Jonathan, age 13, spent his Saturday morning with his Wii playing Guitar Hero. After a cookie and bag of chips for lunch he moved on to his computer where he checked in with his friends on Facebook.com. Then, he spent a couple of hours on the couch watching TV while eating a hamburger, french fries and milk shake for dinner.

There are many children who actually do spend days like the fictional Jonathan. And, it’s a real problem for a child’s health when too much time is spent in front of a screen. “Screen time” — whether it’s in front of a television, a computer or gaming platform — should be limited to no more than two hours total daily for both health and developmental reasons. Why? Because lack of physical activity coupled with a high calorie fat-laden diet not only causes obesity in childhood but it sets up youngsters for a lifetime risk of the attendant health problems that come with it: heart disease, type 2 diabetes and high blood pressure, to name a few.

In addition to too much screen time, Jonathan’s diet is a call for help.

What I tell parents is at its most basic level weight management boils down to two things: how many calories you are eating and how many calories you are burning. I see nine-year-olds eating super-sized fast food meals that I would not want to see an adult eat. The problem is these patterns are established early in life and become more difficult to change the older the child gets. Providing a low-fat diet with five or more servings of fruits and vegetables daily and limiting screen time are the most important things a parent can do to improve a child’s health significantly, especially when coupled with regular exercise.

Another problem with how Jonathan spent his Saturday is that he spent it alone without a chance to interact with others. TV watching, surfing the Web and video games are not activities that foster interaction between kids.

Watching a screen for hours a day causes another problem that parents should take seriously. An article published in The Journal of Pediatrics in 2006 shows a study that concluded “both the content and (amount of) screen time had independent (negative) associations with school performance. These findings support parental enforcement of American Academy of Pediatrics guidelines for media time (particularly weekdays) and content limits to enhance school success.”

Translation? If you want to help ensure a child’s success in school, limit screen time and monitor what your child is watching. I believe along with fellow pediatricians across the nation that the guidelines on screen time issued by the American Academy of Pediatrics are the healthy way to go.

Further information can be obtained from the American Academy of Pediatrics at www.aap.org/healthtopics/mediause.cfm.

At the top of the “to do” list is limiting children’s total entertainment media time to no more than one to two hours of quality programming per day. If a child has a television in his or her room it needs to be removed despite the potential for protest. Prevention is easier than the cure: If your child has no television in the room yet, don’t put one there. Television should be avoided for children younger than age two. Parents need to encourage more interactive activities that will promote proper brain development, such as talking, playing, singing, and reading together. For older children, I advise parents to encourage alternative entertainment for children, including reading, athletics, hobbies, and creative play.

Although it can be challenging, parents should monitor the shows their young children and teens are viewing. Most programs should be informational, educational, and nonviolent, according to the guidelines from the American Academy of Pediatrics. Guidelines also suggest that parents view television programs along with children, and discuss the content and not to just depend on the ratings on the DVD or video game. Two recent surveys involving a total of nearly 1500 parents found that less than half of parents reported always watching television with their children.

Dr. Shelton Chapman is a board certified pediatrician at Pacific Medical Centers Totem Lake and First Hill clinics. Dr. Chapman received his medical education from The Chicago Medical School and did his advanced training at Loma Linda University in California. Dr. Chapman has been in practice for more than 10 years. For more information about Dr. Chapman, please call 425-814-5000.