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Promoting Family Meals and Placing Limits on Television Viewing: Practical Advice for Parents
APPLICATION
Promoting Family Meals and Placing Limits on Television Viewing: Practical Advice for Parents
T
he fact that increased television (TV) viewing and computer use leads to pediatric overweight has already received a great deal of publicity, so many parents may be in the contemplation stage with respect to attempting to limit children’s screen time (1-3). The fact that family mealtime can decrease the risk of pediatric overweight has not been well publicized, although there has been a great deal of attention paid to the other benefits of family meals (4-6). In both instances, registered dietitians (RDs) face challenges in moving parents along the continuum of behavior change with motivational counseling. Asking a parent to describe a child’s daily routine can be very revealing. As a parent describes various activities, the RD can inquire as to whether the child is watching TV while getting dressed, while having breakfast, while waiting to be driven to school, etc. The RD should ask about the child’s use of a computer for games, homework, and entertainment. While reviewing a typical day, the RD can gather information on foods usually served for meals and snacks, and can determine which family members are generally present when the child is having meals and snacks. It is not unusual for parents to be surprised when they find out that their child is spending far more hours in front of a screen than they would have estimated. This provides motivation for parents to move into the preparation stage and to consider various actions they can take. Moving TVs and computers out of bedrooms into family space is one strategy that can reduce screen time (7). Asking the question, “What would happen if you moved the TV out of your child’s room and just made it available in the family/living room?” is an appropriate way to introduce this possibility. The action of turning off the TV set is apt to be met with considerable protest on the part of the child, especially if the child has spent a significant amount of time watching TV in early childhood (8). Advising parents to sit down with their child and help the child select the 2 hours of TV programming that will be viewed each day is apt to be met with less resistance (9). It allows the child to make deliberate choices so that favorite programs will not be missed. It also provides parents with the opportunity to guide the child in choosing age-appropriate programming. The way to introduce this suggestion is to ask,
This article was written by Joanne P. Ikeda, MA, RD, a nutrition education specialist and lecturer, Department of Nutritional Sciences and Toxicology, University of California, Berkeley, CA, and chair, Pediatric Subunit, American Dietetic Association Weight Management Practice Group. doi: 10.1016/j.jada.2006.11.019
62
January 2007 Volume 107 Number 1
“What would happen if you and your child sat down and planned out his or her 2 hours of TV viewing for each day of the week so it would include favorite programming?” RDs should be sympathetic to the fact that parents will have to endure children’s objections when new rules about TV and computer use are implemented. At the same time, it is important to point out that consistent enforcement gradually leads to fewer complaints while inconsistent application of rules is apt to result in more resistance on the part of the child (10). Posing the question, “When your child begs to go over the 2-hour screen allowance, how will you handle it?” can help parents recognize that they need to be prepared to deal with their child’s opposition to limited TV viewing and computer use. Parents may wonder about alternative activities that will engage children as much as TV programming does. There are a number of Web sites that provide descriptions of enjoyable activities families can do when the TV set is turned off (11-13). With respect to promoting family meals, inquiring, “How do you think your children might benefit from having family meals?” will most likely result in a positive response because 80% of parents view family meals as important (14). Reinforcing whatever benefit the parent ascribes to family meals and then expanding on it can help move parents from contemplation to preparation with respect to considering this practice. Asking, “What would need to change if you decided to have family meals a certain number of times each week?” can help parents to identify barriers as well as alternative ways to overcome them. RDs can point out that family meals can be quick and easy to assemble with everyone helping, can be eaten off of paper plates with disposable utensils, can happen at any time of day, and should focus on sharing and caring. Again, there are many resources that dietitians can access for practical ideas on promoting family mealtime as well as overcoming barriers to having family meals (15-17). Equipped with practical advice, RDs can motivate and support parents as they adopt new family behaviors such as limiting TV viewing and having more family meals. These behaviors will benefit family members in multiple ways, including reducing the risk of pediatric overweight. References 1. Rideout V, Vandewater E, Wartella E. Electronic Media in the Lives of Infants, Toddlers and Preschoolers. Washington, DC: Kaiser Family Foundation Report; 2003. 2. Center for Screen Time Awareness. TV Turnoff Network. Available at: http://tvturnoff.org/index.htm. Accessed September 25, 2006. 3. United States Department of Health and Human Services, National Institute of Health. WE CAN! Project.
4.
5.
6. 7.
8.
9.
10.
