Advertisement

European Journal of Pediatrics

, Volume 174, Issue 5, pp 631–639 | Cite as

Television, sleep, outdoor play and BMI in young children: the GECKO Drenthe cohort

  • Anna SijtsmaEmail author
  • Marjory Koller
  • Pieter J. J. Sauer
  • Eva Corpeleijn
Original Article

Abstract

In this study, we investigated the interplay between screen time, sleep duration, outdoor play, having a television in the bedroom and the number of televisions at home and their association with body mass index (BMI) in preschool children. All participants, 3–4 years of age (n = 759), were part of the Groningen expert center for kids with obesity (GECKO) Drenthe birth cohort. Weight and height were measured. Total screen time, number of televisions at home, a television in the bedroom, sleep duration and time of outdoor play were self-reported by parents in a questionnaire. Ordinary least square (OLS) regression-based path analysis was used to estimate direct and indirect effects on BMI in mediation models. A television in the bedroom or more televisions at home gave a higher screen time, which were associated with decreased sleep duration and resulted in higher BMI (indirect effect = 0.0115, 95 % bootstrap interval = 0.0016; 0.0368 and indirect effect = 0.0026, 95 % bootstrap interval = 0.0004; 0.0078, respectively). In contrast to the direct effect of screen time, sleep duration and a television in the bedroom on BMI, no direct effect was found for outdoor play and number or televisions at home on BMI.

Conclusions: Short sleep duration, long screen time and a television in the bedroom were associated with the presence of overweight in preschool children.

Keywords

Obesity Preschool Sedentary lifestyle Computer use Home environment Obesogenic environment 

Abbreviations

BMI

Body mass index

GECKO

Groningen expert center for kids with obesity

TV

Television

Notes

Acknowledgments

The study was sponsored with an unrestricted grant by Hutchison Whampoa Limited, 22/F Hutchison House, 10 Harcourt Road, Hong Kong. The study sponsor had no role in (1) the design and conduct of the study; (2) the collection, management, analysis and interpretation of the data; (3) the preparation, review or approval of the manuscript; and (4) the decision to submit the manuscript for publication.

Ethical standards

For all children, written informed consent was obtained from parents, and the study was approved by the medical ethics committee of the University Medical Center Groningen. It has been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

Conflicts of interest

The authors declare that they have conflict of interest.

