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Khalsa AS, Andridge R, Keim SA, Zvara BJ, Anderson SE. Screen Time, Outdoor Play, and Sleep Routines in Early Childhood: Longitudinal Associations with Parenting Stress during Toddler to Preschool Years. J Pediatr Health Care 2024:S0891-5245(24)00177-9. [PMID: 39306782 DOI: 10.1016/j.pedhc.2024.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Revised: 07/02/2024] [Accepted: 07/02/2024] [Indexed: 10/16/2024]
Abstract
INTRODUCTION Our study examined the longitudinal relationship between parenting stress and screen time, outdoor play, and sleep routines in toddler to preschool-aged children. METHOD We conducted a descriptive quantitative analysis of a prospective observational cohort study of 300 families with an 18-month-old toddler who were followed for 2 years. Parenting stress was measured using a subscale of the Parenting Stress Index-4 Short Form at child age 18 months. Screen time, outdoor play, and sleep routines were parent-reported at child age 36 months. Multivariable regression estimated associations between parenting stress and screen time behaviors, outdoor play, and sleep routines. RESULTS Data from 280 children (42.1% female) showed that 39.6% did not have rules around screen time and 82% of families reported frequently having the television on without anyone watching. In adjusted models, a 1-standard deviation increase in parenting stress at 18 months was associated with increased odds of having a television on without anyone watching (OR 1.26, 95% CI: 1.01, 1.57) and decreased odds of not having rules about the amount of screen time at 36 months (OR 0.75, 95% CI: 0.58, 0.96). DISCUSSION Increased parenting stress in early childhood was associated with some suboptimal screen time behaviors and sleep routines when children were preschool-aged.
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Saltaouras G, Kyrkili A, Bathrellou E, Georgoulis M, Yannakoulia M, Bountziouka V, Smrke U, Dimitrakopoulos G, Kontogianni MD. Associations between Meal Patterns and Risk of Overweight/Obesity in Children and Adolescents in Western Countries: A Systematic Review of Longitudinal Studies and Randomised Controlled Trials. CHILDREN (BASEL, SWITZERLAND) 2024; 11:1100. [PMID: 39334632 PMCID: PMC11430606 DOI: 10.3390/children11091100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2024] [Revised: 08/30/2024] [Accepted: 09/06/2024] [Indexed: 09/30/2024]
Abstract
Childhood overweight/obesity (OV/OB) is a major public health problem in Western countries, often accompanied with comorbidities (e.g., hypertension and insulin resistance) (i.e., metabolically unhealthy obesity-MUO). Among diet-related risk factors of OV/OB risk and MUO, meal patterns remain limitedly studied. The aim of this systematic review was to explore associations between meal patterns and the risk of childhood OV/OB and MUO in children/adolescents aged 2-19 years. Longitudinal studies and randomised controlled trials from PUBMED and Scopus published between January 2013 and April 2024 were retrieved. Twenty-eight studies were included, all of which reported on OV/OB risk, with none on MUO risk. Regular consumption of breakfast (n = 3) and family meals (n = 4) and avoiding dining while watching TV (n = 4) may be protective factors against childhood OV/OB, whereas meal skipping (primarily breakfast; n = 4) may be a detrimental factor. Mixed effects of meal frequency on OV/OB risk were observed; no effects of frequency of lunch or of fast-food consumption and of meals served at school were found. There was insufficient evidence to support the role of other patterns (meal timing, eating in other social contexts). Meals were mainly participant-identified, leading to increased heterogeneity. Research focusing on childhood MUO and the use of harmonised definitions regarding the assessment of meal patterns are highly warranted.
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Affiliation(s)
- Georgios Saltaouras
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University of Athens, 17671 Athens, Greece; (G.S.); (A.K.); (E.B.); (M.G.); (M.Y.)
| | - Athanasia Kyrkili
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University of Athens, 17671 Athens, Greece; (G.S.); (A.K.); (E.B.); (M.G.); (M.Y.)
| | - Eirini Bathrellou
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University of Athens, 17671 Athens, Greece; (G.S.); (A.K.); (E.B.); (M.G.); (M.Y.)
| | - Michael Georgoulis
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University of Athens, 17671 Athens, Greece; (G.S.); (A.K.); (E.B.); (M.G.); (M.Y.)
| | - Mary Yannakoulia
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University of Athens, 17671 Athens, Greece; (G.S.); (A.K.); (E.B.); (M.G.); (M.Y.)
| | - Vasiliki Bountziouka
- Computer Simulation, Genomics and Data Analysis Laboratory, Department of Food Science and Nutrition, University of the Aegean, 81400 Lemnos, Greece;
- Department of Cardiovascular Science, College of Life Science, University of Leicester, Leicester LE1 7RH, UK
- NIHR Leicester Biomedical Research Centre, Glenfield Hospital, Leicester LE3 9QP, UK
- Population, Policy and Practice Research and Teaching Department, GOS Institute of Child Health, University College London, London WC1N 1EH, UK
| | - Urška Smrke
- Faculty of Electrical Engineering and Computer Science, University of Maribor, 2000 Maribor, Slovenia;
| | - George Dimitrakopoulos
- Department of Informatics and Telematics, School of Digital Technology, Harokopio University of Athens, 17671 Athens, Greece;
| | - Meropi D. Kontogianni
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University of Athens, 17671 Athens, Greece; (G.S.); (A.K.); (E.B.); (M.G.); (M.Y.)
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Litterbach EK, Laws R, Zheng M, Campbell KJ, Spence AC. Mothers' experiences of reducing family mealtime screen use in Australian households with young children. Public Health Nutr 2023; 27:e21. [PMID: 38099428 PMCID: PMC10830358 DOI: 10.1017/s1368980023002847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 08/20/2023] [Accepted: 12/11/2023] [Indexed: 01/13/2024]
Abstract
OBJECTIVE Screen use at mealtimes is associated with poor dietary and psychosocial outcomes in children and is disproportionately prevalent among families of low socio-economic position (SEP). This study aimed to explore experiences of reducing mealtime screen use in mothers of low SEP with young children. DESIGN Motivational interviews, conducted via Zoom or telephone, addressed barriers and facilitators to reducing mealtime screen use. Following motivational interviews, participants co-designed mealtime screen use reduction strategies and trialled these for 3-4 weeks. Follow-up semi-structured interviews then explored maternal experiences of implementing strategies, including successes and difficulties. Transcripts were analysed thematically. SETTING Australia. PARTICIPANTS Fourteen mothers who had no university education and a child between six months and six years old. RESULTS A range of strategies aimed to reduce mealtime screen use were co-designed. The most widely used strategies included changing mealtime location and parental modelling of expected behaviours. Experiences were influenced by mothers' levels of parenting self-efficacy and mealtime consistency, included changes to mealtime foods and an increased value of mealtimes. Experiences were reportedly easier, more beneficial and offered more opportunities for family communication, than anticipated. Change required considerable effort. However, effort decreased with consistency. CONCLUSIONS The diverse strategies co-designed by mothers highlight the importance of understanding why families engage in mealtime screen use and providing tailored advice for reduction. Although promising themes were identified, in this motivated sample, changing established mealtime screen use habits still required substantial effort. Embedding screen-free mealtime messaging into nutrition promotion from the inception of eating will be important.
