Abstract
BackgroundThe high prevalence of childhood obesity underscores the importance of monitoring population trends in children's activity and screen time, and describing associations with child age, gender, race/ethnicity, and weight status. Our objective was to estimate the proportion of young children in the US who have low levels of active play or high levels of screen time, or who have both these behaviors, and to describe associations with age, gender, race/ethnicity, and weight status.MethodsWe analyzed data collected during the National Health and Nutrition Examination Surveys 2001–2004, a US nationally representative cross-sectional study. We studied 2964 children aged 4.00 to 11.99 years. Our main outcomes were reported weekly times that the child played or exercised hard enough to sweat or breathe hard (active play), daily hours the child watched television/videos, used computers, or played computer games (screen time), and the combination of low active play and high screen time. Low active play was defined as active play 6 times or less per week. High screen time was defined as more than 2 hours per day. We accounted for the complex survey design in analyses and report proportions and 95% confidence intervals. We used Wald Chi-square to test for differences between proportions. To identify factors associated with low active play and high screen time, we used multivariate logistic regression.ResultsOf US children aged 4 to 11 years, 37.3% (95% confidence interval, 34.1% to 40.4%) had low levels of active play, 65.0% (95% CI, 61.4% to 68.5%) had high screen time, and 26.3% (95% CI, 23.8% to 28.9%) had both these behaviors. Characteristics associated with a higher probability of simultaneously having low active play and high screen time were older age, female gender, non-Hispanic black race/ethnicity, and having a BMI-for-age ≥95th percentile of the CDC growth reference.ConclusionMany young children in the US are reported to have physical activity and screen time behaviors that are inconsistent with recommendations for healthy pediatric development. Children who are overweight, approaching adolescence, girls, and non-Hispanic blacks may benefit most from public health policies and programs aimed at these behaviors.
Highlights
The high prevalence of childhood obesity underscores the importance of monitoring population trends in children's activity and screen time, and describing associations with child age, gender, race/ethnicity, and weight status
The American Academy of Pediatrics recommend that children accumulate no more than 2 hours per day of screen time [3,5], and the Centers for Disease Control and Prevention recommend that children be active daily for at least 60 minutes [7]
Among 9–13 year old US youth surveyed by telephone in 2002 [9], participation in organized physical activity was related to race/ethnicity, parental education, and parental income with Hispanic and non-Hispanic black youth less likely than non-Hispanic white youth to have participated in organized physical activity in the preceding 7 days, and greater parental education and income being associated with greater likelihood of the child having participated in organized physical activity [10]
Summary
The high prevalence of childhood obesity underscores the importance of monitoring population trends in children's activity and screen time, and describing associations with child age, gender, race/ethnicity, and weight status. Analyses from NHANES III (1988–1994) of 8– 16 year old children's reported bouts of vigorous physical activity per week found differences in levels of physical activity relative to child age, gender, and race/ethnicity [8]. Adolescent boys were more likely than girls to engage in vigorous activity, but at younger ages no difference by gender was observed; non-Hispanic white children reported more bouts of vigorous activity per week than non-Hispanic black or Mexican American children [8]. Participation in organized physical activity was not related to gender or age, but boys were significantly more likely than girls to report having participated in free-time physical activity during the prior week (74.1% vs 80.5%) [10]
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