased BP and total
cholesterol/HDL ratio.
Carson and
Janssen found in a representative popula-
tion of 619-year-olds that time spent
watching TV was predictive of a higher
score of an aggregated or clustered
measure of cardio-metabolic risk, but rec-
reational computer time was not.
in prepubertal children, Martinez-Gomez
et al
found that TV viewing but not
computer time was associated with
increased BP.
Studies of HPA stress-regulation and ST
shed further light on underlying mechan-
isms. Wallenius et al
found school-aged
children who had used Information and
Communication Technology (ICT) equip-
ment for an average of 3 h the preceding
day (only half the UK child norm)
showed a signicantly reduced cortisol
increase 1 h after waking compared with
children who had not used ICT at all, or
for less than 1 h. The results suggest a stress
response as a consequence of a long period of
ICTuse[which] can persist over night and
have an impact on the regulation of
HPA-activity even the next morning.They
suggest that child ST day after day may
predispose some adolescents to the devel-
opment of allostatic load.There is
already concern that even HPA changes
within the normal range may be subtle
early indicators of, and contributors to,
unfavourable physical health outcomes in
adolescence and adulthood.
The educational value of screen mater-
ial being viewed does not preclude the
signicant associations reported above
between ST and morbidity, mortality and
associated biomarkers.
Increased TV viewing has been consist-
ently shown to be linked to increased
body mass index (BMI) in both children
and adults independent of physical activ-
22 29
The association appears stronger
in young children. A cross-sectional study
assessing fat mass by Jackson et al
found a dose-response relationship: Each
extra hour of watching TV was asso-
ciated with an extra 1 kg of body fat
Preschool children who watch more TV
are fatter and are less active the rela-
tion between TV viewing and fatness is
not mediated by physical activity…’.
ST is clearly associated with unhealthy
dietary behaviours in children, adoles-
cents and adults.
However, in addition
to the inuence of food advertising,
studies of childrens ingestive behaviour
in direct response to screen viewing
suggest it can act as a distraction away
from vital satiation food cues toward
non-food cues (screen), thereby disrupt-
ing the development of habituation to
food and, therefore, increasing energy
intake while children are viewing.
Eating a meal while viewing screens is
also thought to disrupt the encoding and
memory formation of the meal. Impaired
memory for recent eating may increase
food intake hours after viewing stops. A
study in the journal Appetite found that
the effects of television watching on
food intake extend beyond the time of
television watching to affect subsequent
In a randomised crossover study, video
game playing was found to signicantly
increase food intake in adolescents imme-
diately after playing and was not com-
pensated for during the rest of the day.
One hour of playing a video game
resulted in a daily energy surplus of
163 kcal, a rate of 60 000 kcal/year, which
could help manufacture almost 8 kg of
body fat per year.
All these effects are taking place at a
time in our history when 68% of dinners
in the UK are eaten while watching
Interestingly, a randomised controlled
clinical intervention trial divided 4
7-year-olds into two groups: one had its
TV and computer viewing reduced by
half; the other did not. After 3 years,
there had been a signicant reduction in
the BMI of those who had halved their
screen viewing, and relatively little in
those who had not.
The above ndings may have signi-
cant public health implications. Children
912 years with a high BMI are more
likely to have high BP, cholesterol and
blood insulin levels by adolescence.
Even marginally elevated BMI in adoles-
cence constitutes a substantial risk factor
for early occurrence of angiography-
proven coronary heart disease.
The EU
ToyBox study has in its Evidence-based
recommendations for the development of
obesity prevention programs targeted
at preschool childrenjust called for
Limitation of leisure screen time to
<1 h/d (or the amount of time recom-
mended by appropriate national guide-
lines, if less than 1 h/d).
ST is associated in a dose-response
manner with subsequent attention pro-
blems in a variety of age groups. A longi-
tudinal study of 2623 children reported
that children who watched television at
ages 1 and 3 years had a signicantly
increased risk of developing attentional
problems by the time they were 7 years
old. For every hour of television a child
watched per day, there was a 9% increase
in subsequent attentional problems con-
sistent with a diagnosis of ADHD.
A longer-term dose-response association
has been found between television
viewing at the ages of 5 and 11 years,
and subsequent attention problems in
adolescence independent of early atten-
tion problems and other confounders.
Similar associations have been reported
in 1422-year-olds, and in a study of
824-year-olds, Swing et al concluded,
Viewing television and playing video
2Arch Dis Child Month 2012 Vol 0 No 0
Leading article
games each are associated with increased
subsequent attention problems in child-
hoodlate adolescence and early
40 41
In addition to ST, screen speed’—the
pace of editing and degree of novelty
within screen materialis increasingly
thought to be an important factor in the
above ndings. Lillard and Peterson
found that 9 minutes of viewing a
popular fast-paced fantastical television
show immediately impaired 4-year-olds
EF [executive function], a result about
which parents of young children should
be aware.
Dopamine is central to the ability to
pay attention and implicated in attention
problems. It is produced in response to
screen novelty. Signicant dopamine
release within the striatum is found to
occur quickly in young adult brains while
playing computer games.
43 44
is also a key component of the brains
reward system, and is heavily implicated
in the formation and maintenance of
addictions. There are growing concerns
that extensive computer game playing
may lead to long-term changes in the
reward circuitry that resemble the effects
of substance dependence.
In addition to
computer games, screen viewing by
youngsters begets more viewing and,
unlike other sedentary behaviours, most
of the criteria of substance dependence
apply to people with higher levels of
Screen addiction, once a populist
catch phrase, is increasingly being used
by physicians to describe the growing
number of children engaging in screen
activities in a dependent manner.
ST is strongly associated with measures
of child mental well-being.
has recently published a report on The
Impact of Social Media on Children,
Adolescents and Families, which contains
a section entitled Facebook Depression,
which is dened as depression that devel-
ops when preteens and teens spend a
great deal of time on social media sites,
such as Facebook, and then begin to
exhibit classic symptoms of depression.