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Affiliation(s)
- Eloise-Kate Litterbach
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Burwood, Australia
- The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, VIC3053, Australia
| | - Rachel Laws
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Burwood, Australia
| | - Miaobing Zheng
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Burwood, Australia
| | - Karen J Campbell
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Burwood, Australia
| | - Alison C Spence
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Burwood, Australia
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Rietz M, Schmidt-Persson J, Rasmussen MGB, Egebaek HK, Wedderkopp N, Kristensen PL, Grøntved A. Recreational screen time trajectories during early childhood and imaging-measured body composition at age 7 in the Odense child cohort. Paediatr Perinat Epidemiol 2023. [PMID: 36799105 DOI: 10.1111/ppe.12956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 01/09/2023] [Accepted: 01/11/2023] [Indexed: 02/18/2023]
Abstract
BACKGROUND Children spend increasing amounts of time on recreational screen media, which may lead to an obesogenic environment. OBJECTIVES We investigated the association of trajectories of screen time across ages 3, 5 and 7 years with body composition at age 7 in the Odense Child Cohort. METHODS Data were collected in the Municipality of Odense, Denmark, between 2010 and 2019. Group-based trajectory modelling was applied to group participants into four trajectories of prospective parent-reported screen time. Body composition was assessed using dual-energy x-ray absorptiometry with calculated fat-mass index (FMI) as the primary outcome. Primary models were linear multivariable regression models adjusted for participants' sex, age, birthweight, maternal origin, maternal education, maternal body-mass-index, and maternal age. Further models were adjusted for additional possible confounders. Selection bias was addressed by inverse probability weighting. RESULTS In total, 803 children (48.2% female) were included in the primary analysis. Participants with screen time at all time points were assigned to four trajectory groups [constant low screen time (12.7%), low increase (36.3%), high increase between ages 3 and 5 (33.5%) and high increase in screen time (17.5%)]. Sample characteristics differed across missing data status and trajectories. Mean FMI (kg/m2 ) and standard deviation (SD) were 3.7 (SD 1.3) and 3.9 (SD 1.6) for the constant low versus high screen time, respectively. No differences in FMI were found between screen time trajectory groups at age 7 (adjusted mean difference 0.1 kg/m2 , 95% confidence interval -0.3, 0.5 for constant low versus high screen time). No consistent associations between screen time groups and secondary body composition outcomes were found. CONCLUSIONS Results from this study do not suggest that recreational screen time from age 3 to 7 years is associated with adiposity or other measures of body composition.
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Affiliation(s)
- Marlene Rietz
- Center for Research in Childhood Health, Research Unit for Exercise Epidemiology, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Jesper Schmidt-Persson
- Center for Research in Childhood Health, Research Unit for Exercise Epidemiology, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Martin Gillies Banke Rasmussen
- Center for Research in Childhood Health, Research Unit for Exercise Epidemiology, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.,Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark
| | - Heidi Klakk Egebaek
- Center for Research in Childhood Health, Research Unit for Exercise Epidemiology, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.,University College South Denmark, Haderslev, Denmark
| | - Niels Wedderkopp
- The Pediatric Research Unit, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Peter Lund Kristensen
- Center for Research in Childhood Health, Research Unit for Exercise Epidemiology, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Anders Grøntved
- Center for Research in Childhood Health, Research Unit for Exercise Epidemiology, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
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Litterbach EK, Laws R, Zheng M, Campbell KJ, Spence AC. "That's the routine": A qualitative exploration of mealtime screen use in lower educated Australian families with young children. Appetite 2023; 180:106377. [PMID: 36410562 DOI: 10.1016/j.appet.2022.106377] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 10/31/2022] [Accepted: 11/12/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND Family meals are an opportune context for initiating healthy eating habits in young children. However, using screens at family mealtimes may negate some of the associated nutritional and social benefits. In High Income countries, frequent mealtime screen use is common, particularly in families of low socioeconomic position (SEP). This study aimed to explore experiences and acceptability of mealtime screen use in families of low SEP with young children. METHODS Qualitative interviews with 25 mothers of low SEP were conducted via telephone or Zoom™ using Photo Interviewing and a semi-structured interview script. Transcripts were analysed thematically using a Constructivist paradigm. RESULTS Many parents reported an eagerness for reducing family mealtime screen use. Three major themes were identified in explaining the reasons behind levels of engagement in family mealtime screen use. These included parental self-efficacy, such as parental confidence in saying no to screens at mealtimes, physical resources such as having enough space in the home for a functioning dining table without view of a television, and temporal priorities such as prioritising screen use for managing children's difficult behaviour at mealtimes over long-term health considerations. CONCLUSIONS This study highlights that although family mealtime screen use is likely linked with a range of child behaviours and parenting practices that may negatively influence children's dietary intake and social engagement, parents often considered screens acceptable at mealtimes. Nonetheless, parents' desire to reduce family mealtime screen use provides an important opportunity to determine how best to support parents to achieve this.
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Affiliation(s)
- Eloise-Kate Litterbach
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia.
| | - Rachel Laws
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Miaobing Zheng
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Karen J Campbell
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Alison C Spence
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
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Wang C, Qian H, Li H, Wu D. The status quo, contributors, consequences and models of digital overuse/problematic use in preschoolers: A scoping review. Front Psychol 2023; 14:1049102. [PMID: 36874856 PMCID: PMC9980908 DOI: 10.3389/fpsyg.2023.1049102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Accepted: 02/01/2023] [Indexed: 02/18/2023] Open
Abstract
Digital devices play a critical role in preschoolers' learning and development. Despite the evidence that digital devices use may facilitate preschoolers' learning and development, their overuse/problematic use has become a global concern as the popularity and widespread use of digital devices. This scoping review aims to synthesize the empirical evidence to identify the status quo, influential factors, developmental outcomes, and models of overuse/problematic use in preschoolers. This search has identified 36 studies published in international peer-reviewed journals during 2001-2021, converging into four common topics: the current situation, the influential factors, the consequences, and the models. First, the average percentages of overuse and problematic use across the studies collected in this research were 48.34%, and 26.83%, separately. Second, two influential factors were identified: (1) children's characteristics and (2) parental and family factors. Third, early digital overuse/problematic use was found to have a negative impact on the following domains: (1) physical health, (2) psychosocial health, (3) problematic behaviors, and (4) cognitive development; Fourth, most relevant studies adopted general linear models, while few of them adopted experimental designs. Finally, the implications for future studies and practical improvements are also addressed.
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Affiliation(s)
- Chenggong Wang
- College of Science and Technology, Ningbo University, Ningbo, Zhejiang, China
| | - Haoyue Qian
- Shanghai Institute of Early Childhood Education, Shanghai Normal University, Shanghai, China
| | - Hui Li
- Shanghai Institute of Early Childhood Education, Shanghai Normal University, Shanghai, China.,Macquarie School of Education, Macquarie University, Sydney, NSW, Australia
| | - Dandan Wu
- Department of Early Childhood Education, Faculty of Education and Human Development, The Education University of Hong Kong, Hong Kong, Hong Kong SAR, China
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Litterbach EK, Zheng M, Campbell KJ, Laws R, Spence AC. Mealtime TV Use Is Associated with Higher Discretionary Food Intakes in Young Australian Children: A Two-Year Prospective Study. Nutrients 2022; 14:nu14132606. [PMID: 35807787 PMCID: PMC9268203 DOI: 10.3390/nu14132606] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 05/29/2022] [Accepted: 06/17/2022] [Indexed: 02/05/2023] Open
Abstract
Background: Mealtime television use has been cross-sectionally associated with suboptimal diets in children. This study aimed to assess the two-year prospective association between baseline mealtime television use and subsequent diets in young children, and identify socioeconomic differences. Methods: Parents reported their child’s television use at meals, and fruit, vegetable, and discretionary food intakes. Multivariable linear and logistic regression analyses assessed the association between baseline mealtime television use and follow-up diet outcomes. Differences were assessed by socioeconomic position. Results: Participants were 352 Australian parents of children aged six months to six years. Daily mealtime television use (average frequency/day) was associated with higher daily frequency of discretionary food intakes (β 0.2, 95% confidence interval (CI) 0.07–0.67) at the 2-year follow-up. Individually, television use during breakfast and dinner (1–2 days/week compared to never) predicted higher daily intake frequency of discretionary food, β 0.36 (95% CI 0.12–0.60) and β 0.19 (95% CI 0.00–0.39), respectively. Similarly, 3–7 days/week of television use during breakfast and lunch predicted higher frequency of discretionary food intake, β 0.18 (95% CI 0.02–0.37) and β 0.31 (95% CI 0.07–0.55), respectively. Associations were not socioeconomically patterned. Conclusions: Investigating mealtime television use motivators across the socioeconomic spectrum could inform interventions targeting the high consumption of discretionary foods in children.