Helpful Ways to Reduce Screen Time. Available at: http://www.nhlbi.nih.gov/health/public/heart/obesity/ wecan/live-it/screen-time.htm. Accessed September 25, 2006. Fulkerson JA, Story M, Mellin A, Leffert N, Neumark-Sztainer D, French SA. Family dinner meal frequency and adolescent development: Relationships with developmental assets and high-risk behaviors. J Adolesc Health. 2006;39:337-345. Johnson DB, Birkett D, Evens C, Pickering S. Promoting family meals in WIC: Lessons learned from a statewide initiative. J Nutr Educ Behav. 2006;38: 177-182. Spear BA. The need for family meals. J Am Diet Assoc. 2006;106:218-219. Dennison BA, Erb TA, Jenkins PL. Television viewing and television in bedroom associated with overweight risk among low-income preschool children. Pediatrics. 2002;109:1028-1035. Christakis DA, Zimmerman FJ. Early television viewing is associated with protesting turning off the television at age 6. Med Gen Med. 2006:8;63. American Academy of Pediatrics. Using Television Wisely. Available at: http://www.aap.org/healthtopics/ mediause.cfm. Accessed September 25, 2006. Dimwiddie S. Setting Limits: Steering Down the Rocky Road of Childrearing. Available at: http://www.
11. 12.
13.
14.
15. 16.
17.
kidsource.com/better.world.press/setting.limits.html. Accessed September 25, 2006. Creative Kids at Home Activity Library. Available at: http://www.creativekidsathome.com. Accessed September 25, 2006. California Obesity Prevention Initiative. Do More, Watch Less. Available at: http://www.dhs.ca.gov/ps/ cdic/copi/copiforms/tvtool.htm. Accessed September 25, 2006. Centers for Disease Control and Prevention. Youth Media Campaign: Verb: It’s What You Can Do. Available at: http://www.cdc.gov/youthcampaign/. Accessed September 25, 2006. PR Newswire. Survey Finds Parents Make Family Meals a Priority. Available at: http://www.prnewswire. com/cgi-bin/stories.pl?ACCT⫽109&STORY⫽/www/ story/07-24-2006/0004401984&EDATE⫽. Accessed September 25, 2006. American Dietetic Association. Nutrition Fact Sheet: Eating Better Together. Chicago, IL: American Dietetic Association; 2005. National Center on Addiction and Substance Abuse at Columbia University. Family Day—A Day to Eat Dinner With Your Children. Available at: http://www. casafamilyday.org/. Accessed September 25, 2006. Dairy Council of California. Meals Matter. Available at: http://www.mealsmatter.org/. Accessed September 25, 2006.
January 2007 ● Journal of the AMERICAN DIETETIC ASSOCIATION
63
Promoting Family Meals and Placing Limits on Television Viewing: Practical Advice for Parents
T
he fact that increased television (TV) viewing and computer use leads to pediatric overweight has already received a great deal of publicity, so many parents may be in the contemplation stage with respect to attempting to limit children’s screen time (1-3). The fact that family mealtime can decrease the risk of pediatric overweight has not been well publicized, although there has been a great deal of attention paid to the other benefits of family meals (4-6). In both instances, registered dietitians (RDs) face challenges in moving parents along the continuum of behavior change with motivational counseling. Asking a parent to describe a child’s daily routine can be very revealing. As a parent describes various activities, the RD can inquire as to whether the child is watching TV while getting dressed, while having breakfast, while waiting to be driven to school, etc. The RD should ask about the child’s use of a computer for games, homework, and entertainment. While reviewing a typical day, the RD can gather information on foods usually served for meals and snacks, and can determine which family members are generally present when the child is having meals and snacks. It is not unusual for parents to be surprised when they find out that their child is spending far more hours in front of a screen than they would have estimated. This provides motivation for parents to move into the preparation stage and to consider various actions they can take. Moving TVs and computers out of bedrooms into family space is one strategy that can reduce screen time (7). Asking the question, “What would happen if you moved the TV out of your child’s room and just made it available in the family/living room?” is an appropriate way to introduce this possibility. The action of turning off the TV set is apt to be met with considerable protest on the part of the child, especially if the child has spent a significant amount of time watching TV in early childhood (8). Advising parents to sit down with their child and help the child select the 2 hours of TV programming that will be viewed each day is apt to be met with less resistance (9). It allows the child to make deliberate choices so that favorite programs will not be missed. It also provides parents with the opportunity to guide the child in choosing age-appropriate programming. The way to introduce this suggestion is to ask,
This article was written by Joanne P. Ikeda, MA, RD, a nutrition education specialist and lecturer, Department of Nutritional Sciences and Toxicology, University of California, Berkeley, CA, and chair, Pediatric Subunit, American Dietetic Association Weight Management Practice Group. doi: 10.1016/j.jada.2006.11.019