References

  1. 1.
    Anderson SE, Whitaker RC (2010) Household routines and obesity in US preschool-aged children. Pediatrics 125:420–428CrossRefPubMedGoogle Scholar
  2. 2.
    Baidal JA, Taveras EM (2012) Childhood obesity: shifting the focus to early prevention. Arch Pediatr Adolesc Med 166:1179–1181CrossRefPubMedGoogle Scholar
  3. 3.
    Benedict C, Hallschmid M, Lassen A, Mahnke C, Schultes B, Schioth HB, Born J, Lange T (2011) Acute sleep deprivation reduces energy expenditure in healthy men. Am J Clin Nutr 93:1229–1236CrossRefPubMedGoogle Scholar
  4. 4.
    Bocca G, Corpeleijn E, Stolk RP, Sauer PJ (2012) Results of a multidisciplinary treatment program in 3-year-old to 5-year-old overweight or obese children: a randomized controlled clinical trial. Arch Pediatr Adolesc Med 166:1109–1115CrossRefPubMedGoogle Scholar
  5. 5.
    Bonsignore MR, McNicholas WT, Montserrat JM, Eckel J (2012) Adipose tissue in obesity and obstructive sleep apnoea. Eur Respir J 39:746–767CrossRefPubMedGoogle Scholar
  6. 6.
    Burdette HL, Whitaker RC (2005) A national study of neighborhood safety, outdoor play, television viewing, and obesity in preschool children. Pediatrics 116:657–662CrossRefPubMedGoogle Scholar
  7. 7.
    Cespedes EM, Gillman MW, Kleinman K, Rifas-Shiman SL, Redline S, Taveras EM (2014) Television viewing, bedroom television, and sleep duration from infancy to mid-childhood. Pediatrics. doi: 10.1542/peds. 2013-3998 PubMedCentralGoogle Scholar
  8. 8.
    Cole TJ, Bellizzi MC, Flegal KM, Dietz WH (2000) Establishing a standard definition for child overweight and obesity worldwide: international survey. Br Med J 320:1240–1243CrossRefGoogle Scholar
  9. 9.
    Danielsson P, Kowalski J, Ekblom O, Marcus C (2012) Response of severely obese children and adolescents to behavioral treatment. Arch Pediatr Adolesc Med 166:1103–1108CrossRefPubMedGoogle Scholar
  10. 10.
    de Jong E, Stocks T, Visscher TL, Hirasing RA, Seidell JC, Renders CM (2012) Association between sleep duration and overweight: the importance of parenting. Int J Obes (Lond) 36:1278–1284CrossRefGoogle Scholar
  11. 11.
    de Jong E, Visscher TL, Hirasing RA, Heymans MW, Seidell JC, Renders CM (2013) Association between TV viewing, computer use and overweight, determinants and competing activities of screen time in 4- to 13-year-old children. Int J Obes (Lond) 37:47–53CrossRefGoogle Scholar
  12. 12.
    De Kroon ML, Renders CM, Van Wouwe JP, Van Buuren S, Hirasing RA (2010) The Terneuzen birth cohort: BMI changes between 2 and 6 years correlate strongest with adult overweight. PLoS ONE 5:e9155CrossRefPubMedCentralPubMedGoogle Scholar
  13. 13.
    de Onis M, Blossner M, Borghi E (2010) Global prevalence and trends of overweight and obesity among preschool children. Am J Clin Nutr 92:1257–1264CrossRefPubMedGoogle Scholar
  14. 14.
    Dennison BA, Erb TA, Jenkins PL (2002) Television viewing and television in bedroom associated with overweight risk among low-income preschool children. Pediatrics 109:1028–1035CrossRefPubMedGoogle Scholar
  15. 15.
    Fletcher EN, Whitaker RC, Marino AJ, Anderson SE (2014) Screen time at home and school among low-income children attending head start. Child Indic Res 7:421–436CrossRefPubMedGoogle Scholar
  16. 16.
    Fuller-Tyszkiewicz M, Skouteris H, Hardy LL, Halse C (2012) The associations between TV viewing, food intake, and BMI. A prospective analysis of data from the longitudinal study of Australian children. Appetite 59:945–948CrossRefPubMedGoogle Scholar
  17. 17.
    Hense S, Pohlabeln H, De Henauw S, Eiben G, Molnar D, Moreno LA, Barba G, Hadjigeorgiou C, Veidebaum T, Ahrens W (2011) Sleep duration and overweight in European children: is the association modified by geographic region? Sleep 34:885–890PubMedCentralPubMedGoogle Scholar
  18. 18.
    Hinkley T, Salmon J, Okely AD, Hesketh K, Crawford D (2012) Correlates of preschool children's physical activity. Am J Prev Med 43:159–167CrossRefPubMedGoogle Scholar
  19. 19.
    Hinkley T, Salmon J, Okely AD, Trost SG (2010) Correlates of sedentary behaviours in preschool children: a review. Int J Behav Nutr Phys Act 7:66CrossRefPubMedCentralPubMedGoogle Scholar
  20. 20.
    Jiang F, Zhu S, Yan C, Jin X, Bandla H, Shen X (2009) Sleep and obesity in preschool children. J Pediatr 154:814–818CrossRefPubMedGoogle Scholar
  21. 21.
    Kimbro RT, Brooks-Gunn J, McLanahan S (2011) Young children in urban areas: links among neighborhood characteristics, weight status, outdoor play, and television watching. Soc Sci Med 72:668–676CrossRefPubMedCentralPubMedGoogle Scholar
  22. 22.
    Kuhl ES, Clifford LM, Stark LJ (2012) Obesity in preschoolers: behavioral correlates and directions for treatment. Obesity (Silver Spring) 20:3–29CrossRefGoogle Scholar
  23. 23.
    L'Abee C, Sauer PJ, Damen M, Rake JP, Cats H, Stolk RP (2008) Cohort profile: the GECKO Drenthe study, overweight programming during early childhood. Int J Epidemiol 37:486–489CrossRefPubMedGoogle Scholar
  24. 24.
    Lumeng JC, Rahnama S, Appugliese D, Kaciroti N, Bradley RH (2006) Television exposure and overweight risk in preschoolers. Arch Pediatr Adolesc Med 160:417–422CrossRefPubMedGoogle Scholar
  25. 25.