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Roy D, Boss R, Saroj S, Karandikar B, Pradhan M, Pandey H. Snack Food Consumption across the Pune Transect in India: A Comparison of Dietary Behaviors Based on Consumer Characteristics and Locations. Nutrients 2021; 13:nu13124325. [PMID: 34959878 PMCID: PMC8707810 DOI: 10.3390/nu13124325] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 11/28/2021] [Accepted: 11/28/2021] [Indexed: 12/01/2022] Open
Abstract
This study examines patterns of snack food consumption (SFC) in the rural-urban-slum transect (RUST) of a large city Pune and its precincts (population 10 million) in India. The transect structure aims to mimic a representative survey for the location capturing differences by age, gender, urbanicity, and socio-economic levels. Dietary data from 1405 individuals were used to describe snacking patterns and other food consumed at different frequencies; extent of physical activity; and Body Mass Index (BMI) and waist circumference of children, adolescents, and adults. Our results indicate high incidence of SFC across all population age groups, gender, socio-economic levels, and locations. A distinctive finding in relation to studies in high income countries is the prevalence of hunger snacking with 70% identifying hunger as the primary reason for SFC. Apart from hunger, particularly for adolescents, peer influence and social interactions played a significant role in SFC. Dietary behaviors of slum dwellers were characterized by three-quarters of them having SFC together with family members at home. SFC supplemented calories for low-income consumers and complemented calorie intake for high income ones. No significant association with BMI is possibly due to obesogenic SFC being likely offset by lower consumption of non-snack food and higher physical activity among poor and slum dwellers. Promoting awareness about diets and lifestyles, improving physical and economic access to healthier snacks and nutrient dense foods can improve diet quality in a large and heterogeneous population such as Pune.
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Affiliation(s)
- Devesh Roy
- International Food Policy Research Institute (IFPRI), Agriculture for Nutrition and Health (A4NH), New Delhi 110012, India;
- Correspondence:
| | - Ruchira Boss
- International Food Policy Research Institute (IFPRI), Agriculture for Nutrition and Health (A4NH), New Delhi 110012, India;
| | - Sunil Saroj
- International Food Policy Research Institute (IFPRI), South-Asia Office (SAO), New Delhi 110012, India; (S.S.); (M.P.)
| | | | - Mamata Pradhan
- International Food Policy Research Institute (IFPRI), South-Asia Office (SAO), New Delhi 110012, India; (S.S.); (M.P.)
| | - Himanshi Pandey
- Centre for Chronic Disease Control (CCDC), New Delhi 110016, India;
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Padmapriya N, Tint MT, Sadananthan SA, Michael N, Chen B, Cai S, Toh JY, Lanca C, Tan KH, Saw SM, Shek LPC, Chong YS, Gluckman PD, Lee YS, Yap F, Fortier MV, Chong MFF, Godfrey KM, Eriksson JG, Velan SS, Kramer MS, Bernard JY, Müller-Riemenschneider F. The longitudinal association between early-life screen viewing and abdominal adiposity-findings from a multiethnic birth cohort study. Int J Obes (Lond) 2021; 45:1995-2005. [PMID: 34108642 PMCID: PMC7611569 DOI: 10.1038/s41366-021-00864-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 05/02/2021] [Accepted: 05/18/2021] [Indexed: 02/05/2023]
Abstract
IMPORTANCE Screen viewing in adults has been associated with greater abdominal adiposity, with the magnitude of associations varying by sex and ethnicity, but the evidence is lacking at younger ages. We aimed to investigate sex- and ethnic-specific associations of screen-viewing time at ages 2 and 3 years with abdominal adiposity measured by magnetic resonance imaging at age 4.5 years. METHODS The Growing Up in Singapore Towards healthy Outcomes is an ongoing prospective mother-offspring cohort study. Parents/caregivers reported the time their child spent viewing television, handheld devices, and computer screens at ages 2 and 3 years. Superficial and deep subcutaneous and visceral abdominal adipose tissue volumes were quantified from magnetic resonance images acquired at age 4.5 years. Associations between screen-viewing time and abdominal adipose tissue volumes were examined by multivariable linear regression adjusting for confounding factors. RESULTS In the overall sample (n = 307), greater total screen-viewing time and handheld device times were associated with higher superficial and deep subcutaneous adipose tissue volumes, but not with visceral adipose tissue volumes. Interactions with child sex were found, with significant associations with superficial and deep subcutaneous and visceral adipose tissue volumes in boys, but not in girls. Among boys, the increases in mean (95% CI) superficial and deep subcutaneous and visceral adipose tissue volumes were 24.3 (9.9, 38.7), 17.6 (7.4, 27.8), and 7.8 (2.1, 13.6) mL per hour increase in daily total screen-viewing time, respectively. Ethnicity-specific analyses showed associations of total screen-viewing time with abdominal adiposity only in Malay children. Television viewing time was not associated with abdominal adiposity. CONCLUSION Greater total screen-viewing time (and in particular, handheld device viewing time) was associated with higher abdominal adiposity in boys and Malay children. Additional studies are necessary to confirm these associations and to examine screen-viewing interventions for preventing excessive abdominal adiposity and its adverse cardiometabolic consequences.
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Affiliation(s)
- Natarajan Padmapriya
- Department of Obstetrics & Gynaecology and Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.
| | - Mya-Thway Tint
- Department of Obstetrics & Gynaecology and Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
| | - Suresh Anand Sadananthan
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
| | - Navin Michael
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
| | - Bozhi Chen
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Shirong Cai
- Department of Obstetrics & Gynaecology and Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
| | - Jia Ying Toh
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
| | - Carla Lanca
- Singapore Eye Research Institute, Singapore, Singapore
| | - Kok Hian Tan
- KK Women's and Children's Hospital, Singapore, Singapore
- Duke-National University of Singapore, Singapore, Singapore
| | - Seang Mei Saw
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
- Singapore Eye Research Institute, Singapore, Singapore
- Duke-National University of Singapore, Singapore, Singapore
| | - Lynette Pei-Chi Shek
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Khoo Teck Puat-National University Children's Medical Institute, National University Health System, Singapore, Singapore
| | - Yap Seng Chong
- Department of Obstetrics & Gynaecology and Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
| | - Peter D Gluckman
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Yung Seng Lee
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Khoo Teck Puat-National University Children's Medical Institute, National University Health System, Singapore, Singapore
| | - Fabian Yap
- KK Women's and Children's Hospital, Singapore, Singapore
- Duke-National University of Singapore, Singapore, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | | | - Mary Foong-Fong Chong
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
| | - Keith M Godfrey
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Johan G Eriksson
- Department of Obstetrics & Gynaecology and Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
- Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Folkhälsan Research Center, Helsinki, Finland
| | - S Sendhil Velan
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
- Institute for Bioengineering and Bioimaging, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
| | - Michael S Kramer
- Department of Obstetrics & Gynaecology and Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Department of Pediatrics, McGill University Faculty of Medicine, Montreal, QC, Canada
- Department of Epidemiology and Biostatistics, McGill University Faculty of Medicine, Montreal, QC, Canada
| | - Jonathan Y Bernard
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
- Centre for Research in Epidemiology and Statistics (CRESS), Université de Paris, Inserm, INRAE, Paris, France
| | - Falk Müller-Riemenschneider
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
- Berlin Institute of Health, Charite University Medical Centre, Berlin, Germany
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Byrne R, Terranova CO, Trost SG. Measurement of screen time among young children aged 0-6 years: A systematic review. Obes Rev 2021; 22:e13260. [PMID: 33960616 PMCID: PMC8365769 DOI: 10.1111/obr.13260] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 03/24/2021] [Accepted: 03/30/2021] [Indexed: 12/16/2022]
Abstract
The impact of screen-based devices on children's health and development cannot be properly understood without valid and reliable tools that measure screen time within the evolving digital landscape. This review aimed to summarize characteristics of measurement tools used to assess screen time in young children; evaluate reporting of psychometric properties; and examine time trends related to measurement and reporting of screen time. A systematic review of articles published in English across three databases from January 2009 to April 2020 was undertaken using PROSPERO protocol (registration: CRD42019132599) and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Included articles measured screen time as outcome, exposure, or confounder in children 0-6 years. The search identified 35,868 records, 1035 full-text articles were screened for eligibility, and 622 met inclusion criteria. Most measures (60%) consisted of one to three items and assessed duration of screen time on a usual day. Few measures assessed content (11%) or coviewing (7%). Only 40% of articles provided a citation for the measure, and only 69 (11%) reported psychometric properties-reliability n = 58, validity n = 19, reliability and validity n = 8. Between 2009 and 2019, the number of published articles increased from 28 to 71. From 2015, there was a notable increase in the proportion of articles published each year that assessed exposure to mobile devices in addition to television. The increasing number of published articles reflects increasing interest in screen time exposure among young children. Measures of screen time have generally evolved to reflect children's contemporary digital landscape; however, the psychometric properties of measurement tools are rarely reported. There is a need for improved measures and reporting to capture the complexity of children's screen time exposures.
