A Randomized Trial of the Effects of Reducing Television Viewing and Computer Use on Body Mass Index in Young Children

Abstract

To assess the effects of reducing television viewing and computer use on children's body mass index (BMI) as a risk factor for the development of overweight in young children.Design: Randomized controlled clinical trial.Setting: University children's hospital.Participants: Seventy children aged 4 to 7 years whose BMI was at or above the 75th BMI percentile for age and sex.Interventions: Children were randomized to an intervention to reduce their television viewing and computer use by 50% vs a monitoring control group that did not reduce television viewing or computer use.Main Outcome Measures: Age-and sex-standardized BMI (zBMI), television viewing, energy intake, and physical activity were monitored every 6 months during 2 years.Results: Children randomized to the intervention group showed greater reductions in targeted sedentary behavior (PϽ.001), zBMI (PϽ.05), and energy intake (PϽ.05) compared with the monitoring control group. Socioeconomic status moderated zBMI change (P =.01), with the experimental intervention working better among families of low socioeconomic status. Changes in targeted sedentary behavior mediated changes in zBMI (PϽ.05). The change in television viewing was related to the change in energy intake (PϽ.001) but not to the change in physical activity (P =.37). Conclusions:Reducing television viewing and computer use may have an important role in preventing obesity and in lowering BMI in young children, and these changes may be related more to changes in energy intake than to changes in physical activity.

Prevention of overweight in preschool children: results of kindergarten-based interventions

“…The interesting finding of the differential impact of interventions as a function of socio economic status (SES), seen in this study, has not been examined in most studies and mixed findings have been reported in few recent studies. 18,25 In the Kiel Obesity Prevention Study, 25 the effect of an education program involving nutrition education and increased activity at school on prevalence of overweight at 4-year follow-up was significant in children from families with high SES. In contrast, Epstein et al 18 found that with an intervention targeting only television viewing and computer use over a 2-year period, change in BMI z-score was significant only in children from families of low SES.…”

“…18,25 In the Kiel Obesity Prevention Study, 25 the effect of an education program involving nutrition education and increased activity at school on prevalence of overweight at 4-year follow-up was significant in children from families with high SES. In contrast, Epstein et al 18 found that with an intervention targeting only television viewing and computer use over a 2-year period, change in BMI z-score was significant only in children from families of low SES. Similarly, Foster et al 26 showed that a multicomponent school-based intervention for 2 years involving older children (mean age 11 years) from low SES, resulted in marked reduction in the prevalence of overweight; odds ratios and 95% confidence interval were 0.65 (0.54-0.79).…”

“…Few randomized controlled studies aiming at reducing overweight have been carried out with children o7 years of age. [13][14][15][16][17][18][19][20][21] In recent years, preschool age has been identified as a critical period for targeting interventions against obesity prevention. 22 Our goal was to evaluate interventions with young children that could be incorporated into existing schools, community and health-care programs, with physicians and community involvement, to optimize effectiveness and resources.…”

Effects of Parenting Style and Parent-Related Weight and Diet on Adolescent Weight Status

“…Specifically, 39.5% of non-Hispanic black adolescents are considered overweight or obese as defined by body mass index greater than or equal to sex-and age-specific 85th percentile from the 2000 CDC Growth Charts (Ogden, et al, 2010). Previous studies have demonstrated significant positive associations between sedentary behaviors, including screen time, and adolescent weight status (Eisenmann, Bartee, Smith, Welk, & Fu, 2008;Epstein et al, 2008;Mitchell et al, 2009;Robinson, 1999). These associations are especially troubling among African American youth, given that 55.5% of African American adolescents report watching !3 hr of television per day as compared with the national average of 32.8% (Eaton et al, 2010).…”

Television food advertising and the prevalence of childhood overweight and obesity: a multicountry comparison

“…Often persisting into adulthood, childhood obesity increases the risk of suffering from a range of diseases, including diabetes mellitus and CVD, which can lead to poor quality of life and a shortened lifespan (3)(4)(5) . Overweight among children is related to many factors at the individual, family and environmental levels.Cross-sectional and longitudinal studies have shown a positive association between time spent watching television (TV) and an increase in the prevalence of childhood overweight and obesity (6)(7)(8)(9) ; whereas the results of published studies indicate a positive relationship between TV viewing and overweight (10)(11)(12) , mechanisms driving this are not clear. Two primary mechanisms by which TV viewing contributes to weight gain in children have been suggested: reduced physical activity or increased energy intake or a combination of both.…”