Associations of obesogenic behaviors in mothers and obese children participating in a randomized trial

Relatively little research has assessed the association between obesogenic behaviors in parents and their children. The objective of the present analysis was to examine cross-sectional associations in television (TV)/video viewing, sugar-sweetened beverage intake, and fast food intake between mothers and their preschool aged children. We studied baseline data among 428 participants in High Five for Kids, a randomized controlled trial of behavior change among overweight and obese children of ages 2-6.9 years. The main exposures were whether mothers viewed TV/videos <1 h/day, drank <1 serving/day of sugar-sweetened beverages, and ate fast food <1 time/week. The main outcomes were whether children met these goals for the same behaviors. Using multivariate logistic regression adjusted for maternal and child characteristics, we estimated odds ratios of children meeting the behavioral goals. The majority of mothers ate fast food <1 time/week (73%) and drank <1 serving/day of sugar-sweetened beverages (73%), while few mothers viewed <1 h/day of TV/videos (31%). Most children met the fast food goal (68%), but not the goals for sugar-sweetened beverages (31%) or TV/video viewing (13%). In adjusted models, the odds ratios for a child meeting the goal were 3.2 (95% confidence interval (CI) 1.7, 6.2) for TV/video viewing, 5.8 (95% CI 2.8, 12.0) for sugar-sweetened beverage intake, and 17.5 (95% CI 9.8, 31.2) for fast food intake if their mothers met the goal for the same behavior. Obesogenic behaviors of mothers and preschool aged children were strongly associated. Our findings lend support to obesity prevention strategies that target parental behavior and the family environment.     

Ethnic Differences in Physical Activity and Inactivity Patterns and Overweight Status

Objective: To examine the relationship between physical activity and inactivity patterns and overweight in U.S. adolescents using baseline and 1-year change in activity and inactivity data. Research Methods and Procedures: Nationally representative data from 12,759 participants (6997 non-Hispanic whites, 2676 non-Hispanic blacks, 2185 Hispanics, and 901 Asians) in the National Longitudinal Study of Adolescent Health (1995 and 1996). Data on moderate to vigorous and low-intensity physical activity, TV/video viewing, and video game/computer use were obtained from questionnaires. Multivariate models assessed the association of overweight (body mass index ≥ 95th percentile Centers for Disease Control and Prevention/National Center for Health Statistics 2000 curves) with initial (and 1-year change) activity and inactivity levels, controlling for age, ethnicity, socioeconomic status, urban residence, cigarette smoking, and region of residence. Results: Overweight prevalence was positively associated with high level TV/video viewing among white boys (odds ratio [OR] = 1.52; 95% confidence interval [1.08 to 2.14]) and girls (OR = 2.45 [1.51 to 3.97]). The odds of overweight decreased with high levels of moderate to vigorous physical activity among white boys (OR = 0.81 [0.76 to 0.87]), non-Hispanic black boys (OR = 0.86 [0.76 to 0.98]) and girls (OR = 0.88 [0.78 to 0.99]), and Hispanic boys (OR = 0.90 [0.83 to 0.97]) and girls (OR = 0.91 [0.84 to 0.99]). Discussion: Predicted probabilities generated from the logistic regression models, which examined the experimental effects of altering hours of TV/video viewing and bouts of moderate to vigorous physical activity, show lower overweight among adolescents who watched less TV per week combined with frequent moderate to vigorous physical activity than those who watched more TV per week combined with fewer bouts of weekly moderate to vigorous physical activity. Predicted probabilities suggest important sex and ethnic differences in these associations.     