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Affiliation(s)
- Rebecca Byrne
- School of Exercise and Nutrition Sciences, Faculty of Health, Centre for Children's Health Research (CCHR)Queensland University of Technology (QUT)South BrisbaneQueenslandAustralia
| | - Caroline O. Terranova
- School of Exercise and Nutrition Sciences, Faculty of Health, Centre for Children's Health Research (CCHR)Queensland University of Technology (QUT)South BrisbaneQueenslandAustralia
| | - Stewart G. Trost
- School of Exercise and Nutrition Sciences, Faculty of Health, Centre for Children's Health Research (CCHR)Queensland University of Technology (QUT)South BrisbaneQueenslandAustralia
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11
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Sdravou K, Emmanouilidou-Fotoulaki E, Printza A, Andreoulakis E, Beropouli S, Makris G, Fotoulaki M. Factors Associated with Feeding Problems in Young Children with Gastrointestinal Diseases. Healthcare (Basel) 2021; 9:healthcare9060741. [PMID: 34204179 PMCID: PMC8234215 DOI: 10.3390/healthcare9060741] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 06/10/2021] [Accepted: 06/11/2021] [Indexed: 11/26/2022] Open
Abstract
Feeding problems are associated with the consumption of a limited amount or restricted variety of foods and often occur in children with gastrointestinal diseases. The majority of studies to date do not use valid and reliable measurements to detect feeding problems. The aim of this cross-sectional study was to assess behavioral and skill-based feeding problems in young children with gastrointestinal diseases by using a well-established parent-reported feeding measure and identify demographic, anthropometric, and environmental factors associated with maladaptive feeding behaviors in this pediatric population. Parents completed the Greek version of the Behavioral Pediatrics Feeding Assessment Scale (BPFAS) and self-reported questionnaires assessing mealtime environment and parental feeding practices. It was found that 18.6% of the sample had abnormal Total Frequency Score (TFS) (frequency of problematic feeding behaviors) and 39.5% had abnormal Total Problem Score (TPS) (number of behaviors perceived as problematic by parents). Younger children, with lower body mass index, lower birth weight, and only children were more likely to have feeding problems. The study showed that parent-reported feeding problems are increased in young children with gastrointestinal diseases and are associated with specific aspects of mealtime environment and parental feeding practices.
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Affiliation(s)
- Katerina Sdravou
- 4th Department of Pediatrics, School of Medicine, Aristotle University of Thessaloniki, General “Papageorgiou” Hospital, 56403 Thessaloniki, Greece; (E.E.-F.); (M.F.)
- Correspondence:
| | - Elpida Emmanouilidou-Fotoulaki
- 4th Department of Pediatrics, School of Medicine, Aristotle University of Thessaloniki, General “Papageorgiou” Hospital, 56403 Thessaloniki, Greece; (E.E.-F.); (M.F.)
| | - Athanasia Printza
- 1st Otolaryngology Department, School of Medicine, University Hospital AHEPA, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece;
| | - Elias Andreoulakis
- Hellenic Centre for Mental Health and Research, Department of Thessaloniki, Adult Psychiatric Unit, 36 Kaftatzoglou Str, 55337 Thessaloniki, Greece;
| | - Stavroula Beropouli
- Department of Pediatrics, General Hospital of Kozani (Mamatseio), 1 K. Mamatsiou, 50100 Kozani, Greece;
| | - Giorgos Makris
- Department of Speech and Language Therapy, School of Health Sciences, University of Peloponnese, 2400 Kalamata, Greece;
| | - Maria Fotoulaki
- 4th Department of Pediatrics, School of Medicine, Aristotle University of Thessaloniki, General “Papageorgiou” Hospital, 56403 Thessaloniki, Greece; (E.E.-F.); (M.F.)
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12
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Collings PJ, Blackwell JE, Pal E, Ball HL, Wright J. Associations of diarised sleep onset time, period and duration with total and central adiposity in a biethnic sample of young children: the Born in Bradford observational cohort study. BMJ Open 2021; 11:e044769. [PMID: 34035099 PMCID: PMC8154936 DOI: 10.1136/bmjopen-2020-044769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 03/25/2021] [Accepted: 04/08/2021] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES To investigate associations of parent-reported sleep characteristics with adiposity levels in a biethnic sample of young children. DESIGN A cross-sectional observational study. SETTING The Born in Bradford 1000 study, UK. PARTICIPANTS Children aged approximately 18 months (n=209; 40.2% South Asian; 59.8% white) and 36 months (n=162; 40.7% South Asian; 59.3% white). PRIMARY AND SECONDARY OUTCOME MEASURES Children's body mass index (BMI) z-score, sum of two-skinfolds (triceps and subscapular) and waist circumference. Adjusted regression was used to quantify associations of sleep parameters with adiposity stratified by ethnicity and age group. The results are beta coefficients (95% CIs) and unless otherwise stated represent the difference in outcomes for every 1-hour difference in sleep parameters. RESULTS The average sleep onset time was markedly later in South Asian (21:26±68 min) than white children (19:41±48 min). Later sleep onset was associated with lower BMI z-score (-0.3 (-0.5 to -0.0)) and sum of two-skinfolds (-1.5 mm (-2.8 mm to -0.2 mm)) in white children aged 18 months and higher BMI z-score in South Asian children aged 36 months (0.3 (0.0-0.5)). Longer sleep duration on weekends than weekdays was associated with higher BMI z-score (0.4 (0.1-0.8)) and waist circumference (1.2 cm (0.3-2.2 cm)) in South Asian children aged 18 months, and later sleep onset on weekends than weekdays was associated with larger sum of two-skinfolds (1.7 mm (0.3-3.1 mm)) and waist circumference (1.8 cm (0.6-2.9 cm)). Going to sleep ≥20 min later on weekends than weekdays was associated with lower waist circumference in white children aged 18 months (-1.7 cm (-3.2 cm to -0.1 cm)). CONCLUSIONS Sleep timing is associated with total and central adiposity in young children but associations differ by age group and ethnicity. Sleep onset times and regular sleep schedules may be important for obesity prevention.
