A new study from the Kaiser Family Foundation, and expert Dr. Michael Rich, a pediatrician at Children’s Hospital Boston who directs the Center on Media and Child Health, examined the potential link between the increased use of media products by America’s youth and the effects on their behavior and health. Physical activity is important for children to stay healthy. People wonder and worry that the increased amount of time young people spend playing with electronics could have negative social and health related impact

By TAMAR LEWIN
New York Times

The average young American now spends practically every waking minute — except for the time in school — using a smart phone, computer, television or other electronic device, according to a new study from the Kaiser Family Foundation.

Those ages 8 to 18 spend more than seven and a half hours a day with such devices, compared with less than six and a half hours five years ago, when the study was last conducted. And that does not count the hour and a half that youths spend texting, or the half-hour they talk on their cellphones.

And because so many of them are multitasking — say, surfing the Internet while listening to music — they pack on average nearly 11 hours of media content into that seven and a half hours.

“I feel like my days would be boring without it,” said Francisco Sepulveda, a 14-year-old Bronx eighth grader who uses his smart phone to surf the Web, watch videos, listen to music — and send or receive about 500 texts a day.

The study’s findings shocked its authors, who had concluded in 2005 that use could not possibly grow further, and confirmed the fears of many parents whose children are constantly tethered to media devices. It found, moreover, that heavy media use is associated with several negatives, including behavior problems and lower grades.

The third in a series, the study found that young people’s media consumption grew far more in the last five years than from 1999 to 2004, as sophisticated mobile technology like iPods and smart phones brought media access into teenagers’ pockets and beds.

Dr. Michael Rich, a pediatrician at Children’s Hospital Boston who directs the Center on Media and Child Health, said that with media use so ubiquitous, it was time to stop arguing over whether it was good or bad and accept it as part of children’s environment, “like the air they breathe, the water they drink and the food they eat.”

Contrary to popular wisdom, the heaviest media users reported spending a similar amount of time exercising as the light media users. Nonetheless, other studies have established a link between screen time and obesity.

While most of the young people in the study got good grades, 47 percent of the heaviest media users — those who consumed at least 16 hours a day — had mostly C’s or lower, compared with 23 percent of those who typically consumed media three hours a day or less. The heaviest media users were also more likely than the lightest users to report that they were bored or sad, or that they got into trouble, did not get along well with their parents and were not happy at school.

The study could not say whether the media use causes problems, or, rather, whether troubled youths turn to heavy media use.

“This is a stunner,” said Donald F. Roberts, a Stanford communications professor emeritus who is one of the authors of the study. “In the second report, I remember writing a paragraph saying we’ve hit a ceiling on media use, since there just aren’t enough hours in the day to increase the time children spend on media. But now it’s up an hour.”

The report is based on a survey of more than 2,000 students in grades 3 to 12 that was conducted from October 2008 to May 2009.

On average, young people spend about two hours a day consuming media on a mobile device, the study found. They spend almost another hour on “old” content like television or music delivered through newer pathways like the Web site Hulu or iTunes. Youths now spend more time listening to or watching media on their cellphones, or playing games, than talking on them.

“I use it as my alarm clock, because it has an annoying ringtone that doesn’t stop until you turn it off,” Francisco Sepulveda said of his phone. “At night, I can text or watch something on YouTube until I fall asleep. It lets me talk on the phone and watch a video at the same time, or listen to music while I send text messages.”

Francisco’s mother, Janet Sepulveda, bought his phone, a Sidekick LX, a year ago when the computer was not working, to ensure that he had Internet access for school. But schoolwork has not been the issue.

“I’d say he uses it about 2 percent for homework and 98 percent for other stuff,” she said. “At the beginning, I would take the phone at 10 p.m. and tell him he couldn’t use it anymore. Now he knows that if he’s not complying with what I want, I can suspend his service for a week or two. That’s happened.”

The Kaiser study found that more than 7 in 10 youths have a TV in their bedroom, and about a third have a computer with Internet access in their bedroom.

“Parents never knew as much as they thought they did about what their kids are doing,” Mr. Roberts said, “but now we’ve created a world where they’re removed from us that much more.”

The study found that young people used less media in homes with rules like no television during meals or in the bedroom, or with limits on media time.

Victoria Rideout, a Kaiser vice president who is lead author of the study, said that although it has become harder for parents to control what their children do, they can still have an effect.

“I don’t think parents should feel totally disempowered,” she said. “They can still make rules, and it still makes a difference.”