Television viewing and long-term weight maintenance: results from the National Weight Control Registry

Objective: To examine the role of television (TV) viewing in long‐term maintenance of weight loss. Research Methods and Procedures: All subjects (N = 1422) were enrolled in the National Weight Control Registry (NWCR), a national sample of adults who have maintained a minimum weight loss of 13.6 kg for at least 1 year. Participants self‐reported the average number of hours of weekly TV viewing at entry into the NWCR and at a 1‐year follow‐up. Cross‐sectional and prospective analyses were performed to determine the frequency of TV viewing and the extent to which TV viewing was independently associated with weight regain over the 1‐year of follow‐up. Results: A relatively high proportion (62.3%) of participants reported watching 10 or fewer hours of TV per week on entry in the NWCR. More than one third of the sample (36.1%) reported watching <5 h/wk, whereas only 12.4% watched ≥21 h/wk, which contrasts markedly from the national average of 28 hours of TV viewing per week reported by American adults. Both baseline TV viewing (p ≤ 0.02) and increases in TV viewing (p ≤ 0.001) over the follow‐up were significant predictors of 1‐year weight regain, independent of physical activity and dietary behaviors. Discussion: Individuals who are successful at maintaining weight loss over the long term are likely to spend a relatively minimal amount of time watching TV.     

Primary Care Providers' Knowledge,Practices, and Perceived Barriers to the Treatment and Prevention of Childhood Obesity

This study evaluated primary care providers' (PCPs, pediatricians, and nurse practitioners) knowledge, current practices, and perceived barriers to childhood obesity prevention and treatment, with an emphasis on first‐year well‐child care visits. A questionnaire was distributed to 192 PCPs in the primary care network at The Children's Hospital of Philadelphia (CHOP) addressing (i) knowledge of obesity and American Academy of Pediatrics (AAP) guidelines, (ii) anticipatory guidance practices at well visits regarding nutrition and exercise, and (iii) perceived barriers to childhood obesity treatment and prevention. Eighty pediatricians and seven nurse practitioners responded, and a minority correctly identified the definition (26%) and prevalence (9%) of childhood overweight and AAP guidelines for exercise (39%) and juice consumption (44%). Most PCPs (81%) spent 11–20 min per well visit during the first 2 years, and 79% discussed diet, nutrition, and exercise for ≥3 min. Although >95% of PCPs discussed juice, fruits and vegetables, sippy cups, and finger foods during the first year, over 35% never discussed fast food, TV, or candy, and 55% never discussed exercise. Few rated current resources as adequate to treat or prevent childhood obesity. Over 90% rated the following barriers for obesity prevention and treatment as important or very important: parent is not motivated, child is not motivated, parents are overweight, families often have fast food, watch too much TV, and do not get enough exercise. In conclusion, there is much room to improve PCPs' knowledge of obesity and AAP guidelines. Although PCPs rate fast‐food consumption, TV viewing, and lack of exercise as important treatment barriers, many never discussed these topics during the first year.     

Away-from-home food intake and risk for obesity: examining the influence of context

Objective: This study examined sociodemographic and cultural determinants of away‐from‐home food consumption in two contexts and the influence of frequency of away‐from‐home food consumption on children's dietary intake and parent and child weight status. Methods and Procedures: Parents of children (N = 708) in grades K‐2 were recruited from 13 elementary schools in Southern California. Parents were asked through a questionnaire the frequency with which they eat meals away from home and the restaurant they frequented most often. The height and weight of the parents and their children were measured to calculate BMI. Results: Consuming foods at least once a week from relatives/neighbors/friends (RNF) homes was associated with children's dietary intake and children's risk for obesity. For example, children of parents with weekly or greater RNF food consumption drank more sugar‐sweetened beverages. Parents of families who ate at restaurants at least weekly reported that their children consumed more sugar‐sweetened beverages, more sweet/savory snacks, and less water compared with families who did not frequent restaurants this often. The type of restaurant visited did not affect diet intake or obesity. More acculturated families exhibited less healthy dietary behaviors than less acculturated families. Discussion: Restaurants remain an important setting for preventing child and adult obesity, but other settings outside the home need to be considered in future intervention research. This may especially involve eating in the homes of RNF.     