A British study found that children who
spent more than 2 h/day watching televi-
sion or using a computer were at [60%]
increased risk of high levels of psycho-
logical difculties and this risk increased
if the children also failed to meet physical
activity guidelines. Both television
viewing and computer use are important
independent targets for intervention for
optimal well-being for children, irrespect-
ive of levels of moderate/vigorous
physical activity (MVPA) or overall sed-
entary time.
A cross-sectional analysis
of 910-year-old girls found ST to be
negatively associated with self-esteem.
A survey of 3461 North American girls
aged 812 years found a signicant asso-
ciation between STas well as measures of
media multitasking, and negative psycho-
social well-being.
Conversely, face-to-face communica-
tion was strongly associated with posi-
tive psychosocial well-being.
A study of
Japanese children aged 514 years reports
ST had a strong association with negative
feeling upon awakening and recommends
guidelines for child ST as a preventive
Adjusting for pre-existing individual
and family factors, a prospective longitu-
dinal study of 1314 Canadian children
found signicant negative associations
between ST at 29 and 53 months of age,
and psychosocial well-being at age
10 years. Each 1 h increase in early child-
hood exposure corresponded to a 7% unit
decrease in classroom engagement and
10% unit increase in victimisation in
middle childhood. Researchers reported
Higher levels of early childhood televi-
sion exposure predicted greater chances of
peer rejection experiences such as being
teased, assaulted, or insulted by other
students our results suggest that
reduced time for critical social interac-
tions in early childhood owing to dis-
placed time spent watching television
may present later specic risks of devel-
oping inadequate social skills.
In understanding the above associa-
tions, several mechanisms have been pro-
posed. Humans require a certain amount
of co-presence’—regular eye-to-eye
contact for optimal physical and mental
Moreover, the fundamental
ability to relate to others is dependent on
social and emotional skills that are learnt
through regular social interaction.
Face-to-face conversations confer linguis-
tic skills, along with the ability to have
conversationsto know when and how
to listen and contribute. This learning
process is highly technical and time con-
For example, during
face-to-face interaction, in addition to
hearing a voice and accompanying facial
expressions of the speakers face, the
speech sounds produce tiny bursts of
aspirationair pressure which hit the
childs skintactile information contrib-
uting to auditory perception.
Neurobiology of socialisation
The development of empathy and com-
passion requiring subtle skills of reading
the nonverbal nuances of othersemo-
tions involve similar learning processes
which appear to have a neural basis. For
example, the insular cortex has been iden-
tied as a key brain mechanism involved
in experiencing the emotional states of
others and is thought to underlie egalitar-
ian behaviour in humans.
empathy for a friends emotional suffer-
ing activates affective pain regions (dorsal
anterior cingulate cortex (dACC) and
insula) associated with having rsthand
experience of the same suffering.
learning effects of routinely experiencing
such social emotions are reected neuro-
logically. The deliberate cultivation of
compassionthrough compassion train-
ingfor empathic responses are associated
with changes in functional
At the same time, researchers conduct-
ing functional magnetic resonance
imaging (fMRI) research have expressed
concern that when using the internet, for
example, the areas of the brain associated
with empathy showed virtually no
increase in stimulation, concluding
Young people are growing up immersed
in this technology and their brains are
more malleable, more plastic and chan-
ging than with older brains As the
brain evolves and shifts its focus towards
new technological skills, it drifts away
from fundamental social skills.
59 60
Mirror neurons
A childs brain is also believed to have
multiple mirror neuron systems that spe-
cialise in carrying out and understanding
not just the actions of others, but their
intentionsthe social meaning of their
behaviour and their emotions.
People who rank high on a scale meas-
uring empathy have particularly active
mirror neuron systems. A study of the
brain activity of 10-year-olds who
observed and imitated emotional expres-
sions and social skills found a direct rela-
tionship between the level of activity in
the childrens mirror neuron systems and
two distinct indicators of social func-
tioning in typically developing children:
empathy and social skills. The authors
concluded that the importance of observ-
ing and copying everyday social beha-
viours and the mirror neuron system
may indeed be relevant to social func-
tioning in everyday life during typical
human development.
It may be that children must exercise
specic brain areas and systems regularly
and extensively in situ, in order to
develop crucial social and emotional skills
or decits will emerge later.
Arch Dis Child Month 2012 Vol 0 No 0 3
Leading article
A meta-analysis of 72 studies on
empathy conducted between 1979 and
2009 among almost 14 000 university
students found the biggest drop in
empathy after the year 2000. College kids
today are about 40 per cent lower in
empathy than their counterparts of 20 or
thirty years ago, as measured by standard
tests of this personality trait.The
authors believe that the sheer increase in
child and adolescent ST during this time
could be one very important factor, and
concluded that the rise of social media
may also play a role in the decline in
empathy: The ease of having friends
online might make people more likely to
just tune out when they dont feel like
responding to othersproblems, a behav-
iour that could carry over ofine.They
also believe electronic media has contrib-
uted to a social environment that works
against slowing down and listening to
someone who requires sympathy.
Returning to the potential role of ST
in psychosocial learning, it is known that
younger children experience considerable
difculty when translating to real life
what they see on a screen. Children learn
tasks better from a live demonstration
than from an equivalent televised demon-
stration, a problem referred to as the video
This effect becomes more pro-
nounced and may persist at older ages as
the task complexity increasesand psy-
chosocial tasks, such as perceiving and
interpreting others actions, emotions
and intentions are highly complex.
Regarding the daily time available for
children to learn psychosocial skills
through face-to-face interactions, studies
at Stanford University have led to a dis-
placementtheory of internet use:
In short, no matter how time online is
measured and no matter which type of
social activity is considered, time spent
on the Internet reduces time spent in
face-to-face relationshipsan hour on
the Internet reduces face-to-face time
with family by close to twenty-
four minutes.
