Hashemi Ladan, Ghasemi Maryam, Schlichting Deborah, Pirouzi Maryam, Grant Cameron, Swinburn Boyd
Violence and Society Centre, School of Policy and Global Affairs, City St George's, University of London, London, United Kingdom.
School of Population Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
Eur J Public Health. 2025 Feb 1;35(1):114-120. doi: 10.1093/eurpub/ckae169.
Family screen use rules (FSRs) could plausibly protect against the development of childhood obesity, although the mechanisms underlying these protective effects remain largely unexplored. This research aimed to investigate prospectively the associations between exposure to FSRs at age 24 months, obesogenic behaviours (excessive screen time and short sleep duration) at age 45 months, and obesity at age 54 months. Additionally, a model proposing the mediating role of obesogenic behaviours in the association between FSRs and childhood obesity was tested. Data were obtained from 5733 children and their mothers participating in the 'Growing Up in New Zealand' study. Logistic regressions examined the association between three FSRs (rules on quality, quantity and timing of screen time, and different numbers of FSRs), obesogenic behaviours, and childhood obesity. Structural equation modelling (SEM) was applied to assess the potential mediating roles of obesogenic behaviours in the association between FSRs and zBMI. Neither exposure to individual nor all three FSRs was significantly associated with lower odds of obesity. However, protective effects of FSRs were observed concerning obesogenic behaviours. Exposure to individual or all three FSRs correlated with reduced odds of not meeting screen time and sleep duration recommendations. SEM analysis indicated no direct association between FSRs and zBMI; nevertheless, a significant indirect association was identified through the mediation of obesogenic behaviours. These findings suggest the potential benefits of promoting the adoption of FSRs as a promising population-based strategy to enhance child health behaviours and mitigate the risk of childhood obesity.
家庭屏幕使用规则（FSRs）可能会预防儿童肥胖的发生，尽管这些保护作用背后的机制在很大程度上仍未得到探索。本研究旨在前瞻性地调查24个月大时接触FSRs、45个月大时的致肥胖行为（屏幕时间过长和睡眠时间短）与54个月大时肥胖之间的关联。此外，还测试了一个提出致肥胖行为在FSRs与儿童肥胖之间关联中起中介作用的模型。数据来自参与“新西兰成长”研究的5733名儿童及其母亲。逻辑回归分析了三种FSRs（屏幕时间的质量、数量和时间规则，以及不同数量的FSRs）、致肥胖行为和儿童肥胖之间的关联。应用结构方程模型（SEM）来评估致肥胖行为在FSRs与zBMI之间关联中的潜在中介作用。接触单个或所有三种FSRs均与较低的肥胖几率无显著关联。然而，观察到FSRs对致肥胖行为有保护作用。接触单个或所有三种FSRs与未达到屏幕时间和睡眠时间建议的几率降低相关。SEM分析表明FSRs与zBMI之间无直接关联；然而，通过致肥胖行为的中介作用发现了显著的间接关联。这些发现表明，推广采用FSRs作为一种有前景的基于人群的策略，以增强儿童健康行为并降低儿童肥胖风险具有潜在益处。
