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


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.


Obesity Preschool Sedentary lifestyle Computer use Home environment Obesogenic environment 



Body mass index


Groningen expert center for kids with obesity





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.


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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

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