Division of Metabolic and Nutritional Medicine, Department of Pediatrics, Dr. von Hauner Children's Hospital, University Hospital, LMU, Munich, Germany.
Neonatal Intensive Care Unit, Children's Memorial Health Institute, Warsaw, Poland.
PLoS One. 2020 Mar 2;15(3):e0229708. doi: 10.1371/journal.pone.0229708. eCollection 2020.
In view of the current obesity epidemic, studies focusing on the interplay of playing outside (PO), screen time (ST) and anthropometric measures in preschool age are necessary to guide evidence-based public health planning. We therefore investigated the relationship between average time spent PO and ST from the ages 3 to 6 years and anthropometric measures at 6 years of age.
PO and ST of 526 children of the European Childhood Obesity Project (CHOP) were annually assessed by questionnaire from 3 until 6 years of age. Body weight, waist circumference and height were measured at 3 and 6 years of age to calculate Body-Mass-Index z-Scores (zBMI) and waist-to-height ratio (WTH). Linear, logistic and quantile regressions were used to test whether average time spent PO and ST in the 4 year period had an effect on anthropometric measures at age 6 years.
Longer daily ST was associated with a higher zBMI (P = 0.002) and WTH (P = 0.001) at 6 years of age. No significant associations were found for time spent PO. Each additional hour of average ST during the 4 year period resulted in a 66% higher risk of having a zBMI score over 1 (P < 0.001) and almost twice the risk (94% higher risk) of having an zBMI score over 2 (P < 0.001) at 6 years.
Excessive ST during preschool age is a risk factor for increased zBMI at 6 years, regardless of time spent PO. Reducing high levels of ST during preschool age, for e.g. at least 1h per week, could help preventing childhood obesity.
鉴于当前肥胖症的流行，有必要研究学龄前儿童户外活动（PO）、屏幕时间（ST）和人体测量指标之间的相互作用，以指导基于证据的公共卫生规划。因此，我们调查了 3 至 6 岁期间平均 PO 时间和 ST 时间与 6 岁时人体测量指标之间的关系。
欧洲儿童肥胖项目（CHOP）的 526 名儿童的 PO 和 ST 每年通过问卷进行评估，从 3 岁到 6 岁。3 岁和 6 岁时测量体重、腰围和身高，以计算体重指数 z 分数（zBMI）和腰高比（WTH）。线性、逻辑和分位数回归用于检验 4 年内平均 PO 和 ST 时间是否对 6 岁时的人体测量指标有影响。
每天 ST 时间较长与 6 岁时 zBMI（P = 0.002）和 WTH（P = 0.001）较高相关。PO 时间与 zBMI 和 WTH 之间没有显著关联。在 4 年期间，平均每天增加 1 小时的 ST 会使 zBMI 超过 1 的风险增加 66%（P < 0.001），zBMI 超过 2 的风险增加近两倍（风险增加 94%）（P < 0.001）。
学龄前儿童过度 ST 是 6 岁时 zBMI 增加的一个危险因素，而与 PO 时间无关。减少学龄前儿童的高水平 ST，例如每周至少 1 小时，可能有助于预防儿童肥胖。