Association of Family Environment with Children's Television Viewing and with Low Level of Physical Activity

Objective: This study examined associations between the family environment and children's television (TV) viewing and likelihood of being low‐active. Research Methods and Procedures: In 2001, children were recruited from 19 primary schools in Melbourne, Australia. Parents completed a questionnaire about their child's TV viewing and the family environment. Children also completed a questionnaire and wore an accelerometer for 8 days. Movement counts were used to identify low‐active children (lowest quartile). Data were analyzed in May 2004. Results: The sample consisted of 878 children (mean age = 11.5 ± 0.6 yrs). Multiple logistic regression revealed that socioeconomic status [adjusted odds ratios (AOR) = 0.4 boys], frequency families watched TV together (AOR = 2.0 boys), mothers’ (AOR = 1.8 boys; AOR = 2.5 girls) and fathers’ (AOR = 2.6 boys; AOR = 2.8 girls) TV viewing, and rules prohibiting TV during mealtimes (AOR = 0.6 boys; AOR = 0.6 girls) related to children watching TV ≥2 h/d. Variables associated with low‐level physical activity included self‐reported enjoyment of Internet use (AOR = 1.7 boys) and preference for watching TV (AOR = 2.3 girls), perception that mother uses computer a lot (AOR = 1.9 boys) and likes using the computer (AOR = 0.6 girls), fathers’ reported computer/electronic games use (AOR = 1.7 girls), frequency families used computer together (AOR = 0.4 girls), rules that TV viewing must be supervised (AOR = 1.9 boys; AOR = 0.6 girls), and having pay TV (AOR = 0.6 boys) and electronic games at home (AOR = 2.6 boys). Discussion: These findings suggest that the relationships between the family environment and TV viewing and low‐level activity are complex and that these behaviors are distinct.     

Physical Activity,TV Viewing,and Weight in U.S. Youth: 1999 Youth Risk Behavior Survey

Objective: To examine the relationship between physical activity, TV watching, and weight in U.S. youth ages 14 to 18 years. Research Methods and Procedures: Data from a nationally representative sample of 15,143 U.S. high‐school students participating in the 1999 Centers for Disease Control and Prevention (CDC) Youth Risk Behavior Survey were examined. Prevalence rates of participation in moderate physical activity (MPA), vigorous physical activity (VPA), and television watching (TV) were determined. The association between MPA, VPA, TV and the body mass index (BMI) and overweight status (BMI ≥85th percentile of age‐ and sex‐specific CDC/National Center for Health Statistics reference values) were examined by analysis of covariance and logistic regression. Results: Overall, 45% reported participating in MPA ≥3 d/wk, 65% reported participating in VPA ≥3 d/wk, and 25% reported watching TV ≥4 h/school day. Boys reporting six to seven bouts of MPA had a significantly lower BMI compared with boys reporting three to five or less than two. The mean BMI differed significantly between the lowest and highest levels of MPA groups in girls. The mean BMI was significantly lower in the highest VPA group compared with the other two groups in both sexes. There was a significant graded response for BMI across all levels of TV. Decreased levels of MPA and 3 to 4 days of VPA were significantly associated with an increased risk of overweight in boys when compared with those engaging in 6 to 7 d/wk (odds ratio = 1.26 to 1.37). A graded response existed between TV and overweight in both sexes. Boys and girls were ～20% to 25% less likely to be classified as overweight if they reported 2 to 3 hours of TV per day and ～40% less likely to be classified as overweight if they reported ≤1 hour of TV per day compared with those who watched ≥4 hours of TV. In general, youth who engaged in less physical activity watched more TV per week. Discussion: Increased levels of physical activity are associated with a lower BMI and less TV watching. However, the relationship between TV watching and weight status is more pronounced.     

