Social Factors and Television Use during Meals and Snacks Is Associated with Higher BMI among Pre-School Children

Department of Epidemiology and Community Medicine, Faculty of Medicine, University of Ottawa, Institute of Population Health, 1 Stewart Street - Office 303, Ottawa, Ontario, Canada, K1N 6N5.
Public Health Nutrition (Impact Factor: 2.68). 07/2008; 11(12):1267-79. DOI: 10.1017/S1368980008002887
Source: PubMed


The present paper examines the relationship between social factors, food consumption during television viewing, and overall television viewing and how these are associated with BMI when the role of familial and social factors are considered in a population-based birth cohort of pre-school children from Québec (Canada).
The analyses were performed using data from the Longitudinal Study of Child Development in Québec (1998-2002) (LSCDQ). The study follows a representative sample (n 2103) of children born in 1998 in the Canadian province of Québec. A nutrition assessment was conducted on 1549 children aged 4.5 years and included a 24 h dietary recall, an eating behaviour and television viewing questionnaire, and a measurement of children's heights and weights. Statistical analyses were performed.
Nearly one-quarter of children ate at least twice daily in front of the television. Children who consumed snacks while watching television on a daily basis had higher BMI than children who did so less frequently. Children who ate snacks in front of the television every day, or some times during the week, ate more carbohydrates (total), more fat and less protein, fewer fruits and vegetables, and drank soft drinks more often than children who never ate snacks in front of the television.
Health professionals should target parents of children at risk of overweight/obesity with focused strategies to help children change the types of foods consumed during television viewing and to reduce the time spent watching television, particularly during meal times, which may change children's dietary intake and eating patterns.

