Objective: Environmental factors and behaviors associated with obesity have not been well described in children living in Europe. Although television watching has been repeatedly associated with obesity, it is unclear whether other sedentary activities, such as use of electronic games, are independently associated with obesity in children. The hypothesis was that various types of sedentary activities are associated with obesity in children living in Switzerland. Research Methods and Procedures: This was a cross-sectional study of children (grades one to three) from four communities in the Greater Zurich Area (Switzerland). Obesity was defined as a combination of overweight (BMI) and overfat (skinfold thicknesses). Environmental factors were assessed by questionnaire. The children's physical activity was estimated by their teacher (scale 0 to 10). Results: Of 922 eligible subjects, 872 (94.6%) took part in the study. Use of electronic games [odds ratio (OR) = 2.03 per hour per day, 95% confidence interval (Cl): 1.57 to 2.61, p < 0.001], television (OR = 2.83 per hour per day, 95% CI: 2.08 to 3.86, p < 0.001), physical activity (OR = 0.80 per unit, 95% CI: 0.72 to 0.88, p < 0.001), maternal work (OR = 1.93, 95% Cl: 1.13 to 3.29, p = 0.02), and paternal smoking (OR = 1.78, 95% CI: 1.07 to 2.96, p = 0.03) were independently associated with obesity. Further adjustment for socioeconomic status, when available, did not change these results. Discussion: In this sample of children living in Switzerland, the use of electronic games was significantly associated with obesity, independently of confounding factors. The association of obesity with television use and lack of physical activity confirms results from other populations and points to potential strategies for obesity prevention. Read more...

Objectives: Excessive 'screen time' has been associated with a range of psychosocial disturbances and increasing pediatric obesity. This study describes the magnitude, distribution, composition and time-distribution of children's screen use; examines correlates of screen use; and characterises 'extreme' screen users (top quartile). Methods: 1,039 South Australian children aged 10-13 years old completed a multimedia 24-hour activity recall diary on 2-4 occasions in 2002, including at least one school day and one non-school day. Results: The median screen time was 229 minutes.d(-1). This was higher in boys (264 vs. 196 minutes; p < 0.001) and on non-school days (260 vs. 190 minutes; p < 0.001), increased with age (p=0.003), and decreased with socio-economic status (SES; p=0.003). Television consumed 73% of all screen time, video games 19%, non-game computer use 6%, and cinema 2%. The top quartile of screen users were more likely to be boys (OR=3.8), have low physical activity (OR=4.3), spend > 25% of screen time playing video games (OR=1.8), sleep less, and be of lower SES. Conclusions and Implications: Interventions to reduce screen time should target inactive, low-SES boys, encourage earlier bedtimes, and limit video game use. Read more...

Background and Objective: Waist circumference (W) has been shown to be a good predictor of cardiovascular risk. The aim of this study was to investigate whether physical activity (PA) is related to W in adolescents as previously shown in adults. Design and Subjects: Cross-sectional population-based survey of 2714 12-y-old adolescents from the eastern part of France. MEASUREMENTS: Body mass index (BMI) and W were measured. Structured PA, active commuting to and from school and sedentary activities (SED), for example television viewing, computer/video games and reading and different potential confounders (dietary habits, parental overweight, family annual income tax and educational level) were assessed by a questionnaire. Results: The adolescents had a mean BMI of 19.0+/-3.4 kg/m(2), and 20.2% of them were overweight, with no gender difference. Boys had a greater W than girls (67.6+/-9.1 vs 65.7+/-8.9 cm, P<0.0001). In all, 42% of the girls and 25% of the boys did not practice any structured PA outside school and less than 40% of the adolescents commuted actively to school more than 20 min/day. About one-third of the adolescents devoted more than 2 h/day to SED. In univariate analyses, BMI was negatively associated with structured PA but significantly only for girls (P<0.01) and positively associated with SED for both genders (P<0.0001 for girls, P<0.01 for boys). W was negatively associated with structured PA and positively associated with SED both in girls (P<0.0001 and P=0.03, respectively) and boys (P<0.01 and P=0.08, respectively). Multiple general linear models show that SED is associated with BMI, independently of structured PA, in both genders. On the other hand, structured PA was inversely associated with W, independently of SED. The inverse relation between structured PA and W persisted after additional adjustment on BMI, with a greater effect of PA for the adolescents with higher BMI. Conclusions: In 12-y-old adolescents, structured PA is inversely associated with W, an indicator of total adiposity but also more specifically of abdominal fat. This suggests that PA may have a beneficial effect on youth metabolic and cardiovascular risks, in particular in the presence of overweight. Read more...

Objective: To assess the relationship between short sleep duration and obesity-related variables in children involved in the 'Quebec en Forme' Project. Design: Cross-sectional study. Subjects: A total of 422 children (211 boys and 211 girls) aged between 5 and 10 years from primary schools in the City of Trois-Rivieres (Quebec) were selected to participate in this study. Measurements: Body weight, height and waist circumference were measured. The children were classified as normal, underweight, overweight or obese, according to body mass index (BMI) per age. An exhaustive questionnaire was administered by telephone to the parents of children. Results: The percentage of overweight/obesity was 20.0% in boys and 24.0% in girls. When compared to children reporting 12-13 h of sleep per day, the adjusted odds ratio for childhood overweight/obesity was 1.42 (95% confidence interval 1.09-1.98) for those with 10.5-11.5 h of sleep and 3.45 (2.61-4.67) for those with 8-10 h of sleep after adjustment for age, sex, and other risk factors. Parental obesity, low parental educational level, low total family income, long hours of TV watching, playing videogames or computer utilization, absence of breastfeeding and physical inactivity were also significantly associated with childhood overweight/obesity. In addition, we observed a significant negative association adjusted for age between sleep duration and body weight (-0.33, P < 0.01), BMI (-0.12, P < 0.01) and waist circumference (-0.24, P < 0.01) in boys. Conclusion: An inverse association was observed between sleep duration and the risk to develop childhood overweight/obesity. Longitudinal research will be required to confirm a potential link of causality between these variables. Read more...

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BACKGROUND: Several cross-sectional studies reported that heavier children eat breakfast less often. However, no longitudinal studies have addressed whether skipping breakfast leads to excessive weight gain. OBJECTIVE: To investigate whether skipping breakfast was prospectively associated with changes in body fatness. METHODS: A cohort of 414 000 boys and girls from all over the US, 9- to 14-y-old in 1996, returned annual mailed questionnaires (1996 - 1999) for the Growing Up Today Study. We analyzed change in body mass index (BMI; kg/m(2)) over three 1-y periods among children who reported breakfast frequency. RESULTS: Children who reported that they never eat breakfast had lower energy intakes than those who eat breakfast nearly every day. Children who were more physically active reported higher energy intakes, as did those who reported more time watching television/ videos and playing videogames. Like previous studies, skipping breakfast was associated with overweight, cross-sectionally. However, overweight children who never ate breakfast lost BMI over the following year compared to overweight children who ate breakfast nearly every day (boys: - 0.66 kg/m(2) (s.e. = 0.22); girls: - 0.50 kg/m(2) (s.e. = 0.14)). But normal weight children who never ate breakfast gained weight relative to peers who ate breakfast nearly every day ( boys: + 0.21 kg/m(2) (s.e. = 0.13); girls: + 0.08 kg/m(2) (s. e. = 0.05)). Breakfast frequency was positively correlated with self-reported quality of schoolwork. CONCLUSIONS: Overweight children who never eat breakfast may lose body fat, but normal weight children do not. Since numerous studies link skipping breakfast to poorer academics, children should be encouraged to eat breakfast. Read more...