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Affiliation(s)
- Paul James Collings
- Department of Health Sciences, University of York, York, UK
- Bradford Institute for Health Research, Bradford, UK
| | - Jane Elizabeth Blackwell
- Department of Health Sciences, University of York, York, UK
- Leeds and York Partnership NHS Foundation Trust, Leeds, UK
| | - Elizabeth Pal
- Better Start Bradford, Bradford Trident, Bradford, UK
| | - Helen L Ball
- Department of Anthropology, Durham Infancy and Sleep Centre, Durham University, Durham, UK
| | - John Wright
- Bradford Institute for Health Research, Bradford, UK
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13
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Zhang Z, Sousa-Sá E, Pereira JR, Okely AD, Feng X, Santos R. Correlates of Sleep Duration in Early Childhood: A Systematic Review. Behav Sleep Med 2021; 19:407-425. [PMID: 32496141 DOI: 10.1080/15402002.2020.1772264] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
OBJECTIVE This systematic review aimed to summarize correlates of sleep duration in children under 5 years of age. METHODS Six electronic databases (PubMed, PsycINFO, MEDLINE, CINAHL, SPORTDiscus, and Scopus) were searched from inception to May 2019. Observational studies and intervention studies reporting cross-sectional results from baseline data were considered. Data were extracted using a predesigned form and potential correlates were categorized following a sociological framework. RESULTS One-hundred and sixteen studies, representing 329,166 children, met the inclusion criteria, with a high risk of bias in 62 included studies. A total of 83 correlates of sleep duration were identified. Among the associations studied four or more times, correlates of nap duration were child's age and nighttime sleep onset/bedtime; correlates of nighttime sleep duration were household income, parent marital status, parental adiposity level, nighttime sleep duration at younger age, nighttime sleep onset/bedtime, nighttime sleep wakeup time, and frequency of current bedtime routine; correlate of total sleep duration was screen time. CONCLUSIONS Young children from low-income households, single families, or having overweight parents may be at risk for short sleep duration. Promoting healthy sleep duration from an early age appears essential. Effective practices may include encouraging an earlier bedtime, limiting screen time, and establishing a regular bedtime routine. The absence of consistent evidence in the psychological, cognitive, and emotional domain as well as the physical environmental domain warrants further research.
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Affiliation(s)
- Zhiguang Zhang
- Early Start, Faculty of Social Sciences, University of Wollongong, Australia
| | - Eduarda Sousa-Sá
- Early Start, Faculty of Social Sciences, University of Wollongong, Australia.,Illawarra Health and Medical Research Institute, Australia
| | - João R Pereira
- Early Start, Faculty of Social Sciences, University of Wollongong, Australia.,CIDAF (Uid/dtp/04213/2016), University of Coimbra, Coimbra, Portugal
| | - Anthony D Okely
- Early Start, Faculty of Social Sciences, University of Wollongong, Australia.,Illawarra Health and Medical Research Institute, Australia
| | - Xiaoqi Feng
- School of Public Health and Community Medicine, Faculty of Medicine, University of New South Wales, Australia.,Population Wellbeing and Environment Research Lab (PowerLab), School of Health and Society, Faculty of Social Sciences, University of Wollongong, Wollongong, Australia
| | - Rute Santos
- Early Start, Faculty of Social Sciences, University of Wollongong, Australia.,Research Centre in Physical Activity, Health and Leisure, University of Porto, Porto, Portugal.,Universidade Lusófona de Humanidades e Tecnologia, Lisboa, Portugal
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14
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Lin Q, Jiang Y, Wang G, Sun W, Dong S, Deng Y, Meng M, Zhu Q, Mei H, Zhou Y, Zhang J, Clayton PE, Spruyt K, Jiang F. Combined effects of weight change trajectories and eating behaviors on childhood adiposity status: A birth cohort study. Appetite 2021; 162:105174. [PMID: 33636216 DOI: 10.1016/j.appet.2021.105174] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Revised: 02/14/2021] [Accepted: 02/15/2021] [Indexed: 01/06/2023]
Abstract
Previous studies have suggested that infant rapid weight change can be associated with an increased weight later in life. However, the weight change trajectory in early life over time and which childhood lifestyle behaviors may modify the risk of rapid weight change have not been characterized. Using our ongoing birth cohort study, we have addressed these issues. Nine follow-up time points (birth, 3, 6, 9, 12, 18, 24, 36, and 48 months) were used to calculate the change between two adjacent weight-for-age z-scores (WAZ-change), and then WAZ-change trajectories were defined via group-based trajectory modeling. The solitary, independent and combined effects of WAZ-change trajectories and each lifestyle factor (eating behaviors, physical activity, media exposure time and total sleep duration) on childhood adiposity measures at age 4 years were determined using multivariate regression analysis. Overall, 84 (38%) children had a steady growth trajectory from birth to 4 years, while the other 137 (62%) children had an early infancy rapid growth trajectory, particularly in the first three months. Compared to children with steady growth, children with early infancy rapid growth had a significantly higher body mass index, waist circumference, and subcutaneous fat. Moreover, weight change trajectory and three eating behaviors (i.e. food responsiveness, satiety responsiveness and food fussiness), not only had independent effects, but also combined (synergistic) effects on the majority of adiposity measures. Our results extend the current literature and provide a potentially valuable model to aid clinicians and health professionals in designing early-life interventions targeting specific populations, specific ages and specific lifestyle behaviors to prevent childhood overweight/obesity.
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Affiliation(s)
- Qingmin Lin
- Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China; Pediatric Translational Medicine Institution, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China; MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China.
| | - Yanrui Jiang
- Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China; Pediatric Translational Medicine Institution, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China; MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China.
| | - Guanghai Wang
- Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China; Pediatric Translational Medicine Institution, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China; MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China.
| | - Wanqi Sun
- Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China; Pediatric Translational Medicine Institution, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China; MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China.
| | - Shumei Dong
- Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China; Pediatric Translational Medicine Institution, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China; MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China.
| | - Yujiao Deng
- Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China; Pediatric Translational Medicine Institution, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China; MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China.
| | - Min Meng
- Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China; Pediatric Translational Medicine Institution, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China; MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China.
| | - Qi Zhu
- Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China; Pediatric Translational Medicine Institution, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China; MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China.
| | - Hao Mei
- Pediatric Translational Medicine Institution, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China; Department of Data Science, School of Population Health, University of Mississippi Medical Center, Jackson, MS 39216, USA.
| | - Yingchun Zhou
- KLATASDS-MOE, School of Statistics, East China Normal University, Shanghai 200062, China.
| | - Jun Zhang
- MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China; School of Public Health, Shanghai Jiao Tong University, Shanghai 200025, China.
| | - Peter E Clayton
- Division of Developmental Biology and Medicine, Faculty of Biology, Medicine and Health, University of Manchester and Manchester Academic Health Science Centre, Manchester M13 9PL, United Kingdom.
| | - Karen Spruyt
- Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China; INSERM, University Claude Bernard, School of Medicine, Lyon, France.
| | - Fan Jiang
- Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China; Pediatric Translational Medicine Institution, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China; MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China.
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15
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Kanellopoulou A, Diamantis DV, Notara V, Panagiotakos DB. Extracurricular Sports Participation and Sedentary Behavior in Association with Dietary Habits and Obesity Risk in Children and Adolescents and the Role of Family Structure: a Literature Review. Curr Nutr Rep 2021; 10:1-11. [PMID: 33595804 DOI: 10.1007/s13668-021-00352-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/02/2021] [Indexed: 01/10/2023]
Abstract
PURPOSE OF REVIEW Childhood obesity is considered a major problem in the modern world, associated with many health issues in youth. This review aimed the association between extracurricular sports participation, sedentary time/screen time, and "obesogenic" and "non-obesogenic" dietary habits among youth and to explore the role of family structure on the adoption of sedentary behaviors by children. RECENT FINDINGS Increased participation in extracurricular sports was associated with a healthier dietary pattern, containing more "non-obesogenic" food choices. Opposite results were indicated by sedentary activities. Increased time in watching TV, computer/electronic games, and other screen devices was positively associated with unhealthy dietary patterns. Overall, extracurricular activities influence the quality of food choices, which may prevent or promote childhood obesity; thus, sport-related activities should be promoted through public health policies. The role of the family structure is contradictory.
