Investigating the Association Between Child Television Viewing and Measured Child Adiposity Outcomes in a Large Nationally Representative Sample of New Zealanders: A Cross-Sectional Study

in Journal of Physical Activity and Health
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Background: This study investigates the association between television (TV) viewing and child adiposity and if parental education and child ethnicity moderate this association. Method: Cross-sectional, pooled (2013/2014–2016/2017) adult and child New Zealand Health Survey were matched resulting in 13,039 children (2–14 y) and parent dyads. Child TV viewing was estimated using self-reported time for each weekday and weekend. The height (in centimeters), weight (in kilograms), and waist circumference of parents and children were measured. Childhood body mass index and obesity were defined using the International Obesity Task Force cutoff values. Effect modification was assessed by interaction and then by stratifying regression analyses by parent education (low, moderate, and high) and child ethnicity (Asian, European/other, Māori, and Pacific). Results: Overall, watching ≥2 hours TV on average per day in the past week, relative to <2 hours TV viewing, was associated with a higher odds of obesity (adjusted odds ratio = 1.291 [1.108–1.538]), higher body mass index z score (b = 0.123 [0.061–0.187]), and higher waist circumference (b = 0.546 [0.001–1.092]). Interactions considering this association by child ethnicity and parent education revealed little evidence of effect modification. Conclusion: While TV viewing was associated with child adiposity, the authors found little support for a moderating role of parental education and child ethnicity.

Hobbs, Marek, Tomintz, Wiki, Campbell, and Kingham are with the GeoHealth Laboratory, Geospatial Research Institute, University of Canterbury, Christchurch, New Zealand. Biddle is with the Physically Active Lifestyles Research Group, Centre for Health, Informatics, and Economic Research, University of Southern Queensland, Darling Heights, QLD Australia. Kingsnorth is with the School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, Leicestershire, United Kingdom; and the National Centre for Sport and Exercise Medicine, Loughborough, United Kingdom. McCarthy is with the Ministry of Health, Wellington, New Zealand.

Hobbs (matt.hobbs@canterbury.ac.nz) is corresponding author.
  • 1.

    Abarca-Gómez L, Abdeen ZA, Hamid ZA, et al. Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128 million children, adolescents, and adults. The Lancet. 2017;390(10113):26272642.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 2.

    Ministry of Health. New Zealand Health Survey 2016/17 Annual Data Explorer. Secondary New Zealand Health Survey 2016/17 Annual Data Explorer 2018. https://minhealthnz.shinyapps.io/nz-health-survey-2016-17-annual-data-explorer/_w_c13033de/#!/explore-indicators. Accessed from 2 August, 2020.

    • Search Google Scholar
    • Export Citation
  • 3.

    Ministry of Health. Childhood obesity plan. Wellington: Ministry of Health, 2018.

  • 4.

    Church TS, Thomas DM, Tudor-Locke C, et al. Trends over 5 Decades in U.S. occupation-related physical activity and their associations with obesity. PLoS One. 2011;6(5):e19657. PubMed ID: 21647427 doi:10.1371/journal.pone.0019657

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 5.

    Katzmarzyk P, Mason C. The physical activity transition. J Phys Act Health. 2009;6(3):269280. PubMed ID: 19564654 doi:10.1123/jpah.6.3.269

  • 6.

    Tremblay MS, Aubert S, Barnes JD, et al. Sedentary Behavior Research Network (SBRN)—Terminology Consensus Project process and outcome. Int J Behav Nut Phys Act. 2017;14(1):75. doi:10.1186/s12966-017-0525-8

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 7.

    Dietz WH, Jr., Gortmaker SL. Do we fatten our children at the television set? Obesity and television viewing in children and adolescents. Pediatrics. 1985;75(5):807812.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 8.

    Katzmarzyk PT, Church TS, Craig CL, Bouchard C. Sitting time and mortality from all causes, cardiovascular disease, and cancer. Med Sci Sports Exerc. 2009;41(5):9981005.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 9.

