Attainment of ‘5-2-1-0’ obesity recommendations in preschool-aged children

Abstract

Obesity prevention guidelines recommend children eat ≥ 5 servings of fruits and vegetables, view ≤ 2 h of screen time, participate in 1 h of physical activity, and consume 0 sugar-sweetened beverages daily, commonly known as ‘5-2-1-0’. We sought to determine: the extent to which preschool-aged children attending child care meet these guidelines, predictors of attainment, and associations of attainment with weight status. We analyzed in 2016, 24-hour dietary, physical activity, and screen time data collected in 2009–10 from 398 preschool-aged children in 30 child-care centers in Cincinnati, OH. Dietary intake, screen time and body-mass index (BMI) were obtained by research staff during child care and from parents when at home. Accelerometers measured physical activity. Mixed-effects models and generalized estimating equations were used to determine associations between ‘5-2-1-0’ recommendations, demographic variables, and BMI z-scores. Average child age was 4.3 ± 0.7 years; 26% had a BMI ≥ 85th percentile. Seventeen percent of children with complete dietary data (n = 307) consumed ≥ 5 servings of fruits and vegetables and 50% consumed 0 sugar-sweetened beverages. < 1% with complete physical activity data (n = 386) met the activity recommendation; 81% of children (n = 379) had ≤ 2 h of screen time. Only 1 child met all of the ‘5-2-1-0’ recommendations. There were no consistent demographic predictors of attaining individual recommendations. An additional hour of screen time was associated with a 0.11 (SD 0.06) increase in BMI z-score. Our data suggests there is ample room to increase fruit and vegetable intake and physical activity in preschool-aged children.

INSIGHT responsive parenting intervention reduces infant’s screen time and television exposure

“…Across all participants in INSIGHT, a greater percentage of mothers reported compliance with the AAP screen time recommendations when children were 2 and 2.5 years of age, compared to when children were < 2 years of age. Similar patterns are evidenced across a recent systematic review [ 17 ] showing low compliance among children 0–2 years of age for recommendations of no television viewing, while among children > 2 years of age [ 36 ], a greater percentage of parents reported compliance with the < 2 h/day screen time recommendations. Notably, INSIGHT increased the percentage of RP mothers who reported compliance with the AAP screen time recommendations during infancy, with no study group differences beyond age 1 year.…”

Patterns of Screen Time Among Rural Mexican-American Children on the New Mexico-Mexico Border

“…In aggregate, the total screen time reported for many of these elementary-school–aged children exceed previous recommendations to limit screen time to 2 hours per day ( 18 ). Comparison with other populations of children is difficult because of differences in ages of study populations, outcome measures, and scope.…”

Factors Influencing Children’s Eating Behaviours

“…Dietary quality is influenced by practices such as eating breakfast [ 37 ], family meals [ 38 ], and fast-food consumption [ 39 ]. Both dietary quality and meal practices are linked with sociodemographic characteristics [ 40 , 41 , 42 ].…”