Dose-response associations between screen time and overweight among youth

Objective. To examine dose-response associations between screen time and overweight, independent of physical activity and dietary intake.

Methods. Participants were 580 Dutch youth (13 years; 48% boys). Body mass index, waist circumference and skinfold thickness at four sites determined weight status. Questionnaires examined television viewing and computer use, participation in organized sport and high caloric snack and sugar-containing beverage consumption.

Results. There were no significant associations among boys. Compared with girls spending less than two hours/day in screen time, those who spent three to four hours/day were more likely to be classified as overweight by waist circumference (odds ratio [OR]=3.4; 95% confidence intervals [CI]=1.1-10.7; p=0.03), and this likelihood increased substantially among those spending more than four hours/day (OR=5.5; 95% CI=2.1-14.1; p≤0.0001).

Conclusions. Girls who spend three or more hours/day in screen time are at increased risk of being classified as overweight by waist circumference.

Profiling the sport consumption attitudes and behaviours of fantasy football players

Most sporting codes encourage participation in Fantasy Sport (FS), despite few making direct revenue from it. There is a lack of empirical evidence whether this is good practice, for although FS can increase involvement and education, it may also compete with other forms of sport consumption for consumers limited resources. This study begins to address whether FS competes with or  complements sport consumption by comparing FS players with nonplayers. Data was collected from surveys (n=182) of AFL fans, with findings indicating FS players had higher tested measures of attitudes (e.g., team identification, commitment) and behaviours (e.g., game attendance, television viewing) related  to the sport. What remains to be determined is causality, and suggestions on how to examine this are given.

Personal, social and environmental correlates of resilience to physical inactivity among women from socio-economically disadvantaged backgrounds

While sex and socio-economic disparities in physical activity have been well documented, not all disadvantaged women are inactive. This study aimed to examine correlates of achieving recommended levels of physical activity among women of low socio-economic position. In 2005, a population-based sample of 291 women with low educational attainment provided survey data on leisure time physical activity (LTPA). Participants reported potential personal (enjoyment and self-efficacy; barriers; intentions; guilt and priorities; routines and scheduling; occupational physical activity; television viewing), social (support from family/friends; social participation; sport/recreation club membership; dog ownership) and environmental (aesthetics; safety; local access; footpaths; interesting walks; busy roads to cross; heavy traffic) correlates of physical activity. Nearly 40% of participants achieved recommended LTPA (150 min week–1). Multivariable analyses revealed that higher levels of self-efficacy for walking [prevalence ratio (PR) 2.05, 95% confidence interval (CI) 1.19–3.53], higher enjoyment of walking (PR 1.48, 95% CI 1.04–2.12), greater intentions to be active (PR 1.97, 95% CI 1.12–3.45) and having set routines for physical activity (PR 1.91, 95% CI 1.18–3.09) were significantly associated with achieving recommended LTPA. Personal factors were the characteristics most strongly associated with achieving recommended levels of LTPA among women from socio-economically disadvantaged backgrounds.

Correlates of sedentary behaviours in preschool children : a review

Background: Sedentary behaviour has been linked with a number of health outcomes. Preschool-aged children spend significant proportions of their day engaged in sedentary behaviours. Research into the correlates of sedentary behaviours in the preschool population is an emerging field, with most research being published since 2002. Reviews on correlates of sedentary behaviours which include preschool children have previously been published; however, none have reported results specific to the preschool population. This paper reviews articles reporting on correlates of sedentary behaviour in preschool children published between 1993 and 2009.
Methods: A literature search was undertaken to identify articles which examined correlates of sedentary behaviours in preschool children. Articles were retrieved and evaluated in 2008 and 2009.
Results: Twenty-nine studies were identified which met the inclusion criteria. From those studies, 63 potential correlates were identified. Television viewing was the most commonly examined sedentary behaviour. Findings from the review suggest that child’s sex was not associated with television viewing and had an indeterminate association with sedentary behaviour as measured by accelerometry. Age, body mass index, parental education and race had an indeterminate association with television viewing, and outdoor playtime had no association with television viewing. The remaining 57 potential correlates had been investigated too infrequently to be able to draw robust conclusions about associations.
Conclusions: The correlates of preschool children’s sedentary behaviours are multi-dimensional and not well established. Further research is required to provide a more comprehensive understanding of the influences on preschool children’s sedentary behaviours to better inform the development of interventions.

Novel strategies to promote children's physical activities and reduce sedentary behavior

Physical activity and sedentary behavior (performed primarily while sitting) play a key role in the current and future health of young people. Most health evidence and intervention strategies targeting reductions in children’s sedentary behavior have focused on television viewing, with mixed evidence as to the effectiveness of these strategies and of the importance of television viewing for children’s health. Evidence from studies with adults using objective measures of sedentary behavior suggests that accumulated sedentary time is independently associated with metabolic health; importantly, emerging evidence suggests that the manner in which the sedentary behavior is accrued (ie, frequency of interruptions to time spent sedentary) may also have independent effects on health. Potential novel intervention approaches to reduce children’s sedentary time include activity breaks during class time at school, delivery of active lessons and homework, and changes to the classroom environment. Further evidence of the importance of sedentary time (both total accumulation and frequency of interruptions) on children’s health is required. Future studies should assess the effectiveness of interventions targeting organizational and pedagogical changes in schools as well as using homework to engage with families in more active ways.