In Kensington, Md., Kim Calinan let her baby son, Trey, watch Baby Einstein videos, and soon moved him on to “Dora the Explorer.”

“By the time he was 4, he had all these math and science DVDs, and he was clicking through by himself, and he learned to read and do math early,” she said. “So if we’d had the conversation then, I would have said they were great educational tools.”

But now that Trey is 9 and wild about video games, Ms. Calinan feels differently.

Last year, she sensed that video games were displacing other interests and narrowing his social interactions. After realizing that Trey did not want to sign up for any after-school activities that might cut into his game time, Ms. Calinan limited his screen time to an hour and half a day on weekends only.

So last Wednesday, Trey came home and read a book — but said he was looking forward to the weekend, when he could play his favorite video game.

Many experts believe that media use is changing youthful attitudes.

“It’s changed young people’s assumptions about how to get an answer to a question,” Mr. Roberts said. “People can put out a problem, whether it’s ‘Where’s a good bar?’ or ‘What if I’m pregnant?’ and information pours in from all kinds of sources.”

The heaviest media users, the study found, are black and Hispanic youths and “tweens,” or those ages 11 to 14.

Even during the survey, media use was changing.

“One of the hot topics today is Twitter, but when we first went into the field and began interviewing, Twitter didn’t exist,” Ms. Rideout said.

It’s no wonder that in a country where the rates of obesity are rising, other negative health consequences are increasing too. According to a new study accepted for publication in The Endocrine Society’s Journal of Clinical Endocrinology & Metabolism (JCEM), Nelly Mauras, MD, of Nemours Children’s Clinic in Jacksonville, Florida and senior author of the study, investigated the correlation between childhood obesity and cardiovascular risk factors.

ScienceDaily (Jan. 26, 2010) — By as early as 7 years of age, being obese may raise a child’s risk of future heart disease and stroke, even in the absence of other cardiovascular risk factors such as high blood pressure, according to a new study accepted for publication in The Endocrine Society’s Journal of Clinical Endocrinology & Metabolism (JCEM).
“This new study demonstrates that the unhealthy consequences of excess body fat start very early,” said Nelly Mauras, MD, of Nemours Children’s Clinic in Jacksonville, Florida and senior author of the study. “Our study shows that obesity alone is linked to certain abnormalities in the blood that can predispose individuals to developing cardiovascular disease early in adulthood.
These findings suggest that we need more aggressive interventions for weight control in obese children, even those who do not have the co-morbidities of the metabolic syndrome.”
The metabolic syndrome is a cluster of risk factors that raise the risk of developing heart disease, stroke and diabetes. It is being increasingly diagnosed in children as being overweight becomes a greater problem. Although debate exists as to its exact definition, to receive a diagnosis of metabolic syndrome, one must have at least three of the following characteristics: increased waist circumference (abdominal fat), low HDL (“good”) cholesterol, high triglycerides (fats in the blood), high blood pressure and high blood glucose (blood sugar).
Mauras and her colleagues wanted to know if obesity could raise cardiovascular disease risk prior to the onset of the metabolic syndrome. Researchers therefore screened more than 300 individuals ages 7 to 18 years and included only those without features of the metabolic syndrome. They included 202 participants in the study: 115 obese children and 87 lean children as controls. Half of the children were prepubertal and the other half were in late puberty. Obese children had a body mass index (a measure of body fat) above the 95th percentile for their sex, age and height.
To be eligible to participate in the study, the children and adolescents had to have normal fasting blood sugar levels, normal blood pressure and normal cholesterol and triglycerides. Lean controls also could not have a close relative with type 2 diabetes, high cholesterol, high blood pressure or obesity. The latter group proved very difficult to find.
All study participants underwent blood testing for known markers for predicting the development of cardiovascular disease. These included elevated levels of C-reactive protein (CRP), a marker of inflammation, and abnormally high fibrinogen, a clotting factor, among others. Obese children had a 10 fold higher CRP and significantly higher fibrinogen concentrations, compared with age- and sex-matched lean children, the authors reported. These abnormalities occurred in obese children as young as age 7, long before the onset of puberty.
The results were striking Mauras stated, as the children were entirely healthy otherwise. Although it is not yet known whether early therapeutic interventions can reverse high CRP and fibrinogen, she said it would be prudent for health care providers to advise more aggressive interventions to limit calories and increase activity in “healthy” overweight children, even before the onset of puberty.
“Doctors often do not treat obesity in children now unless they have other features of the metabolic syndrome,” Mauras said. “This practice should be reconsidered. Further studies are needed to offer more insight into the effects of therapeutic interventions in these children.