Sigman reported that between 1987
and 2007 the number of hours per day of
face-to-face social interaction declined
markedly as the use of electronic media
has increased.
There is good evidence that childrensST
can be reduced through simple measures,
mainly raising parental awareness. A sys-
tematic review by researchers at Harvard
Medical School recently reported that 29
studies achieved signicant reductions in
TV viewing or screen-media use.
Research by the Centers for Disease
Control and Prevention (CDC), along
with other studies, has found parental
rules and limits on ST effectively reduce
ST, as does not having screens in bed-
67 68
The CDC study also found a
negative dose-response relationship
between weekly physical activity and the
risk of exceeding recommended ST limits,
recommending the promotion of physical
activity as an additional means of redu-
cing ST.
Role modelling is another important
factor. Parent and child levels of screen
viewing are strongly related: children
who live in a household that promotes
TV-watching (TV is on when the child
comes home from school, and meals are
eaten in front of the TV) are more likely
to watch excessive amounts of television
themselves. If parents watch television
for more than 4 h/day, their son and
daughter, respectively, will be 10.5 and
three times more likely to watch it for
more than 4 h/day too.
The associations between ST and health
risks are reported to occur generally
beyond exposure of 2 h/day. Yet the
average child is exposed to three times
this amount. Therefore, reducing total
daily ST for children, and delaying the
age at which they start, could provide sig-
nicant advantages for their health and
well-being. Although popular phrases
such as striking a balanceor everything
in moderationmay sound reassuringly
sensible, one of the main obstacles in
encouraging parents to reduce their chil-
drens ST is the vagueness of the terms
moderationand excessive.
Paediatricians must now dene these
terms by rst considering ST as simply
another form of consumption measured
in units of hours/minutes consumed per
day: a simple public health concept to
grasp and act upon. Considering the
existing empirical research and position
of medical bodies and governments in
other countries, the following guidance
on recreational ST (eg, before and after
school) are only ideals for parents. Even
if they are not adhered to, it is important
to establish such ideals as a reference
point to work from.
Eighty per cent of adult brain size
growth occurs during a childsrst
3 years, when they may be most vul-
nerable to the effects of screen media.
There should be a buffer zone in the
early years, whereby this stage of child
development is cordoned offfrom
premature exposure to screen media.
Screen viewing should be delayed, or
minimised, until age 3 years.
Encourage no screens in childrens
Parents of younger children should be
advised to choose screen material with
a slower pace, less novelty and more
of a single narrative quality.
Parents should be encouraged to
monitor and control the time their
children spend on hand-held computer
Ideal discretionary ST limits are:
37 years: 0.51 h/day
712 years: 1 h
1215 years: 1.5 h
16+ years: 2 h
Parents must take into consideration
how much time their children are spend-
ing doing homework on computers
before coming to a decision on discretion-
ary ST for their child.
Parents should be aware of the role-
modelling inuence their own viewing
habits may have on their children
along with the potential inuence of
background or passivemedia.
Information about infants and tod-
dlers watching screens should be
included within maternity ward birth
packsgiven to mothers.
Health visitors should be aware of
medical evidence and advise new
Nurseries and day care centres should
make parents aware of this issue, as is
the case in Belgium and France.
Schools should adopt a position on
the amount of time children spend in
front of a screen in and out of school
and communicate this to pupils and
The study of STas a public health subject
is relatively new, and the associations
between ST and health risk cited in the
observational studies above do not prove
direct causation. While it is not possible
within the connes of this paper to
describe and compare the design and inde-
pendent variables, including the demo-
graphic prole of each study, others are
beginning to do so. For example, a
meta-analysis of relevant studies, includ-
ing some of the above, involving
European, US and Australian populations
on ST and risk of Type 2 Diabetes, CVD
and all-cause mortality carried out at the
Harvard School of Public Health, included
large sample sizes, long durations of
follow-up, and well established prospect-
ive studies. In addition, their pooled
4Arch Dis Child Month 2012 Vol 0 No 0
Leading article
estimates were based on prospective ana-
lyses with detailed adjustment for a wide
range of confounding variables. After
adjusting for BMI or other obesity mea-
sures and dietary variables, the associa-
tions with health risk still remained
highly signicant.
The various studies nding associations
between ST and subsequent attention
problems were predominantly prospective
and controlled for relevant confounding
variables including pre-existing attention
Several of the above
studies on STand psychosocial well-being
used cross-sectional designs, making it
more difcult to determine whether
higher levels of ST were associated with
the development of negative well-being,
or negative well-being preceded higher
levels of ST.
For example, whether
children with psychological difculties,
such as extreme shyness, are more likely
to gravitate towards ST over more soci-
able activities.
However, the prospective longitudinal
Canadian study controlling for pre-
existing psychosocial problems found sig-
nicant associations with ST.
There are additional concerns not
addressed above, regarding safeguarding
children from online exploitation and
exposure to inappropriate material. There
are also emerging concerns about the
potential effect of 3D screens on the
development of the childs stereoscopic
vision and depth perception through pos-
sible alterations in the development of
the fusion centerof the brain.
Interestingly, in their Nintendo 3DS
ParentsInformation, 3D Concerns,
Nintendo of America states, children 6
and under should not use the 3D feature
of the Nintendo 3DS system.
The simple arithmetic of hours of
eye-to-screen contact versus eye-to-eye
contact are making clear the profound
implications of such extensive ST for
family and social relationships. In 2007,
when children had access to far fewer
screens, a large-scale study by Britains
Childrens Society found that television
alone was already displacing the parental
role, eclipsing by a factor of ve or ten
the time parents spend actively engaging
with children.
