Department of Pediatrics (MR Lutz and EM Perrin), Johns Hopkins University School of Medicine, Baltimore, Md.
Department of Pediatrics (CJ Orr and KB Flower), University of North Carolina, Chapel Hill.
Acad Pediatr. 2024 Jul;24(5):741-747. doi: 10.1016/j.acap.2023.09.019. Epub 2023 Oct 5.
While several studies examine the relationship between screen time and dietary practices in children and teenagers, there is limited research in toddlers. This study evaluates the association between television (TV) exposure and dietary practices in 2-year-old children.
We conducted a cross-sectional, secondary data analysis from the Greenlight Intervention Study. Toddlers' daily TV watching time, mealtime TV, and dietary practices were assessed by caregiver report at the 24-month well-child visit. Separate regression models were used and adjusted for sociodemographic/household characteristics and clinic site.
Five hundred and thirty-two toddlers were included (51% Latino; 30% non-Latino Black; 59% ≤$20,000 annual household income). Median daily TV watching time was 42 minutes (interquartile range: 25, 60); 25% reported the TV was "usually on" during mealtimes. After adjustment, toddlers who watched more TV daily had higher odds of consuming sugar-sweetened beverages, fast food, and more junk food; those watching less TV had higher odds of consuming more fruits/vegetables. Those with the TV "usually on" during mealtimes were more likely to consume sugar-sweetened beverages (aOR 3.72 [95% confidence interval {CI} 2.16-6.43]), fast food (aOR 2.83 [95%CI 1.54-5.20]), and more junk food (aOR 4.25 [95%CI 2.71-6.65]).
Among toddlers from primarily minoritized populations and of lower socioeconomic status, those who watched more TV daily and usually had the TV on during meals had significantly less healthy dietary practices, even after adjusting for known covariates. This study supports the current American Academy of Pediatrics screen time guidelines and underscores the importance of early counseling on general and mealtime TV.
虽然有几项研究考察了儿童和青少年的屏幕时间与饮食行为之间的关系，但针对 2 岁幼儿的研究有限。本研究评估了 2 岁儿童的电视（TV）暴露与饮食行为之间的关联。
我们对 Greenlight 干预研究进行了横断面、二次数据分析。在 24 个月的儿童健康检查时，通过照顾者报告评估了幼儿的每日 TV 观看时间、进餐时 TV 观看情况和饮食行为。使用单独的回归模型进行分析，并根据社会人口统计学/家庭特征和诊所地点进行调整。
共纳入 532 名幼儿（51%拉丁裔；30%非拉丁裔黑人；59%家庭年收入≤20000 美元）。每日 TV 观看时间中位数为 42 分钟（四分位距：25，60）；25%的幼儿报告在进餐时间通常开着电视。调整后，每日观看更多电视的幼儿更有可能饮用含糖饮料、快餐和更多垃圾食品；观看电视较少的幼儿更有可能食用更多的水果/蔬菜。进餐时电视通常开着的幼儿更有可能饮用含糖饮料（优势比 3.72[95%置信区间{CI}2.16-6.43]）、快餐（优势比 2.83[95%CI 1.54-5.20]）和更多垃圾食品（优势比 4.25[95%CI 2.71-6.65]）。
在主要来自少数族裔和社会经济地位较低的幼儿中，每天观看更多电视且通常在进餐时开着电视的幼儿，其饮食行为明显不够健康，即使在调整了已知协变量后也是如此。本研究支持当前美国儿科学会的屏幕时间指南，并强调了对一般和进餐时电视进行早期咨询的重要性。
