Household Routines and Obesity in US Preschool-Aged Children

OBJECTIVE: To determine the association between the prevalence of obesity in preschool-aged children and exposure to 3 household routines: regularly eating the evening meal as a family, obtaining adequate sleep, and limiting screen-viewing time. METHODS: We conducted a cross-sectional analysis of a nationally representative sample of ∼8550 four-year-old US children who were assessed in 2005 in the Early Childhood Longitudinal Study, Birth Cohort. Height and weight were measured. We assessed the association of childhood obesity (BMI ≥ 95th percentile) with 3 household routines: regularly eating the evening meal as a family (>5 nights per week); obtaining adequate nighttime sleep on weekdays (≥10.5 hours per night); and having limited screen-viewing (television, video, digital video disk) time on weekdays (≤2 hours/day). Analyses were adjusted for the child's race/ethnicity, maternal obesity, maternal education, household income, and living in a single-parent household. RESULTS: Eighteen percent of children were obese, 14.5% were exposed to all 3 routines, and 12.4% were exposed to none of the routines. The prevalence of obesity was 14.3% (95% confidence interval [CI]: 11.3%–17.2%) among children exposed to all 3 routines and 24.5% (95% CI: 20.1%–28.9%) among those exposed to none of the routines. After adjusting for covariates, the odds of obesity associated with exposure to all 3, any 2, or only 1 routine (compared with none) were 0.63 (95% CI: 0.46–0.87), 0.64 (95% CI: 0.47–0.85), and 0.84 (95% CI: 0.63–1.12), respectively. CONCLUSIONS: US preschool-aged children exposed to the 3 household routines of regularly eating the evening meal as a family, obtaining adequate nighttime sleep, and having limited screen-viewing time had an ∼40% lower prevalence of obesity than those exposed to none of these routines. These household routines may be promising targets for obesity-prevention efforts in early childhood.

[1]  S. Gortmaker,et al.  Reducing obesity via a school-based interdisciplinary intervention among youth: Planet Health. , 1999, Archives of pediatrics & adolescent medicine.

[2]  B. Fiese,et al.  Routine and ritual elements in family mealtimes: contexts for child well-being and family identity. , 2006, New directions for child and adolescent development.

[3]  Policy Briefs,et al.  Health Resources and Services Administration | Maternal and Child Health Bureau , 2010 .

[4]  B. Dennison,et al.  An intervention to reduce television viewing by preschool children. , 2004, Archives of pediatrics & adolescent medicine.

[5]  J. Montplaisir,et al.  Associations between sleep duration patterns and overweight/obesity at age 6. , 2008, Sleep.

[6]  F. Verhulst,et al.  Parent-reported sleep problems during development and self-reported anxiety/depression, attention problems, and aggressive behavior later in life. , 2008, Archives of pediatrics & adolescent medicine.

[7]  V. Strasburger,et al.  Children, adolescents, and television. , 1990, Pediatrics in review.

[8]  P. Prinz Sleep, Appetite, and Obesity—What Is the Link? , 2004, PLoS medicine.

[9]  J. Wardle,et al.  Parental perceptions of overweight in 3–5 y olds , 2005, International Journal of Obesity.

[10]  S. Crow,et al.  Parents are key players in the prevention and treatment of weight-related problems. , 2004, Nutrition reviews.

[11]  P. Veugelers,et al.  Prevalence of and risk factors for childhood overweight and obesity , 2005, Canadian Medical Association Journal.

[12]  J. Buscemi,et al.  Beyond Parenting Practices: Family Context and the Treatment of Pediatric Obesity. , 2008 .

[13]  Thomas N Robinson,et al.  A randomized trial of the effects of reducing television viewing and computer use on body mass index in young children. , 2008, Archives of pediatrics & adolescent medicine.

[14]  S. Redline,et al.  Pediatric sleep apnea: implications of the epidemic of childhood overweight. , 2007, American journal of respiratory and critical care medicine.

[15]  C. Braet,et al.  Observation of family functioning at mealtime: a comparison between families of children with and without overweight. , 2007, Journal of pediatric psychology.

[16]  Dianne Neumark-Sztainer,et al.  Correlations between family meals and psychosocial well-being among adolescents. , 2004, Archives of pediatrics & adolescent medicine.

[17]  G. Colditz,et al.  Family dinner and adolescent overweight. , 2005, Obesity research.

[18]  Barbara H. Fiese,et al.  RECLAIMING THE FAMILY TABLE: MEALTIMES AND CHILD HEALTH AND WELLBEING , 2008 .

[19]  T. Videon,et al.  Influences on adolescent eating patterns: the importance of family meals. , 2003, The Journal of adolescent health : official publication of the Society for Adolescent Medicine.

[20]  J. Capizzano The Hours That Children Under Five Spend in Child Care: Variation across States , 2000 .

[21]  James L. Green,et al.  Early Childhood Longitudinal Study, Birth Cohort (ECLS-B): Methodology Report for the 9-Month Data Collection (2001-02). Volume 2: Sampling. NCES 2005-147. , 2005 .

[22]  S. Barlow,et al.  Expert committee recommendations regarding the prevention, assessment, and treatment of child and adolescent overweight and obesity: summary report. , 2007, Pediatrics.

[23]  John J Reilly,et al.  Early life risk factors for obesity in childhood: cohort study , 2005, BMJ : British Medical Journal.

[24]  R C Whitaker,et al.  Maternal perceptions of overweight preschool children. , 2000, Pediatrics.

