1
|
Tsujiguchi H, Sakamoto Y, Hara A, Suzuki K, Miyagi S, Nakamura M, Takazawa C, Pham KO, Nguyen TTT, Kambayashi Y, Shimizu Y, Tsuboi H, Ono Y, Hamagishi T, Shibata A, Hayashi K, Konoshita T, Nakamura H. Longitudinal relationship between screen-based sedentary behavior and nutrient intake in Japanese children: an observational epidemiological cohort study. Environ Health Prev Med 2024; 29:15. [PMID: 38479859 PMCID: PMC10957337 DOI: 10.1265/ehpm.23-00307] [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: 10/31/2023] [Accepted: 01/08/2024] [Indexed: 03/24/2024] Open
Abstract
BACKGROUND Concerns regarding the impact of screen-based sedentary behavior on health have been increasing. Therefore, the present study investigated the longitudinal relationship between multiple screen time and nutrient intake in children and adolescents. METHODS The present study was conducted utilizing 3 years longitudinal data. Study subjects were 740 Japanese children aged between 6 and 12 years at baseline and between 9 and 15 years in the follow-up. Screen-based sedentary behavior was assessed using screen time, including television (TV) viewing, personal computer (PC) use, and mobile phone (MP) use. The main outcomes were the intakes of nutrients. Mixed effect multivariate linear regression analyses were used to examine the longitudinal relationship between screen-based sedentary time and nutrient intake. Covariates included in the multivariable analysis consisted of sex, age, solitary eating, skipping breakfast, staying up late, and body weight status, as confounders, and physical inactivity, as mediator. RESULTS In boys, a longer total screen time longitudinally correlated with higher intake of energy and lower intakes of protein, dietary fiber, minerals, and vitamins. In girls, longer total screen time longitudinally associated with higher intake of sucrose and lower intakes of protein, minerals, and vitamins. In boys, a longer TV viewing time was associated with higher intake of sucrose and lower intakes of protein, minerals, and vitamins. In girls, a longer TV viewing time was associated with higher intake of carbohydrates and lower intakes of protein, fat, minerals, and vitamins. In boys, relationships were observed between a longer PC use time and higher intakes of energy as well as lower intakes of protein, minerals, and vitamins. Relationship was observed between longer PC use time and lower intakes of minerals in girls. An increased MP use time was associated with higher intakes of energy, and lower intakes of protein, sucrose, dietary fiber, minerals, and vitamins in boys. A longer MP use time was associated with higher intakes of fat, and salt as well as lower intakes of carbohydrates, protein, minerals, and vitamins in girls. CONCLUSIONS The present results revealed that longer screen-based sedentary behaviors were longitudinally associated with nutrient intake in children and adolescents. Future study is needed to elucidate these relationships.
Collapse
Affiliation(s)
- Hiromasa Tsujiguchi
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 13-1 Takaramachi, Kanazawa, Ishikawa, Japan
- Department of Public Health, Graduate School of Advanced Preventive Medical Sciences, Kanazawa University, 13-1 Takaramachi, Kanazawa, Ishikawa, Japan
- Advanced Preventive Medical Sciences Research Center, Kanazawa University, 13-1 Takaramachi, Kanazawa, Ishikawa, Japan
| | - Yuriko Sakamoto
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 13-1 Takaramachi, Kanazawa, Ishikawa, Japan
| | - Akinori Hara
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 13-1 Takaramachi, Kanazawa, Ishikawa, Japan
- Department of Public Health, Graduate School of Advanced Preventive Medical Sciences, Kanazawa University, 13-1 Takaramachi, Kanazawa, Ishikawa, Japan
- Advanced Preventive Medical Sciences Research Center, Kanazawa University, 13-1 Takaramachi, Kanazawa, Ishikawa, Japan
| | - Keita Suzuki
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 13-1 Takaramachi, Kanazawa, Ishikawa, Japan
| | - Sakae Miyagi
- Innovative Clinical Research Center, Kanazawa University, 13-1 Takaramachi, Kanazawa, Ishikawa, Japan
| | - Masaharu Nakamura
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 13-1 Takaramachi, Kanazawa, Ishikawa, Japan
| | - Chie Takazawa
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 13-1 Takaramachi, Kanazawa, Ishikawa, Japan
| | - Kim Oanh Pham
- Data Management Department, Asia Center for Air Pollution Research, 1182 Sowa Nishi-ku, Niigata, Japan
| | - Thao Thi Thu Nguyen
- Department of Epidemiology, Faculty of Public Health, Haiphong University of Medicine and Pharmacy, 72A Nguyen Binh Khiem, Ngo Quyen (district), Hai Phong, Vietnam
| | - Yasuhiro Kambayashi
- Department of Public Health, Faculty of Veterinary Medicine, Okayama University of Science, 1-3 Ikoi-no-oka, Imabari, Ehime, Japan
| | - Yukari Shimizu
- Department of Nursing, Faculty of Health Sciences, Komatsu University, 14-1 He Mukai-motoori-machi, Komatsu, Ishikawa, Japan
| | - Hirohito Tsuboi
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 13-1 Takaramachi, Kanazawa, Ishikawa, Japan
- Graduate School of Human Nursing, The University of Shiga Prefecture, 2500 Hassaka-cho, Hikone, Shiga, Japan
| | - Yasuki Ono
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 13-1 Takaramachi, Kanazawa, Ishikawa, Japan
- Department of Neuropsychiatry, Graduate School of Medicine, Hirosaki University, 1 Bunkyocho, Hirosaki, Aomori, Japan
| | - Toshio Hamagishi
- Department of Nursing and Rehabilitation, Chubu Gakuin University, 2-1 Kirigaoka, Seki, Gifu, Japan
| | - Aki Shibata
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 13-1 Takaramachi, Kanazawa, Ishikawa, Japan
| | - Koichi Hayashi
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 13-1 Takaramachi, Kanazawa, Ishikawa, Japan
- Department of Food Sciences and Nutrition, School of Human Environmental Sciences, Mukogawa Women’s University, 6-46 Ikebirakicho, Nishinomiya, Hyogo, Japan
| | - Tadashi Konoshita
- Third Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuokashimoaiduki, Eiheiji, Fukui, Japan
| | - Hiroyuki Nakamura
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 13-1 Takaramachi, Kanazawa, Ishikawa, Japan
- Department of Public Health, Graduate School of Advanced Preventive Medical Sciences, Kanazawa University, 13-1 Takaramachi, Kanazawa, Ishikawa, Japan
- Advanced Preventive Medical Sciences Research Center, Kanazawa University, 13-1 Takaramachi, Kanazawa, Ishikawa, Japan
| |
Collapse
|
2
|
Murray RM, Doré I, Sabiston CM, Michael F, O'Loughlin JL. A time compositional analysis of the association between movement behaviors and indicators of mental health in young adults. Scand J Med Sci Sports 2023; 33:2598-2607. [PMID: 37635273 DOI: 10.1111/sms.14471] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 07/06/2023] [Accepted: 08/09/2023] [Indexed: 08/29/2023]
Abstract
BACKGROUND Movement behaviors (i.e., physical activity [PA], sedentary behaviors [SB], sleep) relate to mental health. Although movement behaviors are often analyzed as distinct entities, they are in fact highly inter-dependent (e.g., if an individual increases sleep, then PA and/or SB must be reduced) and these dependencies should be accounted for in the analysis. We tested whether perceptions of time spent in movement behaviors (i.e., moderate-to-vigorous intensity PA [MVPA], light physical activity [LPA], SB, and sleep) related to depressive symptoms and self-report mental health in young adults using a compositional analysis. We then estimated change in depressive symptoms with reallocation of time across movement behaviors using compositional time-reallocation models. METHODS Data were drawn from the longitudinal NDIT dataset. Complete data were available for 770 young adults (Mage = 20.3, 55% females). RESULTS The proportion of time spent in MVPA relative to other movement behaviors related to depressive symptoms non-significantly and to mental health significantly. Reallocating 15 min from MVPA to SB resulted in a significant (0.46 unit) increase in depressive symptoms, and reallocating 15 min of MVPA to LPA was associated with a (0.57) increase in depressive symptoms. CONCLUSION These results indicate the importance of relative time spent in each movement behavior to mental health. Further research should examine these associations over time.
Collapse
Affiliation(s)
| | - Isabelle Doré
- Université de Montréal, Montreal, Quebec, Canada
- CHUM Research Centre, Montreal, Quebec, Canada
| | | | - Fady Michael
- Université de Montréal, Montreal, Quebec, Canada
| | - Jennifer L O'Loughlin
- Université de Montréal, Montreal, Quebec, Canada
- CHUM Research Centre, Montreal, Quebec, Canada
| |
Collapse
|
3
|
Wong JP, Bachman J, Griggs S, Hartz J. Decreasing Sedentary Behaviors in Youth to Prevent and Manage Childhood Obesity: Is It Realistic? Curr Atheroscler Rep 2023; 25:479-485. [PMID: 37378698 DOI: 10.1007/s11883-023-01121-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/07/2023] [Indexed: 06/29/2023]
Abstract
PURPOSE OF REVIEW Decreasing sedentary behaviors has been proposed as one approach to reduce the rate of obesity in youth. This review summarizes the contemporary literature examining the efficacy of these interventions in the school and community along with an additional focus on the role of socioeconomic status in these interventions. RECENT FINDINGS Studies that focus on decreasing sedentary behavior have utilized a wide variety of strategies in a number of settings. The effects of these interventions are often hindered by non-standard outcome measures, study infidelity, and subjective measures of sedentary time. However, interventions that incorporate engaged stakeholders and include younger subjects appear to be the most likely to succeed. Promising interventions to decrease sedentary behaviors have been shown in recent clinical trials; however, replicating and sustaining these results is challenging. From the available literature, school-based interventions have the potential of reaching the largest group of children. In contrast, interventions in younger children, particularly those with invested parents, seem to be the most effective.
Collapse
Affiliation(s)
- Jonathan P Wong
- Labatt Family Heart Centre, The Hospital for Sick Children, University of Toronto, Toronto, Canada
| | - Jennifer Bachman
- Department of Cardiology, Boston Children's Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA, 02115, USA
| | - Suzanne Griggs
- Department of Cardiology, Boston Children's Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA, 02115, USA
| | - Jacob Hartz
- Department of Cardiology, Boston Children's Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA, 02115, USA.
| |
Collapse
|
4
|
Perez O, Garza T, Hindera O, Beltran A, Musaad SM, Dibbs T, Singh A, Chug S, Sisson A, Kumar Vadathya A, Baranowski T, O'Connor TM. Validated assessment tools for screen media use: A systematic review. PLoS One 2023; 18:e0283714. [PMID: 37053175 PMCID: PMC10101444 DOI: 10.1371/journal.pone.0283714] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 03/15/2023] [Indexed: 04/14/2023] Open
Abstract
OBJECTIVE Accurate measurement of adult and child screen media use are needed to robustly assess its impact on health outcomes. Our objective was to systematically review screen media use measurement tools that have been validated against an objective "gold standard" tool. METHODS The search strategy was initially conducted in Medline Ovid and translated to Embase, Web of Science, PsychInfo and Cochrane. A modified natural language search was conducted in Google Scholar and IEEE. The initial search was conducted in March 2021, and an updated search was conducted in June 2022. Additional studies were included from the references. Studies had to describe the validation of a tool to measure screen media use on participants of any age against a 'gold standard' or comparable objective measure. The COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) was used to assess the criterion validity. Four authors reviewed the titles in two rounds and extracted data. RESULTS Twenty-nine articles were included in the review. Studies measured TV, computer, mobile device and social media site screen media use through: self or parent report, direct or video observation, computer and mobile device use tracking programs, and through other novel devices such as wearable devices and cameras. Correlations of self or parent report of screen media with the gold standard were lower than correlations of technology-based measures, and video observation with the gold standard. The COSMIN criterion validity ratings ranged from poor to excellent; most of the studies received a global score of fair or poor. CONCLUSIONS Technology based validated tools that more directly measure screen use are emerging that have been validated against a gold standard for measuring screen use. However, practical, objective measures of diverse types of screen media use that have been tested on diverse populations are needed to better understand the impact of screen media use on the development and physical and mental health of children and adults.
Collapse
Affiliation(s)
- Oriana Perez
- USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, Houston, Texas, United States of America
| | - Tatyana Garza
- USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, Houston, Texas, United States of America
| | - Olivia Hindera
- Baylor College of Medicine, Houston, Texas, United States of America
| | - Alicia Beltran
- USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, Houston, Texas, United States of America
| | - Salma M Musaad
- USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, Houston, Texas, United States of America
| | - Tracey Dibbs
- Rice University, Houston, Texas, United States of America
| | - Anu Singh
- Rice University, Houston, Texas, United States of America
| | - Shria Chug
- Rice University, Houston, Texas, United States of America
| | - Amy Sisson
- The Texas Medical Center Library, Houston, Texas, United States of America
| | - Anil Kumar Vadathya
- Rice University, Electrical & Computer Engineering, Houston, Texas, United States of America
| | - Tom Baranowski
- USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, Houston, Texas, United States of America
| | - Teresia M O'Connor
- USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, Houston, Texas, United States of America
| |
Collapse
|
5
|
Perez O, Kumar Vadathya A, Beltran A, Barnett RM, Hindera O, Garza T, Musaad SM, Baranowski T, Hughes SO, Mendoza JA, Sabharwal A, Veeraraghavan A, O'Connor TM. The Family Level Assessment of Screen Use-Mobile Approach: Development of an Approach to Measure Children's Mobile Device Use. JMIR Form Res 2022; 6:e40452. [PMID: 36269651 PMCID: PMC9636534 DOI: 10.2196/40452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 08/30/2022] [Accepted: 09/15/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND There is a strong association between increased mobile device use and worse dietary habits, worse sleep outcomes, and poor academic performance in children. Self-report or parent-proxy report of children's screen time has been the most common method of measuring screen time, which may be imprecise or biased. OBJECTIVE The objective of this study was to assess the feasibility of measuring the screen time of children on mobile devices using the Family Level Assessment of Screen Use (FLASH)-mobile approach, an innovative method that leverages the existing features of the Android platform. METHODS This pilot study consisted of 2 laboratory-based observational feasibility studies and 2 home-based feasibility studies in the United States. A total of 48 parent-child dyads consisting of a parent and child aged 6 to 11 years participated in the pilot study. The children had to have their own or shared Android device. The laboratory-based studies included a standardized series of tasks while using the mobile device or watching television, which were video recorded. Video recordings were coded by staff for a gold standard comparison. The home-based studies instructed the parent-child dyads to use their mobile device as they typically use it over 3 days. Parents received a copy of the use logs at the end of the study and completed an exit interview in which they were asked to review their logs and share their perceptions and suggestions for the improvement of the FLASH-mobile approach. RESULTS The final version of the FLASH-mobile approach resulted in user identification compliance rates of >90% for smartphones and >80% for tablets. For laboratory-based studies, a mean agreement of 73.6% (SD 16.15%) was achieved compared with the gold standard (human coding of video recordings) in capturing the target child's mobile use. Qualitative feedback from parents and children revealed that parents found the FLASH-mobile approach useful for tracking how much time their child spends using the mobile device as well as tracking the apps they used. Some parents revealed concerns over privacy and provided suggestions for improving the FLASH-mobile approach. CONCLUSIONS The FLASH-mobile approach offers an important new research approach to measure children's use of mobile devices more accurately across several days, even when the child shares the device with other family members. With additional enhancement and validation studies, this approach can significantly advance the measurement of mobile device use among young children.
