Abstract
BackgroundExtensive research has demonstrated the role of the Home Environment (HE) in shaping children’s energy balance behaviours. Less is known about direct relationships with bodyweight. This review examines associations between the social and physical aspects of three pre-defined Home Environment domains (food, physical activity and media) and adiposity measures in children ≤12 years.MethodsSix electronic databases (PubMed, Medline, EBSCO CINAHL, EMBASE, Web of Science, PsycInfo) were systematically searched up to October 2020. Studies reporting at least one physical and/or social aspect of the food, physical activity and/or media domains of the Home Environment in relation to child adiposity outcomes were included (n = 62).ResultsMost studies examined one (n = 41) or two domains (n = 16). Only five studies assessed all three domains of the Home Environment. Most consistent relationships were observed for physical aspects of the home media environment; with greater availability of electronic devices associated with higher child adiposity (21/29 studies). Findings were less consistent for the smaller number of studies examining physical aspects of the home food or physical activity environments. 8/15 studies examining physical food environments reported null associations with adiposity. Findings were similarly mixed for physical activity environments; with 4/7 reporting null associations, 2/7 reporting negative associations and 1/7 reporting positive associations between access to physical activity equipment/garden space and adiposity. Fewer studies assessed social aspects (e.g. caregiver modelling or limit setting) of the Home Environment in relation to child adiposity and findings were again mixed; 9/16 media environment, 7/11 food environment and 9/13 physical activity environment studies reported null associations with child adiposity outcomes.ConclusionsThe home media environment was most consistently associated with adiposity in childhood. Findings were less consistent for the home food and physical activity environments. Greater agreement on definitions and the measurement of the obesogenic home environment is required in order to clarify the strength and direction of relationships with child adiposity. Robust longitudinal research using comprehensive measures of the holistic home environment is needed to better identify which aspects contribute to excess weight gain in childhood.Trial registrationPROSPERO Systematic review registration number: CRD42018115139.
Highlights
Excess adiposity in childhood is a major public health issue, it is associated with a wide range of negative physical and psychological health outcomes [1, 2]
Following title and abstract review, 12,257 were excluded and a further 367 papers were excluded after assessment of the full texts
An additional seven papers were identified through searching relevant manuscript reference lists during the screening stage
Summary
Excess adiposity in childhood is a major public health issue, it is associated with a wide range of negative physical and psychological health outcomes [1, 2]. It is hypothesised that the home environment is a major factor in shaping children’s weight trajectories. Numerous models have been developed to conceptualise how different aspects of the home environment may influence children’s growth and development [5, 9, 10]. The multifaceted and complex nature of the home environment (HE) complicates attempts to characterise and measure its contribution to excess weight development in childhood. A variety of measures have been developed to capture different aspects of the obesogenic HE, such as the types and frequency of foods available in the home [11] or the availability of electronic devices in a child’s bedroom [12]. This review examines associations between the social and physical aspects of three pre-defined Home Environment domains (food, physical activity and media) and adiposity measures in children ≤12 years
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