Self-monitoring continuously is an effective intervention for losing weight. Using a pedometer is just another way you can track your steps and progress to your weight loss goal. Simon Marshall, associate professor of exercise and nutritional science at San Diego State University, Karen Croteau, a professor in the department of exercise, health and sport sciences at the University of Southern Maine, and Dr. Kathy Magliato of St. John’s Health Center in Santa Monica or Torrance Memorial Medical Center discuss the benefits and positive effects a pedometer can have in building a healthy lifestyle.

The step-tracking gadgets are easy to use and relatively inexpensive. Plus, evidence indicates that they truly inspire people.

By Jeannine Stein

January 11, 2010

If the journey toward fitness begins with a single step, make sure it’s counted with a pedometer.

These little step-tracking gadgets now have a solid track record when it comes to motivating people to exercise. And their popularity is growing.

Inside this small-as-an-egg device are the keys to exercise success that have eluded far more complex and expensive fitness programs: accountability, goal-setting and being able to monitor progress. If the objective is to reach 10,000 steps in a day (the recommended amount), seeing a tally of 4,000 steps at 3 p.m. is a wake-up call to start walking.

“When we ask people to start an exercise program, it’s important to have measurable, achievable goals, and adding this self-monitoring component is very critical,” says Simon Marshall, associate professor of exercise and nutritional science at San Diego State University. “We don’t know why exactly, but keeping a number, a prompt, in our consciousness on a regular basis is important, and that’s why pedometers are superior to other methods. It’s on you all the time.”

Pedometers are easy to use day after day in various settings, none of which has to be a gym.

Perhaps better yet, the average cost is around $20.

“People describe them as being like little personal trainers,” says Catrine Tudor-Locke, associate professor and director of the Walking Behavior Laboratory at Pennington Biomedical Research Center in Baton Rouge, La. “They provide ready, real-time data so you can make decisions about how you’re going to spend the rest of your day and make adjustments as needed.”

Los Angeles-based personal trainer Harley Pasternak has been studying the health habits of various cultures for his latest book, “The 5-Factor World Diet.” He says, “What I found was that in the 10 healthiest countries in the world, they all have different [dietary habits]. But one thing they all share is that they all walk way more than we do in America. For those in these 10 countries, being fit and healthy is about having an active lifestyle, while here in America, being fit is about performing an exercise in a room designated for fitness.”

Pedometers can create that lifestyle balance that many Americans otherwise would lack.

Fits any lifestyle

At 12:30 on a recent afternoon, Dr. Kathy Magliato’s pedometer already reads 19,000 steps for the day. “I’m a cardiothoracic surgeon who’s also a busy mommy with two small kids, so I run around quite a bit,” she says. She typically gets her steps in while doing rounds at St. John’s Health Center in Santa Monica or Torrance Memorial Medical Center. On days when she’s in surgery for 10 hours, she takes her children for a walk when she gets home.

Magliato clipped on her first pedometer six years ago after the birth of her first child. With 10 pounds to lose and no time to go to a gym, she had to do something to stay in shape — both for herself and as a role model for her patients, many of whom have heart disease. Through walking and watching her diet, she dropped the 10 pounds and realized that walking provided the activity she needed, which some fitness experts and researchers say is the key to true health.

“When my patients tell me they can’t work out because they don’t have time, I say, ‘Look at my lifestyle.’ ”

Pedometers have even made their way into the White House. In October, Peter Orszag, director of the Office of Management and Budget, issued a pedometer challenge through the end of 2009 to all willing agency employees. In an office blog post, Orszag (a runner and marathoner) wrote: “This year, as part of their budget submissions, federal agencies have been asked to report on their efforts to improve the health and wellness of their employees. I want to make sure that the staff at OMB doesn’t just talk the talk on wellness, but that we also walk the walk — literally.”

With approximately 115 to 200 men and women taking part, weekly step averages went from 10,871 the first week (beginning Oct. 4) to 13,000 in early December. (Final tallies aren’t yet available.)

Research confirms that monitoring daily steps helps people get the recommended amount of exercise, bolsters their cardiovascular system and often contributes to weight loss.

