Household factors, family behavior patterns, and adherence to dietary and physical activity guidelines among children at risk for obesity

Abstract

Objective: To describe the proportion of children adhering to recommended physical activity and dietary guidelines, and examine demographic and household correlates of guideline adherence.

Design: Cross-sectional (pre-randomization) data from a behavioral intervention trial designed to prevent unhealthy weight gain in children.

Participants: A total of 421 children (aged 5-10 years) at risk for obesity (body mass index percentile, 70-95).

Main outcomes measured: Physical activity (accelerometry), screen time (parent survey), and fruit and vegetable and sugar-sweetened beverage intake (24-hour dietary recall).

Analysis: Proportions meeting guidelines were calculated. Logistic regression examined associations between demographic and household factors and whether children met recommended guidelines for (1) physical activity (≥ 60 min/d), (2) screen time (≤ 2 h/d), (3) fruit and vegetable intake (≥ 5 servings/d), and (4) sugar-sweetened beverage avoidance.

Results: Few children met more than 1 guideline. Only 2% met all 4 recommended guidelines and 19% met none. Each guideline had unique sociodemographic and domain-specific household predictors (ie, availability of certain foods and beverages, media, and active play and exercise equipment).

Conclusions and implications: Families equipped to promote healthy child behavior patterns in 1 activity or dietary domain may not be in others. Results have implications for the development of interventions to affect children's weight-related behaviors and growth trajectories.

Trial registration: ClinicalTrials.gov NCT01084590.

Keywords: child; diet; guidelines; home environment; physical activity.

Copyright © 2015 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

Figures

Figure 1. Percentage of children meeting recommended dietary and activity guidelines

Note: FV= fruit/vegetable intake; SSB = sugar-sweetened beverage intake; PA = physical activity; ScT = screen time; None = meeting none of these activity and dietary guidelines. Figure includes those who provided valid accelerometry, reliable dietary intake, and screen time surveys (n=302).

Figure 2

Figure 2a. Percentage of children meeting recommended guidelines for physical activity as a function of age and sex Figure 2b. Percentage of children meeting recommended guidelines for physical activity as a function of age and BMI percentile