Collapse
Affiliation(s)
- Oriana Perez
- United States Department of Agriculture/Agricultural Research Service Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX, United States
| | - Anil Kumar Vadathya
- Department of Electrical & Computer Engineering, Rice University, Houston, TX, United States
| | - Alicia Beltran
- United States Department of Agriculture/Agricultural Research Service Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX, United States
| | - R Matthew Barnett
- Center for Research Computing, Rice University, Houston, TX, United States
| | | | - Tatyana Garza
- United States Department of Agriculture/Agricultural Research Service Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX, United States
| | - Salma M Musaad
- United States Department of Agriculture/Agricultural Research Service Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX, United States
| | - Tom Baranowski
- United States Department of Agriculture/Agricultural Research Service Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX, United States
| | - Sheryl O Hughes
- United States Department of Agriculture/Agricultural Research Service Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX, United States
| | - Jason A Mendoza
- Public Health Sciences Division, Fred Hutchinson Cancer Center, Seattle, WA, United States.,Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, WA, United States
| | - Ashutosh Sabharwal
- Department of Electrical & Computer Engineering, Rice University, Houston, TX, United States
| | - Ashok Veeraraghavan
- Department of Electrical & Computer Engineering, Rice University, Houston, TX, United States
| | - Teresia M O'Connor
- United States Department of Agriculture/Agricultural Research Service Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX, United States
| |
Collapse
|
6
|
Vadathya AK, Musaad S, Beltran A, Perez O, Meister L, Baranowski T, Hughes SO, Mendoza JA, Sabharwal A, Veeraraghavan A, O'Connor T. An Objective System for Quantitative Assessment of Television Viewing Among Children (Family Level Assessment of Screen Use in the Home-Television): System Development Study. JMIR Pediatr Parent 2022; 5:e33569. [PMID: 35323113 PMCID: PMC8990369 DOI: 10.2196/33569] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 01/11/2022] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Television viewing among children is associated with developmental and health outcomes, yet measurement techniques for television viewing are prone to errors, biases, or both. OBJECTIVE This study aims to develop a system to objectively and passively measure children's television viewing time. METHODS The Family Level Assessment of Screen Use in the Home-Television (FLASH-TV) system includes three sequential algorithms applied to video data collected in front of a television screen: face detection, face verification, and gaze estimation. A total of 21 families of diverse race and ethnicity were enrolled in 1 of 4 design studies to train the algorithms and provide proof of concept testing for the integrated FLASH-TV system. Video data were collected from each family in a laboratory mimicking a living room or in the child's home. Staff coded the video data for the target child as the gold standard. The accuracy, sensitivity, specificity, positive predictive value, and negative predictive value were calculated for each algorithm, as compared with the gold standard. Prevalence and biased adjusted κ scores and an intraclass correlation using a generalized linear mixed model compared FLASH-TV's estimation of television viewing duration to the gold standard. RESULTS FLASH-TV demonstrated high sensitivity for detecting faces (95.5%-97.9%) and performed well on face verification when the child's gaze was on the television. Each of the metrics for estimating the child's gaze on the screen was moderate to good (range: 55.1% negative predictive value to 91.2% specificity). When combining the 3 sequential steps, FLASH-TV estimation of the child's screen viewing was overall good, with an intraclass correlation for an overall time watching television of 0.725 across conditions. CONCLUSIONS FLASH-TV offers a critical step forward in improving the assessment of children's television viewing.
Collapse
Affiliation(s)
- Anil Kumar Vadathya
- Department of Electrical & Computer Engineering, Rice University, Houston, TX, United States
| | - Salma Musaad
- Agricultural Research Service, US Department of Agriculture, Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX, United States
| | - Alicia Beltran
- Agricultural Research Service, US Department of Agriculture, Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX, United States
| | - Oriana Perez
- Agricultural Research Service, US Department of Agriculture, Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX, United States
| | - Leo Meister
- Department of Electrical & Computer Engineering, Rice University, Houston, TX, United States
| | - Tom Baranowski
- Agricultural Research Service, US Department of Agriculture, Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX, United States
| | - Sheryl O Hughes
- Agricultural Research Service, US Department of Agriculture, Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX, United States
| | - Jason A Mendoza
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, United States.,General Pediatrics, Department of Pediatrics, University of Washington, Seattle, WA, United States
| | - Ashutosh Sabharwal
- Department of Electrical & Computer Engineering, Rice University, Houston, TX, United States
| | - Ashok Veeraraghavan
- Department of Electrical & Computer Engineering, Rice University, Houston, TX, United States
| | - Teresia O'Connor
- Agricultural Research Service, US Department of Agriculture, Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX, United States
| |
Collapse
|
7
|
Reesor-Oyer L, Parker H, Burkart S, Smith MT, Dugger R, von Klinggraeff L, Weaver RG, Beets MW, Armstrong B. Measuring Micro Temporal Processes Underlying Preschoolers Screen Use and Behavioral Health: Protocol for the Tots & Tech Study (Preprint). JMIR Res Protoc 2022; 11:e36240. [PMID: 36169993 PMCID: PMC9557980 DOI: 10.2196/36240] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 08/10/2022] [Accepted: 08/29/2022] [Indexed: 12/19/2022] Open
Abstract
Background Excessive screen time is associated with poor health and behavioral outcomes in children. However, research on screen time use has been hindered by methodological limitations, including retrospective reports of usual screen time and lack of momentary etiologic processes occurring within each day. Objective This study is designed to assess the feasibility and utility of a comprehensive multibehavior protocol to measure the digital media use and screen time context among a racially and economically diverse sample of preschoolers and their families. This paper describes the recruitment, data collection, and analytical protocols for the Tots and Tech study. Methods The Tots and Tech study is a longitudinal, observational study of 100 dyads: caregivers and their preschool-age children (aged 3-5 years). Both caregivers and children will wear an Axivity AX3 accelerometer (Axivity Ltd) for 30 days to assess their physical activity, sedentary behavior, and sleep. Caregivers will complete ecological momentary assessments (EMAs) for 1 week to measure child behavioral problems, caregiver stress, and child screen time. Results The Tots and Tech study was funded in March 2020. This study maintains rolling recruitment, with each dyad on their own assessment schedule, depending on the time of enrollment. Enrollment was scheduled to take place between September 2020 and May 2022. We aim to enroll 100 caregiver-child dyads. The Tots and Tech outcome paper is expected to be published in 2022. Conclusions The Tots and Tech study attempts to overcome previous methodological limitations by using objective measures of screen time, physical activity, sedentary behavior, and sleep behaviors with contextual factors measured by EMA. The results will be used to evaluate the feasibility and utility of a comprehensive multibehavior protocol using objective measures of mobile screen time and accelerometry in conjunction with EMA among caregiver-child dyads. Future observational and intervention studies will be able to use this study protocol to better measure screen time and its context. International Registered Report Identifier (IRRID) DERR1-10.2196/36240
Collapse
Affiliation(s)
- Layton Reesor-Oyer
- Department of Exercise Science, University of South Carolina, Columbia, SC, United States
| | - Hannah Parker
- Department of Exercise Science, University of South Carolina, Columbia, SC, United States
| | - Sarah Burkart
- Department of Exercise Science, University of South Carolina, Columbia, SC, United States
| | - Michal T Smith
- Department of Exercise Science, University of South Carolina, Columbia, SC, United States
| | - Roddrick Dugger
- Department of Exercise Science, University of South Carolina, Columbia, SC, United States
| | - Lauren von Klinggraeff
- Department of Exercise Science, University of South Carolina, Columbia, SC, United States
| | - R Glenn Weaver
- Department of Exercise Science, University of South Carolina, Columbia, SC, United States
| | - Michael W Beets
- Department of Exercise Science, University of South Carolina, Columbia, SC, United States
| | - Bridget Armstrong
- Department of Exercise Science, University of South Carolina, Columbia, SC, United States
| |
Collapse
|
8
|
Jensen ML, Dillman Carpentier FR, Corvalán C, Popkin BM, Evenson KR, Adair L, Taillie LS. Television viewing and using screens while eating: Associations with dietary intake in children and adolescents. Appetite 2022; 168:105670. [PMID: 34478756 PMCID: PMC8671257 DOI: 10.1016/j.appet.2021.105670] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 07/15/2021] [Accepted: 08/29/2021] [Indexed: 01/03/2023]
Abstract
Screen time has been associated with overweight and obesity, as well as with poorer dietary quality. However, the reasons explaining these associations are not well understood. The objectives of this cross-sectional study were [1] to determine the extent of overall TV viewing as well as using screens while eating (e.g., watching TV or using a tablet), [2] to compare food and nutrient consumption of on-versus off-screen eating occasions, and [3] to determine whether TV viewing and using screens while eating is associated with overall dietary intake. Participants were from the Food Environment Chilean Cohort (n = 938, 4-6 y) and the Growth and Obesity Cohort Study (n = 752, 12-14 y). Dietary data was collected via one 24-h food recall. For each eating occasion, activity performed during consumption (e.g., watching TV, playing sports) was reported. Weekly TV viewing time was collected via an additional survey instrument. Analyses included multivariable linear and logistic regression. Post-hoc pairwise comparisons examined differences in outcomes by tertiles. Our sample reported a median of 9-13.5 weekly hours of TV viewing and 87.5% reported consuming at least one meal or snack per day while using screens. The median kilocalories contributed by eating during screen use was 387 kcal/d in children and 848 kcal/day in adolescents, which represents 34.7% and 42.3% of daily energy intake, respectively. There were no consistent differences when comparing eating occasions consumed on-screen versus off-screen. Higher weekly TV viewing was associated with elements of a less healthy diet including more sweets and desserts in children, and more sugar sweetened beverages in adolescents. A large percentage of Chilean children and adolescents' daily energy is consumed while using screens. In depth, longitudinal work is needed to understand how screen time eating affects diet quality and nutritional status.
Collapse
Affiliation(s)
- Melissa L Jensen
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA; Global Food Research Program, Carolina Population Center, Chapel Hill, NC, USA; School of Nutrition, University of Costa Rica, San José, Costa Rica
| | | | - Camila Corvalán
- Instituto de Nutrición y Tecnología de Alimentos, Universidad de Chile, Macul, Chile
| | - Barry M Popkin
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA; Global Food Research Program, Carolina Population Center, Chapel Hill, NC, USA
| | - Kelly R Evenson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Linda Adair
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Lindsey Smith Taillie
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA; Global Food Research Program, Carolina Population Center, Chapel Hill, NC, USA.
| |
Collapse
|
9
|
Supper W, Guay F, Talbot D. The Relation Between Television Viewing Time and Reading Achievement in Elementary School Children: A Test of Substitution and Inhibition Hypotheses. Front Psychol 2021; 12:580763. [PMID: 34733194 PMCID: PMC8558249 DOI: 10.3389/fpsyg.2021.580763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 09/16/2021] [Indexed: 11/29/2022] Open
Abstract
Research has focused on the relations between television (TV) viewing time and children’s reading achievement. Two hypotheses have been proposed to explain this relation. The substitution hypothesis proposes that TV viewing distracts students from activities that are important for their learning. The inhibition hypothesis proposes that watching television inhibits important affective/cognitive skills. In this study, we test both hypotheses by estimating the relation between TV viewing time and reading achievement. We use the frequency of students’ leisure reading and the frequency of interactions between students and their parents as potential mediators to test the substitution hypothesis, whereas for the inhibition one, we use students’ intrinsic motivation to read and their level of inattention. Data come from the Québec Longitudinal Study of Child Development (QLSCD). Designed by the Institut de la statistique du Québec, QLSCD covers a wide range of themes. The QLSCD is representative of children in Québec and contains 2223 participants who were followed from 0 to 21 years old. The four structural models tested are built as follows: the TV viewing time at 6 years old predicts the four mediating variables at 8 years old, which in turn predicts reading achievement at 10 years old. In addition, we have tested models’ gender invariance. Results indicate that TV viewing time is not directly or indirectly associated with reading achievement. Specifically, it is not associated with the mediating variables of child-parent interactions, intrinsic motivation, and inattention. However, the frequency of leisure reading is negatively associated with the time spent watching TV. This association is very small (−0.07) and has no indirect effect on reading achievement. Finally, results do not vary according to the gender of the participants. Our results are in line with those of previous studies in the field and cast some doubts on the potential negative effects of TV viewing time on reading achievement.
Collapse
Affiliation(s)
- Wilfried Supper
- Département des fondements et pratiques en éducation, Faculté des sciences de l'éducation, Université Laval, Quebec, QC, Canada
| | - Frédéric Guay
- Département des fondements et pratiques en éducation, Faculté des sciences de l'éducation, Université Laval, Quebec, QC, Canada
| | - Denis Talbot
- Département de médecine sociale et préventive, Faculté de Médecine, Université Laval, Quebec, QC, Canada
| |
Collapse
|
10
|
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.
Collapse
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
| |
Collapse
|
11
|
TV advertising and dietary intake in adolescents: a pre- and post- study of Chile's Food Marketing Policy. Int J Behav Nutr Phys Act 2021; 18:60. [PMID: 33947436 PMCID: PMC8097821 DOI: 10.1186/s12966-021-01126-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 04/19/2021] [Indexed: 01/31/2023] Open
Abstract
Background The first phase of a comprehensive marketing policy was implemented in Chile in 2016. The policy restricted child-directed marketing of foods and beverages considered high in energy, total sugars, sodium or saturated fat (“high-in”). The objective of this study was to examine the role of high-in TV food advertising as a mediator in the association between policy implementation and consumption of high-in foods and beverages between 2016 and 2017. Methods Dietary data were from 24-hour diet recalls collected in 2016 and 2017 in a cohort of 12–14 y children (n = 721). Television use was assessed concurrently and linked to analyses of food advertisements on broadcast and paid television to derive individual-level estimates of exposure to high-in food advertising. A multilevel mediation analysis examined direct and indirect effects of the policy through advertising exposure. Results Following the policy implementation, high-in advertising exposure was significantly reduced (p < 0.01). High-in food intake decreased in adolescents with lower levels, but not higher levels, of high-in advertising at baseline. We did not find evidence of mediation by changes in high-in ad exposure. Conclusions Adolescents’ exposure to high-in TV advertising decreased after the 2016 implementation of the Chilean Food Labeling and Marketing Law. However, evidence that changes in advertisement mediated dietary changes was not found. Further research is needed to understand how marketing changes will relate to dietary changes after full implementation of the law and in the long term. Supplementary Information The online version contains supplementary material available at 10.1186/s12966-021-01126-7.
Collapse
|
12
|
Chemtob K, Reid RER, Guimarães RDF, Henderson M, Mathieu ME, Barnett TA, Tremblay A, Van Hulst A. Adherence to the 24-hour movement guidelines and adiposity in a cohort of at risk youth: A longitudinal analysis. Pediatr Obes 2021; 16:e12730. [PMID: 32997442 DOI: 10.1111/ijpo.12730] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 07/30/2020] [Accepted: 08/24/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND The 24-hour movement guidelines provide recommendations for physical activity, screen time and sleep duration for children. OBJECTIVES Describe adherence to the guidelines and their cross-sectional and longitudinal associations with adiposity from childhood to adolescence. METHODS Data are from the QUALITY Cohort. Children were followed at 8 to 10 years (childhood; n = 630), 10 to 12 years (early adolescence; n = 564) and 15 to 17 years (adolescence; n = 377). Physical activity, screen time, and sleep duration were measured by accelerometry and questionnaires. Body mass index z-scores (zBMI), waist circumference, waist-to-height ratio and percent body fat were based on clinical measurements. Multiple linear regressions estimated associations. RESULTS In childhood, early adolescence and adolescence, 14%, 6%, and 0% of participants met the 24-hour movement guidelines, respectively. Meeting fewer guideline components was cross-sectionally associated with higher adiposity at each visit. Meeting fewer guideline components in childhood was longitudinally associated with higher adiposity at later visits. For example, those meeting none of the guideline components (vs all) in childhood had a 1.66 SD (95% CI: 0.42, 2.89) higher zBMI in early adolescence. CONCLUSION Few participants met the guidelines. Not meeting the guidelines in childhood is associated with higher adiposity 2 and 7 years later. Interventions are needed to increase adherence to the 24-hour movement guidelines across childhood and adolescence.
