The Effect of Television Watching on Obesity

3526 words (14 pages) Nursing Case Study

20th May 2020 Nursing Case Study Reference this

Tags: obesity

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Abstract

This study looks to further the theory that too much time spent sedentary or watching television will lead to a higher rate of obesity and type 2 diabetes.  Participants in this study will be from a diverse background of SES (socioeconomic statuses), races, and ages.  Participants will be gathered from social media.  One group will be allowed only one hour of television watching per day, while another group will be allowed to watch as much television as they want.  Both groups will be subjected to measures of their heart rate, blood pressure, weight, and BMI before the experiment begins and at intervals of two weeks over a span of six months.  Participants of both groups are also expected to self-report their daily exercise and dietary habits.  The results of this study could provide essential information on what could be causing obesity and type 2 diabetes in the present time, and therefore assist in making efforts to counter these diseases for the generations that follow.

Introduction

As a result of technological advances and the linked sedentary behaviors, obesity continues to become a greater problem.  “In the 12 years between the Second National Health and Nutrition Examination Survey (NHANES II, 1976 through 1980) and NHANES III (1988 through 1991), the prevalence of overweight in US adults increased from 25% to 33%” (Andersen, Crespo, Bartlett, Cheskin & Pratt 1998).  Even with America’s obsession with body image the obesity rate has continued to increase amongst all sexes, ages groups, and races.  Exercise is the main focus of many current health campaigns, but decreasing sedentary behaviors is not often implemented.  This begs the question, does television watching and sedentary behavior result in higher obesity and type 2 diabetes rates.  The research will support the idea that television watching and time spent stationary will lead to higher obesity and type 2 diabetes rates.

Watching television results in a lower metabolic rate than other sedentary behaviors like sewing, playing board games, reading writing, or driving a car.  The increased exposure to food advertising that comes with watching television can be linked to higher caloric intake and unhealthy eating habits (Andersen, Crespo, Bartlett, Cheskin & Pratt 1998).  Increased physical activity levels and the dietary intake of a person can combat a person’s level of obesity regardless of the amount of time that person spends being inactive.  In the past, television was not accessible in every household the same way it is today. Adults were more likely to go for a walk to clear their mind instead of turning on the television. Children were also more likely to go outside and play with friends instead of passing the time watching television or playing video games.

Most of these studies focus on the sedentariness of individuals and do not put emphasis on the activity level of the individuals.  A person can be sedentary for a decent amount of time, but as long as they get some form of exercise a few days a week this should be able to counteract the effects of being stationary.  The amount of television watching, and the use of technology is a large contributor to the high obesity rates in America and other developed countries.  The data provided on this topic should help researchers to provide new ways to fight obesity and improve the overall health of the general public.

Literature Review

Obesity

Obesity has become a major problem in the United States, with 27% of adults being obese and 34% being overweight.  Two of the main reasons for this is the promotion of fast-food, junk food, and overall unhealthy food and the decrease in physical activity in individuals.  In order to prevent obesity in children there must be a change in how unhealthy food products are constantly thrown in the face of youth and anyone who watches television, uses the internet, or listens to the radio.  A paper by Wadden, Brownell, and Foster (2002) discusses just how bad the obesity problem is becoming in America and possible measures that could be taken in order to counteract this growing problem.

Obesity is a growing problem among not only the adult population, but the adolescent population as well.  From the NHANES III study 4,063 children between the ages of 8 and 16 years old were interviewed, after completing the physical activity questionnaire and the body measurement component at an examination center.  More children of Mexican-American descent, non-Hispanic blacks, and young children were picked to guarantee a big enough sample size for these groups in a study by Andersen, Crespo, Bartlett, Cheskin, and Pratt (1998).  Children with mental or physical handicaps were excluded from the study.  The goal of the study was to measure the number of hours children took part in rigorous physical activity and television watching per week.  Many American children watch a significant amount of television per week and do not get enough physical activity to match.