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Affiliation(s)
- Aikaterini Kanellopoulou
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 70 Eleftheriou Venizelou (Thiseos) Ave, Kallithea, 176 71, Athens, Greece
| | - Dimitrios V Diamantis
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 70 Eleftheriou Venizelou (Thiseos) Ave, Kallithea, 176 71, Athens, Greece
| | - Venetia Notara
- Department of Public and Community Health, Laboratory of Hygiene and Epidemiology, School of Public Health, University of West Attica, Athens, Greece
| | - Demosthenes B Panagiotakos
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 70 Eleftheriou Venizelou (Thiseos) Ave, Kallithea, 176 71, Athens, Greece. .,Faculty of Health, University of Canberra, ACT, Canberra, Australia.
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16
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Sdravou K, Emmanouilidou-Fotoulaki E, Printza A, Andreoulakis E, Evangeliou A, Fotoulaki M. Mealtime Environment and Control of Food Intake in Healthy Children and in Children with Gastrointestinal Diseases. CHILDREN-BASEL 2021; 8:children8020077. [PMID: 33498758 PMCID: PMC7912501 DOI: 10.3390/children8020077] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 01/14/2021] [Accepted: 01/20/2021] [Indexed: 12/15/2022]
Abstract
Parental feeding practices and mealtime routine significantly influence a child’s eating behavior. The aim of this study was to investigate the mealtime environment in healthy children and children with gastrointestinal diseases. We conducted a cross-sectional case–control study among 787 healthy, typically developing children and 141 children with gastrointestinal diseases, aged two to seven years. Parents were asked to provide data on demographics and describe their mealtime environment by answering to 24 closed-ended questions. It was found that the majority of the children had the same number of meals every day and at the same hour. Parents of both groups exerted considerable control on the child’s food intake by deciding both when and what their child eats. Almost one third of the parents also decided how much their child eats. The two groups differed significantly in nine of the 24 questions. The study showed that both groups provided structured and consistent mealtime environments. However, a significant proportion of children did not control how much they eat which might impede their ability to self-regulate eating. The presence of a gastrointestinal disease was found to be associated with reduced child autonomy, hampered hunger cues and frequent use of distractions during meals.
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Affiliation(s)
- Katerina Sdravou
- 4th Department of Pediatrics, School of Medicine, Aristotle University of Thessaloniki, General “Papageorgiou” Hospital, 56403 Thessaloniki, Greece; (E.E.-F.); (A.E.); (M.F.)
- Correspondence:
| | - Elpida Emmanouilidou-Fotoulaki
- 4th Department of Pediatrics, School of Medicine, Aristotle University of Thessaloniki, General “Papageorgiou” Hospital, 56403 Thessaloniki, Greece; (E.E.-F.); (A.E.); (M.F.)
| | - Athanasia Printza
- 1st E.N.T. Department, School of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece;
| | - Elias Andreoulakis
- Hellenic Centre for Mental Health and Research, Adult Psychiatric Unit, Department of Thessaloniki, 55337 Thessaloniki, Greece;
| | - Athanasios Evangeliou
- 4th Department of Pediatrics, School of Medicine, Aristotle University of Thessaloniki, General “Papageorgiou” Hospital, 56403 Thessaloniki, Greece; (E.E.-F.); (A.E.); (M.F.)
| | - Maria Fotoulaki
- 4th Department of Pediatrics, School of Medicine, Aristotle University of Thessaloniki, General “Papageorgiou” Hospital, 56403 Thessaloniki, Greece; (E.E.-F.); (A.E.); (M.F.)
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17
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Li C, Cheng G, Sha T, Cheng W, Yan Y. The Relationships between Screen Use and Health Indicators among Infants, Toddlers, and Preschoolers: A Meta-Analysis and Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E7324. [PMID: 33036443 PMCID: PMC7579161 DOI: 10.3390/ijerph17197324] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 09/30/2020] [Accepted: 10/01/2020] [Indexed: 12/04/2022]
Abstract
Evidence suggests that excessive screen time in early childhood is related to children's physical and mental health. This study aimed to review the relationships between screen media use and several health indicators in infants, toddlers, and preschoolers. A systematic search was conducted by two independent reviewers on PubMed, Web of Science, Embase, and Cochrane Library to identify the eligible studies, with an end date of 13 August 2019. Included studies (published in English) were peer-reviewed and met the determinate population (children aged 0-7 years with screen media exposure and related health outcomes). The AHRQ, NOS, and the Cochrane Handbook were used to evaluate the cross-sectional study, cohort study, and RCT, respectively. A meta-analysis and narrative syntheses were employed separately. Eighty studies (23 studies for meta-analysis) met the inclusion criteria for the systematic review. Strong evidence of the meta-analysis suggested that excessive screen time was associated with overweight/obesity and shorter sleep duration among toddlers and preschoolers. Excessive screen use was associated with various health indicators in physical, behavioral, and psychosocial aspects. Better-quality research on newer media devices, on various kinds of contents in young children, and on dose-response relationships between excessive screen use and health indicators are needed to update recommendations of screen use.
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Affiliation(s)
- Chao Li
- Department of Epidemiology and Medical Statistics, Xiangya School of Public Health, Central South University, Changsha 410078, China; (C.L.); (G.C.)
| | - Gang Cheng
- Department of Epidemiology and Medical Statistics, Xiangya School of Public Health, Central South University, Changsha 410078, China; (C.L.); (G.C.)
| | - Tingting Sha
- Hunan Key Laboratory of Joint Degeneration and Injury, Xiangya Hospital, Central South University, Changsha 410008, China;
| | - Wenwei Cheng
- Third Xiangya Hospital of Central South University, Changsha 410000, China;
| | - Yan Yan
- Department of Epidemiology and Medical Statistics, Xiangya School of Public Health, Central South University, Changsha 410078, China; (C.L.); (G.C.)
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18
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Evolution of the Habits of Physical Activity and Television Viewing in Spanish Children and Pre-Adolescents between 1997 and 2017. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17186836. [PMID: 32962116 PMCID: PMC7558877 DOI: 10.3390/ijerph17186836] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 09/15/2020] [Accepted: 09/16/2020] [Indexed: 01/23/2023]
Abstract
Background: Promoting healthy lifestyles in children, has become a priority for public health institutions. However, electronic devices with screens encourage sedentary behaviors. The aim of this study was to analyze the evolution of the habits of physical activity practice and television watching in a cohort of 20 years of research in Spanish children. Methods: A cross-sectional, observational study was based on data from the Spain National Health Surveys between 1997 and 2017 (N = 11,444). The dependent variables considered were the frequency with which the minor practiced physical activity (PA) in his/her spare time, the daily TV viewing habit, and the daily hours of TV viewing. Results: The children who practiced physical activity daily has decreased 7.3% throughout the study period. The proportion of children who watched the television daily for more hours increased significantly (6.3%). Such increase was constant throughout the years, and the analysis by sex showed that the proportion of boys who watched television for more than three hours per day increased three percent, and that of girls increased fourfold. Conclusions: The habits of physical activity practice and television viewing have changed towards sedentary lifestyle. Particularly, the girls and the children between 12 and 14 years showed the most sedentary behavior. Public health policies must consider the differences between sexes in order for such interventions to be effective in the population of pre-adolescents, in general, and girls, in particular.
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19
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Nutritional Quality of Hidden Food and Beverage Advertising Directed to Children: Extent and Nature of Product Placement in Mexican Television Programs. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17093086. [PMID: 32365478 PMCID: PMC7246833 DOI: 10.3390/ijerph17093086] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 04/18/2020] [Accepted: 04/19/2020] [Indexed: 11/30/2022]
Abstract
(1) Background: Nutrient-poor, energy-dense food and beverage (F&B) advertisements influence children’s food preferences, consumption, and purchase requests, contributing to overweight and obesity. Objective: To characterize the nutritional quality of F&B advertised by product placement (PP) in Mexican television programs with the highest audience ratings for children. (2) Methods: A total of 48 h of television programs between December 2016 and January 2017 during the hours with the highest ratings for children were analyzed. Nutritional quality was assessed through the Mexican Ministry of Health (MMH-NPM), the World Health Organization Regional Office for Europe (WHO-Europe), and the Pan American Health Organization nutrient profile models (PAHO-NPM). (3) Results: A total of 119 F&B were broadcast, of which more than 60% were unhealthy according to the three nutritional models. Reality shows and movies presented the most PP advertising. The food category most frequently advertised was sugar-sweetened beverages (41.2%). F&B advertised in children’s programs had a higher content of energy, total fat, and saturated fat (p < 0.01). (4) Conclusion: The MMH-NPM was the most permissive and the PAHO-NPM was the strictest for evaluating nutritional quality. Mexico must strengthen the regulation of advertising to protect children from its negative effects on health.