Collapse
Affiliation(s)
- Keryn Chemtob
- Ingram School of Nursing, McGill University, Montreal, Quebec, Canada
| | - Ryan E R Reid
- Human Kinetics Department, St Francis Xavier University, Antigonish, Nova Scotia, Canada
| | - Roseane de Fátima Guimarães
- École de kinésiologie et des sciences de l'activité physique, Université de Montréal, Montreal, Quebec, Canada.,Centre de recherche du CHU Sainte Justine, Montreal, Quebec, Canada
| | - Mélanie Henderson
- Centre de recherche du CHU Sainte Justine, Montreal, Quebec, Canada.,Department of Pediatrics, Université de Montréal, Montreal, Quebec, Canada
| | - Marie-Eve Mathieu
- École de kinésiologie et des sciences de l'activité physique, Université de Montréal, Montreal, Quebec, Canada.,Centre de recherche du CHU Sainte Justine, Montreal, Quebec, Canada
| | - Tracie A Barnett
- Centre de recherche du CHU Sainte Justine, Montreal, Quebec, Canada.,Department of Family Medicine, McGill University, Montreal, Quebec, Canada
| | - Angelo Tremblay
- Département de kinésiologie, Université Laval, Quebec City, Quebec, Canada
| | - Andraea Van Hulst
- Ingram School of Nursing, McGill University, Montreal, Quebec, Canada
| |
Collapse
|
13
|
Jensen ML, Carpentier FD, Adair L, Corvalán C, Popkin BM, Taillie LS. Examining Chile's unique food marketing policy: TV advertising and dietary intake in preschool children, a pre- and post- policy study. Pediatr Obes 2021; 16:e12735. [PMID: 33105522 PMCID: PMC8073213 DOI: 10.1111/ijpo.12735] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 08/14/2020] [Accepted: 09/10/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND The Chilean government implemented the first phase of a comprehensive marketing policy in 2016, restricting child-directed marketing of products high in energy, total sugars, sodium or saturated fat (hereafter "high-in"). OBJECTIVES To examine the role that high-in TV food advertising had in the effect of the policy on consumption of high-in products between 2016 and 2017. METHODS Dietary data were obtained from 24-hour diet recall measured in 2016 (n = 940) and 2017 (n = 853), pre- and post-policy, from a cohort of 4 to 6 years children. Television use was linked to analyses of food advertisements to derive individual-level estimates of exposure to advertising. A multilevel mediation analysis examined direct and indirect effects of the policy through advertising exposure. RESULTS Children's high-in food consumption and advertising exposure declined significantly from 2016 to 2017 (P < .01). Consumption changes were not significantly mediated by changes in advertising exposure, which might suggest other elements of the Chilean Law potentially driving decreases in consumption to a greater extent than TV ads. CONCLUSIONS Preschoolers' exposure to high-in advertising and consumption of high-in products decreased post-policy. Further research is needed to understand how marketing changes will relate to dietary changes after full implementation of the law and in the long term.
Collapse
Affiliation(s)
- Melissa L. Jensen
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
- Global Food Research Program, Carolina Population Center, Chapel Hill, NC, USA
- School of Nutrition, University of Costa Rica, San José, Costa Rica
| | | | - Linda Adair
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Camila Corvalán
- Instituto de Nutrición y Tecnología de Alimentos, Universidad de Chile, Macul, Chile
| | - Barry M. Popkin
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
- Global Food Research Program, Carolina Population Center, Chapel Hill, NC, USA
| | - Lindsey Smith Taillie
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
- Global Food Research Program, Carolina Population Center, Chapel Hill, NC, USA
| |
Collapse
|
14
|
Lifestyle Behaviors Associated With Body Fat Percent in 9- to 11-Year-Old Children. Pediatr Exerc Sci 2021; 33:40-47. [PMID: 33771944 DOI: 10.1123/pes.2020-0010] [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: 01/13/2020] [Revised: 10/27/2020] [Accepted: 11/06/2020] [Indexed: 11/18/2022]
Abstract
PURPOSE To examine (1) associations between body fat percent (BF) and lifestyle behaviors in children aged 9-11 years and (2) the consistency of these associations over a 10-year period. METHODS In this repeat, cross-sectional study, 15,977 children aged 9-11 years completed an anthropometric assessment and the SportsLinx Lifestyle survey between 2004 and 2013. Body fat was estimated according to the sum of the triceps and subscapular skinfold measurements. Multilevel models were utilized to examine associations between BF and responses to the lifestyle survey while controlling for known covariates. RESULTS Lifestyle behaviors explained 8.6% of the total variance in body fat. Specifically, negative associations were found between BF and active transport to school ( β = -0.99 [0.19], P < .001), full-fat milk (-0.07 [0.15], P < .001), and sweetened beverage consumption (-0.40 [0.15], P = .007). Relative to the reference group of ≤8:00 PM, later bedtime was positively associated with BF: 8:00 to 8:59 PM ( β = 1.60 [0.26], P < .001); 9:00 to 10:00 PM ( β = 1.04 [0.24], P < .001); ≥10:00 PM ( β = 1.18 [0.30], P < .001). Two-way interactions revealed opposing associations between BF and the consumption of low-calorie beverages for boys ( β = 0.95 [0.25], P < .001) and girls ( β = -0.85 [0.37], P = .021). There was no significant change in these associations over a 10-year period. CONCLUSIONS In this population-level study covering a decade of data collection, lifestyle behaviors were associated with BF. Policies and interventions targeting population-level behavior change, such as active transport to school, sleep time, and consumption of full-fat milk, may offer an opportunity for improvements in BF.
Collapse
|
15
|
Schmid D, Willett WC, Forman MR, Ding M, Michels KB. TV viewing during childhood and adult type 2 diabetes mellitus. Sci Rep 2021; 11:5157. [PMID: 33664288 PMCID: PMC7933176 DOI: 10.1038/s41598-021-83746-4] [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] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 02/05/2021] [Indexed: 11/28/2022] Open
Abstract
We examined whether regular television (TV) viewing at ages 3-5 and 5-10 years is related to the incidence of type 2 diabetes mellitus (T2D) in adult women. We used data from 34,512 mother-nurse daughter dyads in the Nurses' Health Study (NHS) II and the Nurses' Mothers' Cohort Study. Mothers of NHS II participants completed a questionnaire on their pregnancy with the nurse and her early life experience. During 391,442 person-years of follow-up from 2001 to 2013, 1515 nurses developed T2D. Increasing levels of TV viewing at 3-5 years of age retrospectively reported by the mothers were related to a greater risk of T2D in adulthood: multivariable-adjusted hazard ratios (HRs) for ≤ 1, 2, and ≥ 3 h/day vs. no TV viewing were 1.11 [95% confidence interval (CI) 0.96-1.28], 1.20 (95% CI 1.02-1.41), and 1.35 (95% CI 1.11-1.65), p trend = 0.002, respectively, after adjustment for early life variables, including childhood physical activity and adiposity. Retrospectively reported TV viewing for ≥ 3 h/day at 5-10 years of age was associated with a 34% greater risk of adult T2D (HR 1.34, 95% CI 1.05-1.70, p trend < 0.001). Additional adjustments for adult variables, including adult TV viewing and current BMI attenuated the effect estimates (≥ 3 h/day TV viewing at 3-5 years: HR 1.22, 95% CI 0.99-1.49, p trend = 0.07; TV viewing at 5-10 years: 1.16, 95% CI 0.91-1.49, p trend = 0.09). The present study suggests that TV viewing during early childhood increases risk of T2D in adult women; adult BMI explains part of this association. Further research is required to confirm this observation and understand the mediating pathways.
Collapse
Affiliation(s)
- Daniela Schmid
- Institute for Prevention and Cancer Epidemiology, Faculty of Medicine and Medical Center, University of Freiburg, Elsässerstr. 2, 79110, Freiburg, Germany
- Division for Quantitative Methods in Public Health and Health Services Research, Institute of Public Health, Medical Decision Making and Health Technology Assessment, UMIT-University for Health Sciences, Medical Informatics and Technology, Hall in Tyrol, Austria
| | - Walter C Willett
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Michele R Forman
- Department of Nutrition Science, College of Health and Human Science, Purdue Center for Cancer Research, Purdue University, West Lafayette, IN, USA
| | - Ming Ding
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Karin B Michels
- Institute for Prevention and Cancer Epidemiology, Faculty of Medicine and Medical Center, University of Freiburg, Elsässerstr. 2, 79110, Freiburg, Germany.
- Department for Epidemiology, Fielding School of Public Health, University of California, Los Angeles, CA, USA.
| |
Collapse
|
16
|
Lona G, Hauser C, Köchli S, Infanger D, Endes K, Faude O, Hanssen H. Changes in physical activity behavior and development of cardiovascular risk in children. Scand J Med Sci Sports 2021; 31:1313-1323. [PMID: 33527518 DOI: 10.1111/sms.13931] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 01/19/2021] [Accepted: 01/26/2021] [Indexed: 11/29/2022]
Abstract
The study aimed to investigate the association of changes in physical activity, screen time, and cardiorespiratory fitness (CRF) with development of body mass index (BMI), blood pressure (BP), and retinal microvascular health in children over four years. In 2014, 391 children aged 6-8 years were screened, and thereof 262 children were reexamined after four years following standardized protocols. Retinal arteriolar (CRAE) and venular diameters were measured by a retinal vessel analyzer. CRF was objectively assessed by a 20 m shuttle run, physical activity, and screen time by use of a questionnaire. Children who achieved higher CRF levels reduced their BMI (β [95% CI] -0.35 [-0.46 to -0.25] kg/m2 per stage, P ≤ .001) and thereby developed wider CRAE (β [95% CI] 0.25 [0.24 to 0.48] µm per stage, P = .03) at follow-up. Moreover, children with elevated or high systolic BP at baseline, but lower levels of screen time during the observation period, had wider CRAE at follow-up (β [95% CI] -0.37 [-0.66 to -0.08] µm per 10 min/d, P = .013). Change in CRF was not directly associated with better microvascular health at follow-up. However, an increase of CRF over four years was associated with a reduced BMI and consequently wider retinal arterioles at follow-up. In children with elevated or high systolic BP, a reduction of screen time significantly improved retinal microvascular health as a primary prevention strategy to promote childhood health and combat development of manifest CV disease later in life.
Collapse
Affiliation(s)
- Giulia Lona
- Department of Sport, Exercise and Health, Medical Faculty, University of Basel, Basel, Switzerland
| | - Christoph Hauser
- Department of Sport, Exercise and Health, Medical Faculty, University of Basel, Basel, Switzerland
| | - Sabrina Köchli
- Department of Sport, Exercise and Health, Medical Faculty, University of Basel, Basel, Switzerland
| | - Denis Infanger
- Department of Sport, Exercise and Health, Medical Faculty, University of Basel, Basel, Switzerland
| | - Katharina Endes
- Department of Sport, Exercise and Health, Medical Faculty, University of Basel, Basel, Switzerland
| | - Oliver Faude
- Department of Sport, Exercise and Health, Medical Faculty, University of Basel, Basel, Switzerland
| | - Henner Hanssen
- Department of Sport, Exercise and Health, Medical Faculty, University of Basel, Basel, Switzerland
| |
Collapse
|
17
|
Riglea T, Doré I, O'Loughlin J, Bélanger M, Sylvestre MP. Contemporaneous trajectories of physical activity and screen time in adolescents. Appl Physiol Nutr Metab 2021; 46:676-684. [PMID: 33406004 DOI: 10.1139/apnm-2020-0631] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Adolescents often report low moderate-to-vigorous physical activity (MVPA) and high screen time. We modeled sex-specific MVPA and screen time trajectories during adolescence and identified contemporaneous patterns of evolution. Data were drawn from 2 longitudinal investigations. The Nicotine Dependence in Teens (NDIT) study included 1294 adolescents recruited at age 12-13 years who completed questionnaires every 3 months for 5 years. The Monitoring Activities of Teenagers to Comprehend their Habits (MATCH) study included 937 participants recruited at age 9-12 years who completed questionnaires every 4 months for 7 years. MVPA was measured as the number of days per week of being active for at least 5 min (NDIT) or 60 min (MATCH). In both studies, screen time was measured as the number of hours spent weekly in screen activities. In each study, sex-specific group-based trajectories were modeled separately for MVPA and screen time from grade 7 to 11. Contemporaneous patterns of evolution were examined in mosaic plots. In both studies, 5 MVPA trajectories were identified in both sexes, and 4 and 5 screen time trajectories were identified in boys and girls, respectively. All combinations of MVPA and screen time trajectories were observed. However, the contemporaneous patterns of evolution were favourable in 14%-31% of participants (i.e., they were members of the stable high MVPA and the lower screen time trajectories). Novelty: MVPA and screen time trajectories during adolescence and their combinations showed wide variability in 2 Canadian studies. Up to 31% of participants showed favourable contemporaneous patterns of evolution in MVPA and screen time. Using uniform methods for trajectory modeling may increase the potential for replication across studies.
Collapse
Affiliation(s)
- Teodora Riglea
- Centre de recherche du centre hospitalier de l'Université de Montréal, Montréal, QC H2X 0A9, Canada
| | - Isabelle Doré
- Centre de recherche du centre hospitalier de l'Université de Montréal, Montréal, QC H2X 0A9, Canada.,School of Kinesiology and Physical Activity Sciences, Faculty of Medicine, Université de Montréal, Montréal, QC H3T 1J4, Canada
| | - Jennifer O'Loughlin
- Centre de recherche du centre hospitalier de l'Université de Montréal, Montréal, QC H2X 0A9, Canada.,Department of Social and Preventive Medicine, School of Public Health, Université de Montréal, Montréal, QC H3N 1X9, Canada
| | - Mathieu Bélanger
- Department of Family Medicine, Université de Sherbrooke, Sherbrooke, QC J1H 5N4, Canada.,Centre de formation médicale du Nouveau-Brunswick, Moncton, NB E1A 3E9, Canada.,Research Services, Vitalité Health Network, Bathurst, NB E2A 1A9, Canada
| | - Marie-Pierre Sylvestre
- Centre de recherche du centre hospitalier de l'Université de Montréal, Montréal, QC H2X 0A9, Canada.,Department of Social and Preventive Medicine, School of Public Health, Université de Montréal, Montréal, QC H3N 1X9, Canada
| |
Collapse
|
18
|
Maternal Education Level and Excessive Recreational Screen Time in Children: A Mediation Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17238930. [PMID: 33271768 PMCID: PMC7730269 DOI: 10.3390/ijerph17238930] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 11/28/2020] [Accepted: 11/30/2020] [Indexed: 12/24/2022]
Abstract
There is increasing recognition of the adverse health consequences of excessive recreational screen time (RST) in children and adolescents. Early interventions that aim to reduce RST are crucial, but there are some controversies about which individual and parental variables affect RST in children. The aim of this study was to determine the relationship of parental education level with RST in children and early adolescents and to identify mediators of these relationships. This cross-sectional study examined a sample of children (2–14 year-old) who attended routine childcare visits in primary health care centers in Spain (n = 402; 53.7% males; mean age: 7 ± 4 year-old). A self-reported questionnaire was given to the parents to assess sociodemographic data, parental education, the home media environment, and RST in children. Separate analysis was performed for two age groups (2–6 year-old and 6–14 year-old). Path analysis, an application of structural equation modeling, was used to analyze the data. Fitty three percent of the children had excessive RST (≥2 h/day). The maternal education level, eating lunch/dinner in front of a TV, presence of a background TV, and the amount of parental TV viewing had significant associations with excessive RST in both age groups. For the younger group, the maternal education level had direct and indirect effects on RST (total effect: β = −0.29, p < 0.01). For the older group, maternal education level only had a significant indirect effect on RST, and this was mediated by the presence of a background TV and the time of parental TV viewing (total indirect effect: β = −0.11, p < 0.01). A higher maternal education level appears to be associated with certain environmental factors or habits that prevent excessive RST.