With the absence of research on different alternatives that may influence the reinforcing valve of food, Carr and Epsetein (2017) were behind this study.  It encompassed two sections of research.  One, comparing how frequency and enjoyability take part in a nonfood activity and your BMI.  Two, how noneating activities reinforce food value on these additional types: social activities, sedentary activities, and physical activities.  The relative reinforcing value of food in contrast to reinforcing a nonfood alternative is a good predictor of overweight or obese children and adults.  Obese individuals more often have less strong alternative reinforcers.  If you have enjoyable and accessible alternatives to eating you are more likely to have alternative behaviors.

Technology Usage/ Television Watching

Technology usage is a contributor to sedentary behavior which can in turn lead to obesity.  Many people might assume that diet and exercise are the only factors that are important to overall body weight.  A study conducted by Vaterlaus, Jones, Patten, and Cook (2015) analyzed the relationship between technology usage and body mass index (BMI) in young adults.  The study looked at 743 college students in North Utah, consisting of 612 females and 131 males ranging in age from 18-25.  Students were asked online to rate their technology usage on a scale from 0-8 and provide their height and weight to calculate BMI.  They found that there was no significant correlation between technology usage and BMI, as students with normal and high BMI’s use technology at around the same rate.

Food advertising on television can impact a person’s dietary decisions.  The more a person watches television the more they will be exposed to food advertisements, which may increase the likelihood of them buying the products advertised.  The products advertised on television are typically not healthy foods.   Food advertising specifically targets youth-networks and black-networks as shown by the study conducted by Fleming-Milici and Harris (2016).  From 2008-2012 increased television watching and an increase in youth and black-targeted food ads lead to greater exposure to black youth.  In order to slow the rising rates of obesity advertisers must be cognizant of what they advertise to youth on television and social media.

As mentioned in the paragraph above most food advertised in commercials are not nutritious or beneficial to anyone’s health.  Watching television while eating can lead to overeating, as one does not pay close attention to how much they are eating when distracted.  Children and adults exposed to food advertising ate more after exposure in a study by Harris, Bargh, and Brownell (2009).  People are more prone to grab food nearby and eat if they see food advertisements on television.  Advertising influences innate eating behaviors that are difficult to control.  Whether the ads were pertaining to healthy food or unhealthy food, both increased the viewers likelihood to eat more than they would if they had not viewed the advertisement.

Sedentary Behaviors

There has been a need to search for different methods to increase physical activity in obese children, over a long period of time.  Overweight children are not only less physically active, but also find sedentary activity more reinforcing than physical activities.  One notable sedentary behavior is watching television.  Viewing television has been shown to lessen one’s physical activity.  Standard behavioral strategies are no longer successful in increasing physical activities in the long run. A study by Epstein, Saelens, Myers, and Vito (1995), was done on obese children ages 8-12 years old.  In a controlled laboratory setting they studied the contrast of three methods: restricting access to sedentary activities, positive reinforcement for being less sedentary, and punishment for being sedentary.

Sedentary activities such as television viewing and playing computer games resulted in an increase of childhood obesity.  Obese children find being sedentary is more reinforcing than being physically active.  This study was done to see the results of weight control by comparing the outcome of increasing physical activity to reducing the time spent being sedentary.  Participants were obese children between the ages of 8-12 years old.  Habit books were used to track treatment goals for this one-year study.  The children placed in one of the following groups, randomly: reinforcing exercise, reinforcing less sedentary activity, and a combination of both.  Families were taught how to change activity and eating habits.  The results showed that children who were reinforced for reducing sedentary behaviors rather than reinforced for exercising, had a better outcome with weight loss and reduced body fat.

Sedentary behavior whether or not it’s watching television should be limited in order to keep a person’s weight in check.  For the Nurses’ Health Study Cohort 121,700 women ages 30 to 55, answered a questionnaire in the mail about their medical history and health care routine.  Women with cardiovascular disease, cancer, or diabetes were not included in the study.  There were diabetes and obesity analyses conducted, leaving a total of 50,277 women for the final analysis in a study conducted by Hu, Li, Colditz, Willet, and Manson (2003).  The study found that women who watched more television were at a higher risk for obesity and type 2 diabetes.  For every 2 additional hours spent watching TV there was a 23% increase in risk of obesity and a 14% increase in risk of type 2 diabetes.  For every additional 1 hour spent walking there was a 24% decrease in risk of obesity and a 34% decrease in risk of type 2 diabetes.

