Published online February 8, 2010
PEDIATRICS (doi:10.1542/peds.2009-0417)

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Articles

Household Routines and Obesity in US Preschool-Aged Children

Sarah E. Anderson, PhD^a, Robert C. Whitaker, MD, MPH^b

^aDivision of Epidemiology, Ohio State University College of Public Health, Columbus, Ohio; and
^bDepartments of Public Health and Pediatrics, Center for Obesity Research and Education, Temple University, Philadelphia, Pennsylvania

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.

Key Words: obesity • BMI • Early Childhood Longitudinal Study • birth cohort • sleep • television • preschool children • eating behavior • growth and development

Abbreviations: ECLS-B = Early Childhood Longitudinal Study, birth cohort • NCES = National Center for Education Statistics • CI = confidence interval • OR = odds ratio

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Accepted Sep 2, 2009.

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