[25]  Catharyn T. Liverman,et al.  Preventing Childhood Obesity: Health in the Balance , 2005 .

[26]  Melissa Wake,et al.  Maternal concern and perceptions of overweight in Australian preschool‐aged children , 2006, The Medical journal of Australia.

[27]  Nancy F Krebs,et al.  Prevention of pediatric overweight and obesity. , 2003, Pediatrics.

[28]  S. Milan,et al.  The context of preschool children's sleep: racial/ethnic differences in sleep locations, routines, and concerns. , 2007, Journal of family psychology : JFP : journal of the Division of Family Psychology of the American Psychological Association.

[29]  V. Rideout,et al.  Digital Childhood: Electronic Media and Technology Use Among Infants, Toddlers, and Preschoolers , 2007, Pediatrics.

[30]  Youth,et al.  COMMITTEE ON PREVENTION OF OBESITY IN CHILDREN AND YOUTH , 2005 .

[31]  T. Robinson,et al.  Children, Television Viewing, and Weight Status: Summary and Recommendations from an Expert Panel Meeting , 2008 .

[32]  Shumei S. Guo,et al.  2000 CDC Growth Charts for the United States: methods and development. , 2002, Vital and health statistics. Series 11, Data from the National Health Survey.

[33]  Ngianga-Bakwin Kandala,et al.  Meta-analysis of short sleep duration and obesity in children and adults. , 2008, Sleep.

[34]  Ç. Kâğıtçıbaşı,et al.  Effects of an Educational Television Program on Preschoolers: Variability in Benefits. , 2008 .

[35]  Ron Warren Parental Mediation of Preschool Children's Television Viewing , 2003 .

[36]  Abdullah Al Mamun,et al.  Positive maternal attitude to the family eating together decreases the risk of adolescent overweight. , 2005, Obesity research.

[37]  Ronda M. Scantlin,et al.  The relations of early television viewing to school readiness and vocabulary of children from low-income families: the early window project. , 2001, Child development.

[38]  Shumei S. Guo,et al.  CDC GROWTH CHARTS FOR THE UNITED STATES: METHODS AND DEVELOPMENT 2000 , 2002 .

[39]  D. Neumark-Sztainer,et al.  Family dinner meal frequency and adolescent development: relationships with developmental assets and high-risk behaviors. , 2006, The Journal of adolescent health : official publication of the Society for Adolescent Medicine.

[40]  G. Colditz,et al.  Family dinner and diet quality among older children and adolescents. , 2000, Archives of family medicine.

[41]  T. Robinson,et al.  Does children's screen time predict requests for advertised products? Cross-sectional and prospective analyses. , 2006, Archives of pediatrics & adolescent medicine.

[42]  D. Borzekowski,et al.  Children's Television Exposure and Behavioral and Social Outcomes at 5.5 Years: Does Timing of Exposure Matter? , 2007, Pediatrics.

[43]  D. Gozal,et al.  Obesity and obstructive sleep apnea in children. , 2006, Paediatric respiratory reviews.

[44]  T N Robinson,et al.  Reducing children's television viewing to prevent obesity: a randomized controlled trial. , 1999, JAMA.

[45]  Richie Poulton,et al.  Childhood Sleep Time and Long-Term Risk for Obesity: A 32-Year Prospective Birth Cohort Study , 2008, Pediatrics.

[46]  J. Grusec,et al.  Untangling the links of parental responsiveness to distress and warmth to child outcomes. , 2006, Child development.

[47]  Mabel L. Rice,et al.  Words from Sesame Street : learning vocabulary while viewing , 1990 .

[48]  B. Sherry,et al.  Interventions to Prevent or Treat Obesity in Preschool Children: A Review of Evaluated Programs , 2007, Obesity.

[49]  Treatment of Obesity in Adults Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults--The Evidence Report. National Institutes of Health. , 1998, Obesity research.

[50]  Lynn S Edmunds,et al.  Positive effects of family dinner are undone by television viewing. , 2007, Journal of the American Dietetic Association.

[51]  Gail M. Williams,et al.  Do childhood sleeping problems predict obesity in young adulthood? Evidence from a prospective birth cohort study. , 2007, American journal of epidemiology.

[52]  M. Beydoun,et al.  Is Sleep Duration Associated With Childhood Obesity? A Systematic Review and Meta‐analysis , 2008, Obesity.

[53]  J. Capizzano,et al.  The Hours That Children under Five Spend in Child Care: Variation across the States. No. B-8. Assessing the New Federalism: An Urban Institute Program To Assess Changing Social Policies. , 2000 .

[54]  R. Whitaker,et al.  Prevalence of obesity among US preschool children in different racial and ethnic groups. , 2009, Archives of pediatrics & adolescent medicine.

[55]  Sanjay R. Patel,et al.  Short Sleep Duration and Weight Gain: A Systematic Review , 2008, Obesity.

[56]  R. Whitaker Obesity prevention in pediatric primary care: four behaviors to target. , 2003, Archives of pediatrics & adolescent medicine.

[57]  R C Whitaker,et al.  Why don't low-income mothers worry about their preschoolers being overweight? , 2001, Pediatrics.

[58]  S. Powers,et al.  The challenge of preventing and treating obesity in low-income, preschool children: perceptions of WIC health care professionals. , 2002, Archives of pediatrics & adolescent medicine.

[59]  M. Flynn,et al.  Reducing obesity and related chronic disease risk in children and youth: a synthesis of evidence with ‘best practice’ recommendations , 2006, Obesity reviews : an official journal of the International Association for the Study of Obesity.