Do weight status and television viewing influence children's subsequent dietary changes? A National Longitudinal Study in the United States.

Abstract

It is unknown how children's dietary changes would vary by overweight/obese status and length of television (TV) viewing. This study examined whether US children's weight status and TV-viewing duration influenced their subsequent dietary behavioral changes. A national representative sample of the Early Childhood Longitudinal Study-Kindergarten Cohort were followed between 5th and 8th grades during 2004-2007 (N=7720). Children's daily TV-viewing hour and weight status were measured at 5th grade. Children reported their dietary behaviors at the 5th and 8th grades, including fruit/vegetable consumption ⩾5 times per day (five-a-day), daily fast-food and soft drink consumption. Logistic models were used to estimate the odds ratio (OR) of dietary behavioral changes by children's baseline weight status and TV-viewing duration. Gender and race/ethnicity differences in the ORs were examined. Sampling weight and design effect were considered for the analysis. Among those without five-a-day at 5th grade, overweight/obese children were more likely to develop the five-a-day behavior at 8th grade than normal-weight children (for overweight: OR=1.65, 95% confidence interval (CI)=1.14-2.39; obese: OR=1.35, 95% CI=0.81-2.23). Among girls, overweight group was more likely to develop eating vegetable ⩾3 times per day than normal-weight group, but 1 more h day(-1) of TV viewing at baseline was associated with lower odds of developing eating vegetable ⩾3 times per day. Overweight/obese black and Hispanic children were significantly more likely to develop five-a-day than their normal-weight counterparts. TV viewing did not show modification effect on the association between weight status and subsequent dietary changes. Overweight/obese children were more likely to improve their subsequent fruit and vegetable consumption than normal-weight children, but TV viewing's independent relationship with dietary changes may counteract the weight status-associated dietary improvement.