A 2007 study in the Journal of the American Medical Assn. analyzed data from 26 studies assessing pedometer use among adults and found the device to be linked with considerable increases in physical activity and decreases in blood pressure and body mass index. In a 2004 study in Medicine & Science in Sports & Exercise, 27 people were assigned to a pedometer-based exercise group with an emphasis on daily steps and 33 people to an exercise program emphasizing time spent exercising.

At the end of the study, the pedometer-based program proved to be more effective in increasing daily activity than the time-based program.

Set a goal

Clipping on a pedometer and counting steps — even brisk ones — isn’t the end of the fitness story. “It’s one thing to wear a pedometer, but it’s another to have a goal in mind of how many steps you want to get,” says Karen Croteau, a professor in the department of exercise, health and sport sciences at the University of Southern Maine. “These gadgets are effective when serving as a cue, but that has to be in conjunction with setting goals.”

She suggests that new users monitor steps for a few days to find a daily average before upping the amount. Some fitness experts recommend adding 5% to 10% of the starting average per day, but Tudor-Locke believes that fitness levels and daily routines should be taken into consideration. “One person has to juggle child rearing while another has different lifestyle impediments,” she says. “People should find out where they are and realize that more is better.”

And while walking 10,000 steps a day is admirable, reaching that goal every day over a long period of time may cause a fitness plateau, in which cardio gains stop and weight sneaks back on. In that case, users must increase both steps and intensity.

(But keep in mind, walking shouldn’t be the only exercise in the repertoire. Strength training for both the upper and lower body prevents muscle loss and helps stave off bone deterioration, both important as people age.)

Choosing a pedometer can be challenging, considering how many models are on the market. Some are equipped with accelerometers that record movement and intensity. Others tally weekly steps, have calorie counters and come with software to track progress. Some cellphones now come with a pedometer, but since the devices track steps by monitoring hip movement, they won’t work if left on a table or in a purse on the floor.

Many exercise physiologists and trainers generally recommend starting with a basic model that just counts steps and costs about $20. To ensure accuracy, count out from 20 to 50 steps a few times, checking the pedometer. If the count is within a few steps, it should be adequate. You can always upgrade later to a model with more bells and whistles.

Says Marshall, “You’re only limited by how creative you can be.”

According to a poll by the Institute for Medicine and Public Health, Americans lead extremely sedentary lifestyles and it is killing us by way of significant health problems such as obesity, heart disease, and diabetes.

Many researchers and experts such as, James Levine, M.D., Ph.D., of the Mayo Clinic in Rochester, MN, Marc Hamilton, Ph.D., associate professor of biomedical sciences at the University of Missouri, Douglas Lentz, a certified strength and conditioning specialist and the director of fitness and wellness for Summit Health in Chambersburg, PA, Genevieve Healy, Ph.D., a research fellow at the Cancer Prevention Research Centre of the University of Queensland, Australia, and Neville Owen, Ph.D., of the University of Queensland agree that way to nip this problem in the bud is to get up off of our butts – and to start moving every day.

Women’s Health

12/9/09

You might not want to take the following stat sitting down: According to a poll of nearly 6,300 people by the Institute for Medicine and Public Health, it’s likely that you spend a stunning 56 hours a week planted like a geranium — staring at your computer screen, working the steering wheel, or collapsed in a heap in front of your high-def TV. And it turns out women may be more sedentary than men, since they tend to play fewer sports and hold less active jobs.
Even if you think you have an energetic lifestyle, sitting is how most of us spend a good part of our day. And it’s killing us — literally — by way of obesity, heart disease, and diabetes. All this downtime is so unhealthy that it’s given birth to a new area of medical study called inactivity physiology, which explores the effects of our increasingly butt-bound, tech-driven lives, as well as a deadly new epidemic researchers have dubbed “sitting disease.”

The modern-day desk sentence
“Our bodies have evolved over millions of years to do one thing: move,” says James Levine, M.D., Ph.D., of the Mayo Clinic in Rochester, Minn., and author of “Move a Little, Lose a Lot.” “As human beings, we evolved to stand upright. For thousands of generations, our environment demanded nearly constant physical activity.”
But thanks to technological advances, the Internet, and an increasingly longer work week, that environment has disappeared. “Electronic living has all but sapped every flicker of activity from our daily lives,” Levine says. You can shop, pay bills, make a living, and with Twitter and Facebook, even catch up with friends without so much as standing up. And the consequences of all that easy living are profound.