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Duszka K, Gregor A, Reichel MW, Baierl A, Fahrngruber C, König J. Visual stimulation with food pictures in the regulation of hunger hormones and nutrient deposition, a potential contributor to the obesity crisis. PLoS One 2020; 15:e0232099. [PMID: 32330183 PMCID: PMC7182185 DOI: 10.1371/journal.pone.0232099] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Accepted: 04/07/2020] [Indexed: 12/11/2022] Open
Abstract
Food cues affect hunger and nutritional choices. Omnipresent stimulation with palatable food contributes to the epidemics of obesity. The objective of the study was to investigate the impact of food cues on appetite-related hormones and to assess the functionality of the secreted hormones on macronutrient uptake in healthy subjects. Additionally, we aimed at verifying differences in the response of total and active ghrelin to stimulation with food pictures and to a meal followed by the stimulation. We were also interested in the identification of factors contributing to response to food cues. We recruited healthy, non-obese participants for two independent cross-over studies. During the first study, the subjects were presented random non-food pictures on the first day and pictures of foods on the second day of the study. Throughout the second study, following the picture session, the participants were additionally asked to drink a milkshake. Concentrations of blood glucose, triglycerides and hunger-related hormones were measured. The results showed that concentrations of several hormones measured in the blood are interdependent. In the case of ghrelin and gastric inhibitory peptide (GIP) as well as ghrelin and glucagon-like peptide-1 (GLP-1), this co-occurrence relies on the visual cues. Regulation of total ghrelin concentration following food stimulation is highly individual and responders showed upregulated total ghrelin, while the concentration of active ghrelin decreases following a meal. Protein content and colour intensity of food pictures reversely correlated with participants’ rating of the pictures. We conclude that observation of food pictures influences the concentration of several appetite-related hormones. The close link of visual clues to physiological responses is likely of clinical relevance. Additionally, the protein content of displayed foods and green colour intensity in pictures may serve as a predictor of subjective attractiveness of the presented meal.
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Affiliation(s)
- Kalina Duszka
- Department of Nutritional Sciences, University of Vienna, Vienna, Austria
- * E-mail:
| | - András Gregor
- Department of Nutritional Sciences, University of Vienna, Vienna, Austria
| | | | - Andreas Baierl
- Department of Statistics and Operations Research, University of Vienna, Vienna, Austria
| | | | - Jürgen König
- Department of Nutritional Sciences, University of Vienna, Vienna, Austria
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Collings PJ, Dogra SA, Costa S, Bingham DD, Barber SE. Objectively-measured sedentary time and physical activity in a bi-ethnic sample of young children: variation by socio-demographic, temporal and perinatal factors. BMC Public Health 2020; 20:109. [PMID: 31992249 PMCID: PMC6986109 DOI: 10.1186/s12889-019-8132-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Accepted: 12/30/2019] [Indexed: 12/26/2022] Open
Abstract
Background Evidence suggests that South Asian school-aged children and adults are less active compared to the white British population. It is unknown if this generalises to young children. We aimed to describe variability in levels of physical activity and sedentary time in a bi-ethnic sample of young children from a deprived location. Methods This observational study included 202 South Asian and 140 white British children aged 1.5 to 5y, who provided 3181 valid days of triaxial accelerometry (Actigraph GT3X+). Variability in sedentary time and physical activity levels were analysed by linear multilevel modelling. Logistic multilevel regression was used to identify factors associated with physical inactivity (failing to perform ≥180 min of total physical activity including ≥60 min moderate-to-vigorous physical activity (MVPA) per day). Results There were no significant ethnic differences in the overall levels of behaviours; South Asian and white British children spent half of daily time sedentary, just over 40% in light physical activity, and the remaining 7.5 to 8% of time in MVPA. Sedentary time was lower and physical activity levels were higher in older children, and levels of MVPA and vector magnitude counts per minute (CPM) were higher on weekends compared to weekdays. In South Asian children, sedentary time was lower on weekends. Sedentary time was lower and physical activity levels were higher in spring compared to winter in white British children, and in all seasons compared to winter in South Asian children. South Asian children born at high birth weight performed more MVPA, and in both ethnicities there was some evidence that children with older mothers were more sedentary and less active. Sedentary time was higher and light physical activity was lower in South Asian children in the highest compared to the lowest income families. South Asian girls performed less MVPA, registered fewer vector magnitude CPM, and were 3.5 times more likely to be physically inactive than South Asian boys. Conclusions Sedentary time and physical activity levels vary by socio-demographic, temporal and perinatal characteristics in young children from a deprived location. South Asian girls have the most to gain from efforts to increase physical activity levels. Trial registration The Pre-schoolers in the Playground (PiP) pilot randomized controlled trial is registered with the ISRCTN (ISRCTN54165860; http://www.isrctn.com).
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Affiliation(s)
- Paul J Collings
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK. .,Department of Health Sciences, University of York, York, UK.
| | - Sufyan A Dogra
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Silvia Costa
- School of Sport, Exercise and Health Sciences, Loughborough University, Leicestershire, UK
| | - Daniel D Bingham
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Sally E Barber
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
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Improved Understanding of Interactions between Risk Factors for Child Obesity May Lead to Better Designed Prevention Policies and Programs in Indonesia. Nutrients 2020; 12:nu12010175. [PMID: 31936306 PMCID: PMC7019618 DOI: 10.3390/nu12010175] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 12/23/2019] [Accepted: 01/07/2020] [Indexed: 12/14/2022] Open
Abstract
The nutrition transition in low-middle income countries is marked by rising intakes of highly caloric, low nutrient-dense (junk) foods, decreasing intakes of fruits and vegetables, and sedentary behavior. The objective of this study was to explore interactions among fruit-and-vegetable intake, junk food energy intake, sedentary behavior, and obesity in Indonesian children. We conducted this school-based, case-control study in 2013 in Yogyakarta Special Province, Indonesia. The cases were 244 obese children aged 7–12 years having a BMI ≥95th percentile of an age- and sex-specific distribution from the Centers for Disease Control and Prevention. The controls (n = 244) were classroom-matched children with a BMI <85th percentile. Using conditional logistic regression, the relative odds (95% confidence intervals; OR: 95% CI) of obesity given reported frequent fruit-and-vegetable intake (≥3 servings/day), low junk food energy (≤1050 kcal/day) intake and low sedentary behavior (<5 h/day) was 0.46 (0.30–0.69), 0.61 (0.37–0.98), and 0.18 (0.12–0.28), respectively. Effect sizes were dose-responsive and appeared additive. For example, children with low sedentary behavior and frequent fruit-and-vegetable intake were 92% less likely (OR = 0.08; 0.04–0.15) to be obese than children not exceeding either of these thresholds. Similarly, children frequently eating fruits and vegetables and reporting a low junk food energy intake were 70% less likely (OR = 0.30; 0.15–0.59) to be obese. The findings were unchanged after adjusting for child, maternal, and household covariates. Preventive interventions for child obesity need multiple components to improve diets and raise levels of physical activity rather than just addressing one of the three types of assessed behaviors.
