School of Sport, Exercise & Health Sciences, National Centre for Sport & Exercise Medicine, Loughborough University, Loughborough, Leicestershire, LE11 3TU, UK.
Institute for Resilient Regions, University of Southern Queensland, Springfield, Australia.
BMC Public Health. 2018 Jun 18;18(1):753. doi: 10.1186/s12889-018-5698-9.
Screen-time and unhealthy dietary behaviours are highly pervasive in young children and evidence suggests that these behaviours often co-occur and are associated. Identifying clusters of unhealthy behaviours, and their influences early in childhood, can assist in the development of targeted preventive interventions. The purpose of this study was to examine the sociodemographic, behavioural, and home physical environmental correlates of co-occurring screen-time and unhealthy eating behaviours and to assess the clustering of screen-time and unhealthy dietary behaviours in young children.
Parents of 126 children, from the UK, aged 5-6 years (49% boys) completed a questionnaire which assessed their child's screen-time (ST), fruit and vegetable (FV), and energy-dense (ED) snack consumption. Categories of health behaviours were created based on frequencies of children meeting recommendations for FV and ST and median splits of frequencies for ED snacks. Parents reported on their own behaviours (ST, FV, and ED snack consumption), how often they ate meals and watched TV with their child, and on the availability and accessibility of foods within the home. An observed over expected ratio (O/E) was used to assess behavioural clustering. Multivariable multinomial logistic regression was used to examine correlates of behaviour patterns.
Approximately 25% of children had two or three health risk behaviours. Correlates consistently associated with clusters included parental income, eating meals at the TV, parental ST and ED snack food consumption, and home availability of ED snack foods. Observed over expected ratios were close to 1 and ranged from 0.78 to 1.43. The three-risk behaviour combination of insufficient FV consumption, high ED snack consumption, and excessive ST occurred more frequently than expected (1.23 (95% CI 0.89, 1.58)).
ST and unhealthy dietary behaviours cluster in children as young as 5 years of age and parents' own behaviours appear to be important influencing factors. Further research into the development of behavioural clustering in young children to identify and further understand the mechanisms underlying the synergy among health behaviours is needed. Feasibility interventions promoting reductions in both screen-time and unhealthy dietary behaviours reciprocally, while simultaneously focusing on changing parental behaviours, are warranted.
屏幕时间和不健康的饮食行为在幼儿中非常普遍，有证据表明这些行为经常同时发生且相互关联。识别不健康行为的聚类及其在儿童早期的影响，可以帮助制定有针对性的预防干预措施。本研究的目的是探讨社会人口统计学、行为和家庭物理环境与同时发生的屏幕时间和不健康饮食行为的相关性，并评估幼儿中屏幕时间和不健康饮食行为的聚类情况。
来自英国的 126 名 5-6 岁儿童（49%为男孩）的父母完成了一份问卷，该问卷评估了他们孩子的屏幕时间（ST）、水果和蔬菜（FV）以及高能量零食（ED）的摄入量。根据儿童满足 FV 和 ST 建议的频率以及 ED 零食频率的中位数分割，创建了健康行为的类别。父母报告了自己的行为（ST、FV 和 ED 零食消费）、与孩子一起吃饭和看电视的频率，以及家中食物的供应和可及性。使用观察到的超过预期的比值（O/E）来评估行为聚类。多变量多项逻辑回归用于检查行为模式的相关性。
大约 25%的儿童有两种或三种健康风险行为。与聚类一致相关的因素包括父母收入、在电视前吃饭、父母的 ST 和 ED 零食消费以及家庭 ED 零食供应。观察到的超过预期的比值接近 1，范围从 0.78 到 1.43。摄入不足的 FV、高 ED 零食消费和过度 ST 这三种风险行为的组合比预期更频繁（1.23（95%CI 0.89,1.58））。
ST 和不健康的饮食行为在 5 岁的儿童中就已经存在聚类，父母自身的行为似乎是重要的影响因素。需要进一步研究幼儿行为聚类的发展，以识别和进一步了解健康行为之间协同作用的机制。有必要开展可行性干预措施，以互惠的方式减少屏幕时间和不健康的饮食行为，同时注重改变父母的行为。