When you sit for an extended period of time, your body starts to shut down at the metabolic level, says Marc Hamilton, Ph.D., associate professor of biomedical sciences at the University of Missouri. When muscles — especially the big ones meant for movement, like those in your legs — are immobile, your circulation slows and you burn fewer calories. Key flab-burning enzymes responsible for breaking down triglycerides (a type of fat) simply start switching off. Sit for a full day and those fat burners plummet by 50 percent, Levine says.

That’s not all. The less you move, the less blood sugar your body uses; research shows that for every two hours spent on your backside per day, your chance of contracting diabetes goes up by 7 percent. Your risk for heart disease goes up, too, because enzymes that keep blood fats in check are inactive. You’re also more prone to depression: With less blood flow, fewer feel-good hormones are circulating to your brain.
Spending the day on your rear is also hell on your posture and spine health, says Douglas Lentz, a certified strength and conditioning specialist and the director of fitness and wellness for Summit Health in Chambersburg, Pa. “When you sit all day, your hip flexors and hamstrings shorten and tighten, while the muscles that support your spine become weak and stiff,” he says. It’s no wonder that the incidence of chronic lower-back pain among women has increased threefold since the early 1990s.

And even if you exercise, you’re not immune. Consider this: We’ve become so sedentary that 30 minutes a day at the gym may not do enough to counteract the detrimental effects of eight, nine, or 10 hours of sitting, says Genevieve Healy, Ph.D., a research fellow at the Cancer Prevention Research Centre of the University of Queensland in Australia. That’s one big reason so many women still struggle with weight, blood sugar, and cholesterol woes despite keeping consistent workout routines.

In a recent study, Healy and her colleagues found that regardless of how much moderate to vigorous exercise participants did, those who took more breaks from sitting throughout the day had slimmer waists, lower BMIs (body mass indexes), and healthier blood fat and blood sugar levels than those who sat the most. In an extensive study of 17,000 people, Canadian researchers drew an even more succinct conclusion: The longer you spend sitting each day, the more likely you are to die an early death — no matter how fit you are.
The non-exercise answer
So if exercise alone isn’t the solution, what is? Fortunately, it’s easier than you think to ward off the perils of prolonged parking. Just ramp up your daily non-exercise activity thermogenesis — or NEAT. That’s the energy (i.e., calories) you burn doing everything but exercise. It’s having sex, folding laundry, tapping your toes, and simply standing up. And it can be the difference between wearing a sarong or flaunting your bikini on your next beach vacation.

In his groundbreaking study on NEAT, the Mayo Clinic’s Levine used motion-sensing underwear to track every single step and fidget of 20 people who weren’t regular exercisers (half of them were obese; half were not). After 10 days, he found that the lean participants moved an average of 150 minutes more per day than the overweight people did — enough to burn 350 calories, or about one cheeseburger.

Fidgeting, standing, and puttering may even keep you off medications and out of the doctor’s office. Think of your body as a computer: As long as you’re moving the mouse and tapping the keys, all systems are go. But let it idle for a few minutes, and the machine goes into power-conservation mode. Your body is meant to be active, so when you sit and do nothing for too long, it shuts down and burns less energy. Getting consistent activity throughout the day keeps your metabolism humming along in high gear.

When you get out of your chair and start moving around, you turn on fat burners. Simply standing up fries three times as many calories as sitting on your butt, according to Levine. And, he adds, “NEAT activity can improve blood flow and increase the amount of serotonin available to the brain, so that your thinking becomes sharper and you’ll be less likely to feel depressed.”
Get your move on
Shake things up throughout the day by interrupting your sedentary stints as often as possible. “Stand up every half hour,” says Neville Owen, Ph.D., of the University of Queensland. “If you have to sit for longer than that, take more extended and active breaks and move around for a few minutes before sitting back down.”

When you’re reading e-mail and taking phone calls, do it standing. Walk with colleagues to brainstorm ideas. And consider trading your chair for a large stability ball. “It forces you to engage your muscles, and you’re likely to stand up more because you’re not melting into a chair,” Lentz says.

At home, it’s simple: Limit TV time to two hours a day or less. Better yet, watch it from a treadmill or exercise bike. Among women, the risk for metabolic syndrome — a constellation of health woes including high blood pressure, high cholesterol, and high blood sugar — shoots up 26 percent for every hour per day they spend watching the tube.

Not sure how much of a difference these mini moves will make? Check out the chart below. Swapping a more active approach for just a few of your daily activities can help stave off the one-to two-pound weight gain most women accumulate every year — and it can keep your metabolism buzzing the way nature intended it to.