Sedentary behavior has been a popular topic for research since the prevalence of television began to rise.  Obesity in children in relation to sedentary behavior has been a largely studied topic.  In a study conducted by Biddle, Bengoechea, and Wiesner;(2017) the three reviewed over 450 papers to compile an analysis of evidence on the relationship between childhood obesity and sedentary behavior.  The main conclusion the authors drew from their research was that there was small population where this relationship exists, but in most youth, they found little to no evidence for a causal association between the childhood obesity and sedentary behavior.

Methods

Participants:  For this study it would be ideal if half the participants have healthy BMI’s and half the participants have BMI’s that are overweight.  Participants with high, moderate, and low socioeconomic statuses would be incorporated.  All races of people would be included to see how the results apply to different races.  The age range of participants would go from children to elderly as this could impact all people.  Not everyone that volunteers will be accepted, as a diverse background of people is necessary for this experiment.  Once the needs for a particular group of people are met no more applicants will be accepted for that particular criterion.  Participants must also own a television set in order to take part in the experiment.

Procedure:  Participants would be gathered from social media advertising offering money to participate.  One group of people would be able to watch television for no more than one hour per day.  This would be the control group for the experiment.  The experimental group would have no restriction on the number of hours they can watch television per day.  Both groups would have their blood pressure, heart rate, weight, and body mass index (BMI) measured before the experiment.  Each group would also have their blood pressure, heart rate, weight, and BMI measured every two weeks over a six-month span to monitor the changes in their weight, heart rate, blood pressure, and BMI.  Each individual subject would be asked to monitor their food intake and their exercise daily.

Materials:  A sphygmomanometer would be used to measure the blood pressure of all of the subjects.  A heart rate monitor would be used to measure the heart rate of the subjects.  A dexa scan would be used to measure the BMI of the subjects.  A scale would be used to measure the weight of the participants.  Height would not be a required measurement for calculating BMI as that will be measured through the use of the dexa scan.

Design:  This is an independent measures study as there is an independent variable (television watching) and a dependent variable (Body Mass Index), with participants only being part of one group for the duration of the experiment.  Group A (control group) would be allowed one hour per day of television watching and consist of twenty-five subjects.  Group B (the experimental group) would have no restriction on the amount of time they can watch television per day and would also consist of twenty-five participants.

Discussion

The expected outcome of this experiment is that increased television watching and sedentary behavior does lead to higher obesity and type 2 diabetes rates.  From the research gathered in the literature review, this is the most prominent and consistent finding.  The Nurses’ Health Study Cohort found that for every 2 additional hours spent watching TV there was a 23% increase in risk of obesity.  Children along with adults are experiencing much more advertising than ever before.  This is due to the increased amount of time people of all ages are spending on technological devices.  Whether people are scrolling social media, browsing Youtube or the internet, or just watching TV they can be subjected to a multitude of food advertisements.  This puts people at a greater risk for obesity because increased exposure will more than likely lead to the viewer buying one of the products at some point in time.  Many people have chosen more sedentary hobbies such as watching television or playing video games instead of going out for a walk or playing with friends, which people did more of in the past.

The expected results of the study would be that group B (experimental group) would have higher heart rates, blood pressures, and BMI’s than the participants in group A (control group).  The expected reason for this outcome is that sedentary behavior and television watching promote unhealthy eating and exercising behaviors.  It is not expected that any particular race or the age of any particular participant will influence their results negatively or positively.  One factor that could impact the results of the study could be the SES (socioeconomic status) of a participant.  This could impact the quality of food they can afford to purchase.