62
January 2007 Volume 107 Number 1
“What would happen if you and your child sat down and planned out his or her 2 hours of TV viewing for each day of the week so it would include favorite programming?” RDs should be sympathetic to the fact that parents will have to endure children’s objections when new rules about TV and computer use are implemented. At the same time, it is important to point out that consistent enforcement gradually leads to fewer complaints while inconsistent application of rules is apt to result in more resistance on the part of the child (10). Posing the question, “When your child begs to go over the 2-hour screen allowance, how will you handle it?” can help parents recognize that they need to be prepared to deal with their child’s opposition to limited TV viewing and computer use. Parents may wonder about alternative activities that will engage children as much as TV programming does. There are a number of Web sites that provide descriptions of enjoyable activities families can do when the TV set is turned off (11-13). With respect to promoting family meals, inquiring, “How do you think your children might benefit from having family meals?” will most likely result in a positive response because 80% of parents view family meals as important (14). Reinforcing whatever benefit the parent ascribes to family meals and then expanding on it can help move parents from contemplation to preparation with respect to considering this practice. Asking, “What would need to change if you decided to have family meals a certain number of times each week?” can help parents to identify barriers as well as alternative ways to overcome them. RDs can point out that family meals can be quick and easy to assemble with everyone helping, can be eaten off of paper plates with disposable utensils, can happen at any time of day, and should focus on sharing and caring. Again, there are many resources that dietitians can access for practical ideas on promoting family mealtime as well as overcoming barriers to having family meals (15-17). Equipped with practical advice, RDs can motivate and support parents as they adopt new family behaviors such as limiting TV viewing and having more family meals. These behaviors will benefit family members in multiple ways, including reducing the risk of pediatric overweight. References 1. Rideout V, Vandewater E, Wartella E. Electronic Media in the Lives of Infants, Toddlers and Preschoolers. Washington, DC: Kaiser Family Foundation Report; 2003. 2. Center for Screen Time Awareness. TV Turnoff Network. Available at: http://tvturnoff.org/index.htm. Accessed September 25, 2006. 3. United States Department of Health and Human Services, National Institute of Health. WE CAN! Project.
4.
5.
6. 7.
8.
9.
10.
Helpful Ways to Reduce Screen Time. Available at: http://www.nhlbi.nih.gov/health/public/heart/obesity/ wecan/live-it/screen-time.htm. Accessed September 25, 2006. Fulkerson JA, Story M, Mellin A, Leffert N, Neumark-Sztainer D, French SA. Family dinner meal frequency and adolescent development: Relationships with developmental assets and high-risk behaviors. J Adolesc Health. 2006;39:337-345. Johnson DB, Birkett D, Evens C, Pickering S. Promoting family meals in WIC: Lessons learned from a statewide initiative. J Nutr Educ Behav. 2006;38: 177-182. Spear BA. The need for family meals. J Am Diet Assoc. 2006;106:218-219. Dennison BA, Erb TA, Jenkins PL. Television viewing and television in bedroom associated with overweight risk among low-income preschool children. Pediatrics. 2002;109:1028-1035. Christakis DA, Zimmerman FJ. Early television viewing is associated with protesting turning off the television at age 6. Med Gen Med. 2006:8;63. American Academy of Pediatrics. Using Television Wisely. Available at: http://www.aap.org/healthtopics/ mediause.cfm. Accessed September 25, 2006. Dimwiddie S. Setting Limits: Steering Down the Rocky Road of Childrearing. Available at: http://www.
11. 12.
13.
14.
15. 16.
17.
kidsource.com/better.world.press/setting.limits.html. Accessed September 25, 2006. Creative Kids at Home Activity Library. Available at: http://www.creativekidsathome.com. Accessed September 25, 2006. California Obesity Prevention Initiative. Do More, Watch Less. Available at: http://www.dhs.ca.gov/ps/ cdic/copi/copiforms/tvtool.htm. Accessed September 25, 2006. Centers for Disease Control and Prevention. Youth Media Campaign: Verb: It’s What You Can Do. Available at: http://www.cdc.gov/youthcampaign/. Accessed September 25, 2006. PR Newswire. Survey Finds Parents Make Family Meals a Priority. Available at: http://www.prnewswire. com/cgi-bin/stories.pl?ACCT⫽109&STORY⫽/www/ story/07-24-2006/0004401984&EDATE⫽. Accessed September 25, 2006. American Dietetic Association. Nutrition Fact Sheet: Eating Better Together. Chicago, IL: American Dietetic Association; 2005. National Center on Addiction and Substance Abuse at Columbia University. Family Day—A Day to Eat Dinner With Your Children. Available at: http://www. casafamilyday.org/. Accessed September 25, 2006. Dairy Council of California. Meals Matter. Available at: http://www.mealsmatter.org/. Accessed September 25, 2006.
January 2007 ● Journal of the AMERICAN DIETETIC ASSOCIATION
63