Association between television in bedroom and adiposity throughout adolescence

Objective: The objective was to determine if having a television (TV) in the bedroom is associated with physical activity (PA), TV/video viewing, and adiposity throughout adolescence. Research Methods and Procedures: Longitudinal data (September 2002 through June 2005) were analyzed of 379 initially 12‐year‐old French adolescents participating as controls in the Intervention Centered on Adolescents’ Physical activity and Sedentary behavior (ICAPS). Presence of a TV set in the bedroom (TV_bedroom) and leisure activities were obtained by questionnaire. There was annual assessment of BMI, waist circumference, and body fat by bioimpedance. Results: In boys but not girls, baseline TV_bedroom was associated with higher TV/video viewing over time [odds ratio (OR) of high TV/video = 1.87; 95% confidence interval, 1.2 to 2.8] and less no‐sport club participation (OR = 0.59; 95% confidence interval, 0.35 to 1.0). Both boys and girls with baseline TV_bedroom had lower reading time (p < 0.0001 in boys; p = 0.04 in girls), while PA did not differ according to TV_bedroom for boys or for girls. For boys only, baseline TV_bedroom was associated with higher BMI (mean BMI over time 20.5 ± 0.5 vs. 19.0 ± 0.5 kg/m²; p = 0.001), waist circumference (70.9 ± 0.9 vs. 67.2 ± 0.8 cm; p < 0.001), and body fat (15.9 ± 0.9% vs. 13.5 ± 0.9%; p < 0.001), without interaction with time. These relationships remained significant after adjustment for socioeconomic status. TV/video viewing explained 26%, 42%, and 36% of the relationships of TV_bedroom with BMI, waist circumference, and body fat, respectively, while addition of other leisure activities in the models only marginally reduced the effects. Discussion: These results suggest the importance of keeping TV out of an adolescent's bedroom from an obesity prevention perspective but show gender differences.     

Correlates of Participation in a Pediatric Primary Care‐Based Obesity Prevention Intervention

The purpose of this study was to examine the correlates of participation in a childhood obesity prevention trial. We sampled parents of children recruited to participate in a randomized controlled trial. Eligible children were 2.0–6.9 years with BMI ≥95th percentile or 85th to <95th percentile if at least one parent was overweight. We attempted contact with parents of children who were potentially eligible. We recruited 475 parents via telephone following an introductory letter. We also interviewed 329 parents who refused participation. Parents who refused participation (n = 329) did not differ from those who participated (n = 475) by number of children at home (OR 0.94 per child; 95% CI: 0.77–1.15) or by child age (OR 1.07 per year; 95% CI: 0.95–1.20) or sex (OR 1.06 for females vs. males; 95% CI: 0.80–1.41). After multivariate adjustment, parents who were college graduates vs. <college graduates were less likely to participate (OR 0.62; 95% CI: 0.46–0.83). In addition, parents were less likely (OR 0.41; 95% CI: 0.31–0.56) to participate if their child was overweight vs. obese. Among the 115 refusers with obese children, 21% cited as a reason for refusal that their children did not have a weight problem, vs. 30% among the 214 refusers with overweight children. In conclusion, parents of preschool‐age children with a BMI 85–95th%ile are less likely to have their children participate in an obesity prevention trial than parents of children with BMI >95th%ile. One reason appears to be that they less frequently consider their children to have a weight problem.     

Parental Weight Status and Girls’ Television Viewing,Snacking, and Body Mass Indexes