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Available from: Lise Dubois, Oct 07, 2014
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    • "Other studies of household norms and behaviors have found that household food availability and parental consumption of particular foods influence children’s consumption [35], and that child TV viewing is associated with increased risk of being overweight [35-37]. Consumption of sugar-sweetened beverages has also been consistently associated with excess weight in children [38,39]. "
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    ABSTRACT: Background Early environmental influences have been linked to child weight status, however further understanding of associations in diverse populations is needed. Methods A cross-sectional analysis of household and family factors associated with overweight was conducted on a culturally diverse, urban dwelling sample of 820 first through third graders (mean age 7.6 ± 1.0 years) residing in three eastern Massachusetts cities. Overweight was defined as BMI > 85th percentile, based on measured height and weight, and the CDC growth reference. Multivariate logistic regression was used to identify demographic, behavioral, and social environmental variables significantly related to weight status. Independent variables included race-ethnicity, age, sex, servings of sugar-sweetened beverages/week, hours of screen time/week, parent overweight, (calculated from self-reported weight/height), parent education, household food restriction rules regarding snacking and/or kitchen access, frequency of having dinner as a family (reported as “a lot” vs. “sometimes/rarely/never”) and child vitamin/mineral supplement use. Selected interactions were explored based on prior studies. Results Prevalence of overweight was 35.5% in girls and 40.8% in boys. In the final, adjusted model, compared to white children, the odds of overweight were higher in children of Hispanic race-ethnicity (odds ratio (OR) = 2.4, 95% CI = 1.4 - 4.1). In the same adjusted model, compared to children with no household food restriction rules, the odds of overweight were 2.6 (95% CI = 1.3-5.1) times higher and 3.5 (95% CI = 1.9-6.4) times higher for children having one rule or two rules, respectively. Parent report of frequent family dinner and child vitamin use were protective, with a halving of risk for overweight for each behavior (OR = 0.47, 95% CI = 0.31-0.71 and OR = 0.54, 95% CI = 0.37-0.78, respectively). Conclusions In the presence of other factors, frequent family dinner and vitamin use were associated with lower risk of overweight and household food restriction rules with higher risk. Although such relationships have previously been reported, this investigation is among the first to demonstrate these associations in a low-income, racially-diverse early elementary school population, and suggest potential targets of opportunity within the family context that could reduce child overweight risk in a subgroup of children at elevated risk of obesity.
    BMC Pediatrics 07/2014; 14(1):167. DOI:10.1186/1471-2431-14-167 · 1.93 Impact Factor
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    • "Although we did not observe a statistical association between eating behavior patterns and overweight in kindergarten teachers, further attention should be given to the implementation of workplace health promotion and child health promotion interventions. A link between daily TV use during meals and higher BMI among pre-school children has already been reported by Dubois et al. [40]. They concluded that health professionals (kindergarten teachers) should help families to find strategies to reduce daily TV use during meals. "
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    ABSTRACT: The aim of the study was to investigate obesity status and associated health risk behaviors in a sample of German kindergarten teachers. At present, such data are not available, despite the fact that kindergarten teachers educate children at a formative time in their lives. Kindergarten teachers aged 18--62 years (n = 313) were invited to participate in the Kindergarten Teacher Health Study (KTHS) by completing a self-reported questionnaire. We analyzed their obesity status, health risk behaviors (i.e., habitual physical activity, screen time activities, eating behavior patterns, smoking), and their general ability to identify overweight children and the associated health risks of overweight and obesity based on special age- and sex-specific silhouettes. After adjusting for covariates, bivariate correlations were conducted for associations between body mass index (BMI) and health risk behaviors, while analyses of variance (ANOVAs) were used to analyze differences of health risk behaviors between BMI groups. Logistic regression analyses were conducted to predict determinants of kindergarten teachers who did not correctly identify the overweight silhouettes and their associated physical and mental health risks. Additionally, data regarding kindergarten teachers' weight status and smoking behavior were compared with nationally representative data from the 2009 Microcensus (n = 371310) using the Mann--Whitney U-test. The prevalence rates of overweight and obesity were 41.2% and 17.9%, respectively. The prevalence of obesity was significantly higher in kindergarten teachers (p < 0.001) compared to national Microcensus data. Only 44.6% of teachers were able to identify overweight children correctly. The fact that being overweight is associated with physical and mental health risks was only reported by 40.1% and 21.2% of teachers, respectively. Older kindergarten teachers were more likely to misclassify the overweight silhouettes, while younger, normal-weight, and overweight kindergarten teachers were more likely to underestimate the associated health risks. Obese kindergarten teachers reported spending more time in front of computer and television screens than their normal-weight counterparts, especially on weekends. In addition, obese kindergarten teachers reported eating less often with their families and more frequently reported watching television during meals. Advanced monitoring and multifaceted interventions to improve the health behaviors of kindergarten teachers should be given high priority. Because kindergarten teachers' behavioral modeling presumably mediates children's health behaviors, additional research is needed about kindergarten teachers' health and its proposed interaction with children's health.
    BMC Public Health 10/2013; 13(1):927. DOI:10.1186/1471-2458-13-927 · 2.26 Impact Factor
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    • "We found that children with at least one parent with higher education were more likely to never watch TV at lunch and dinner. Dubois et al. [29] found that a larger proportion of children from mothers with lower socio-economic status watched more TV and also watched more TV frequently during meals and snacks. Coon et al. [49] reported that a greater proportion of children who ate while watching TV came from families with low family income and low socio-economic status. "
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    ABSTRACT: Background To assess the association of eating meals, and never watching TV while eating meals, with weight status among children, ages 10–12 years across Europe. Methods 7915 children (mean age: 11.5 years) in eight European countries (Belgium, Greece, Hungary, the Netherlands, Norway, Slovenia, Spain and Switzerland) completed a questionnaire at school. Data on meals eaten the day before questionnaire administration and the frequency of eating meals while watching TV were collected. Height and weight of the children were objectively assessed. Multinomial and binary regression analyses were conducted to test associations of eating meals (adjusted for gender and ethnicity) and never watching TV while eating meals (adjusted for gender, ethnicity and total TV time) with overweight/obesity, and to test for country- and socio-demographic differences. Results The proportions of children reporting eating breakfast, lunch and dinner were 85%, 96%, and 93% respectively, and 55%, 46% and 32% reported to never watch TV at breakfast, lunch and dinner respectively. The children who ate breakfast (OR = 0.6 (95% CI 0.5-0.7)) and dinner (OR = 0.4 (95% CI 0.3-0.5)), had lower odds of being overweight compared to those who did not. The children who never watched TV at lunch (OR = 0.7 (95% CI 0.7-0.8)) and dinner (OR = 0.8 (95% CI 0.7-0.9)) had lower odds of being overweight compared to those who watched TV at the respective meals. Conclusions The odds of being overweight was lower for children who ate breakfast and dinner compared to those who did not eat the respective meals. The odds of being overweight was lower for children who reported to never watch TV at lunch and dinner compared to those who did. A focus towards meal frequency and watching TV during meals in longitudinal and interventions studies in prevention of overweight and obesity, may contribute to a better understanding of causality.
    International Journal of Behavioral Nutrition and Physical Activity 05/2013; 10(1):58. DOI:10.1186/1479-5868-10-58 · 4.11 Impact Factor
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