Collapse
|
19
|
Chortatos A, Henjum S, Torheim LE, Terragni L, Gebremariam MK. Comparing three screen-based sedentary behaviours' effect upon adolescents' participation in physical activity: The ESSENS study. PLoS One 2020; 15:e0241887. [PMID: 33237914 PMCID: PMC7688164 DOI: 10.1371/journal.pone.0241887] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 10/21/2020] [Indexed: 11/18/2022] Open
Abstract
Background Literature focusing on the association between sedentary behaviours and physical activity has provided equivocal results and has been dominated by TV viewing as the indicator of sedentary behaviour. There is a need for more studies exploring the association between contemporary screen activities and physical activity among youth. Methods A cross-sectional study including 742 adolescents was conducted in 2016. Data were collected at school through an online questionnaire. Regression analyses were used to explore the association between different screen-based sedentary behaviours and participation in physical activity. Results The results showed that those with lower (vs higher) time spent on TV/movie streaming and electronic game playing both on weekdays and weekend days had significantly higher odds of participating in physical activity. There were no significant associations between socializing/surfing online both on weekdays and weekend days and physical activity in adjusted models. Conclusions TV/movie streaming and electronic game playing during both weekdays and weekend days were significantly inversely related with participating in physical activity. Initiatives aimed at reducing screen-based sedentary activities might result in favourable effects on physical activity levels among adolescents.
Collapse
Affiliation(s)
- Arthur Chortatos
- Department of Nursing and Health Promotion, Faculty of Health Sciences, OsloMet–Oslo Metropolitan University, Oslo, Norway
| | - Sigrun Henjum
- Department of Nursing and Health Promotion, Faculty of Health Sciences, OsloMet–Oslo Metropolitan University, Oslo, Norway
| | - Liv Elin Torheim
- Department of Nursing and Health Promotion, Faculty of Health Sciences, OsloMet–Oslo Metropolitan University, Oslo, Norway
- * E-mail:
| | - Laura Terragni
- Department of Nursing and Health Promotion, Faculty of Health Sciences, OsloMet–Oslo Metropolitan University, Oslo, Norway
| | - Mekdes K. Gebremariam
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| |
Collapse
|
20
|
A novel, composite measure of screen-based media use in young children (ScreenQ) and associations with parenting practices and cognitive abilities. Pediatr Res 2020; 87:1211-1218. [PMID: 32050256 DOI: 10.1038/s41390-020-0765-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 12/23/2019] [Accepted: 12/29/2019] [Indexed: 01/11/2023]
Abstract
BACKGROUND Screen-based media use is prevalent in children and is associated with health risks. American Academy of Pediatrics (AAP) recommendations involve access to screens, frequency, content, and co-viewing. The aim of this study was to test the ScreenQ, a composite measure of screen-based media use. METHODS ScreenQ is a 15-item parent report measure reflecting AAP recommendations. Range is 0-26, higher scores reflecting greater non-adherence. With no "gold standard" available, four validated measures of skills and parenting practices cited as influenced by overuse were applied as the external criteria, including expressive language, speed of processing, emergent literacy, and cognitive stimulation at home. Psychometric analyses involved Rasch methods and Spearman's ρ correlations. RESULTS Sixty-nine families were administered ScreenQ. Child age ranged from 36 to 63 months old (52 ± 8; 35 girls). Mean ScreenQ score was 9.6 (±5.0; 1-22). Psychometric properties were strong (rCo-α = 0.74). ScreenQ scores were negatively correlated with CTOPP-2 (Comprehensive Test of Phonological Processing, Second Edition) (rρ = -0.57), EVT-2 (Expressive Vocabulary Test, Second Edition) (rρ = -0.45), GRTR (Get Ready to Read!) (rρ = -0.30) and StimQ-P (rρ = -0.42) scores (all p ≤ 0.01). CONCLUSIONS ScreenQ shows potential as a composite measure of screen-based media use in young children in the context of AAP recommendations. ScreenQ scores were correlated with lower executive, language and literacy skills, and less stimulating home cognitive environment.
Collapse
|
21
|
Healy S, Foley J, Haegele JA. Physical Activity, Screen Time, and Sleep Duration Among Youth With Chronic Health Conditions in the United States. Am J Health Promot 2020; 34:505-511. [PMID: 32233773 DOI: 10.1177/0890117120915687] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To compare the degree to which youth with and without chronic conditions in the United States met physical activity (PA), screen time, and sleep duration guidelines. DESIGN A cross-sectional study using data from the 2016 National Survey of Children's Health. PARTICIPANTS A total of 24 405 youth (aged 10-17 years) with and without 1 of 19 prevalent chronic health conditions who participated in the 2016 National Survey of Children's Health. MEASURES Parents reported on the time spent by their children in PA, screen time, and sleep. ANALYSIS Descriptive and bivariate analyses were conducted to estimate and compare health behavior guideline adherence rates among children with and without chronic conditions. RESULTS Overall, 18.7% of children with chronic conditions did not meet any health behavior guidelines compared to 15.6% of children without chronic conditions. Children with hearing impairments, diabetes, and depression were most likely to not meet any health behavior guidelines (27.9%, 25.4%, and 21.7%, respectively). Of the 3 guidelines, children with and without chronic conditions were least likely to meet the PA guideline (18.6% and 21%, respectively). CONCLUSIONS This study identifies specific groups of children with chronic conditions that are most at risk of not meeting health behavior guidelines. The findings highlight specific behaviors in most need of intervention for children with chronic conditions; PA was identified as the most frequently unmet guideline. Overall findings suggest a need for a more integrated, holistic view of health promotion for children with chronic conditions.
Collapse
Affiliation(s)
- Sean Healy
- Department of Behavioral Health and Nutrition, University of Delaware, Newark, DE, USA
| | - John Foley
- Department of Physical Education, State University of New York at Cortland, Cortland, NY, USA
| | - Justin A Haegele
- Department of Human Movement Sciences, Old Dominion University, Norfolk, VA, USA
| |
Collapse
|
22
|
Chen WT, Wang N, Lin KC, Liu CY, Chen WJ, Chen CY. Childhood social context in relation to alcohol expectancy through early adolescence: A latent profile approach. Drug Alcohol Depend 2020; 208:107851. [PMID: 31954951 DOI: 10.1016/j.drugalcdep.2020.107851] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Revised: 12/27/2019] [Accepted: 01/01/2020] [Indexed: 11/15/2022]
Abstract
BACKGROUND The present study aims to (i) identify patterns in the changes of endorsed positive alcohol expectancies (AEs) through early adolescence and (ii) examine associated childhood social context predictors of such profiles. METHODS We used three waves of longitudinal data from the Alcohol-Related Experiences among Children. The baseline sample comprised 928 6th graders from 17 elementary schools in northern Taiwan (response rate = 60 %); subsequent follow-up was conducted at 7th and 8th grade (follow-up rate = 88 %). Data concerning three domains of positive AEs (i.e., global positive transformation, enhancing social behaviors, and promoting relaxation), social context, and alcohol drinking were collected by self-administered questionnaires. Longitudinal latent profile and survey multinomial logistic regression analyses were used to evaluate the association estimates, stratified by childhood alcohol initiation. RESULTS Three distinct profiles (decreasing, stable, and increasing) of positive AEs were identified for the alcohol-naïve children (n = 466); observing paternal drinking and watching TV more than two hours per day at baseline were strongly linked with the stable and increasing AE profiles (aOR = 1.96-4.80). For the alcohol-experienced children, four profiles (low decreasing, low increasing, high decreasing, and high increasing) emerged; observing maternal drinking was predictive for the high-increasing profile (aOR = 2.94). Regardless of childhood alcohol initiation, recent alcohol use appeared to be the strongest predictor for the increasing profiles of positive AEs. CONCLUSIONS Strategies addressing pro-alcohol social contexts that facilitate a prominent increase in positive AEs should be considered when devising preventive programs targeting underage drinking behaviors and problems.
Collapse
Affiliation(s)
- Wan-Ting Chen
- Institute of Public Health, National Yang-Ming University, Taipei, Taiwan; Center for Neuropsychiatric Research, National Health Research Institutes, Miaoli, Taiwan
| | - Nadia Wang
- Institute of Public Health, National Yang-Ming University, Taipei, Taiwan
| | - Kuan-Chia Lin
- Institute of Hospital and Health Care Management, National Yang-Ming University, Taipei, Taiwan
| | - Chieh-Yu Liu
- Department of Speech and Language Pathology and Audiology, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Wei J Chen
- Center for Neuropsychiatric Research, National Health Research Institutes, Miaoli, Taiwan; Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Chuan-Yu Chen
- Institute of Public Health, National Yang-Ming University, Taipei, Taiwan; Center for Neuropsychiatric Research, National Health Research Institutes, Miaoli, Taiwan; Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.
| |
Collapse
|
23
|
De Moraes ACF, Nascimento-Ferreira MV, Forjaz CLDM, Aristizabal JC, Azzaretti L, Nascimento Junior WV, Miguel-Berges ML, Skapino E, Delgado C, Moreno LA, Carvalho HB. Reliability and validity of a sedentary behavior questionnaire for South American pediatric population: SAYCARE study. BMC Med Res Methodol 2020; 20:5. [PMID: 31924168 PMCID: PMC6954524 DOI: 10.1186/s12874-019-0893-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Accepted: 12/23/2019] [Indexed: 12/14/2022] Open
Abstract
Background Multicenter studies from Europe and the United States have developed specifically standardized questionnaires for assessing and comparing sedentary behavior, but they cannot be directly applied for South American countries. The aim of this study was to assess the reliability and validity of the South American Youth Cardiovascular and Environmental (SAYCARE) sedentary behavior questionnaire. Methods Children and adolescents from seven South American cities were involved in the test-retest reliability (children: n = 55; adolescents: n = 106) and concurrent validity (children: n = 93; adolescents: n = 94) studies. The SAYCARE sedentary behavior questionnaire was administered twice with two-week interval and the behaviors were parent-reported for children and self-reported for adolescents. Questions included time spent watching television, using a computer, playing console games, passive playing (only in children) and studying (only in adolescents) over the past week. Accelerometer was used for at least 3 days, including at least one weekend day. We compared values of sedentary time, using accelerometers, by quartiles of reported sedentary behavior time and their sum. Results The reliability of sedentary behavior time was moderate for children (rho ≥0.45 and k ≥ 0.40) and adolescents (rho ≥0.30). Comparisons between the questionnaire and accelerometer showed a low overall agreement, with the questionnaire systematically underreporting sedentary time in children (at least, − 332.6 ± 138.5 min/day) and adolescents (at least, − 399.7 ± 105.0 min/day). Conclusion The SAYCARE sedentary behavior questionnaire has acceptable reliability in children and adolescents. However, the findings of current study indicate that SAYCARE questionnaire is not surrogate of total sedentary time.
Collapse
Affiliation(s)
- Augusto César Ferreira De Moraes
- Department of Epidemiology, School of Public Health, University of Sao Paulo, São Paulo, Brazil.,YCARE (Youth/Child cArdiovascular Risk and Environmental) Research Group, Faculdade de Medicina, Universidade de Sao Paulo, São Paulo, Brazil
| | - Marcus Vinícius Nascimento-Ferreira
- YCARE (Youth/Child cArdiovascular Risk and Environmental) Research Group, Faculdade de Medicina, Universidade de Sao Paulo, São Paulo, Brazil. .,Growth, Exercise, NUtrition and Development (GENUD) Research Group, Instituto Agroalimentario de Aragon (IA2), Instituto de Investigacion Sanitaria Aragon (IIS Aragon), Centro de Investigacion Biomedica en Red de Fisiopatologıa de la Obesidad y Nutricion (CIBERObn), University of Zaragoza, Zaragoza, Spain.
| | | | - Juan Carlos Aristizabal
- Grupo de Investigación en Fisiología y Bioquímica (PHYSIS), Universidad de Antioquia, Medellín, Colombia
| | - Leticia Azzaretti
- Escuela de Nutrición, Facultad de Medicina, Universidad de Buenos Aires, Buenos Aires, Argentina
| | | | - Maria L Miguel-Berges
- Growth, Exercise, NUtrition and Development (GENUD) Research Group, Instituto Agroalimentario de Aragon (IA2), Instituto de Investigacion Sanitaria Aragon (IIS Aragon), Centro de Investigacion Biomedica en Red de Fisiopatologıa de la Obesidad y Nutricion (CIBERObn), University of Zaragoza, Zaragoza, Spain
| | | | - Carlos Delgado
- Universidad Nacional Mayor de San Marcos (UNMSM), School of Medicine, Department of Pediatrics and Instituto Nacional de Salud del Niño (INSN), Neonatal Unit, Lima, Peru
| | - Luis A Moreno
- Growth, Exercise, NUtrition and Development (GENUD) Research Group, Instituto Agroalimentario de Aragon (IA2), Instituto de Investigacion Sanitaria Aragon (IIS Aragon), Centro de Investigacion Biomedica en Red de Fisiopatologıa de la Obesidad y Nutricion (CIBERObn), University of Zaragoza, Zaragoza, Spain
| | - Heráclito Barbosa Carvalho
- YCARE (Youth/Child cArdiovascular Risk and Environmental) Research Group, Faculdade de Medicina, Universidade de Sao Paulo, São Paulo, Brazil
| |
Collapse
|
24
|
Evaluating the impact of Chile's marketing regulation of unhealthy foods and beverages: pre-school and adolescent children's changes in exposure to food advertising on television. Public Health Nutr 2019; 23:747-755. [PMID: 31822317 DOI: 10.1017/s1368980019003355] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To evaluate the effects of Chile's 2016 regulation restricting child-directed marketing of products high in energy, saturated fats, sodium and sugars on reducing children's exposure to 'high-in' television food advertising. DESIGN Television use by pre-schoolers and adolescents was assessed via surveys in the months prior to implementation and a year after implementation. Hours and channels of television use were linked with the amount of high-in food advertising observed in corresponding content analyses of food advertisements (ads) from popular broadcast and cable channels to estimate changes in exposure to food ads from these channels. SETTING Middle-lower and lower-income neighbourhoods in Santiago, Chile. PARTICIPANTS Pre-schoolers (n 879; mothers reporting) and adolescents (n 753; self-reporting). RESULTS Pre-schoolers' and adolescents' exposure to high-in food advertising in total decreased significantly by an average of 44 and 58 %, respectively. Exposure to high-in food advertising with child-directed appeals, such as cartoon characters, decreased by 35 and 52 % for pre-schoolers and adolescents, respectively. Decreases were more pronounced for children who viewed more television. Products high in sugars were the most prevalent among the high-in ads seen by children after implementation. CONCLUSIONS Following Chile's 2016 child-directed marketing regulation, children's exposure to high-in food advertising on popular broadcast and cable television decreased significantly but was not eliminated from their viewing. Later stages of the regulation are expected to eliminate the majority of children's exposure to high-in food advertising from television.