    Lumeng JC, Somashekar D, Appugliese D, Kaciroti N, Corwyn RF, Bradley RH (2007) Shorter sleep duration is associated with increased risk for being overweight at ages 9 to 12 years. Pediatrics 120:1020–1029CrossRefPubMedGoogle Scholar
  26. 26.
    Magee C, Caputi P, Iverson D (2014) Lack of sleep could increase obesity in children and too much television could be partly to blame. Acta Paediatr 103:e27–e31CrossRefPubMedGoogle Scholar
  27. 27.
    Magee L, Hale L (2012) Longitudinal associations between sleep duration and subsequent weight gain: a systematic review. Sleep Med Rev 16:231–241CrossRefPubMedCentralPubMedGoogle Scholar
  28. 28.
    Marshall NS, Glozier N, Grunstein RR (2008) Is sleep duration related to obesity? A critical review of the epidemiological evidence. Sleep Med Rev 12:289–298CrossRefPubMedGoogle Scholar
  29. 29.
    Miller SA, Taveras EM, Rifas-Shiman SL, Gillman MW (2008) Association between television viewing and poor diet quality in young children. Int J Pediatr Obes 3:168–176CrossRefPubMedCentralPubMedGoogle Scholar
  30. 30.
    Nevarez MD, Rifas-Shiman SL, Kleinman KP, Gillman MW, Taveras EM (2010) Associations of early life risk factors with infant sleep duration. Acad Pediatr 10:187–193CrossRefPubMedCentralPubMedGoogle Scholar
  31. 31.
    Ogden CL, Carroll MD, Kit BK, Flegal KM (2014) Prevalence of childhood and adult obesity in the United States, 2011–2012. JAMA 311:806–814CrossRefPubMedGoogle Scholar
  32. 32.
    Reilly JJ (2008) Physical activity, sedentary behaviour and energy balance in the preschool child: opportunities for early obesity prevention. Proc Nutr Soc 67:317–325CrossRefPubMedGoogle Scholar
  33. 33.
    Reilly JJ, Armstrong J, Dorosty AR, Emmett PM, Ness A, Rogers I, Steer C, Sherriff A (2005) Early life risk factors for obesity in childhood: cohort study. Br Med J 330:1357–1359CrossRefGoogle Scholar
  34. 34.
    Robinson JL, Winiewicz DD, Fuerch JH, Roemmich JN, Epstein LH (2006) Relationship between parental estimate and an objective measure of child television watching. Int J Behav Nutr Phys Act 3:43CrossRefPubMedCentralPubMedGoogle Scholar
  35. 35.
    Scharf RJ, De Boer MD (2014) Sleep timing and longitudinal weight gain in 4- and 5-year-old children. Pediatr Obes. doi: 10.1111/ijpo.229 PubMedGoogle Scholar
  36. 36.
    Schmid SM, Hallschmid M, Jauch-Chara K, Wilms B, Benedict C, Lehnert H, Born J, Schultes B (2009) Short-term sleep loss decreases physical activity under free-living conditions but does not increase food intake under time-deprived laboratory conditions in healthy men. Am J Clin Nutr 90:1476–1482CrossRefPubMedGoogle Scholar
  37. 37.
    Sivak M (2006) Sleeping more as a way to lose weight. Obes Rev 7:295–296CrossRefPubMedGoogle Scholar
  38. 38.
    Skinner AC, Skelton JA (2014) Prevalence and trends in obesity and severe obesity among children in the United States, 1999–2012. JAMA Pediatr 168:561–566CrossRefPubMedGoogle Scholar
  39. 39.
    Spiegel K, Tasali E, Penev P, Van Cauter E (2004) Brief communication: sleep curtailment in healthy young men is associated with decreased leptin levels, elevated ghrelin levels, and increased hunger and appetite. Ann Intern Med 141:846–850CrossRefPubMedGoogle Scholar
  40. 40.
    Strauss RS, Pollack HA (2001) Epidemic increase in childhood overweight, 1986–1998. JAMA 286:2845–2848CrossRefPubMedGoogle Scholar
  41. 41.
    Tandon PS, Zhou C, Christakis DA (2012) The frequency of outdoor play for preschool age children cared for at home-based child care settings. Acad Pediatr 12:475–480CrossRefPubMedGoogle Scholar
  42. 42.
    Taveras EM, Rifas-Shiman SL, Oken E, Gunderson EP, Gillman MW (2008) Short sleep duration in infancy and risk of childhood overweight. Arch Pediatr Adolesc Med 162:305–311CrossRefPubMedCentralPubMedGoogle Scholar
  43. 43.
    Vandewater EA, Rideout VJ, Wartella EA, Huang X, Lee JH, Shim MS (2007) Digital childhood: electronic media and technology use among infants, toddlers, and preschoolers. Pediatrics 119:e1006–e1015CrossRefPubMedGoogle Scholar
  44. 44.
    Veldhuis LM, Vogel IP, Renders CMP, van Rossem LP, Oenema AP, Hirasing RA, Md P, Raat H, Md P (2012) Behavioral risk factors for overweight in early childhood; the 'Be active, eat right' study. Int J Behav Nutr Phys Act 9:74CrossRefPubMedCentralPubMedGoogle Scholar
  45. 45.
    von Kries R, Toschke AM, Wurmser H, Sauerwald T, Koletzko B (2002) Reduced risk for overweight and obesity in 5- and 6-y-old children by duration of sleep—a cross-sectional study. Int J Obes Relat Metab Disord 26:710–716CrossRefGoogle Scholar
  46. 46.
    Weinsier RL, Hunter GR, Heini AF, Goran MI, Sell SM (1998) The etiology of obesity: relative contribution of metabolic factors, diet, and physical activity. Am J Med 105:145–150CrossRefPubMedGoogle Scholar
  47. 47.
    Westerlund L, Ray C, Roos E (2009) Associations between sleeping habits and food consumption patterns among 10-11-year-old children in Finland. Br J Nutr 102:1531–1537CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Anna Sijtsma
    • 1
    Email author
  • Marjory Koller
    • 1
  • Pieter J. J. Sauer
    • 2
  • Eva Corpeleijn
    • 1
  1. 1.Department of Epidemiology (FA40)University of Groningen, University Medical Center GroningenGroningenThe Netherlands
  2. 2.Department of Pediatrics (CA70)University of Groningen, University Medical Center GroningenGroningenThe Netherlands

Personalised recommendations