An ongoing study of families in situ by
the University of CaliforniaLos Angeles
has found that social disengagement is
rapidly increasing, as side-by-side and
eye-to-eye human interactions in the
home are being displaced by the
eye-to-screen relationship. It was reported
that family members seldom came
together as a group.The number of
parents who were ignored or unacknow-
ledged on their return home because chil-
dren were otherwise engaged in [screen]
activitycomprised a substantial percent-
age of observed behavior. The high level
of being unacknowledged encountered by
fathers when they reunited with their chil-
dren was particularly strikingThese
latter results are particularly noteworthy.
Social scientists have long documented the
near universality of positive behavior in
the form of greetings when two or more
people reunite after being apart for a
period of time. Greetings recognize a
persons arrival, status and display positive
intentions that universally facilitate the
transition into social interaction with
another.ST has changed this.
Although this paper is concerned with
ST, when one includes screen content
which may be very much at odds with
the values and desires of parents, but
which children may be absorbing for
many hours a day, the distorting effect
on the parental role in imparting their
own values and providing boundaries for
adolescence could be considerable. A
decade ago, in their Analysis of
Childrens Programming Provision, the
British Governments Broadcasting
Standards Commission concluded The
television is almost like a member of the
family in its own right. With subsequent
birth of multiple screens, today extensive
ST appears to have created the three-
parent family.
Both within and outside the family,
children learn the rules of relationships
through extensive routine face-to-face
experience. Yet, as social media consumes
a larger portion of a childs daily life, this
is likely to create difculties in extrapolat-
ing on-line un-boundariedrelationships
to those of the realworld, thereby
affecting those relationships.
The family environment has been
described as an ecosystem of interruption
technologies. Background media that is
not being actively viewed by the child is
increasingly associated with developmen-
tal risks. A study of 56-year-olds found
that both active TV viewing and back-
ground passiveTV exposure was related
to shorter sleep duration, sleeping disor-
ders and overall sleep disturbances.
Moreover, passive exposure to TV of more
than 3 h/day was strongly related to
sleep disturbances, therefore, parents
should control the quantity of TV
viewing and limit childrens exposure
to passive TV.
A study of 13-year-olds
found that background TV signicantly
reduced the amount of time they played
with their toys, and the amount of time
they spent in focused attention during
play. Researchers concluded, These nd-
ings have implications for subsequent
cognitive development.
have also found both the quantity and
the quality of interactions between
parents and children decline markedly
when background TV is on, which may
have a negative impact on develop-
Current US estimates for chil-
dren 8 months to 8 years of age are 3.9 h
of background TV per day.
The report
by AAP recommends that parents and
caregivers recognize that their own
[background] media use can have a nega-
tive effect on children. The AAP consid-
ers claims by media industry executives
that educational media programmes are
meant to be watched by both the parent
and the child to facilitate social interac-
tions and the learning process as having
quite the opposite effect.
There are limitations in simply advis-
ing parents to reduce childrensST.As
with many preventative health initia-
tives, such advice may be least effective
in families where it matters most.
However, it is wrong to assume that it is
simply the underprivileged families being
referred to. The AAP recently reported
Parents who believe that educational
television is very important for healthy
developmentare twice as likely to keep
the television on all or most of the
Most parents want to reduce
health risks for their children, provided
they understand the rationale behind the
advisory, and a clear course of action is
offered. For example, between 1996 and
2007, children in England, exposed to
passive smoking, declined by nearly 70%.
Most interestingly, declines were greatest
in the 2 years immediately preceding legis-
lation as the result of, it is thought, the
media campaigns and greater publicity on
the impacts of passive smoking during
this period. Subsequent research has
found that absolute declines in exposure
were greater in those most exposed at the
outset including those living in lower
sociodemographic status households.
At the moment, most parents and phy-
sicians are unaware of ST as a health
issue, and if they do harbour concerns,
they remain unaware of the rationale or a
clear rule of thumb as a course of action.
It is, therefore, an imperative to rst
redress this knowledge void. Given that
many parents have grown to rely on ST
as a means of occupying their children—‘the
electronic babysitter’—any guidance on
ST would benet from the inclusion of
suggestions for developing constructive
practical alternatives to ST.
Arch Dis Child Month 2012 Vol 0 No 0 5
Leading article
Although children may be regularly
involved in various screen activities and
using different screen devices, most ST is
recreational, that is, discretionary, and it
is this ST that should be the primary
public health target for reduction. There
may be scope for further reductions.
Preschool and infant schools, if made
aware of this issue, could easily reduce
ST, as much of it is predominantly discre-
tionary at that stage of education. Junior
and secondary schools could reconsider
the extent to which entertainment TV
programmes and lms are used as lessons
and as golden time. There is a concern
that not to expose young children to
screen technology puts them at a devel-
opmental and educational disadvantage.
Furthermore, it is often assumed that if
children do not get used toscreen tech-
nology early on, they will in some way
be intimidated by it, or be less competent
at using it later. However, research has
found that even Rhesus monkeys are
comfortable with, and capable of using,
the same screen technology that children
are exposed to.
The charity, Orangutan
Outreach, has been conducting trials
gauging iPad interaction with their apes.
The director has reported Its not really
toy-like because they are engaging with
them as devices itsdenitely going in
the cognitive direction.
Political implications
Perhaps because ST is not a dangerous
substance or a visibly risky activity, it has
eluded the scrutiny that other health
issues attract. Additionally, there is little
funding and public gratitude in looking
for the negative effects of the worlds
favourite pastime. In 2006, American
paediatric researchers writing in the
American Medical AssociationsArchives
of Pediatric and Adolescent Medicine asked
rhetorically: Why is it that something
that is widely recognised as being so
inuential and potentially dangerous has
resulted in so little effective action?To b e
sure, there has been some lack of political
will to take on the enormously powerful
and inuential entertainment industry
[Screen] media need to be recognised as a
major public health issue.