Collapse
|
25
|
Barnett TA, Kelly AS, Young DR, Perry CK, Pratt CA, Edwards NM, Rao G, Vos MB. Sedentary Behaviors in Today's Youth: Approaches to the Prevention and Management of Childhood Obesity: A Scientific Statement From the American Heart Association. Circulation 2019; 138:e142-e159. [PMID: 30354382 DOI: 10.1161/cir.0000000000000591] [Citation(s) in RCA: 98] [Impact Index Per Article: 19.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This scientific statement is about sedentary behavior and its relationship to obesity and other cardiometabolic outcomes in youth. A deleterious effect of sedentary behavior on cardiometabolic health is most notable for screen-based behaviors and adiposity; however, this relation is less apparent for other cardiometabolic outcomes or when sedentary time is measured with objective movement counters or position monitors. Increasing trends of screen time are concerning; the portability of screen-based devices and abundant access to unlimited programming and online content may be leading to new patterns of consumption that are exposing youth to multiple pathways harmful to cardiometabolic health. This American Heart Association scientific statement provides an updated perspective on sedentary behaviors specific to modern youth and their impact on cardiometabolic health and obesity. As we reflect on implications for practice, research, and policy, what emerges is the importance of understanding the context in which sedentary behaviors occur. There is also a need to capture the nature of sedentary behavior more accurately, both quantitatively and qualitatively, especially with respect to recreational screen-based devices. Further evidence is required to better inform public health interventions and to establish detailed quantitative guidelines on specific sedentary behaviors in youth. In the meantime, we suggest that televisions and other recreational screen-based devices be removed from bedrooms and absent during meal times. Daily device-free social interactions and outdoor play should be encouraged. In addition, parents/guardians should be supported to devise and enforce appropriate screen time regulations and to model healthy screen-based behaviors.
Collapse
|
26
|
Tahir MJ, Willett W, Forman MR. The Association of Television Viewing in Childhood With Overweight and Obesity Throughout the Life Course. Am J Epidemiol 2019; 188:282-293. [PMID: 30321270 PMCID: PMC6357794 DOI: 10.1093/aje/kwy236] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Accepted: 10/09/2018] [Indexed: 12/28/2022] Open
Abstract
Few studies have addressed the association between television viewing time in childhood and overweight/obesity across the life course. Among 30,921 mother-daughter dyads from the Nurses' Mothers' Cohort (2001) and the Nurses' Health Study II (1989 and 1991), the following information was collected: daughter's television viewing time and physical activity (PA) level at ages 3-5 and 5-10 years, somatotype at ages 5 and 10 years, and body mass index at age 18 years and in adulthood (ages 26-45 years). According to multivariable-adjusted logistic regression models, television viewing at least 4 hours/day versus no television at ages 3-5 years was associated with odds ratios of overweight/obesity of 1.61 (95% confidence interval (CI): 1.20, 2.17) at age 5 years, 1.46 (95% CI: 1.14, 1.86) at age 10 years, 1.31 (95% CI: 1.00, 1.70) at age 18 years, and 1.32 (95% CI: 1.10, 1.59) in adulthood. A composite variable of high television viewing time/low PA level versus low television viewing time/high PA level at ages 3-5 years was associated with odds ratios of overweight/obesity ranging from 3.22 (95% CI: 2.23, 4.65) at age 5 years to 1.82 (95% CI: 1.36, 2.45) in adulthood. Findings were similar at ages 5-10 years. Long hours of television viewing in childhood alone and in combination with low PA levels were consistently associated with overweight/obesity throughout life.
Collapse
Affiliation(s)
- Muna J Tahir
- Department of Nutritional Sciences, School of Human Ecology, College of Natural Sciences, The University of Texas at Austin, Austin, Texas
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | - Walter Willett
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts
- Channing Division of Network Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Michele R Forman
- Department of Nutrition Science, College of Health and Human Sciences, Purdue University, West Lafayette, Indiana
| |
Collapse
|
27
|
Grummon AH, Sokol RL, Hecht CA, Patel AI. Measuring beverage consumption in US children and adolescents: a systematic review. Obes Rev 2018; 19:1017-1027. [PMID: 29938891 PMCID: PMC6103833 DOI: 10.1111/obr.12692] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Revised: 02/19/2018] [Accepted: 02/22/2018] [Indexed: 01/14/2023]
Abstract
Beverage consumption habits are associated with weight outcomes for children and adolescents. Many studies have examined youth's beverage consumption, but little is known about what methods are commonly used to assess youth beverage consumption and whether these strategies are valid and reliable. This study aimed to systematically review articles assessing beverage consumption among children and adolescents. We searched PubMed and Scopus for English-language articles published between February 2007 and February 2017 that measured and reported on American youth's (ages 2-18 years) beverage consumption. Searches yielded 17,165 articles, of which 589 articles describing 615 measures were extracted. We examined the types of assessment methods used, characteristics of these methods (e.g. validity, reliability, and literacy level), characteristics of study samples, and beverages assessed. The most common assessment methods were questionnaires/screeners (used by 65.4% of articles) and recalls (24.4%). About three-quarters of articles did not address validity (70.5%) or reliability (79.5%) of any measures used. Study populations were diverse: 54.7% of articles included low-income children, and 90.2% included non-White children. The most commonly assessed beverage category was sugar-sweetened beverages. Findings suggest that improved measurement techniques and reporting are both needed to track progress towards a goal of ensuring all youth have healthy beverage consumption.
Collapse
Affiliation(s)
- Anna H. Grummon
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill; Chapel Hill, NC
- Carolina Population Center, University of North Carolina, Chapel Hill; Chapel Hill, NC
| | - Rebeccah L. Sokol
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill; Chapel Hill, NC
| | - Christina A. Hecht
- Division of Agriculture and Natural Resources, University of California; Berkeley, CA
| | - Anisha I. Patel
- Department of Pediatrics, School of Medicine, University of California, San Francisco; San Francisco, CA
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA
| |
Collapse
|
28
|
Kist-van Holthe J, Blom T, Melchers L, Janga-Jansen A, van Kanten T, Luinstra-Passchier M, Altenburg T, HiraSing R, Chinapaw M. Stabilization of the obesity epidemic and increasing thinness in children in Caribbean Bonaire. BMC Pediatr 2018; 18:168. [PMID: 29776347 PMCID: PMC5960189 DOI: 10.1186/s12887-018-1146-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Accepted: 05/08/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In 2008, the prevalence of overweight and obesity among children in Bonaire was twice as high as the prevalence in northern Europe but comparable to that of other Caribbean islands and the United States. The aim of this study was to examine change in the body mass index status of children in Bonaire and report children's energy balance-related behaviours (EBRB) in 2015. METHODS Two school-based cross sectional surveys of children age 4-14 years were conducted in 2008 and 2015. Height (m) and weight (kg) were measured, body mass index (BMI) calculated and children's BMI categorised according to the International Obesity Task Force criteria. In 2015, children age 10-14 years completed a questionnaire on EBRB and responses were compared between non-overweight/obese children and overweight/obese children. RESULTS In total 2117 children age 4-14 years participated (92.4% response rate). The prevalence of thinness significantly increased between 2008 and 2015 (adjusted OR 1.5 95% CI: 1.2-1.8). There were no other significant differences in children's weight status between survey years. One quarter of children (25.4%) were overweight/obese in 2015. There were no significant differences in EBRB between non-overweight/obese and overweight/obese children in 2015. Few children met recommendations for EBRB. CONCLUSIONS The prevalence of overweight/obesity in children in Bonaire did not significantly change between 2008 and 2015 and remained high. However, the prevalence of thinness has significantly increased. Interventions to improve children's current EBRB are required.
Collapse
Affiliation(s)
- Joana Kist-van Holthe
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, VU Medical Center, Amsterdam, the Netherlands.
| | - Tirza Blom
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, VU Medical Center, Amsterdam, the Netherlands
| | - Laura Melchers
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, VU Medical Center, Amsterdam, the Netherlands
| | - Alcira Janga-Jansen
- Department of Public Health, Openbaar Lichaam Bonaire, Bonaire, the Netherlands
| | - Tahirih van Kanten
- Department of Public Health, Openbaar Lichaam Bonaire, Bonaire, the Netherlands
| | | | - Teatske Altenburg
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, VU Medical Center, Amsterdam, the Netherlands
| | - Remy HiraSing
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, VU Medical Center, Amsterdam, the Netherlands
| | - Mai Chinapaw
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, VU Medical Center, Amsterdam, the Netherlands
| |
Collapse
|
29
|
Factor Structure of Responses to the Portuguese Version of Questions About Screen Time-Based Sedentary Behavior Among Adolescents. J Phys Act Health 2018; 15:263-268. [PMID: 29202643 DOI: 10.1123/jpah.2016-0382] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND This study aimed to examine the factor structure of responses to the Portuguese version of questions related to screen time-based sedentary behavior among adolescents. METHODS This cross-sectional study with a sample of 1083 adolescents aged 14-19 years was conducted in Brazil. The sample was randomly divided into 2 groups for an exploratory factor analysis and for a confirmatory factor analysis. Screen time was investigated by a Portuguese version of questions about time sitting in front of television, computer, and video games on weekdays and weekends. RESULTS Scree plots showed 2 factors with eigenvalues above 1. One factor was formed by items about television and computer use, and the other factor was formed by items about video game use. The exploratory factor analysis with 2 factors resulted in factor loadings above .60. A second model with 1 factor was estimated and resulted in factor loadings above .55. A confirmatory factor analysis was estimated based on the 2-factor exploratory factor analysis and goodness-of-fit statistics were adequate. Confirmatory factor analysis with 1 factor had goodness-of-fit statistics adequate. CONCLUSIONS The Portuguese language version of self-report screen time had 2 possible factor solutions, and items demonstrated good factor structure with reasonable reliability making it suitable for use in the future studies.
Collapse
|
30
|
Socioeconomic differences in children's television viewing trajectory: A population-based prospective cohort study. PLoS One 2017; 12:e0188363. [PMID: 29211770 PMCID: PMC5718560 DOI: 10.1371/journal.pone.0188363] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Accepted: 11/06/2017] [Indexed: 01/28/2023] Open
Abstract
We aimed to evaluate the association between family socioeconomic status and repeatedly measured child television viewing time from early childhood to the school period. We analyzed data on 3,561 Dutch children from the Generation R Study, a population-based study in the Netherlands. Parent-reported television viewing time for children aged 2, 3, 4, 6 and 9 years were collected by questionnaires sent from April 2004 until January 2015. Odds ratios of watching television ≥1 hour/day at each age were calculated for children of mothers with low, mid-low, mid-high and high (reference group) education and children from low, middle and high (reference group) income households. A generalized logistic mixed model was used to assess the association between family socioeconomic status and child television viewing time trajectory. The percentage of children watching television ≥1 hour/day increased from age 2 to 9 years for all children (24.2%-85.0% for children of low-educated mothers; 4.7%-61.4% for children of high-educated mothers; 17.2%-74.9% for children from low income households; 6.2%-65.1% for children from high income households). Independent socioeconomic effect in child television viewing time was found for maternal educational level. The interaction between net household income and child age in longitudinal analyses was significant (p = 0.01), indicating that the television viewing time trajectories were different in household income subgroups. However the interaction between maternal educational level and child age was not significant (p = 0.19). Inverse socioeconomic gradients in child television viewing time were found from the preschool period to the late school period. The educational differences between the various educational subgroups remained stable with increasing age, but the differences between household income groups changed over time. Intervention developers and healthcare practitioners need to raise awareness among non-highly educated parents that the socioeconomic gradient in television viewing time has a tracking effect starting from preschool age.
Collapse
|
31
|
Cabanas-Sánchez V, Martínez-Gómez D, Esteban-Cornejo I, Castro-Piñero J, Conde-Caveda J, Veiga ÓL. Reliability and validity of the Youth Leisure-time Sedentary Behavior Questionnaire (YLSBQ). J Sci Med Sport 2017; 21:69-74. [PMID: 29129459 DOI: 10.1016/j.jsams.2017.10.031] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Revised: 10/17/2017] [Accepted: 10/19/2017] [Indexed: 01/08/2023]
Abstract
OBJECTIVES To develop a questionnaire able to assess time spent by youth in a wide range of leisure-time sedentary behaviors (SB) and evaluate its test-retest reliability and criterion validity. DESIGN Cross-sectional observational. METHODS The reliability sample included 194 youth, aged 10-18 years, who completed the questionnaire twice, separated by one-week interval. The validity study comprised 1207 participants aged 8-18 years. Participants wore an accelerometer for 7 consecutive days. The questionnaire was designed to assess the amount of time spent in twelve different SB during weekdays and weekends, separately. In order to avoid usual phenomenon of time over reporting, values were adjusted to real available leisure-time (LT) for each participant. Reliability was assessed by using Intraclass Correlation Coefficients (ICC) and weighted (quadratic) kappa (k), and validity was assessed by using Pearson correlation and Bland-Altman plots. RESULTS The reliability of questionnaire showed a moderate-to-substantial agreement for the most (91%) of items (k=0.43-0.74; ICC=0.41-0.79) with three items (4%) reaching an almost perfect agreement (ICC=0.82-0.83). Only 'sitting and talking' evidenced fair-to-moderate reliability (k=0.27-0.39; ICC=0.34-0.46). The relationship between average sedentary time assessed by the questionnaire and accelerometry was moderate (r=0.36; p<0.001). Systematic biases were not found between questionnaire and accelerometer sedentary time for average day (r=0.05; p=0.11) but Bland-Altman plots suggest moderate discrepancies between both methods of SB measurement (mean=19.86; limits of agreement=-280.04 to 319.76). CONCLUSIONS The questionnaire showed moderate to good test-retest reliability and a moderate level of validity for assessing SB in youth, similar or slightly better to previously published in this population.
Collapse
Affiliation(s)
- Verónica Cabanas-Sánchez
- Department of Physical Education, Sport and Human Movement, Autonomous University of Madrid, Cantoblanco University City, Spain
| | - David Martínez-Gómez
- Department of Physical Education, Sport and Human Movement, Autonomous University of Madrid, Cantoblanco University City, Spain
| | - Irene Esteban-Cornejo
- Department of Physical Education, Sport and Human Movement, Autonomous University of Madrid, Cantoblanco University City, Spain; Department of Physical Education and Sports, University of Granada, Spain
| | - José Castro-Piñero
- Department of Teaching Physical Education, Fine Arts and Music, University of Cádiz, Spain.
| | - Julio Conde-Caveda
- Department of Teaching Physical Education, Fine Arts and Music, University of Cádiz, Spain
| | - Óscar L Veiga
- Department of Physical Education, Sport and Human Movement, Autonomous University of Madrid, Cantoblanco University City, Spain
| |
Collapse
|
32
|
Määttä S, Konttinen H, Haukkala A, Erkkola M, Roos E. Preschool children's context-specific sedentary behaviours and parental socioeconomic status in Finland: a cross-sectional study. BMJ Open 2017; 7:e016690. [PMID: 29101133 PMCID: PMC5695314 DOI: 10.1136/bmjopen-2017-016690] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES This study examined the associations of parental socioeconomic status (SES) with preschoolers' objectively measured sedentary time (SED) over the course of a week and with parent-reported children's screen and reading times at home as indicators of sedentary behaviours (SB). DESIGN Cross-sectional. SETTING In years 2015 and 2016 in Finland. PARTICIPANTS 864 children, aged 3-6 years, with their parents. OUTCOME MEASURES Children's accelerometer data were transformed into average SED minutes per hour in different contexts (preschool, home during preschool days, weekend and total). Parent-reported children's screen and reading times were expressed as average daily minutes. The SES indicators (maternal and paternal education and relative household income) were grouped into three categories. Linear or logistic regression analyses were used, with municipality, season, and children's gender and age as covariates. CIs were adjusted for clustering at the preschool group level. RESULTS Children with low maternal (β=17.21, 95% CI: 8.71 to 25.71) and paternal (β=10.54, 95% CI: 0.77 to 20.30) education had more overall screen time at home than their more advantaged counterparts. SES differences in overall screen time were mostly explained by TV viewing. Children with low as opposed to high maternal education (β=-2.66, 95% CI: -4.95 to -0.38) had less reading time at home. Children whose fathers were on the middle (β=-1.15, 95% CI: -2.01 to -0.29) educational level had less weekend SED than those with high paternal education. Otherwise, parental SES was not related to objectively measured SED. CONCLUSIONS The results of this study highlight the fact that the associations between parental SES and preschoolers' SB are dependent on the indicators of SES and SBs, and vary between different contexts. Generally, parental SES was not associated with SED, whereas some SES differences existed in screen time and reading time at home. Interventions aiming to diminish SES differences in children's SB should focus on home hours. TRIAL REGISTRATION NUMBER ISRCTN57165350.