Objective: The purpose of this study was to examine whether television viewing (TVV) provides a context for patterns of snacking fostering overweight in young girls from overweight and non‐overweight families. Research Methods and Procedures: Participants were 173 non‐Hispanic white girls and their parents from central Pennsylvania, assessed longitudinally when girls were 5, 7, and 9 years old. Path analysis was used to test patterns of relationships among girls’ TVV, snacking while watching television, snacking frequency, fat intake from energy‐dense snack food, and girls’ increase in body mass index (BMI) from age 5 to 9. Results: In both overweight and non‐overweight families, girls who watched more television consumed more snacks in front of the television. In families where neither parent was overweight, television viewing was the only significant predictor of girls’ increase in BMI. In families where one or both parents were overweight, girls who watched more television snacked more frequently, and girls who snacked more frequently had higher intakes of fat from energy‐dense snacks, which predicted their increase in BMI from age 5 to 9. TVV did not directly predict girls’ increase in BMI in girls from overweight families. Discussion: The results of this study support and extend previous findings that have shown that excessive television viewing and snacking patterns are risk factors for the development of overweight in children; however, patterns of relationships may differ based on parental weight status. For overweight families, TVV may provide a context for excessive snack consumption, in addition to inactivity.     

Television Viewing Is Not Predictive of BMI in Black and Hispanic Young Adult Females

Previous studies have observed that television (TV) viewing is predictive of obesity and weight gain. We examined whether the cross‐sectional association between TV viewing and BMI varied by racial/ethnic subgroups among young women in Wave III (collected in 2001–2002) of the National Longitudinal Study of Adolescent Health. We used multivariate linear regression to examine the relationship between TV viewing and BMI among 6,049 females while controlling for sociodemographic and health attributes. We stratified the sample by race/ethnicity to better understand the association between TV viewing and BMI across different groups. Black and Hispanic females had higher BMIs (black: 28.5 kg/m², Hispanic: 27.3 kg/m², white: 26.0 kg/m²) than white females, while black females reported higher numbers of hours spent watching TV (black: 14.7 h/week, Hispanic: 10.6 h/week, white: 11.2 h/week) when compared to their white and Hispanic peers. TV viewing was positively associated with BMI (β = 0.79, P = 0.003 for 8–14 vs. ≤7 h/week; β = 1.18, P = 0.01 for >14 vs. ≤7 h/week) independent of race/ethnicity, age, maternal education, history of pregnancy, parental obesity, and household income. However, in models stratified by race/ethnicity, increased TV viewing was associated with increased BMI only among white females; TV viewing was not predictive of higher BMI in black or Hispanic young adult females. Among black and Hispanic females, counseling to decrease TV viewing may be important but insufficient for promoting weight loss.     

Youths' perceptions of overweight-related prevention counseling at a primary care visit

Objective: We examined youths’ report of receiving specific overweight‐related preventive counseling and perceived readiness to adopt nutrition and physical activity behaviors recommended by their clinicians. Research Methods and Procedures: We surveyed 324 youth 10 to 18 years old who had a physical exam within the past year. The survey included questions on height, weight, race/ethnicity, mother's education, and topics they discussed with their clinician during their visit. We used multivariable analyses to examine whether weight status and sociodemographic characteristics were predictors of which youth received counseling from their clinicians and which youth were ready to change. Results: The mean (standard deviation) age of participants was 13.7 (1.8) years; 54% were black, and 22% were Hispanic. Less than one‐half of participants reported discussing sugar‐sweetened beverages [38%; 95% confidence interval (CI), 32% to 43%] or television viewing (41%; 95% CI, 36% to 47%) with their clinicians. In multivariable analyses adjusting for participant's age, sex, race/ethnicity, overweight status, and mother's educational attainment, youth whose mothers lacked education beyond high school were significantly less likely to report receiving counseling on any overweight‐specific topic including television viewing [odds ratio (OR), 0.46; 95% CI, 0.27, 0.79], sugar‐sweetened beverage (OR, 0.47; 95% CI, 0.28, 0.80), and fast food consumption (OR, 0.54; 95% CI, 0.32, 0.92). In addition, youth 10 to 14 years old were more likely than those 15 to 18 years old to report they would try to change their television viewing (OR, 4.10; 95% CI, 1.78, 9.44) if recommended by their clinician. Discussion: Youth report infrequently receiving counseling on specific overweight prevention topics during routine primary care visits. Our findings suggest that greater efforts may be needed to reduce social class disparities in overweight prevention counseling and that counseling to prevent overweight in youth may be more acceptable to younger children.     