One strength of the study would be that it is not too expensive to test the four measures suggested (weight, heart rate, blood pressure, and BMI).  All participants have to do is watch television and self-report their daily diet and exercise habits, so there isn’t much money being spent anywhere in the study.  Another strength of the study is that it is not over too long of a time frame, it’s only six months in duration.  A potential weakness of the experiment would be that participants could lie about their diet, exercise, and the amount of television they have watched.  Another weakness of the study could be a participant’s family medical history, such as if obesity, heart disease, or high blood pressure run in the family.  The opposite could also be true with anorexia nervosa or bulimia nervosa.  Another weakness that can’t be avoided is the SES of participants as those on the low end may not be able to afford food that is nutritionally healthy for themselves.

In future studies to get more detailed results, there could be more participants included in the experiment.  This would further legitimize the findings as the sample is much larger and can be applied to society.  In future studies there could be more groups of participants too, with varying limits on how much time they can spend watching television.  So instead of just two groups; one having access to the television for one hour per day and the other group having unlimited access to the television, there could be groups that can watch for three hours per day, 5 hours per day, and so on.  To get even more accurate results from the experiment, participants BMI’s, heart rate, blood pressure, and weight could be taken daily instead of every other week.

 

References

  • Andersen RE, Crespo CJ, Bartlett SJ, Cheskin LJ, Pratt M. Relationship of Physical Activity and Television Watching With Body Weight and Level of Fatness Among ChildrenResults From the Third National Health and Nutrition Examination Survey. JAMA. 1998;279(12):938–942. doi:10.1001/jama.279.12.938
  • Biddle, S. J. H., García Bengoechea, E., & Wiesner, G. (2017). Sedentary behaviour and adiposity in youth: A systematic review of reviews and analysis of causality. The International Journal of Behavioral Nutrition and Physical Activity14. https://doi-org.libproxy.temple.edu/10.1186/s12966-017-0497-8
  • Carr, K. A., & Epstein, L. H. (2018). Influence of sedentary, social, and physical alternatives on food reinforcement. Health Psychology37(2), 125–131. https://doi-org.libproxy.temple.edu/10.1037/hea0000563
  • Epstein, L. H., Saelens, B. E., Myers, M. D., & Vito, D. (1997). Effects of decreasing sedentary behaviors on activity choice in obese children. Health Psychology16(2), 107–113. https://doi-org.libproxy.temple.edu/10.1037/0278-6133.16.2.107
  • Epstein, L. H., Valoski, A. M., Vara, L. S., McCurley, J., Wisniewski, L., Kalarchian, M. A., … Shrager, L. R. (1995). Effects of decreasing sedentary behavior and increasing activity on weight change in obese children. Health Psychology14(2), 109–115. https://doi-org.libproxy.temple.edu/10.1037/0278-6133.14.2.109
  • Fleming‐Milici, F., and  Harris, J. L. ( 2018)  Television food advertising viewed by preschoolers, children and adolescents: contributors to differences in exposure for black and white youth in the United States. Pediatric Obesity,  13:  103– 110. doi: 10.1111/ijpo.12203.
  • Harris, J. L., Bargh, J. A., Brownell, K. D. (2009) Priming Effects of television food advertising on eating behavior. Health Psychology, 28(4), 404-413. https://doi-org.libproxy.temple.edu/10.1037/a0014399
  • Hu FB, Li TY, Colditz GA, Willett WC, Manson JE. Television Watching and Other Sedentary Behaviors in Relation to Risk of Obesity and Type 2 Diabetes Mellitus in Women. JAMA. 2003;289(14):1785–1791. doi:10.1001/jama.289.14.1785
  • J. Mitchell Vaterlaus, Randall M. Jones, Emily V. Patten, Jerry L. Cook,An exploratory study of time spent with interactive technology and body mass among young adults, Computers in Human Behavior, Volume 52, 2015, Pages 107-114, ISSN 0747-5632, https://doi.org/10.1016/j.chb.2015.05.035.
  • Wadden, T. A., Brownell, K. D., & Foster, G. D. (2002). Obesity: Responding to the global epidemic. Journal of Consulting and Clinical Psychology70(3), 510–525. https://doi-org.libproxy.temple.edu/10.1037/0022-006X.70.3.510

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