Collapse
Affiliation(s)
- Suvi Määttä
- Folkhälsan Research Center, Helsinki, Finland
- Department of Social Research, University of Helsinki, Helsinki, Finland
| | - Hanna Konttinen
- Department of Social Research, University of Helsinki, Helsinki, Finland
- Department of Food and Environmental Sciences, University of Helsinki, Helsinki, Finland
| | - Ari Haukkala
- Department of Social Research, University of Helsinki, Helsinki, Finland
| | - Maijaliisa Erkkola
- Department of Food and Environmental Sciences, University of Helsinki, Helsinki, Finland
| | - Eva Roos
- Folkhälsan Research Center, Helsinki, Finland
- Department of Food and Environmental Sciences, University of Helsinki, Helsinki, Finland
- Department of Public Health, University of Helsinki, Clinicum, Helsinki, Finland
| |
Collapse
|
33
|
Määttä S, Kaukonen R, Vepsäläinen H, Lehto E, Ylönen A, Ray C, Erkkola M, Roos E. The mediating role of the home environment in relation to parental educational level and preschool children's screen time: a cross-sectional study. BMC Public Health 2017; 17:688. [PMID: 28865436 PMCID: PMC5581928 DOI: 10.1186/s12889-017-4694-9] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Accepted: 08/22/2017] [Indexed: 01/24/2023] Open
Abstract
Background Previous studies suggest that preschoolers from low socioeconomic backgrounds engage in more screen time. Still, the factors in the social and physical home environment driving these differences in preschool children’s screen time are poorly understood. This study examines potential home environment mediators in the associations between parental educational level and preschoolers’ screen time. Methods A total of 864 children aged 3–6 years and their parents participated in a cross-sectional DAGIS study in 2015–2016. Parents recorded their children’s screen time in a diary (N = 823). For the analyses, the daily average screen time at home was calculated. Parental questionnaires (N = 808) assessed educational level and eight social and physical environment factors in the home (i.e., descriptive norm for children’s screen time, parental screen use in front of children, parental importance for limiting children’s screen time, parental attitude toward societal pressures for children’s screen time, access to screens at home, parental self-efficacy for limiting children’s screen time, satisfaction of children’s screen time, and rules for limiting children’s screen time). Parental education was grouped into low, middle, and high education. The associations were tested by conducting mediation analyses adjusted by season and children’s sex and age. The significant mediators in the single-mediator models were included in the final multiple-mediator models. Results Of the potential eight mediators, the following four had a significant indirect association: descriptive norm for children’s screen time, parental screen use in front of children, parental importance for limiting children’s screen time, and parental attitude toward societal pressures for children’s screen time. Parents with high education had lower descriptive norm and used fewer screens in front of children compared to parents with middle or low education, and in turn, these factors were associated with less screen time among children from parents with a higher education level. Parents with high education placed greater importance on limiting children’s screen time and felt less societal pressures about children’s screen time compared to parents with low education, and in turn, these factors were associated with less screen time among children from parents with a higher education level. Conclusions Our study recognized multiple modifiable mediators in the associations between parental education and preschool children’s screen time. When aiming to diminish socioeconomic status differences in preschool children’s screen time, the focus should be on parental role models, attitudes, and norm related to children’s screen time.
Collapse
Affiliation(s)
- Suvi Määttä
- Folkhälsan Research Center, Samfundet Folkhälsan, Topeliuksenkatu 20, 00250, Helsinki, Finland.
| | - Riikka Kaukonen
- Folkhälsan Research Center, Samfundet Folkhälsan, Topeliuksenkatu 20, 00250, Helsinki, Finland
| | - Henna Vepsäläinen
- Department of Food and Environmental Sciences, University of Helsinki, P.O. Box 66, -00014, Helsinki, FI, Finland
| | - Elviira Lehto
- Folkhälsan Research Center, Samfundet Folkhälsan, Topeliuksenkatu 20, 00250, Helsinki, Finland
| | - Anna Ylönen
- Folkhälsan Research Center, Samfundet Folkhälsan, Topeliuksenkatu 20, 00250, Helsinki, Finland
| | - Carola Ray
- Folkhälsan Research Center, Samfundet Folkhälsan, Topeliuksenkatu 20, 00250, Helsinki, Finland
| | - Maijaliisa Erkkola
- Department of Food and Environmental Sciences, University of Helsinki, P.O. Box 66, -00014, Helsinki, FI, Finland
| | - Eva Roos
- Folkhälsan Research Center, Samfundet Folkhälsan, Topeliuksenkatu 20, 00250, Helsinki, Finland.,Department of Food and Environmental Sciences, University of Helsinki, P.O. Box 66, -00014, Helsinki, FI, Finland.,Clinicum, Department of Public Health, University of Helsinki, P.O. Box 66, -00014, Helsinki, FI, Finland
| |
Collapse
|
34
|
Grummon AH, Vaughn A, Jones DJ, Ward DS. Cumulative Risk Exposure and Waist Circumference in Preschool-Aged Children: the Mediating Role of Television and Moderating Role of Sex. Ann Behav Med 2017; 51:489-499. [PMID: 28097514 PMCID: PMC5513794 DOI: 10.1007/s12160-016-9872-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
BACKGROUND Children exposed to multiple stressors are more likely to be overweight, but little is known about the mechanisms explaining this association. PURPOSE This cross-sectional study examined whether children exposed to multiple stressors had higher waist circumference, and whether this association was mediated through children's television time. METHODS Participants were 319 parent-child dyads. Children were 2-5 years old and had at least one overweight parent (BMI ≥ 25 kg/m2). Data were collected at baseline of a larger childhood obesity prevention study and included information on psychosocial stressors (e.g., parenting stress), demographic stressors (e.g., low income), children's television time, and children's waist circumference. Two cumulative risk scores were created by summing stressors in each domain (demographic and psychosocial). Mediation and moderated mediation analyses were conducted. RESULTS Indirect effects of both cumulative risk scores on waist circumference through television time were not significant; however, moderated mediation analyses found significant moderation by gender. The indirect effects of both risk scores on waist circumference through television time were significant and positive for girls, but near-zero for boys. CONCLUSIONS Reducing television time should be explored as a strategy for buffering against the negative health effects of exposure to multiple stressors among girls. Longitudinal and intervention research is needed to confirm these results and to identify mediating factors between cumulative risk and body weight among boys.
Collapse
Affiliation(s)
- Anna H Grummon
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Amber Vaughn
- Center for Health Promotion and Disease Prevention, University of North Carolina, Chapel Hill, Chapel Hill, NC, USA
| | - Deborah J Jones
- Department of Psychology, University of North Carolina, Chapel Hill, Chapel Hill, NC, USA
| | - Dianne S Ward
- Center for Health Promotion and Disease Prevention, University of North Carolina, Chapel Hill, Chapel Hill, NC, USA.
- Department of Nutrition, Gillings School of Global Public Health, and Center for Health Promotion and Disease Prevention, University of North Carolina, Chapel Hill, 135 Dauer Drive, 2200 McGavran-Greenberg Hall, CB no. 7461, Chapel Hill, NC, 27599-7461, USA.
| |
Collapse
|
35
|
Quelly SB. Developing and testing adapted measures of children’s self-efficacy, intentions, and behaviors associated with childhood obesity. CHILDRENS HEALTH CARE 2017. [DOI: 10.1080/02739615.2016.1275637] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Susan B. Quelly
- College of Nursing, University of Central Florida, Orlando, FL
| |
Collapse
|
36
|
Hilpert M, Brockmeier K, Dordel S, Koch B, Weiß V, Ferrari N, Tokarski W, Graf C. Sociocultural Influence on Obesity and Lifestyle in Children: A Study of Daily Activities, Leisure Time Behavior, Motor Skills, and Weight Status. Obes Facts 2017; 10:168-178. [PMID: 28528341 PMCID: PMC5644947 DOI: 10.1159/000464105] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Accepted: 02/09/2017] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Juvenile overweight is increasing, and effective preventive measures are needed. After years of arbitrarily assigning these measures disregarding socioeconomic and/or cultural differences, it has become necessary to tailor interventions more specific to these target groups. Providing data for such an intervention is the objective of this study. METHODS Influencing variables on children's weight status, motor skills and lifestyle have been analyzed among 997 first graders (53.2% male) involved in the Children's Health InterventionaL Trial (CHILT). RESULTS Median age was 6.9 years; 7.3% were obese, 8.8% were overweight. Children with low socioeconomic status (SES) were more likely to be obese (p = 0.029). Low SES (p ˂ 0.001), migration background (p = 0.001) and low sports activity levels (p = 0.007) contributed most to an increased consumption of television. Migration background (p = 0.003) and male gender (p < 0.001) were the strongest factors in predicting a greater consumption of computer/video games. Children with higher SES (p = 0.02), lower BMI (p = 0.035), and males (p = 0.001) performed better in motor tests. CONCLUSION Children with a low SES and migration background were more likely to exhibit unfavorable health behavior patterns, higher BMI scores, and poorer motor skills. Interventions should integrate motivational and targeting strategies and consider cultural and educational differences to address these vulnerable groups.
Collapse
Affiliation(s)
- Martin Hilpert
- Institute of Movement and Neurosciences, German Sport University, Cologne, Germany
| | - Konrad Brockmeier
- Pediatric Cardiology, Heart Center, University Hospital of Cologne, Cologne, Germany
- Cologne Center of Prevention in Childhood and Adolescence, Heart Center, University Hospital of Cologne, Cologne, Germany
| | - Sigrid Dordel
- Institute of School Sports and School Development, German Sport University, Cologne, Germany
| | - Benjamin Koch
- Institute of Movement and Neurosciences, German Sport University, Cologne, Germany
- Bremen-City Center for Obesity Therapy (ZABS), Bremen, Germany
| | - Verena Weiß
- Institute of Medical Statistics, Informatics and Epidemiology, University of Cologne, Cologne, Germany
| | - Nina Ferrari
- Institute of Movement and Neurosciences, German Sport University, Cologne, Germany
- Cologne Center of Prevention in Childhood and Adolescence, Heart Center, University Hospital of Cologne, Cologne, Germany
| | - Walter Tokarski
- Institute of European Sport Development and Leisure Studies, German Sport University, Cologne, Germany
| | - Christine Graf
- Institute of Movement and Neurosciences, German Sport University, Cologne, Germany
- Cologne Center of Prevention in Childhood and Adolescence, Heart Center, University Hospital of Cologne, Cologne, Germany
- *Prof. Dr. Dr. Christine Graf, Institute of Movement and Neurosciences, German Sport University, Cologne, Am Sportpark Müngersdorf 6, 50933 Köln, Germany,
| |
Collapse
|
37
|
Watanabe E, Lee JS, Mori K, Kawakubo K. Clustering patterns of obesity-related multiple lifestyle behaviours and their associations with overweight and family environments: a cross-sectional study in Japanese preschool children. BMJ Open 2016; 6:e012773. [PMID: 27815299 PMCID: PMC5128936 DOI: 10.1136/bmjopen-2016-012773] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
OBJECTIVES The purpose of this study is (1) to identify obesity-related lifestyle behaviour patterns of diet, physical activity, sedentary and sleep behaviours in preschool children, (2) to examine the association between identified behaviour clusters and overweight/obesity and (3) to investigate differences in children's family environments according to clusters. DESIGN SETTING AND PARTICIPANTS A cross-sectional study on 2114 preschool children aged 3-6 years who attended childcare facilities (24 nursery schools and 10 kindergartens) in Tsuruoka city, Japan in April 2003 was conducted. MAIN OUTCOME MEASURES Children's principal caregivers completed a questionnaire on children's lifestyle behaviours (dinner timing, outside playtime, screen time and night-time sleep duration), family environment (family members, maternal employment, mealtime regularity and parents' habitual exercise and screen time) and measurements of weight and height. Cluster analysis was performed using children's 4 lifestyle behaviours based on those non-missing values (n=1545). The χ2 tests and analysis of variance (ANOVA) estimated cluster differences in overweight/obesity and family environments. RESULTS 6 clusters were identified. Children's overweight/obesity varied across clusters (p=0.007). The cluster with the most screen time, shorter night-time sleep duration, average dinner timing and outside playtime had the highest overweight/obesity prevalence (15.1%), while the cluster with the least screen time, the longest sleep duration, the earliest dinner timing and average outside playtime had the lowest prevalence (4.0%). Family environments regarding mealtime regularity and both parents' screen time also significantly varied across clusters. The cluster having the highest overweight/obesity prevalence had the highest proportion of irregular mealtimes and the most screen time for both parents. CONCLUSIONS This study suggests that public health approaches to prevent children's overweight/obesity should focus on decreasing screen time and increasing night-time sleep duration. To shape those behaviours, regular mealtimes and decreasing parents' screen time within family environments need to be targeted among family members.
Collapse
Affiliation(s)
- Etsuko Watanabe
- Department of Health Promotion Science, School of Public Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Jung Su Lee
- Department of Health Promotion Science, School of Public Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Katsumi Mori
- Department of Health Promotion Science, School of Public Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kiyoshi Kawakubo
- Department of Food Science and Nutrition, Kyoritsu Women's University, Tokyo, Japan
| |
Collapse
|
38
|
Loveday A, Sherar LB, Sanders JP, Sanderson PW, Esliger DW. Novel technology to help understand the context of physical activity and sedentary behaviour. Physiol Meas 2016; 37:1834-1851. [PMID: 27654030 DOI: 10.1088/0967-3334/37/10/1834] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
When used in large, national surveillance programmes, objective measurement tools provide prevalence estimates of low physical activity guideline compliance and high amounts of sedentary time. There are undoubtedly a plethora of reasons for this but one possible contributing factor is the current lack of behavioural context offered by accelerometers and posture sensors. Context includes information such as where the behaviour occurs, the type of activity being performed and is vital in allowing greater refinement of intervention strategies. Novel technologies are emerging with the potential to provide this information. Example data from three ongoing studies is used to illustrate the utility of these technologies. Study one assesses the concurrent validity of electrical energy monitoring and wearable cameras as measures of television viewing. This study found that on average the television is switched on for 202 min d-1 but is visible in just 90 min of wearable camera images with a further 52 min where the participant is in their living room but the television is not visible in the image. Study two utilises indoor location monitoring to assess where older adult care home residents accumulate their sedentary time. This study found that residents were highly sedentary (sitting for an average of 720 min d-1) and spent the majority of their time in their own rooms with more time spent in communal areas in the morning than in the afternoon. Lastly, study three discusses the use of proximity sensors to quantify exposure to a height adjustable desk. These studies are example applications of this technology, with many other technologies available and applications possible. The adoption of these technologies will provide researchers with a more complete understanding of the behaviour than has previously been available.
