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Recommendations Summary

Pediatric Weight Management (PWM) Decreasing Sedentary Behaviors in Children and Adolescents

Click here to see the explanation of recommendation ratings (Strong, Fair, Weak, Consensus, Insufficient Evidence) and labels (Imperative or Conditional). To see more detail on the evidence from which the following recommendations were drawn, use the hyperlinks in the Supporting Evidence Section below.


  • Recommendation(s)

    PWM: Decreasing Sedentary Behaviors - Children

    Children should be counseled to reduce or limit sedentary activities (e.g., television, video games, "screen time"). Intervention research indicates that reducing sedentary activities may have both short-term and longer-term benefits in terms of pediatric obesity. Observational research also indicates that television time may also be associated with increased consumption of energy-dense foods.

    Rating: Fair
    Imperative

    PWM: Decreasing Sedentary Behaviors - Adolescents

    Adolescents should be counseled to reduce or limit sedentary activities (e.g., TV, video games, "screen time"). Limited intervention research indicates that reducing sedentary activities may have both short term benefits in terms of pediatric obesity.

    Rating: Weak
    Imperative

    • Risks/Harms of Implementing This Recommendation

      None.

    • Conditions of Application

      None.

    • Potential Costs Associated with Application

      Absence of health insurance coverage for weight management could limit program access.

    • Recommendation Narrative

      Five studies (four RCTs and one non-randomized trial) were analyzed that included an intervention to reduce sedentary behaviors (e.g., television-watching), as part of a multi-component childhood weight management program. Only one study examined adolescents (Saelens B, Sallis J, et al 2002), while the others focused on children (ages six to 12). All studies earned a positive quality rating.

      In children (ages six to 12), the addition of interventions to decrease sedentary activities to a multi-component pediatric obesity program is associated with improved adiposity outcomes. For adolescents however, the results are promising but less clear.

      Research also indicates that the effectiveness of interventions to reduce sedentary behaviors may be more effective for boys and is dose-dependent.

      Some very limited research (Epstein LH, Valoski AM, Vara LS, McCurley J, et al. 1995 Health Psych) suggests that interventions to reduce sedentary behaviors may be more effective than interventions to increase physical activity alone. However, this research is too limited to be generalized.

    • Recommendation Strength Rationale

      The number of studies on the reduction of sedentary activities and the treatment of pediatric obesity was limited, though the results are consistent (Grade II). The findings with regard to adolescents is promising, but even more limited (Grade III).

    • Minority Opinions

      None.