    Ekelund U, Steene-Johannessen J, Brown WJ, et al. Does physical activity attenuate, or even eliminate, the detrimental association of sitting time with mortality? A harmonised meta-analysis of data from more than 1 million men and women. Lancet. 2016;388(10051):13021310.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10.

    Barnett Tracie A, Kelly Aaron S, Young Deborah R, et al. sedentary behaviors in today’s youth: approaches to the prevention and management of childhood obesity: a scientific statement from the American Heart Association. Circulation. 2018;138(11):e142e159.

    • Search Google Scholar
    • Export Citation
  • 11.

    Biddle SJ, Garcia Bengoechea E, Wiesner G. Sedentary behaviour and adiposity in youth: a systematic review of reviews and analysis of causality. Int J Behav Nutr Phys Act. 2017;14(1):43.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 12.

    Biddle SJH, Pearson N, Salmon J. Sedentary behaviors and adiposity in young people: causality and conceptual model. Exerc Sport Sci Rev. 2018;46(1):1825. PubMed ID: 28885266 doi:10.1249/JES.0000000000000135

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 13.

    Kim Y, Cubbin C, Oh S. A systematic review of neighbourhood economic context on child obesity and obesity-related behaviours. Obes Rev: Offic J Int Assoc Study Obes. 2019;20(3):420431.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 14.

    Hobbs M, Pearson N, Foster P, Biddle S. Sedentary behaviour and diet across the lifespan: an updated systematic review. Br J Sports Med. 2014;49:11791188.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 15.

    Hoyos Cillero I, Jago R. Systematic review of correlates of screen-viewing among young children. Prev Med. 2010;51(1):310.

  • 16.

    Ministry of Health. Annual Update of Key Results 2014/2015. Wellington: New Zealand Health Survey, 2015.

  • 17.

    Herter-Aeberli I, Osuna E, Sarnovská Z, Zimmermann MB. Significant decrease in childhood obesity and waist circumference over 15 years in Switzerland: a repeated cross-sectional study. Nutrients. 2019;11(8):1922.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 18.

    Chiavaroli V, Gibbins JD, Cutfield WS, Derraik JGB. Childhood obesity in New Zealand. World J Pediatr. 2019;15(4):322331. PubMed ID: 31079339 doi:10.1007/s12519-019-00261-3

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 19.

    Bowie C, Beere P, Griffin E, Campbell M, Kingham S. Variation in health and social equity in the spaces where we live: a review of previous literature from the GeoHealth Laboratory. New Zealand Sociol. 2013;28(3):164191.

    • Search Google Scholar
    • Export Citation
  • 20.

    Ministry of Health. Methodology Report 2016/17: New Zealand Health Survey. Secondary Methodology Report 2016/17: New Zealand Health Survey. 2017. https://www.health.govt.nz/publication/methodology-report-2016-17-new-zealand-health-survey. Accessed from 20 August 2020

    • Search Google Scholar
    • Export Citation
  • 21.

    Cole TJ, Lobstein T. Extended international (IOTF) body mass index cut-offs for thinness, overweight and obesity. Pediatr Obes. 2012;7(4):284294. PubMed ID: 22715120 doi:10.1111/j.2047-6310.2012.00064.x

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 22.

    Green MA. Do we need to think beyond BMI for estimating population-level health risks? J Public Health. 2016;38(1):192-193. doi:10.1093/pubmed/fdv007

    • Search Google Scholar
    • Export Citation
  • 23.

    Hobbs M, Tomintz M, McCarthy J, et al. Obesity risk in women of childbearing age in New Zealand: a nationally representative cross-sectional study. Int J Public Health. 2019;64(4):625635. PubMed ID: 31006826 doi:10.1007/s00038-019-01239-8

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 24.

    World Health Organization (WHO). The WHO Child Growth Standards. Secondary The WHO Child Growth Standards. 2019. https://www.who.int/childgrowth/en/. Accessed from 21 August 2020.