Relationship of Attitudes Toward Fast Food and Frequency of Fast‐food Intake in Adults

The purpose of the study was to examine the association between attitudes toward fast food and the frequency of fast‐food intake in adults. This study is a cross‐sectional evaluation of random digit‐dial telephone surveys to identify patterns of eating away from home and attitudes toward it. Participants included 530 adults (94% white, 65% women, 70% married, 42% with college educated). Attitudes toward fast food was measured using an 11‐item, 4‐dimensional scale: perceived convenience of fast food (α = 0.56); fast food is fun and social (α = 0.55); fast food perceived as unhealthful (α = 0.45); and dislike toward cooking (α = 0.52). Frequency of fast‐food intake was found to be significantly associated with age (odds ratios (OR) = 0.981, P = 0.001), gender (men > women), and marital status of the participants (single > married/partnered and divorced/separated/widowed). Additionally, frequency of fast‐food intake was also found to be significantly associated with perceived convenience of fast food (OR = 1.162, P < 0.001) and dislike toward cooking (OR = 1.119, P < 0.001) but not with perceived unhealthfulness of fast food (OR = 0.692, P = 0.207). These findings suggest public education regarding the unhealthfulness of fast food may not influence fast food consumption. Interventions targeting the issue of convenience and quick or efficient preparation of nutritious alternatives to fast food could be more promising.     

The Obesogenic Quality of the Home Environment: Associations with Diet,Physical Activity,TV Viewing,and BMI in Preschool Children

Objectives

The home environment is thought to play a key role in early weight trajectories, although direct evidence is limited. There is general agreement that multiple factors exert small individual effects on weight-related outcomes, so use of composite measures could demonstrate stronger effects. This study therefore examined whether composite measures reflecting the ‘obesogenic’ home environment are associated with diet, physical activity, TV viewing, and BMI in preschool children.

Methods

Families from the Gemini cohort (n = 1096) completed a telephone interview (Home Environment Interview; HEI) when their children were 4 years old. Diet, physical activity, and TV viewing were reported at interview. Child height and weight measurements were taken by the parents (using standard scales and height charts) and reported at interview. Responses to the HEI were standardized and summed to create four composite scores representing the food (sum of 21 variables), activity (sum of 6 variables), media (sum of 5 variables), and overall (food composite/21 + activity composite/6 + media composite/5) home environments. These were categorized into ‘obesogenic risk’ tertiles.

Results

Children in ‘higher-risk’ food environments consumed less fruit (OR; 95% CI = 0.39; 0.27–0.57) and vegetables (0.47; 0.34–0.64), and more energy-dense snacks (3.48; 2.16–5.62) and sweetened drinks (3.49; 2.10–5.81) than children in ‘lower-risk’ food environments. Children in ‘higher-risk’ activity environments were less physically active (0.43; 0.32–0.59) than children in ‘lower-risk’ activity environments. Children in ‘higher-risk’ media environments watched more TV (3.51; 2.48–4.96) than children in ‘lower-risk’ media environments. Neither the individual nor the overall composite measures were associated with BMI.

Conclusions

Composite measures of the obesogenic home environment were associated as expected with diet, physical activity, and TV viewing. Associations with BMI were not apparent at this age.     

Weight-related behavior among adolescents: the role of peer effects

Purpose

To investigate whether social interactions in friendship networks influence the following weight-related behaviors of adolescents: exercising regularly, playing an active sport, hours of TV/Video viewing, sleeping six or fewer hours, eating breakfast on weekdays, frequency of eating at fast food restaurants, eating five servings of fruits/vegetables daily, and consuming calorie-dense snacks.

Method

Data from a nationally representative sample of adolescents are used to examine the association between peer and individual weight-related behaviors. Evidence from multivariate regression analysis controlling for an extensive list of individual- and family-level factors as well as school-level unobserved heterogeneity is obtained.