A problem of provenance
Rather than paediatricians, it has been
the academics in ICT, media literacy, edu-
cation, marketing and social and cogni-
tive psychology, whose research is often
funded by TV, software and technology
industries, who have dominated research,
public and professional understanding of,
and policy considerations on, ST and
child health. Few seem to have spotted
the most salient point: their focus is not
on child health, but as one leading insti-
tution advising successive British govern-
ments states, research focuses on
childrens and young peoplesinteractions
with [authors italics] electronic media,
and on media education.
Information hygiene
Moreover, while medical journals, such as
the BMJ group have instituted measures
to identify competing interests and
sources of funding, particularly regarding
the pharmaceutical industry, in order to
minimise such inuence within their
publications, thereby maintaining a high
standard of information hygiene, the
culture and standard of hygiene with
respect to research on screen media and
children is very different in media, psych-
ology and education journals.
As the most valid impartial arbiter of
child health, British and European paedi-
atric medicine must in future be at the
centre of research, public understanding
and policy formation on ST.
In other areas of child health and
development, when considering the
potential effects of profound new devel-
opments, the paediatric health profes-
sion instinctively adopts a principle of
precaution. Yet, to date, the increasingly
excessive levels of child ST have been
met with relative silence. While many
questions remain regarding the precise
nature of the association between
ST and adverse outcomes, the advice
from a growing number of both research-
ers and other medical associations and
government health departments else-
where is becoming unequivocal: reduce
1017 21 24 29 35 38 41 8083
of whether this will endear paediatricians
to the public or not, Britain and Europes
medical establishments, including the
RCPCH, EAP and Department of Health,
should now formally express some
concern over ST.
A drop in viewing gures may be bad
for TV executivesblood pressure, but
may prove to be very good for child
Children of all ages are spending more
time than ever before, watching screen
media. Viewing screen media is physiolo-
gically distinct from other forms of sed-
entary behaviour, with average daily ST
increasingly considered an independent
risk factor, often exhibiting a dose-
response relationship with disease and
unfavourable child development
outcomes. As health risks are reported to
occur beyond exposure of 2 h of ST per
day, although the average child is exposed
to three times this amount, a robust ini-
tiative to encourage a reduction in daily
recreational ST could lead to signicant
improvements in child health and devel-
opment. Britain and European medical
establishments should consider ST as a
separate entity from sedentary behaviour,
and offer an advisory on the average
number of hours per day young children,
in particular, are viewing screen media,
and the age at which they start.
Contributors Author and guarantor: AS.
Funding None.
Competing interests The author declares: no support
from any organisation for the submitted work; no
nancial relationships with any organisations that might
have an interest in the submitted work in the previous
3 years.
Provenance and peer review Not commissioned;
externally peer reviewed.
Accepted 11 July 2012
Arch Dis Child 2012;0:18
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... Strong evidence shows that parents' awareness-raising and other straightforward actions may significantly lower children's screen time [23]. Early excessive screen-watching habits seem to follow throughout time and tend to cluster with other harmful lifestyle behaviors including a poor diet and lack of sleep [24]. ...
... Possible additions to interventions include the use of an electronic monitoring device to restrict screen time (which allows users to set time limits for TV, digital versatile disc (DVD), computer, or video game use), the TV Turn-off Challenge (a campaign to turn off the TV for a specified number of days), the conditional use of screens on physical activity, or education via mass or small media (such as newsletters, brochures, or billboards) [26]. Birth kits distributed to moms by maternity wards should contain information regarding newborns and toddlers seeing screens [23]. Health visitors should provide new parents with advice and be aware of medical evidence [23]. ...
... Birth kits distributed to moms by maternity wards should contain information regarding newborns and toddlers seeing screens [23]. Health visitors should provide new parents with advice and be aware of medical evidence [23]. Schools should take a stand on how much time kids spend using screens both inside and outside of the classroom and let students and parents know about it [23]. ...
Children's heavy reliance on screen media has raised serious public health issues since it might harm their cognitive, linguistic, and social-emotional growth. This study examines the effects of screen time on many developmental domains and covers management and limitation techniques for kids' screen usage. Screen media has a wide range of cognitive consequences, with both beneficial and detrimental effects noted. Screens can improve education and learning; however, too much time spent in front of a screen and multitasking with other media has been related to worse executive functioning and academic performance. As screen time reduces the amount and quality of interactions between children and their caregivers, it can also have an impact on language development. Contextual elements like co-viewing and topic appropriateness are key in determining how language development is impacted. Additionally, excessive screen usage has detrimental effects on social and emotional growth, including a rise in the likelihood of obesity, sleep disorders, and mental health conditions including depression and anxiety. It can obstruct the ability to interpret emotions, fuel aggressive conduct, and harm one's psychological health in general. Setting boundaries, utilizing parental controls, and demonstrating good screen behavior are all techniques that parents may use to manage children's screen usage. We can reduce the possible negative impacts of excessive screen time and promote children's healthy development and well-being by increasing knowledge and encouraging alternative activities that stimulate development.
... A study published in 2012 (Sigman, 2012) indicates that at a rate of 2 hours/day, a child born nowadays, by the age of seven years, will have spent one full year of 24 h days watching screen media. The same study (Sigman, 2012) calculates that by the age of 18 years, the average European child will have spent 3 years of 24 h days watching screen media and at this rate, by the age of 80 years, they will have spent 17.6 years on media screens. ...
... A study published in 2012 (Sigman, 2012) indicates that at a rate of 2 hours/day, a child born nowadays, by the age of seven years, will have spent one full year of 24 h days watching screen media. The same study (Sigman, 2012) calculates that by the age of 18 years, the average European child will have spent 3 years of 24 h days watching screen media and at this rate, by the age of 80 years, they will have spent 17.6 years on media screens. ...