Collapse
Affiliation(s)
- Adam Loveday
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, Leicestershire, LE11 3TU, UK. The NIHR Leicester-Loughborough Diet, Lifestyle and Physical Activity Biomedical Research Unit, Loughborough, UK
| | | | | | | | | |
Collapse
|
39
|
Saldanha-Gomes C, Heude B, Charles MA, de Lauzon-Guillain B, Botton J, Carles S, Forhan A, Dargent-Molina P, Lioret S. Prospective associations between energy balance-related behaviors at 2 years of age and subsequent adiposity: the EDEN mother-child cohort. Int J Obes (Lond) 2016; 41:38-45. [PMID: 27528250 DOI: 10.1038/ijo.2016.138] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Revised: 06/01/2016] [Accepted: 07/23/2016] [Indexed: 12/20/2022]
Abstract
BACKGROUND/OBJECTIVES Sedentary behavior, physical activity and dietary behavior are formed early during childhood and tend to remain relatively stable into later life. No longitudinal studies have assessed the independent influence of these three energy balance-related behaviors during toddlerhood on later adiposity. We aimed to analyze the associations between TV/DVD watching time, outdoor play time and dietary patterns at the age of 2 years and child adiposity at the age of 5 years, in boys and girls separately. SUBJECTS/METHODS This study included 883 children from the French EDEN mother-child cohort. TV/DVD watching time, outdoor play time and dietary intakes were reported by parents in questionnaires when the child was aged 2 years. Two dietary patterns, labeled 'Guidelines' and 'Processed, fast foods', were identified in a previous study. The percentage of body fat (%BF) based on bioelectrical impedance analysis and body mass index were measured at the age of 5 years. RESULTS In boys, TV/DVD watching time at the age of 2 years was positively associated with %BF at the age of 5 years (β=0.50 (95% confidence interval: 0.001, 1.00) for those boys with ⩾60 min per day of TV/DVD watching time vs those with ⩽15 min per day, P-value for trend 0.05). In girls, outdoor play was inversely associated with %BF (β=-0.96 (95% confidence interval: -1.60, -0.32) for those in the highest tertile of outdoor play time vs those in the lowest tertile, P=0.001). Overall, at the age of 2 years, dietary patterns were associated with both TV/DVD watching time and outdoor play time, but no significant and independent association was observed between dietary patterns and later adiposity. CONCLUSION This study shows longitudinal and gender-differentiated relations between both TV/DVD watching time and outdoor play time in toddlerhood and later adiposity, whereas evidence for a relation between dietary patterns and subsequent fat development was less conclusive. Early childhood-by the age of 2 years-should be targeted as a critical time for promoting healthy energy balance-related behaviors.
Collapse
Affiliation(s)
- C Saldanha-Gomes
- INSERM, UMR1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), Early ORigin of the Child's Health and Development Team (ORCHAD), Paris, France.,Paris-Sud University, Faculty of medicine, Kremlin-Bicêtre, France
| | - B Heude
- INSERM, UMR1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), Early ORigin of the Child's Health and Development Team (ORCHAD), Paris, France.,Paris Descartes University, Paris, France
| | - M-A Charles
- INSERM, UMR1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), Early ORigin of the Child's Health and Development Team (ORCHAD), Paris, France.,Paris Descartes University, Paris, France
| | - B de Lauzon-Guillain
- INSERM, UMR1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), Early ORigin of the Child's Health and Development Team (ORCHAD), Paris, France.,Paris Descartes University, Paris, France
| | - J Botton
- INSERM, UMR1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), Early ORigin of the Child's Health and Development Team (ORCHAD), Paris, France.,Paris-Sud University, Faculty of Pharmacy, Châtenay-Malabry, France
| | - S Carles
- INSERM, UMR1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), Early ORigin of the Child's Health and Development Team (ORCHAD), Paris, France.,Paris-Sud University, Faculty of medicine, Kremlin-Bicêtre, France
| | - A Forhan
- INSERM, UMR1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), Early ORigin of the Child's Health and Development Team (ORCHAD), Paris, France.,Paris Descartes University, Paris, France
| | - P Dargent-Molina
- INSERM, UMR1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), Early ORigin of the Child's Health and Development Team (ORCHAD), Paris, France.,Paris Descartes University, Paris, France
| | - S Lioret
- INSERM, UMR1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), Early ORigin of the Child's Health and Development Team (ORCHAD), Paris, France.,Paris Descartes University, Paris, France
| |
Collapse
|
40
|
Pujadas Botey A, Bayrampour H, Carson V, Vinturache A, Tough S. Adherence to Canadian physical activity and sedentary behaviour guidelines among children 2 to 13 years of age. Prev Med Rep 2016; 3:14-20. [PMID: 26844180 PMCID: PMC4733064 DOI: 10.1016/j.pmedr.2015.11.012] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Active living is relevant for healthy child development and disease prevention. In 2011-2012 new Canadian Physical Activity and Sedentary Behaviour Guidelines were developed for children under four and 5-17 years of age. This cross-sectional study assessed children's adherence to the national guidelines, using a large sample of Alberta children ages 2-4 and 5-13 years in 2013. The proportions of children achieving the average daily duration of physical activity and screen time recommended were determined, and child and parental predictors of non-achievement were identified. Participants were 631 parent and child dyads. Data were collected by parental reports of physical activity and screen time during weekdays, and analysed using univariate and multivariate techniques (p < 0.05). Logistic regression models were used to examine factors associated with children's non-achievement of physical activity and screen time recommendations while adjusting for covariates. Sixty-two percent of children aged 2-4 and 26% of children aged 5-13 did not meet physical activity time recommendations, and 64% of children aged 2-4 and 23% of children aged 5-13 exceeded the maximum screen time recommendation. Several associations between parental age and education with non-achievement were observed but associations were not consistent across age groups or behaviours. Among preschoolers, those with middle-age parents were more likely to not achieve physical activity recommendations. Evidence of high non-achievement of the recommendations among children 2-4 years highlights the need for increased programming targeting preschool children. Further research is required to identify modifiable risk factors that may inform future health promotion efforts.
Collapse
Affiliation(s)
- Anna Pujadas Botey
- Alberta Centre for Child, Family and Community Research, #200, 3820-24 Avenue NW, Calgary, AB T3B 2X9, Canada
| | - Hamideh Bayrampour
- Fac. Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, AB T2N 4Z6, Canada
| | - Valerie Carson
- Fac. Physical Education and Recreation, University of Alberta, 3-100 University Hall, Van Vliet Complex, Edmonton, AB T6G 2H9, Canada
| | - Angela Vinturache
- Fac. Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, AB T2N 4Z6, Canada
| | - Suzanne Tough
- Alberta Centre for Child, Family and Community Research, #200, 3820-24 Avenue NW, Calgary, AB T3B 2X9, Canada
- Fac. Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, AB T2N 4Z6, Canada
| |
Collapse
|
41
|
Carson V, Hunter S, Kuzik N, Gray CE, Poitras VJ, Chaput JP, Saunders TJ, Katzmarzyk PT, Okely AD, Connor Gorber S, Kho ME, Sampson M, Lee H, Tremblay MS. Systematic review of sedentary behaviour and health indicators in school-aged children and youth: an update. Appl Physiol Nutr Metab 2016; 41:S240-65. [DOI: 10.1139/apnm-2015-0630] [Citation(s) in RCA: 656] [Impact Index Per Article: 82.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
This systematic review is an update examining the relationships between objectively and subjectively measured sedentary behaviour and health indicators in children and youth aged 5–17 years. EMBASE, PsycINFO, and Medline were searched in December 2014, and date limits were imposed (≥February 2010). Included studies were peer-reviewed and met the a priori-determined population (apparently healthy children and youth, mean age: 5–17 years), intervention (durations, patterns, and types of sedentary behaviours), comparator (various durations, patterns, and types of sedentary behaviours), and outcome (critical: body composition, metabolic syndrome/cardiovascular disease risk factors, behavioural conduct/pro-social behaviour, academic achievement; important: fitness, self-esteem) study criteria. Quality of evidence by outcome was assessed using the Grading of Recommendations Assessment, Development, and Evaluation framework. Due to heterogeneity, a narrative analysis was conducted. A total of 235 studies (194 unique samples) were included representing 1 657 064 unique participants from 71 different countries. Higher durations/frequencies of screen time and television (TV) viewing were associated with unfavourable body composition. Higher duration/frequency of TV viewing was also associated with higher clustered cardiometabolic risk scores. Higher durations of TV viewing and video game use were associated with unfavourable behavioural conduct/pro-social behaviour. Higher durations of reading and doing homework were associated with higher academic achievement. Higher duration of screen time was associated with lower fitness. Higher durations of screen time and computer use were associated with lower self-esteem. Evidence ranged from “very low” to “moderate” quality. Higher quality studies using reliable and valid sedentary behaviour measures should confirm this largely observational evidence.
Collapse
Affiliation(s)
- Valerie Carson
- Faculty of Physical Education and Recreation, University of Alberta, Edmonton, AB T6G 2H9, Canada
| | - Stephen Hunter
- Faculty of Physical Education and Recreation, University of Alberta, Edmonton, AB T6G 2H9, Canada
| | - Nicholas Kuzik
- Faculty of Physical Education and Recreation, University of Alberta, Edmonton, AB T6G 2H9, Canada
| | - Casey E. Gray
- Healthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON K1H 8L1, Canada
| | - Veronica J. Poitras
- Healthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON K1H 8L1, Canada
| | - Jean-Philippe Chaput
- Healthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON K1H 8L1, Canada
| | - Travis J. Saunders
- Applied Human Sciences, Faculty of Science, University of Prince Edward Island, Charlottetown, PE C1A 4P3, Canada
| | | | - Anthony D. Okely
- Early Start Research Institute, Faculty of Social Sciences, University of Wollongong, Wollongong, New South Wales, 2522, Australia
| | - Sarah Connor Gorber
- Office of the Task Force on Preventive Health Care, Public Health Agency of Canada, Ottawa, ON K1A 0K9, Canada
| | - Michelle E. Kho
- School of Rehabilitation Science, McMaster University, Hamilton, ON L8S 1C7, Canada
| | - Margaret Sampson
- Healthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON K1H 8L1, Canada
| | - Helena Lee
- Faculty of Physical Education and Recreation, University of Alberta, Edmonton, AB T6G 2H9, Canada
| | - Mark S. Tremblay
- Healthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON K1H 8L1, Canada
| |
Collapse
|
42
|
Heshmat R, Qorbani M, Shahr Babaki AE, Djalalinia S, Ataei-Jafari A, Motlagh ME, Ardalan G, Arefirad T, Rezaei F, Asayesh H, Kelishadi R. Joint Association of Screen Time and Physical Activity with Cardiometabolic Risk Factors in a National Sample of Iranian Adolescents: The CASPIANIII Study. PLoS One 2016; 11:e0154502. [PMID: 27167372 PMCID: PMC4864273 DOI: 10.1371/journal.pone.0154502] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2015] [Accepted: 04/14/2016] [Indexed: 02/06/2023] Open
Abstract
Metabolic syndrome (MetS) and its contributing factors are considered important health problems in the pediatric age group. This study was designed to assess the joint association of ST and PA with cardiometabolic risk factors among Iranian adolescents. A representative sample of 5625 (50.2% boys) school students with a mean age of 14.73 (SD: 2.41) were selected through multistage random cluster sampling method from urban and rural areas of 27 provinces in Iran. ST and PA were assessed by self-administered validated questionnaires. Anthropometric measures (height, weight and waist circumference (WC)) and MetS components (abdominal obesity, elevated blood pressure (BP), low high-density lipoprotein cholesterol (HDL-C), elevated triglycerides (TG) and high fasting blood sugar (FBG)) were measured according to standardized protocols. MetS was defined according to the Adult Treatment Panel III criteria modified for the pediatric age group. Moreover, elevated total cholesterol (TC), elevated low-density lipoprotein cholesterol (LDL-C), and generalized obesity were considered as other cardiometabolic risk factors. Students with high ST levels had significantly higher body mass index z-score (BMI z-score), WC, TG, LDL-C, and BP as well as lower HDL-C level; whereas those with high PA levels had significantly higher HDL-C levels as well as lower BMI z-score, TC, and BP. Adolescents with low PA/ high ST levels had significantly higher BMI, WC, LDL-C levels, as well as higher SBP and DBP compared to their other counterparts. In Multivariate model, joint effect of low PA/ high ST (compared to the high PA/low ST group) increased the odds of overweight, abdominal obesity and low HDL-C and decreased the odds of elevated TC. The findings of this study showed that joint association of high ST and low PA have direct association with abdominal obesity, overweight and low HDL-C and indirect association with elevated TC.
Collapse
Affiliation(s)
- Ramin Heshmat
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mostafa Qorbani
- Department of Community Medicine, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- * E-mail: (MQ); (RK)
| | - Amir Eslami Shahr Babaki
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Shirin Djalalinia
- Non-communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Development of Research & Technology Center, Deputy of Research and Technology, Ministry of Health and Medical Education, Tehran, Iran
| | - Asal Ataei-Jafari
- Department of Nutrition, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | | | - Gelayol Ardalan
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Tahereh Arefirad
- Department of Exercise Physiology, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Fatemeh Rezaei
- Department of Social Medicine, Medical School, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Hamid Asayesh
- Department of Medical Emergencies, Qom University of Medical Sciences, Qom, Iran
| | - Roya Kelishadi
- Pediatrics Department, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
- * E-mail: (MQ); (RK)
| |
Collapse
|
43
|
Mendoza JA, Baranowski T, Jaramillo S, Fesinmeyer MD, Haaland W, Thompson D, Nicklas TA. Fit 5 Kids TV Reduction Program for Latino Preschoolers: A Cluster Randomized Controlled Trial. Am J Prev Med 2016; 50:584-592. [PMID: 26572093 PMCID: PMC5108181 DOI: 10.1016/j.amepre.2015.09.017] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Revised: 09/09/2015] [Accepted: 09/17/2015] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Reducing Latino preschoolers' TV viewing is needed to reduce their risk of obesity and other chronic diseases. This study's objective was to evaluate the Fit 5 Kids (F5K) TV reduction program's impact on Latino preschooler's TV viewing. STUDY DESIGN Cluster RCT with randomization at the center level and N=160 participants. SETTING/PARTICIPANTS Latino children aged 3-5 years and their parents were recruited from six Head Start centers in Houston TX in 2010-2012 with analyses in 2013-2014. INTERVENTION F5K was culturally adapted for Latino preschoolers and the overall goal was to reduce TV viewing. Study staff taught F5K over 7-8 weeks during the regular Head Start day directly to intervention students. Control schools provided the usual Head Start curriculum, which did not specifically cover TV viewing. MAIN OUTCOME MEASURES Individual-level outcomes were measured prior to (Time 1) and immediately following (Time 2) the intervention. The primary outcome, TV viewing (minutes/day), was measured by validated 7-day TV diaries (parent-reported). Sedentary time was measured by accelerometers. RESULTS Per the adjusted repeated measures linear mixed effects model for TV viewing (minutes/day), intervention children decreased from 76.2 (9.9) at Time 1 to 52.1 (10.0) at Time 2, whereas control children remained about the same from 84.2 (10.5) at Time 1 to 85.4 (10.5) at Time 2. The relative difference from Time 1 to Time 2 was -25.3 (95% CI= -45.2, -5.4) minutes for intervention versus control children (N=160, p=0.01). In a similar adjusted model, there was a relative decrease in sedentary time (minutes/day) from Time 1 to Time 2 favoring the intervention children (-9.5, 95% CI= -23.0, 4.1), although not significant at p<0.05. CONCLUSIONS F5K reduced Latino preschoolers' TV viewing by >25 minutes daily. These findings have implications for prevention of obesity, related disorders, and health equity. TRIAL REGISTRATION This study is registered at www.clinicaltrials.gov NCT01216306.