Results

We find a significant positive association between individuals'' and friends'' behaviors in terms of sports, exercise and fast food consumption. The estimated associations are robust to controls for individual- and family-level factors, unobserved heterogeneity at the school level and our attempts to account for non-random peer selection.

Conclusions

The social transmission of weight-related behaviors is a viable explanation for the spread of obesity in friendship networks documented in recent research. Traditional weight reduction interventions may be fruitfully complemented with strategies that focus on harnessing peer support to modify behaviors.     

Patterns of Overweight,Inactivity, and Snacking in Chinese Children

Objective: To examine patterns of inactivity and snacking and their relationship with overweight status in Chinese children. Research Methods and Procedures: The study population was drawn from the 1997 China Health National Survey (1385 children, ages 6 to 11 years), conducted with a representative sample from nine provinces. The 2000 Centers for Disease Control and Prevention BMI charts were used to calculate “at risk of overweight” as those above the 85th percentile. Three days of 24‐hour recall dietary data and detailed questions on physical activity and inactivity for the previous 7 days were used. Results: 9.4% of the children were classified as overweight. Weekly mean and range of hours spent watching television/videos, playing video games, studying, and in inactive transport were 5.1 (0 to 35), 0.3 (0 to 10), 4.7 (0 to 60), and 0.14 (0 to 4.2), respectively. Television/video viewing and studying did not differ in any meaningful manner between overweight and normal weight children. Snacking is inconsequential in China, comprising only 0.9% of energy intake. Discussion: Chinese children are less overweight, less inactive, and less likely to ingest calories as snacks than children in the U.S. The absence of impact of these measures of inactivity, which are below an hour per day for the average Chinese child, indicate the possible value of limiting television viewing and other types of inactivity in other countries. Modern Western‐style television programming and advertising started to come to China after 1997; therefore, extensive changes in television viewing patterns are expected to emerge.     

Reducing Portion Size Reduces Food Intake and Plate Waste

As portion size (PS) increases, so does food intake. The effect of decreasing PS on food intake in a nonlaboratory setting is unknown. This 5‐week study sought to determine whether decreasing PS resulted in decreased intake of the same food, and if so, at what point further PS reductions might lack benefit. It also assessed effects of PS reduction on food production and waste in a university all‐you‐can‐eat dining facility (DF). Subjects were primarily freshmen who regularly ate lunch at the DF, and self‐selected French fries (FF) presented in individual paper bags, portioned originally at 88 g, and decreased ～15 g/week for 3 weeks. Diners were covertly observed choosing one or more bags. Total FF production and plate waste (PW) were determined daily. Decreasing PS resulted in significant decreases in consumption per diner (P < 0.05) and PW (P < 0.05), and nonsignificant decreases in total FF consumption and production. PS was positively correlated with consumption per diner (r = 0.897, P = 0.001) and PW (r = 0.852, P = 0.001), but inversely correlated with number of diners choosing ≥2 bags (r = ?0.809, P = 0.003). Total FF production was positively correlated with PW (r = 0.728, P = 0.011). This study shows that reducing PS of a particular item in an all‐you‐can‐eat environment results in reduced intake of that food for most individuals, and that reducing PS reduces PW and food production.     

Relationship Between Self‐report and an Objective Measure of Television‐viewing Time in Adults