... Even if the school schedule includes 5 classes/day the majority of students prefer to have less online classes per a day. These results are very encouraging, students are aware of the implications screen time can have on their development and are really interested in being accordingly trained having into consideration the screen time moderation (Sigman, 2012;Stiglic, Viner, 2019). ...
Conference Paper
Full-text available
The aim of this study is to highlight the importance of time management during online activities for students. At the beginning of the pandemic period, on March the 2020, after the first online activity, a pilot study was conducted to identify the students’ perception about online activities, the time they should spend online during the day, the time students spend on different devices (computer, tablet or mobile phone) and the difficulties they have during the first online activities. A number of 106 students (44 boys and 62 girls) in 5th grade, from a middle school located in an urban area, in Romania, participated in this study. The results demonstrate that most of the students (33) representing 31.1% spend 1-2 hours/day online but there are 6 students (5.6%) who spend more than 6 hours/day online. Most of the students (56.6%) consider they should have 3 online activities/day and the duration of these activities should be 40 - 50 minutes. Strategies to promote students’ wellbeing during online activities are also presented focusing on identifying the best way to use the time spend online in order to reach the necessary curricular objectives and to avoid health problems. The conclusions highlight the importance of finding the best time management strategies for online activities to avoid future health problems for students, especially in the situation in which at the global level the pandemic period is not even closed to the end point. As screen time is a controversial factor, with high implication for health and education, data are important for sustainability of educational system and future decisions.
... The term Screen dependency disorder was introduced as a general term that covers 'addiction' to all types of screen or media (1). Screen dependency has the potential to be a significant public health issue since over the years, the use of screen media has increased and introduced earlier among young children (3). ...
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Introduction: Excessive screen time among young children is associated with screen dependency. At this moment, there is a lack of data on screen dependency among young children in Malaysia. This study aimed to measure the prevalence of screen dependency and its associated factors among preschool children in Kuala Lumpur. Methods: A cross-sectional study was carried out at registered preschools in Kuala Lumpur. 300 parents of preschool children aged 4 to 6 years old who fulfilled the inclusion and exclusion criteria were recruited via simple random sampling. The Screen Dependency Scale (SDS) were used to assess their dependency to screen media. Univariate and multivar-iate statistics were analysed using IBM SPSS version 27. Results: The prevalence of screen dependency among preschool children in Kuala Lumpur was 65.7%. Multivariate logistic regression analysis identified that using the screen to resolve children's quarrels (aOR 2.855, 95% CI 1.187-6.868), children who use smartphones (aOR 2.735, 95% CI: 1.244-6.013), children's screen time exceeds 2 hours over the weekend (aOR 2.261, 95% CI: 1.058-4.830) and having a television in the bedroom (aOR 5.562, 95% CI: 1.591-19.442) were predictors for screen dependency. While active co-use mediation (aOR 0.505, 95% CI: 0.302-0.845) were protective. Conclusion: The prevalence of screen dependency was high among preschool children in Kuala Lumpur. Active screening at health care clinics or in schools is essential to identify early children with risk factors for screen dependency.
... Even though screen time activity primarily involves sitting, it should not be assumed that someone is engaging in it while primarily seated or in a stationary position due to the nature of portable screenbased devices 39 . Furthermore, there is strong evidence that watching screen media differs physiologically from other forms of SB such as reading 40 . Finally, this study's cross-sectional design does not allow for the identification of a causal relationship, so the interpretations of its results should be made with caution. ...
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Objective: To investigate the prevalence of sedentary behavior (SB) and factors associating with meeting the screen time guidelines among the Thai youth using a nationwide population-based survey. Material and Methods: Data from a national representative sample of 3,900 Thai youths aged 14–17 years old across the country were drawn from the Thailand Physical Activity Children Survey. SB was classified into screen time and sitting down activity. The youths were classified as meeting the screen time guidelines if they spent less than 120 min on screen time activities. A logistic regression analysis was conducted to examine the relationship between sociodemographic factors and meeting the screen time guidelines. Results: Overall, 33.7% of Thai youths were highly sedentary; only 30.5% of them met the screen time guidelines. Regarding screen time activity, the participants spent the highest amount of time using online social media; meanwhile, doing homework was the sitting down activity taking the greatest proportion of their time. The youths who were older and engaged in more screen time activities were significantly more likely to meet the screen time guidelines. Moreover, those who resided in regions other than Bangkok and had longer sleep times were significantly more likely to meet the screen time guidelines. Conclusion: The prevalence estimates of meeting the screen time guideline among the Thai youth were low. Age, geographical region of residence, number of engagements in screen time activities, and sleep time were associated with meeting the screen time guidelines. Our findings indicate that public health policies and interventions are needed to reduce SB among Thai youths; particular attention should be paid to the associating factors of SB.
... Harapannya, kita dapat lebih memperhatikan gaya hidup digital tersebut. elektronik dalam satu hari [6]. Media elektronik yang biasa digunakan adalah telepon seluler, tablet, laptop, televisi maupun video game. ...
