July 1, 2004 A new study adds to the evidence that sedentary behaviors are linked to childhood obesity and sheds light on the world-wide dimension of the problem. In a study published in the June issue of the journal Obesity Research, researchers from The Children's Hospital of Philadelphia and the University Hospital Zurich present a strong association between playing electronic video games and childhood obesity in school-aged Swiss children. The researchers also found that obesity was associated with television watching, paternal smoking and mother's working outside the home.
"The goal of this study was to identify environmental and behavioral factors, in particular type and duration of sedentary activities, associated with obesity in children living in Switzerland," said Nicolas Stettler, M.D., M.S.C.E., a pediatric nutrition specialist at The Children's Hospital of Philadelphia and primary investigator of this study. "To our knowledge this study provides the strongest evidence for an independent association between time spent playing electronic games and childhood obesity. Our findings suggest that the use of electronic games should be limited to prevent childhood obesity."
The research team measured 872 children in first, second, and third grades enrolled in 10 schools in northeastern Switzerland. A physician and medical assistant administered questionnaires to the children. Questions assessed age, sex, nationality, number of siblings, smoking status of parents, television programs regularly watched, amount of time playing electronic games, breakfast consumption, watching television during meals and snacking while watching television. Teachers estimated the amount of physical activity. The researchers defined obesity using both skinfold thickness and body mass index (BMI) to provide a more direct assessment of overweight and overfat status.
In this study, children of foreign nationality living in Switzerland were about twice as likely to be obese as Swiss children. Non-Swiss children watched more television and had less physical activity, suggesting that the disparity in obesity prevalence between Swiss and foreign children may be partially amenable to culturally sensitive interventions.
Obesity was independently associated with the time spent playing electronic games and the time spent watching television and was inversely associated with physical activity. The association of obesity with television use and lack of physical activity confirms results from other populations and points to potential strategies for obesity prevention.
"Evidence-based prevention of childhood obesity requires the identification of modifiable risk factors," said Dr. Stettler. "Because obesity is difficult to treat once it has been established, obesity prevention during childhood is an essential component of the efforts to combat this global epidemic and further research on obesity prevention is necessary."
Dr. Stettler's co-authors were Theo M. Signer, M.D. and Paolo N. Suter, M.D., M.Ph. of the Medical Policlinic, Department of Medicine, University Hospital Zurich, Switzerland.
Founded in 1855 as the nation's first pediatric hospital, The Children's Hospital of Philadelphia is ranked in 2003 as the best pediatric hospital in the nation by U.S.News & World Report and Child magazines. Through its long-standing commitment to providing exceptional patient care, training new generations of pediatric healthcare professionals and pioneering major research initiatives, Children's Hospital has fostered many discoveries that have benefited children worldwide. Its pediatric research program is among the largest in the country, ranking second in National Institutes of Health funding among children's hospitals. In addition, its unique family-centered care and public service programs have brought the 430-bed hospital recognition as a leading advocate for children and adolescents from before birth through age 19. Children's Hospital operates the largest pediatric healthcare system in the U.S. with more than 40 locations in Pennsylvania, New Jersey and Delaware.
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