This study compared self‐reported television (TV)‐viewing time with an objective measure obtained by an electronic TV monitor. As part of a larger study, 40 overweight and obese adults (BMI: 31.7 ± 5.4 kg/m²; 53% obese; mean age 41.4 ± 13.0) self‐reported TV‐viewing time at study entry as the response to the question, “How many hours do you watch TV per day, on average?” Objective TV‐viewing time was measured in min/day over 3 weeks/subject using electronic monitors. Self‐reported viewing time was 4.3 ± 1.3 h/day (mean ± s.d.) (range: 3.0–8.0 h/day) vs. 4.9 ± 2.6 h/day (0.8–13.3 h/day) recorded by the electronic TV monitor. Subjects underestimated their viewing time by 0.6 ± 2.3 h/day (95% confidence interval = ?1.34, 0.13), or 4.3 h/week. Slightly over half of the subjects (58%) underestimated their viewing time; 47.5% were within 1 h/day, and 72.5% were within 2 h/day of self‐reported viewing time. Large errors were rare in this group, suggesting that a simple self‐report measure of TV time may be useful for characterizing viewing behavior, although objective measurement adds precision that may be useful in certain settings.     

Maternal feeding strategies, child eating behaviors, and child BMI in low-income African-American preschoolers

Objective: To test the hypothesis that low‐income African‐American preschool children would have a higher BMI if their mothers reported greater “restriction” and “control” in feeding and if mothers reported that children showed greater “food responsiveness” and “desire to drink.” In addition, to test whether higher maternal “pressure to eat” would be associated with lower child BMI. Research Methods and Procedures: A questionnaire was completed by 296 low‐income African‐American mothers of preschool children. It assessed three constructs on maternal feeding strategies (“restriction,” “pressure to eat,” and “control”) and two on child eating behaviors (“food responsiveness” and “desire to drink”). Children's BMI was measured, and mothers’ BMI was self‐reported. Results: The mean (standard deviation) BMI z‐score of the children was 0.34 (1.5), and 44% of the mothers were obese (BMI ≥30 kg/m²). Only maternal “pressure to eat” had a significant overall association with child BMI z‐score (r = ?0.16, p < 0.01). Both maternal “restriction” and “control” were positively associated with children's BMI z‐score in the case of obese mothers (r = 0.20, p = 0.03 and r = 0.24, p = 0.007, respectively), but this was not so in the case of non‐obese mothers (r = ?0.16, p = 0.05 and r = ?0.07, p = 0.39, respectively). Discussion: Among low‐income African Americans, the positive association between maternal restriction and control in feeding and their preschoolers’ BMI was limited to obese mothers. Relations between parent feeding strategies and child weight status in this population may differ on the basis of maternal weight status.     

The Influence of Physical Activity,Socioeconomic Status,and Ethnicity on the Weight Status of Adolescents

Objective: This study examined the effects of physical activity, television viewing, video game play, socioeconomic status (SES), and ethnicity on body mass index (BMI). Research Methods and Procedures: The sample was 2389 adolescents, 10 to 16 years of age (12.7 ± 1.0 years); 1240 (52%) females and 1149 (48%) males; 77% white and 23% African American; from rural (77%) and urban (23%) settings. BMI and skinfolds were directly assessed. All other data were obtained from questionnaires. Results: Watching television on non‐school days was related to being overweight (p < 0.005). However, when BMI analyses were adjusted for ethnicity and SES, there were no significant effects of television viewing on BMI (p > 0.061). Increased hours of video game play enhanced the risk of being overweight for both genders when analyses were adjusted for ethnicity and SES (p < 0.019). In males, participation in as little as one high‐intensity physical activity 3 to 5 days a week decreased the ethnic‐ and SES‐adjusted relative risk of being overweight (RR = 0.646; CI: 0.427 to 0.977). For females, the ethnic‐ and SES‐adjusted relative risk for being overweight was not significantly altered by physical activity. The logistic analyses further indicated the influence of low SES and African American ethnicity overshadowed any direct effect of television or videos. Discussion: Because weight status of male adolescents appears to be more related to exercise habits than to television or video game habits, increased participation in high‐intensity exercise appears to be important. For females, neither videos nor exercise habits appear to be related to risk of being overweight. However, ethnicity and SES may be important factors that can influence body weight status, while television viewing may be of some importance. Thus, programs to reduce obesity in female adolescent should focus their efforts in lower SES communities.