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Parkes A, Green M, Pearce A. Do bedroom screens and the mealtime environment shape different trajectories of child overweight and obesity? Research using the Growing Up in Scotland study. Int J Obes (Lond) 2019; 44:790-802. [PMID: 31827254 DOI: 10.1038/s41366-019-0502-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Revised: 11/06/2019] [Accepted: 11/17/2019] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To investigate how mealtime setting, mealtime interaction and bedroom screens are associated with different trajectories of child overweight and obesity, using a population sample. METHODS Growth mixture modelling used data from children in the Growing Up in Scotland Study born in 2004/5 (boys n = 2085, girls n = 1991) to identify trajectories of overweight or obesity across four time points, from 46 to 122 months. Using data from children present at all sweeps, and combining sexes (n = 2810), mutually adjusted associations between primary exposures (mealtime setting, mealtime interaction and bedroom screens) and trajectory class were explored in multinomial models; controlling for early life factors, household organisation and routines, and children's diet patterns, overall screen use, physical activity and sleep. RESULTS Five trajectories were identified in both sexes: Low Risk (68% of sample), Decreasing Overweight (9%), Increasing Overweight (12%), High/Stable Overweight (6%) and High/Increasing Obesity (5%). Compared with the Low Risk trajectory, High/Increasing Obesity and High/Stable Overweight trajectories were characterised by early increases in bedroom screen access (respective relative risk ratios (RRR) and 95% confidence intervals: 2.55 [1.30-5.00]; 1.62 [1.01-2.57]). An informal meal setting (involving mealtime screen use, not eating in a dining area and not sitting at a table) characterised the High/Increasing Obesity and Increasing Overweight trajectories (respective RRRs compared with Low Risk trajectory: 3.67 [1.99-6.77]; 1.75 [1.17-2.62]). Positive mealtime interaction was associated with membership of the Increasing Overweight trajectory (RRR 1.64 [1.13-2.36]). CONCLUSION Bedroom screen access and informal mealtime environments were associated with higher-risk overweight and obesity trajectories in a representative sample of Scottish children, after adjusting for a wide range of confounders. Findings may challenge the notion that positive mealtime interaction is protective. Promoting mealtimes in a screen-free dining area and removing screens from bedrooms may help combat childhood obesity.
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Affiliation(s)
- Alison Parkes
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK.
| | - Michael Green
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Anna Pearce
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
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Schaan CW, Cureau FV, Salvo D, Kohl HW, Schaan BD. Unhealthy snack intake modifies the association between screen-based sedentary time and metabolic syndrome in Brazilian adolescents. Int J Behav Nutr Phys Act 2019; 16:115. [PMID: 31775773 PMCID: PMC6882160 DOI: 10.1186/s12966-019-0880-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Accepted: 11/08/2019] [Indexed: 12/20/2022] Open
Abstract
Background Excessive screen time has been associated with metabolic syndrome (MetS) among adolescents; however, snack intake in front of screens may play a role in this association. Therefore, our objective was to investigate the association between screen-based sedentary time with MetS and whether this association is modified by unhealthy snack intake in front of screens. Methods This study was a nationwide, cross-sectional, school-based survey in Brazil including adolescents aged 12 to 17 years. The frequency of snack consumption in front of screen and screen-based sedentary time (TV view, computers and videogames use) were self-reported. Thereafter, screen time was categorized (≤2, 3–5 and ≥ 6 h/day); snack consumption in front of screens was dichotomized. Metabolic syndrome diagnosis was defined based on the International Diabetes Federation criteria. Associations between screen time and MetS were investigated using logistic regression in overall sample and after stratification by snack intake in front of screens. Results A total of 33,900 adolescents were included in the analysis. The final adjusted model, which included sociodemographic data, physical activity, and energy intake, showed that adolescents who spent ≥6 h/day in front of screens had an increased odds ratio for MetS (OR = 1.68, 95%CI: 1.03–2.74). However, after stratifying the sample according to reported snack intake, the association between higher screen-based sedentary time and MetS remained significant only for adolescents who reported consumption of snacks in front of screens. Conclusion Longer screen-based sedentary times were directly associated with MetS. However, this association seems to be modified by reported snack intake in front of screens.
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Affiliation(s)
- Camila Wohlgemuth Schaan
- Post-graduate Program in Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre. Hospital de Clínicas de Porto Alegre, St. Ramiro Barcelos 2350/21, 90035-003, Porto Alegre, RS, Brazil.
| | - Felipe Vogt Cureau
- Post-graduate Program in Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre. Hospital de Clínicas de Porto Alegre, St. Ramiro Barcelos 2350/21, 90035-003, Porto Alegre, RS, Brazil
| | - Deborah Salvo
- Washington University in St. Louis, Brown School, Prevention Research Center in St. Louis, Saint Louis, MO, USA
| | - Harold W Kohl
- University of Texas Health Science Center at Houston, School of Public Health, Michael and Susan Dell Center for Healthy Living and University of Texas at Austin, Department of Kinesiology and Health Education, Austin, TX, USA
| | - Beatriz D Schaan
- Post-graduate Program in Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre. Hospital de Clínicas de Porto Alegre, St. Ramiro Barcelos 2350/21, 90035-003, Porto Alegre, RS, Brazil
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Nagy LC, Faisal M, Horne M, Collings P, Barber S, Mohammed M. Factors associated with accelerometer measured movement behaviours among White British and South Asian children aged 6-8 years during school terms and school holidays. BMJ Open 2019; 9:e025071. [PMID: 31427310 PMCID: PMC6701686 DOI: 10.1136/bmjopen-2018-025071] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 03/21/2019] [Accepted: 07/12/2019] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES To investigate factors associated with movement behaviours among White British (WB) and South Asian (SA) children aged 6-8 years during school terms and holidays. DESIGN Cross-sectional. SETTING Three primary schools from the Bradford area, UK. PARTICIPANTS One hundred and sixty WB and SA children aged 6-8 years. PRIMARY AND SECONDARY OUTCOMES Sedentary behaviour (SB), light physical activity (LPA) and moderate-to-vigorous physical activity (MVPA) measured by accelerometry during summer, winter and spring and during school terms and school holidays. Data were analysed using multivariate mixed-effects multilevel modelling with robust SEs. Factors of interest were ethnicity, holiday/term, sex, socioeconomic status (SES), weight status, weekend/weekday and season. RESULTS One hundred and eight children (67.5%) provided 1157 valid days of data. Fifty-nine per cent of children were WB (n=64) and 41% (n=44) were SA. Boys spent more time in MVPA (11 min/day, p=0.013) compared with girls and SA children spent more time in SB (39 min, p=0.017) compared with WB children in adjusted models. Children living in higher SES areas were more sedentary (43 min, p=0.006) than children living in low SES areas. Children were more active during summer (15 min MVPA, p<0.001; 27 LPA, p<0.001) and spring (15 min MVPA, p=0.005; 38 min LPA, p<0.001) and less sedentary (-42 min and -53 min, p<0.001) compared with winter. Less time (8 min, p=0.012) was spent in LPA during school terms compared with school holidays. Children spent more time in MVPA (5 min, p=0.036) during weekend compared with weekdays. Overweight and obese children spent more time in LPA (21 min, p=0.021) than normal-weight children. CONCLUSION The results of our study suggest that significant child level factors associated with movement behaviours are ethnicity, sex, weight-status and area SES. Significant temporal factors are weekends, school holidays and seasonality. Interventions to support health enhancing movement behaviours may need to be tailored around these factors.
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Affiliation(s)
- Liana Carmen Nagy
- Oxford Brookes University, Faculty of Health and Life Sciences, Oxford, UK
- Faculty of Health Studies, University of Bradford, Bradford, UK
- Bradford Institute for Health Research, Bradford, UK
| | - Muhammad Faisal
- Faculty of Health Studies, University of Bradford, Bradford, UK
- Yorkshire & Humberside Academic Health Sciences Network, Wakefield, UK
| | - Maria Horne
- School of Healthcare, University of Leeds, Faculty of Medicine and Health, Leeds, UK
| | - Paul Collings
- Bradford Institute for Health Research, Bradford, UK
- Health Sciences, University of York, York, UK
| | - Sally Barber
- Bradford Institute for Health Research, Bradford, UK
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