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Seiring berkembangnya teknologi yang ada, banyak masyarakat yang menjadikan alat elektronik menjadi kebutuhan sekunder atau bahkan menjadikan sebagai kebutuhan primer. Terbukti bahwa penjualan ponsel pintar pada kuartal pertama tahun 2019 mencapai 370 ribu unit[1]. Tentunya lama waktu screen time untuk tiap orang beda-beda, telebih keadaan saat ini dimana bebrapa persahaan menerapkan sistem work from home. Berdasarkan data yang kami terima dari 46 responden, kami melakukan perbandingan terkait umur, screen time harian, bidang pekerjaan, dan perubahan kebiasaan screen time, kemudian dibandingkan dengan waktu tidur harian dari responden. Pada hubungan umur dengan waktu tidur didapatkan data sebanyak 30,43% responden yang berumur 20-25 tahun menghabiskan waktunya untuk tidur selama 6-8 jam sehari. Lalu hubungan screen time harian dengan waktu tidur didapatkan data bahwa sebanyak 12 responden yang menatap layar selama 3-5 jam sehari, menghabiskan waktunya untuk tidur selama 6-8 jam sehari dengan persentase 26,09%. Selanjutnya hubungan antara bidang pekerjaan dengan waktu tidur, dimana sebanyak 17 responden yang bekerja di bidang teknologi informasi mengabiskan waktu selama 6-8 jam sehari untuk tidur dengan persentase 36,96%. Lalu hubungan antara perubahan kebiasaan screen time dengan waktu tidur dimana terdapat 22 responden yang mengaku bahwasanya mereka lebih sering menatap layar disaat pandemi ini namun masih menghabiskan waktu selama 6-8 jam sehari untuk tidur dengan persentase 47,83%. Dari penelitian ini, dapat disimpulkan bahwa tidak terdapat cukup bukti untuk menyangkal hipotesa tidak terdapat korelasi antara total screen time harian, bidang pekerjaan, perubahan kebiasaan screen time di tengah pandemi terhadap kuantitas waktu tidur.
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The rapid development of gadgets has a significant impact, including on young children, which can lead to delays in their developmental stages. The purpose of this research is to understand the effects of gadget usage on young children. The research was conducted using a qualitative method, with the subjects being young children in the village of Suci, Manyar District, Gresik. Data for the research was gathered through observation, interviews, and documentation. The results of the research revealed that the impact of gadget usage on young children in the village of Suci has both positive and negative effects. The positive effects include facilitating communication, increasing knowledge, enhancing creativity, and aiding in the development of creativity and intelligence in children. On the other hand, the negative effects include the risk of radiation from gadgets, a decline in psychomotor skills, difficulties in adapting to learning materials, and a lack of self-control due to reduced social interactions.
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The COVID-19 lockdowns have forced young children to spend more time in front of the media and significantly impacted their mothers' mental health. This study explored how mothers' individual distress influences children's problematic media use during the Shanghai citywide lockdown caused by COVID-19. Data were collected from 1889 Chinese mothers ( M age = 34.69 years, SD = 3.94 years) with preschoolers aged 3–6 years ( M ag e = 4.38 years, SD = 1.06 years; 49.0% boys) via an online survey. The statistical analyses relied on SPSS Statistics version 26.0 and macro-program PROCESS 3.3. to investigate the associations and mediation analysis among all the study variables. The results indicated that: (1) significant associations between individual maternal distress with children's problematic media use; (2) maternal parenting stress and maladaptive parenting serial mediated the relationship between mothers' individual distress and children's problematic media use. The findings imply that parents need to enhance their ability to manage risk and promote mental health during periods of significant stress and routine disruption to reduce children's problematic media use.
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An unplugged approach to teaching enables students to explore Computational Thinking without using a computer. It might appear that if students are to learn programming, they should focus on computer-based work; however, it appears that using “unplugged” activities before engaging in computer-based coding (programming) activities for each unit of work leads to better outcomes for students in the same amount of time. In this paper we explore why this could be the case, by reviewing literature that reports on these experiences, and also using different theoretical lenses (Notional Machines, Semantic Profiles, and the Zone of Proximal Development) to analyse how the combination of experiences can engage students. We also explore how the approach integrates with mathematics education.
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One of the most pronounced changes in the daily habits of British citizens is a reduction in the number of minutes per day that they interact with another human being. Recent history has seen people in marked retreat from one another as Britain moves from a culture of greater common experience to a society of more isolated experience. She is in good company, as Americans too step back from one another in unprecedented magnitude.
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Early television exposure and subsequent attentional problems in children . Christakis DA, Zimmerman FJ, Di Giuseppe DL & McCarty CA. ( 2004 ) Pediatrics , 113 , 708 – 713 . Cross-sectional research has suggested that television viewing may be associated with decreased attention spans in children. However, longitudinal data of early television exposure and subsequent attentional problems have been lacking. The objective of this study was to test the hypothesis that early television exposure (at ages 1 and 3) is associated with attentional problems at age 7. We used the National Longitudinal Survey of Youth, a representative longitudinal data set. Our main outcome was the hyperactivity subscale of the Behavioural Problems Index determined on all participants at age 7. Children who were > 1.2 standard deviations above the mean were classified as having attentional problems. Our main predictor was hours of television watched daily at ages 1 and 3 years. Data were available for 1278 children at age 1 and 1345 children at age 3. Ten percent of children had attentional problems at age 7. In a logistic regression model, hours of television viewing per day at both ages 1 and 3 were associated with attentional problems at age 7 [1.09 (1.03–1.15) and 1.09 (1.02–1.16), respectively]. Early television exposure is associated with attentional problems at age 7. Efforts to limit television viewing in early childhood may be warranted, and additional research is needed.
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Long periods of use of Information and Communication Technology (ICT) may raise strong emotions and lead to cog-nitive fatigue. The current study focused on the impact of ICT use the preceding day on the next-day salivary cortisol pattern in 72 school-aged children (39 at the age ten and 33 at the age 13). Salivary cortisol levels were measured at five time points from awakening to bedtime. Time spent in different ICT activities the day before salivary sampling was measured by an activity diary. Results showed that the participants who had used ICT on an average three hours the preceding day showed a significantly reduced cortisol increase one hour after awakening (awakening response) com-pared to those who had used ICT not at all or less than one hour after controlling for pubertal status and the level of depression. The results suggest a stress response as a consequence of a long period of ICT use.