    • Search Google Scholar
    • Export Citation
  • 25.

    World Health Organization (WHO). Growth reference data for 5-19 years. Secondary Growth reference data for 5–19 years. 2019. https://www.who.int/growthref/en/.

    • Search Google Scholar
    • Export Citation
  • 26.

    Atkinson J, Salmond C, Crampton P. NZDep2013 Index of Deprivation. Wellington: University of Otago, 2014.

  • 27.

    de Jong E, Visscher TL, HiraSing RA, Heymans MW, Seidell JC, Renders CM. 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. 2013;37(1):4753. doi:10.1038/ijo.2011.244

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 28.

    Gordon-Larsen P, Adair LS, Popkin BM. Ethnic differences in physical activity and inactivity patterns and overweight status. Obes Res. 2002;10(3):141149.

  • 29.

    Ministry of Health. How Much Activity Is Recommended? Wellington: Ministry of Health, 2017.

  • 30.

    World Health Organization (WHO). Guidelines on Physical Activity, Sedentary Behaviour and Sleep for Children Under 5 Years of Age. Geneva: World Health Organization, 2019.

    • Search Google Scholar
    • Export Citation
  • 31.

    Ogden CL, Yanovski SZ, Carroll MD, Flegal KM. The epidemiology of obesity. Gastroenterology. 2007;132(6):20872102. PubMed ID: 17498505 doi:10.1053/j.gastro.2007.03.052

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 32.

    McNeish DM, Stapleton LM. The effect of small sample size on two-level model estimates: a review and illustration. Edu Psychol Rev. 2016;28(2):295314.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 33.

    Metz CE. Basic principles of ROC analysis. Sem Nucl Med. 1978;8(4):283298. PubMed ID: 112681 doi:10.1016/S0001-2998(78)80014-2

  • 34.

    Zhang G. Television watching and risk of childhood obesity: a meta-analysis. Eur J Public Health. 2016;26(1):1318. PubMed ID: 26604324 doi:10.1093/eurpub/ckv213

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 35.

    Royal college pediatrics and child health. The Health Impacts of Screen Time: A Guide for Clinicians and Parents. London: Royal college pediatrics and child health, 2019.

    • Search Google Scholar
    • Export Citation
  • 36.

    Rutter H. Where next for obesity? The Lancet. 2011;378(9793):746747. doi:10.1016/S0140-6736(11)61272-5

  • 37.

    Tate EB, Shah A, Jones M, Pentz MA, Liao Y, Dunton G. Toward a better understanding of the link between parent and child physical activity levels: the moderating role of parental encouragement. J Phys Act Health. 2015;12(9):12381244. doi:10.1123/jpah.2014-0126

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 38.

    Foster C, Moore JB, Singletary CR, Skelton JA. Physical activity and family-based obesity treatment: a review of expert recommendations on physical activity in youth. Clin Obes. 2018;8(1):6879. PubMed ID: 29224232 doi:10.1111/cob.12230

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 39.

    Shackleton N, Derraik JGB, Audas R, et al. Decomposing ethnic differences in body mass index and obesity rates among New Zealand pre-schoolers. Int J Obes. 2019;43:1.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 40.

    Starkey L, Eppel EA, Sylvester A. How do 10-year-old New Zealanders participate in a digital world? Information, Commun Soc. 2018:116.

    • Search Google Scholar
    • Export Citation
  • 41.

    Glover M, Wong SF, Fa’alili-Fidow J, et al. Ranked importance of childhood obesity determinants: parents’ views across ethnicities in New Zealand. Nutrients. 2019;11(9):2145.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 42.

    Hume C, van der Horst K, Brug J, Salmon J, Oenema A. Understanding the correlates of adolescents’ TV viewing: a social ecological approach. Int J Pediatr Obes. 2010;5(2):161168. PubMed ID: 20210679 doi:10.3109/17477160903242550

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
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