Collapse
Affiliation(s)
- Jason A Mendoza
- General Pediatrics, Department of Pediatrics, University of Washington School of Medicine, and Nutritional Sciences Program, University of Washington School of Public Health, Seattle, Washington; Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, Washington; Health Disparities Research Center, Fred Hutchinson Cancer Research Center, Seattle, Washington.
| | - Tom Baranowski
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| | - Sandra Jaramillo
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| | - Megan D Fesinmeyer
- Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, Washington
| | - Wren Haaland
- Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, Washington
| | - Debbe Thompson
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| | - Theresa A Nicklas
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| |
Collapse
|
44
|
Chen YY, Chiu YC, Ting TT, Liao HY, Chen WJ, Chen CY. Television viewing and alcohol advertising with alcohol expectancies among school-aged children in Taiwan. Drug Alcohol Depend 2016; 162:219-26. [PMID: 27032607 DOI: 10.1016/j.drugalcdep.2016.03.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Revised: 03/17/2016] [Accepted: 03/17/2016] [Indexed: 11/25/2022]
Abstract
OBJECTIVES This study is aimed to examine the strength of association between television watching and potential exposure to alcohol advertising with multidimensional alcohol expectancies in school-aged children. METHODS A total of 779 4th (age 10) and 768 6th (age 12) grade students were recruited from 17 public elementary schools in northern Taiwan in 2006, with two waves of follow-up at 6 months apart. Self-administered questionnaires were used to collect information concerning individual characteristics, parental attributes, past-week screen time, drinking behaviors, and alcohol expectancies. Data of aired alcohol advertisements at baseline were obtained from the Nielsen Media Research Advertising Information Services; parenting styles were ascertained from the 1st follow-up. Alcohol Expectancies Questionnaire-Children version was used to measure alcohol expectancies (AEs) at baseline and the 2nd follow-up. RESULTS Nearly 27% of students reported watching television for more than two hours per day and 58% watching television after 9 p.m. Dimension-related heterogeneity exists in the relationship between TV viewing and alcohol advertising with AEs. With statistical adjustment for covariates, spending more than two hours watching TV per day was associated with increased levels of positive AEs "Promoting Relaxation or Tension Reduction [PRTR]" (β=1.52, 95% CI=0.92, 2.12; p<0.001); the exposure to alcohol advertising was associated with decline in negative AEs "Deteriorated Cognitive and Behavioral Function" (e.g., >8.0 ads: β=-1.06, 95% CI=-1.66, -0.47, p<0.01). CONCLUSIONS Greater screen time is associated with elevated positive expectancies of PRTR and alcohol advertising exposure is linked with lowered negative expectancies in late childhood. School-based anti-underage drinking programs may consider integrating the media literacy curriculum.
Collapse
Affiliation(s)
- Ying-Ying Chen
- Institute of Public Health, National Yang-Ming University, Taipei, Taiwan
| | - Yu-Chan Chiu
- Department of Bio-Industry Communication and Development, National Taiwan University, Taipei, Taiwan
| | - Te-Tien Ting
- Institute of Sociology, Academia Sinica, Taipei, Taiwan
| | - Hsin-Yao Liao
- Institute of Public Health, National Yang-Ming University, Taipei, Taiwan
| | - Wei J Chen
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Chuan-Yu Chen
- Institute of Public Health, National Yang-Ming University, Taipei, Taiwan; Center of Neuropsychiatric Research, National Health Research Institutes, Miaoli, Taiwan; Children and Family Research Center, National Taiwan University, Taipei, Taiwan.
| |
Collapse
|
45
|
Gordia AP, Quadros TMBD, Silva LR, Mota J. Cut-off values for step count and TV viewing time as discriminators of hyperglycaemia in Brazilian children and adolescents. Ann Hum Biol 2015; 43:423-9. [PMID: 26479698 DOI: 10.3109/03014460.2015.1096418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND The use of step count and TV viewing time to discriminate youngsters with hyperglycaemia is still a matter of debate. AIM To establish cut-off values for step count and TV viewing time in children and adolescents using glycaemia as the reference criterion. SUBJECTS AND METHODS A cross-sectional study was conducted on 1044 schoolchildren aged 6-18 years from Northeastern Brazil. Daily step counts were assessed with a pedometer over 1 week and TV viewing time by self-report. RESULTS The area under the curve (AUC) ranged from 0.52-0.61 for step count and from 0.49-0.65 for TV viewing time. The daily step count with the highest discriminatory power for hyperglycaemia was 13 884 (sensitivity = 77.8; specificity = 51.8) for male children and 12 371 (sensitivity = 55.6; specificity = 55.5) and 11 292 (sensitivity = 57.7; specificity = 48.6) for female children and adolescents respectively. The cut-off for TV viewing time with the highest discriminatory capacity for hyperglycaemia was 3 hours/day (sensitivity = 57.7-77.8; specificity = 48.6-53.2). CONCLUSION This study represents the first step for the development of criteria based on cardiometabolic risk factors for step count and TV viewing time in youngsters. However, the present cut-off values have limited practical application because of their poor accuracy and low sensitivity and specificity.
Collapse
Affiliation(s)
- Alex Pinheiro Gordia
- a Physical Education Course, Federal University of Reconcavo of Bahia , Amargosa , Bahia , Brazil .,b Faculty of Medicine , Post-Graduate Program in Medicine and Health, Federal University of Bahia , Salvador , Bahia , Brazil , and.,c Research Centre in Physical Activity Health and Leisure, Faculty of Sport Sciences, University of Porto , Porto , Portugal
| | - Teresa Maria Bianchini de Quadros
- a Physical Education Course, Federal University of Reconcavo of Bahia , Amargosa , Bahia , Brazil .,b Faculty of Medicine , Post-Graduate Program in Medicine and Health, Federal University of Bahia , Salvador , Bahia , Brazil , and.,c Research Centre in Physical Activity Health and Leisure, Faculty of Sport Sciences, University of Porto , Porto , Portugal
| | - Luciana Rodrigues Silva
- b Faculty of Medicine , Post-Graduate Program in Medicine and Health, Federal University of Bahia , Salvador , Bahia , Brazil , and
| | - Jorge Mota
- c Research Centre in Physical Activity Health and Leisure, Faculty of Sport Sciences, University of Porto , Porto , Portugal
| |
Collapse
|
46
|
Abstract
BACKGROUND Physical activity is associated with long-term benefits for health and tracks from early childhood into later adolescence. Limited information exists about factors influencing physical activity among Latino preschoolers. We aimed to identify correlates of objectively measured light-to-vigorous-intensity physical activity as a proportion of wear time (% PA) in Latino 3-5 year olds. METHODS Latino preschoolers (n = 96) were recruited from Head Start centers in Houston, TX, USA, from 2009 to 2010. Sociodemographics, anthropometrics, acculturation, neighborhood disorder, and TV viewing were measured. Actigraph GT1M accelerometers measured physical activity. Block linear regression was used with % PA as the dependent variable. RESULTS Children achieved 285.7 ± 58.0 min/day of PA. In the final adjusted-model, child age, parental education and neighborhood disorder were positively associated with % PA (beta = 0.33, p = .002; beta = 0.25, p = .038; beta = 0.22, p = .039, respectively). TV viewing was inversely associated with % PA (beta=-0.23, p = .027). CONCLUSION The majority of Latino preschoolers in our study exceeded US national and international guidelines of physical activity duration. Future interventions to sustain physical activity should focus on the influence of age, socioeconomic status, neighborhood disorder, and TV viewing on Latino preschoolers' attainment of physical activity.
Collapse
|
47
|
Peck T, Scharf RJ, Conaway MR, DeBoer MD. Viewing as little as 1 hour of TV daily is associated with higher change in BMI between kindergarten and first grade. Obesity (Silver Spring) 2015; 23:1680-6. [PMID: 26179163 DOI: 10.1002/oby.21132] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2015] [Revised: 04/13/2015] [Accepted: 04/14/2015] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Evaluate associations between TV viewing and weight status in children from kindergarten to first grade. METHODS Linear and logistic regression was used to evaluate associations of TV-viewing time on BMI-z-score cross-sectionally at kindergarten and first grade and longitudinally in between, among a nationally representative sample of 14,645 children from the Early Childhood Longitudinal Study-Kindergarten Cohort 2011. All analyses were adjusted for sex, race/ethnicity, parental education, and household income. RESULTS Weekday TV-viewing time was correlated with BMI-z-score (P < 0.01) at kindergarten and first grade and with change in BMI-z-score in between (P < 0.05). Compared with children watching <1 h of TV daily, children watching ≥1 h in kindergarten and first grade had a greater odds of overweight (1.50-1.60) and obesity (1.58-1.73). Children watching 1-<2 h and ≥2 h daily had higher BMI-z-scores (P < 0.0001) and less favorable changes in BMI-z-score between time points (P < 0.05). Children who were not overweight or obese in kindergarten and watched ≥1 h of TV had a greater odds of becoming overweight (1.39) and obese (1.86) between evaluations. CONCLUSIONS Children watching as little as 1-<2 h of TV daily were more likely to become overweight and obese over time. Physicians should encourage families to restrict TV-viewing time to reduce weight gain.
Collapse
Affiliation(s)
- Travis Peck
- Division of Pediatric Endocrinology, University of Virginia, Charlottesville, Virginia, USA
- Department of Pediatrics, University of Virginia, Charlottesville, Virginia, USA
| | - Rebecca J Scharf
- Department of Pediatrics, University of Virginia, Charlottesville, Virginia, USA
- Division of Developmental Pediatrics, University of Virginia, Charlottesville, Virginia, USA
| | - Mark R Conaway
- Department of Public Health Sciences, University of Virginia, Charlottesville, Virginia, USA
| | - Mark D DeBoer
- Division of Pediatric Endocrinology, University of Virginia, Charlottesville, Virginia, USA
- Department of Pediatrics, University of Virginia, Charlottesville, Virginia, USA
| |
Collapse
|
48
|
Soumerai SB, Starr D, Majumdar SR. How Do You Know Which Health Care Effectiveness Research You Can Trust? A Guide to Study Design for the Perplexed. Prev Chronic Dis 2015; 12:E101. [PMID: 26111157 PMCID: PMC4492215 DOI: 10.5888/pcd12.150187] [Citation(s) in RCA: 67] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Affiliation(s)
- Stephen B Soumerai
- Harvard Medical School and Harvard Pilgrim Health Care Institute, 133 Brookline Ave, 6th Floor, Boston, MA 02215. . Dr Soumerai is also co-chair of the Evaluative Sciences and Statistics Concentration of Harvard University's PhD Program in Health Policy
| | - Douglas Starr
- College of Communication, Science Journalism Program, Boston University, Boston, Massachusetts
| | - Sumit R Majumdar
- Medicine and Dentistry and Pharmacy and Pharmaceutical Sciences, University of Alberta, Edmonton, Alberta
| |
Collapse
|
49
|
Bryant M, Ashton L, Brown J, Jebb S, Wright J, Roberts K, Nixon J. Systematic review to identify and appraise outcome measures used to evaluate childhood obesity treatment interventions (CoOR): evidence of purpose, application, validity, reliability and sensitivity. Health Technol Assess 2015; 18:1-380. [PMID: 25125212 DOI: 10.3310/hta18510] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Lack of uniformity in outcome measures used in evaluations of childhood obesity treatment interventions can impede the ability to assess effectiveness and limits comparisons across trials. OBJECTIVE To identify and appraise outcome measures to produce a framework of recommended measures for use in evaluations of childhood obesity treatment interventions. DATA SOURCES Eleven electronic databases were searched between August and December 2011, including MEDLINE; MEDLINE In-Process and Other Non-Indexed Citations; EMBASE; PsycINFO; Health Management Information Consortium (HMIC); Allied and Complementary Medicine Database (AMED); Global Health, Maternity and Infant Care (all Ovid); Cumulative Index to Nursing and Allied Health Literature (CINAHL) (EBSCOhost); Science Citation Index (SCI) [Web of Science (WoS)]; and The Cochrane Library (Wiley) - from the date of inception, with no language restrictions. This was supported by review of relevant grey literature and trial databases. REVIEW METHODS Two searches were conducted to identify (1) outcome measures and corresponding citations used in published childhood obesity treatment evaluations and (2) manuscripts describing the development and/or evaluation of the outcome measures used in the childhood intervention obesity evaluations. Search 1 search strategy (review of trials) was modelled on elements of a review by Luttikhuis et al. (Oude Luttikhuis H, Baur L, Jansen H, Shrewsbury VA, O'Malley C, Stolk RP, et al. Interventions for treating obesity in children. Cochrane Database Syst Rev 2009;1:CD001872). Search 2 strategy (methodology papers) was built on Terwee et al.'s search filter (Terwee CB, Jansma EP, Riphagen II, de Vet HCW. Development of a methodological PubMed search filter for finding studies on measurement properties of measurement instruments. Qual Life Res 2009;18:1115-23). Eligible papers were appraised for quality initially by the internal project team. This was followed by an external appraisal by expert collaborators in order to agree which outcome measures should be recommended for the Childhood obesity Outcomes Review (CoOR) outcome measures framework. RESULTS Three hundred and seventy-nine manuscripts describing 180 outcome measures met eligibility criteria. Appraisal of these resulted in the recommendation of 36 measures for the CoOR outcome measures framework. Recommended primary outcome measures were body mass index (BMI) and dual-energy X-ray absorptiometry (DXA). Experts did not advocate any self-reported measures where objective measurement was possible (e.g. physical activity). Physiological outcomes hold potential to be primary outcomes, as they are indicators of cardiovascular health, but without evidence of what constitutes a minimally importance difference they have remained as secondary outcomes (although the corresponding lack of evidence for BMI and DXA is acknowledged). No preference-based quality-of-life measures were identified that would enable economic evaluation via calculation of quality-adjusted life-years. Few measures reported evaluating responsiveness. LIMITATIONS Proposed recommended measures are fit for use as outcome measures within studies that evaluate childhood obesity treatment evaluations specifically. These may or may not be suitable for other study designs, and some excluded measures may be more suitable in other study designs. CONCLUSIONS The CoOR outcome measures framework provides clear guidance of recommended primary and secondary outcome measures. This will enhance comparability between treatment evaluations and ensure that appropriate measures are being used. Where possible, future work should focus on modification and evaluation of existing measures rather than development of tools de nova. In addition, it is recommended that a similar outcome measures framework is produced to support evaluation of adult obesity programmes. FUNDING The National Institute for Health Research Health Technology Assessment programme.
Collapse
Affiliation(s)
- Maria Bryant
- Clinical Trials Research Unit, University of Leeds, Leeds, UK
| | - Lee Ashton
- Clinical Trials Research Unit, University of Leeds, Leeds, UK
| | - Julia Brown
- Clinical Trials Research Unit, University of Leeds, Leeds, UK
| | - Susan Jebb
- Medical Research Council (MRC) Human Nutrition Research, Cambridge, UK
| | - Judy Wright
- Institute of Health Sciences, University of Leeds, Leeds, UK
| | | | - Jane Nixon
- Clinical Trials Research Unit, University of Leeds, Leeds, UK
| |
Collapse
|
50
|
Television viewing and food intake during television viewing in normal-weight, overweight and obese 9- to 11-year-old Canadian children: a cross-sectional analysis. J Nutr Sci 2015; 4:e8. [PMID: 26090104 PMCID: PMC4463011 DOI: 10.1017/jns.2014.72] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2013] [Revised: 07/07/2014] [Accepted: 11/19/2014] [Indexed: 11/05/2022] Open
Abstract
It is unclear if children of different weight status differ in their nutritional habits while watching television. The objective of the present paper was to determine if children who are overweight or obese differ in their frequency of consumption of six food items while watching television compared with their normal-weight counterparts. A cross-sectional study of 550 children (57·1 % female; mean age = 10 years) from Ottawa, Canada was conducted. Children's weight status was categorised using the Centers for Disease Control and Prevention cut-points. Questionnaires were used to determine the number of hours of television watching per day and the frequency of consumption of six types of foods while watching television. Overweight/obese children watched more television per day than normal-weight children (3·3 v. 2·7 h, respectively; P = 0·001). Obese children consumed fast food and fruits/vegetables more frequently while watching television than normal-weight or overweight children (P < 0·05). Children who watched more than 4 h of television per d had higher odds (OR 3·21; 95% CI 1·14, 9·03; P = 0·03) of being obese, independent of several covariates, but not independent of moderate-to-vigorous physical activity. The finding that both television watching and the frequency of consumption of some food items during television watching are higher in children who are obese is concerning. While the nature of the present study does not allow for the determination of causal pathways, future research should investigate these weight-status differences to identify potential areas of intervention.
Collapse
|