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Very few studies have explored links between physical activity, sedentary behaviours and blood pressure (BP) in early adolescence. We aimed to assess the association between a range of sedentary activities (screen time, television (TV) viewing, computer usage, video game usage and time spent in homework or reading) and BP in schoolchildren. Eligible year-7 students (2353/3144, mean age 12.7 years) from a random cluster sample of 21 Sydney schools were examined during 2003-2005. Parents and children completed detailed questionnaires of activity. BP was measured using a standard protocol and high BP was defined using published guidelines. Height and weight were measured, and body mass index (BMI) calculated. After adjusting for age, sex, ethnicity, parental education, height, BMI and time spent in physical activity, each hour per day spent in screen time, watching TV and playing video games was associated with a significant increase in diastolic BP of 0.44 (P=0.0001), 0.99 (P<0.0001) and 0.64 mm Hg (P=0.04), respectively. In contrast, each hour per day spent reading was associated with a decrease of 0.91 (P=0.01) and 0.69 mm Hg (P=0.02) in systolic and diastolic BP, respectively. Our results indicate that addressing different types of sedentary activities could be a potentially important strategy to reduce the prevalence of elevated BP in children.
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The development of social emotions such as compassion is crucial for successful social interactions as well as for the maintenance of mental and physical health, especially when confronted with distressing life events. Yet, the neural mechanisms supporting the training of these emotions are poorly understood. To study affective plasticity in healthy adults, we measured functional neural and subjective responses to witnessing the distress of others in a newly developed task (Socio-affective Video Task). Participants' initial empathic responses to the task were accompanied by negative affect and activations in the anterior insula and anterior medial cingulate cortex-a core neural network underlying empathy for pain. Whereas participants reacted with negative affect before training, compassion training increased positive affective experiences, even in response to witnessing others in distress. On the neural level, we observed that, compared with a memory control group, compassion training elicited activity in a neural network including the medial orbitofrontal cortex, putamen, pallidum, and ventral tegmental area-brain regions previously associated with positive affect and affiliation. Taken together, these findings suggest that the deliberate cultivation of compassion offers a new coping strategy that fosters positive affect even when confronted with the distress of others.
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Individuals are willing to sacrifice their own resources to promote equality in groups. These costly choices promote equality and are associated with behavior that supports cooperation in humans, but little is known about the brain processes involved. We use functional MRI to study egalitarian preferences based on behavior observed in the “random income game.” In this game, subjects decide whether to pay a cost to alter group members’ randomly allocated incomes.Wespecifically examinewhether egalitarian behavior is associated with neural activity in the ventromedial prefrontal cortex and the insular cortex, two regions that have been shown to be related to social preferences. Consistent with previous studies, we find significant activation in both regions; however, only the insular cortex activations are significantly associated with measures of revealed and expressed egalitarian preferences elicited outside the scanner. These results are consistentwith the notion that brainmechanisms involved in experiencing the emotional states of others underlie egalitarian behavior in humans. Includes supporting information.
Objectives The aim of this study was to examine the independent relationships of television viewing or other screen-based entertainment (“screen time”) with all-cause mortality and clinically confirmed cardiovascular disease (CVD) events. A secondary objective was to examine the extent to which metabolic (body mass index, high-density lipoprotein and total cholesterol) and inflammatory (C-reactive protein) markers mediate the relationship between screen time and CVD events. Background Although some evidence suggests that prolonged sitting is linked to CVD risk factor development regardless of physical activity participation, studies with hard outcomes are scarce. Methods A population sample of 4,512 (1,945 men) Scottish Health Survey 2003 respondents (≥35 years) were followed up to 2007 for all-cause mortality and CVD events (fatal and nonfatal combined). Main exposures were interviewer-assessed screen time (<2 h/day; 2 to <4 h/day; and ≥4 h/day) and moderate to vigorous intensity physical activity. Results Two hundred fifteen CVD events and 325 any-cause deaths occurred during 19,364 follow-up person-years. The covariable (age, sex, ethnicity, obesity, smoking, social class, long-standing illness, marital status, diabetes, hypertension)-adjusted hazard ratio (HR) for all-cause mortality was 1.52 (95% confidence interval [CI]: 1.06 to 2.16) and for CVD events was 2.30 (95% CI: 1.33 to 3.96) for participants engaging in ≥4 h/day of screen time relative to <2 h/day. Adjusting for physical activity attenuated these associations only slightly (all-cause mortality: HR: 1.48, 95% CI: 1.04 to 2.13; CVD events: HR: 2.25, 95% CI: 1.30 to 3.89). Exclusion of participants with CVD events in the first 2 years of follow-up and previous cancer registrations did not change these results appreciably. Approximately 25% of the association between screen time and CVD events was explained collectively by C-reactive protein, body mass index, and high-density lipoprotein cholesterol. Conclusions Recreational sitting, as reflected by television/screen viewing time, is related to raised mortality and CVD risk regardless of physical activity participation. Inflammatory and metabolic risk factors partly explain this relationship.
This study aimed to examine the association of television (TV) time, the frequency of meals while watching TV and the presence of TV set in the bedroom with total and abdominal obesity and to assess whether physical activity (PA) attenuates the obesity risk of TV viewing. Cross-sectional data were obtained from 2200 adolescents (46% boys) from 10 European cities, The Healthy Lifestyle in Europe by Nutrition in Adolescence study, between 2006 and 2007. TV viewing, PA (by accelerometry) and body composition were measured. Binary logistic regression analyses were performed. Even adjusting by vigorous PA, TV in the bedroom (odds ratio [OR]: 1.33, 95% confidence interval [CI], 1.01-1.74) and >4 h d(-1) TV during week days (OR: 1.30, 95% CI, 1.02-1.67) (in boys) and eating every day with TV (OR: 1.18, 95% CI, 1.07-1.30) and >2 h d(-1) TV during weekend days (OR: 1.68, 95% CI, 1.25-2.26) (in girls) were significantly associated with total obesity. Likewise, in both sexes, having a TV set at bedroom was significantly associated with abdominal obesity. Adolescents spending excessive TV time are prone to obesity independently of their PA levels. Families should put TV sets out of adolescents' bedroom and keep TV sets off during meal times.