Maternal self-efficacy regarding children's eating and sedentary behaviours in the early years : Associations with children's food intake and sedentary behaviours

Introduction. This cross-sectional study aimed to describe parents' views regarding self-efficacy to influence children's eating and sedentary behaviours at two time points in early childhood, and to examine associations between these views and children's eating and sedentary behaviours.

Methods. Mothers of 1-year (n=60) and 5-year-old children (n=80) were recruited through Maternal and Child Health Centres and kindergartens in Victoria, Australia. Mothers reported children's dietary intake, television viewing and perceptions of their self-efficacy regarding children's eating and sedentary behaviours.

Results. Overall, 5-year-old children consumed significantly more energy-dense food and drink and spent significantly more time viewing TV/DVD and video. Mothers of 1-year-olds were significantly more likely to report they felt confident to limit child's consumption of non-core foods/drinks, and to limit screen access (p<0.001). Measures of maternal self-efficacy were directly associated with 5-year-old children's water (p<0.05), and fruit and vegetable consumption (p<0.005), and with 1-year-old children's vegetable consumption (p<0.05), and were inversely associated with cordial and cake consumption (p<0.05). Maternal self-efficacy to limit viewing time was inversely associated with screen-time exposure in both age groups (p<0.01).

Conclusion. This study suggests that mother's self-efficacy regarding limiting non-core foods/drinks and limiting screen-time exposures may decline during the first few years of a child's life. Higher maternal self-efficacy was associated with children having more obesity protective eating and sedentary behaviours at both ages. Interventions to support the development of healthy lifestyle behaviours may be most effective if they target mothers' self-efficacy in these domains early in their child's life.

Call for research – the consuming child-in-context in unhealthy and unsustainable times

Childhood obesity is a highly complex issue with serious health and environmental implications. It has been postulated that young children (preschool-aged in particular) are able to internalise positive environmental beliefs. Applying a socioecological theoretical perspective, in this discussion paper we argue that although children may internalise such beliefs, they commonly behave in ways that contradict these beliefs as demonstrated by their consumer choices. The media directly influences these consumer choices and growing evidence suggests that media exposure (particularly commercial television viewing) may be a significant “player” in the prediction of childhood obesity. However, there is still debate as to whether childhood obesity is caused by digital media use per se or whether other factors mediate this relationship. Growing evidence suggests that researchers should examine whether different types of content have conflicting influences on a child’s consumer choices and, by extension, obesity. The extent to which young children connect their consumer choices and the sustainability of the product/s they consume with their overall health and wellbeing has not previously been researched. To these ends, we call for further research on this socioecological phenomenon among young children, particularly with respect to the influence of digital media use on a child’s consumer behaviours.

Parental status and childhood obesity in Australia

The overall aim of this study was to examine obesogenic factors in children from single and dual parent families. Data from the Longitudinal Study of Australian Children (LSAC) (8,717 children) were analyzed to examine the differences in children ’ s activity levels, dietary intake and BMI according to parental status and determine the likelihood of childhood overweight and obesity in a single-parent household. There were higher rates of overweight and obesity in girls aged four to nine whose parents were single (OR 1:60). Children in single-parent households watched more television, ate more food high in fat and sugar and less fresh fruit and vegetables than children from dual-parent households. The findings suggested that an additive effect of dietary and activity variables may contribute to the higher rates of overweight and obesity in Australian children, and that girls from single-parent households may be particularly at risk.

Individual, social, and physical environment factors associated with electronic media use among children : sedentary behavior at home

Background: Individual, home social and physical environment correlates of electronic media (EM) use among children were examined and pattern of differences on school and weekend days.
Methods: Youth (n = 298) aged 11 to 12 years self-reported time spent using EM (TV, video/DVD, computer use, and electronic games) on a typical school and a weekend day, each dichotomized at the median to indicate heavy and light EM users. Anthropometric measurements were taken. Logistic regression examined correlates of EM use.
Results: In total, 87% of participants exceeded electronic media use recommendations of ≤ 2 hrs/day. Watching TV during breakfast (OR = 3.17) and after school (OR = 2.07), watching TV with mother (OR = 1.96), no rule(s) limiting time for computer game usage (OR = 2.30), having multiple (OR = 2.99) EM devices in the bedroom and BMI (OR = 1.15) were associated with higher odds of being heavy EM user on a school day. Boys (OR = 2.35) and participants who usually watched TV at midday (OR = 2.91) and late at night (OR = 2.04) had higher odds of being a heavy EM user on the weekend.
Conclusions: Efforts to modify children’s EM use should focus on a mix of intervention strategies that address patterns and reinforcement of TV viewing, household rules limiting screen time, and the presence of EM devices in the child’s bedroom.

