Household Routines and Obesity in US Preschool-Aged Children

OBJECTIVE: To determine the association between the prevalence of obesity in preschool-aged children and exposure to 3 household routines: regularly eating the evening meal as a family, obtaining adequate sleep, and limiting screen-viewing time. METHODS: We conducted a cross-sectional analysis of a nationally representative sample of similar to 8550 four-year-old US children who were assessed in 2005 in the Early Childhood Longitudinal Study, Birth Cohort. Height and weight were measured. We assessed the association of childhood obesity (BMI >= 95th percentile) with 3 household routines: regularly eating the evening meal as a family (>5 nights per week); obtaining adequate nighttime sleep on weekdays (>= 10.5 hours per night); and having limited screen-viewing (television, video, digital video disk) time on weekdays (<= 2 hours/day). Analyses were adjusted for the child's race/ethnicity, maternal obesity, maternal education, household income, and living in a single-parent household. RESULTS: Eighteen percent of children were obese, 14.5% were exposed to all 3 routines, and 12.4% were exposed to none of the routines. The prevalence of obesity was 14.3% (95% confidence interval [CI]: 11.3%-17.2%) among children exposed to all 3 routines and 24.5% (95% CI: 20.1%-28.9%) among those exposed to none of the routines. After adjusting for covariates, the odds of obesity associated with exposure to all 3, any 2, or only 1 routine (compared with none) were 0.63 (95% CI: 0.46-0.87), 0.64 (95% CI: 0.47-0.85), and 0.84 (95% CI: 0.63-1.12), respectively. CONCLUSIONS: US preschool-aged children exposed to the 3 household routines of regularly eating the evening meal as a family, obtaining adequate nighttime sleep, and having limited screen-viewing time had an similar to 40% lower prevalence of obesity than those exposed to none of these routines. These household routines may be promising targets for obesity-prevention efforts in early childhood. Pediatrics 2010;125:420-428