Is the neighbourhood environment associated with sedentary behaviour outside of school hours among children?

Background Little is known about neighbourhood environments and children’s sedentary behaviour outside school hours.
Purpose This study aims to examine the associations between public open spaces (POS), parent perceptions of the neighbourhood and children’s sedentary behaviours.
Methods Parents reported their child’s television viewing and computer/electronic game time and their perceptions of the physical and social neighbourhood. Children’s sedentary
time was objectively assessed. The closest POS was audited.
Results Cross-sectionally, living near a POS with a water feature and greater parental satisfactionwith POS quality were negatively associated with computer/e-games; greater POS area was negatively associated with TV viewing. Longitudinally, living in a cul-de-sac and greater satisfaction with POS quality were negatively associated with computer/e-games and TV viewing, respectively. Awalking path in the POS was positively associated with computer/e-games.
Conclusion Neighbourhood features appear to positively and negatively influence children’s sedentary behaviours, highlighting the complexity of urban planning on behaviour. Further age- and context-specific studies are required.

Socioeconomic variation in diet and activity-related behaviours of Australian children and adolescents aged 2–16 years

Background

Evidence for age-related variation in the relationship between obesity-related behaviours and socioeconomic position may assist in the targeting of dietary and physical activity interventions among children.
Objective

To investigate the relationship between different indicators of socioeconomic position and obesity-related behaviours across childhood and adolescence.
Methods

Data were from 4487 children aged 2 to 16 years participating in the cross-sectional 2007 Australian National Children's Nutrition and Physical Activity Survey. Socioeconomic position was defined by the highest education of the primary or secondary carer and parental income. Activity was assessed using recall methods with physical activity also assessed using pedometers. Intake of energy-dense drinks and snack foods, fruits and vegetables was assessed using 2 × 24-h dietary recalls.
Results

A socioeconomic gradient was evident for each dietary measure (although in age-specific analyses, not for energy-dense snacks in older children), as well as television viewing, but not physical activity. Whether each behaviour was most strongly related to parental income or education of the primary or secondary carer was age and sex dependent. The socioeconomic gradient was strongest for television viewing time and consumption of fruit and energy-dense drinks.
Conclusions

A strong socioeconomic gradient in eating behaviours and television viewing time was observed. Relationships for particular behaviours differed by age, sex and how socioeconomic position was defined. Socioeconomic indicators define different population groups and represent different components of socioeconomic position. These findings may provide insights into who should be targeted in preventive health efforts at different life stages.

Youth physical activity and sedentary time and associations with cardiometabolic health

In recent years, there has been increasing interest in the effects of sedentary behaviour on children’s health, defined as sitting behaviours that require low levels of energy expenditure (≤1.5 METs).¹ There is some evidence that sedentary behaviours may be detrimental to children’s health, though the majority of associations observed are derived from cross-sectional studies examining television viewing and adiposity.² This study adds to the literature by examining cross-sectional and prospective associations between objectively measured moderate- to vigorous physical activity (MVPA) and sedentary time, and cardiometabolic risk factors in youth aged 4–18 years.

A parent-focused intervention to reduce infant obesity risk behaviors: a randomized trial

OBJECTIVE: To assess the effectiveness of a parent-focused intervention on infants’ obesity-risk behaviors and BMI.
METHODS: This cluster randomized controlled trial recruited 542 parents and their infants (mean age 3.8 months at baseline) from 62 first-time parent groups. Parents were offered six 2-hour dietitian-delivered sessions over 15 months focusing on parental knowledge, skills, and social support around infant feeding, diet, physical activity, and television viewing. Control group parents received 6 newsletters on nonobesity-focused themes; all parents received usual care from child health nurses. The primary outcomes of interest were child diet (3 × 24-hour diet recalls), child physical activity (accelerometry), and child TV viewing (parent report). Secondary outcomes included BMI z-scores (measured). Data were collected when children were 4, 9, and 20 months of age.
RESULTS: Unadjusted analyses showed that, compared with controls, intervention group children consumed fewer grams of noncore drinks (mean difference = –4.45; 95% confidence interval [CI]: –7.92 to –0.99; P = .01) and were less likely to consume any noncore drinks (odds ratio = 0.48; 95% CI: 0.24 to 0.95; P = .034) midintervention (mean age 9 months). At intervention conclusion (mean age 19.8 months), intervention group children consumed fewer grams of sweet snacks (mean difference = –3.69; 95% CI: –6.41 to –0.96; P = .008) and viewed fewer daily minutes of television (mean difference = –15.97: 95% CI: –25.97 to –5.96; P = .002). There was little statistical evidence of differences in fruit, vegetable, savory snack, or water consumption or in BMI z-scores or physical activity.
CONCLUSIONS: This intervention resulted in reductions in sweet snack consumption and television viewing in 20-month-old children.

Associations between psychological stress, eating, physical activity, sedentary behaviours and body weight among women: a longitudinal study

Background: