Impact of sleep and screen times on incidence of overweight in European children and adolescents

Background A deeper understanding of the modifiable risk factors leading to excess weight in children and adolescents can provide unique opportunities for preventing the immediate and long-lasting health consequences of overweight. The aim of the study was to explore independent, prospective associations of screen time and sleep duration with incident overweight in a sample of European children. Methods Data from 4285 participants of the IDEFICS/I.Family cohort who were followed-up from 2009/2010 to 2013/2014 was analyzed. Hours per day of screen time and sleep duration were collected by parental report at baseline. Logistic regression analyses were carried in separate and mutually adjusted models controlled for sex, age, European country region, parental level of education and baseline BMI z-scores. Results At baseline screen time (hours/day) and sleep duration (hours/day) were inversely correlated behaviors (rs= -0.226, p<.001), indicating the necessity of exploring their separate and joint effects on the weight trajectory. In the non-overweight/non-obese population at baseline (N = 3734), separate models suggest that every hour increase on screen time and every hour decrease on sleep duration were associated with higher odds of the child becoming overweight or obese at follow up (OR = 1.156, 95% CI 1.015-1.316 and OR = 1.226, 95% CI 1.053- 1.428 respectively). In the mutually adjusted model, the screen time association was attenuated to non-significance (OR = 1.125, 95% CI 0.986- 1.284), while the association with sleep duration was also attenuated but remained statistically significant (OR = 1.198, 95% CI 1.026-1.398). Conclusions Both screen time and sleep duration are significant predictors of incident overweight in children and adolescents. However, according to our results sleep duration plays a stronger role than screen time, suggesting an increased value of overweight prevention strategies that emphasize adequate sleep duration. Key messages A holistic and integrated approach is needed to prevent overweight from early age and with a life-course perspective. New strategies for overweight prevention could benefit from prioritizing interventions that promote adequate sleep duration and reduce excessive screen time.

The effectiveness of a web-based Dutch parenting program to prevent overweight in children age 9-13

Background We developed a web-based parenting program for parents entitled “Making a healthy deal with your child”. This e-learning program can be incorporated into existing prevention programs, thereby improving these interventions by reinforcing the role of parenting and providing parents with practical tools for use in everyday situations in order to stimulate a healthy lifestyle. Methods The effectiveness was studied in a two-armed cluster randomized controlled trial. We recruited 548 parent-child dyads of children 9-13 years in the Netherlands who participated in an existing school-based overweight prevention program. Primary outcomes included the child’s dietary and sedentary behavior, and level of physical activity. Secondary outcomes included general parenting style, specific parenting practices (set of rules, modeling, monitoring), and parental self-efficacy. Multilevel multiple regression analyses in Mplus were conducted. Results 87% of the parent-child dyads participated in the study and 47% of the parents in the intervention group completed 2 or more episodes of the e-learning. The score that parents gave to the e-learning is a 7.Main effect analyses showed in the intention-to-treat analyses that the the parents in the intervention group have more strict rules regarding eating snacks (0.046) and children of parents in the intervention group drink more milk (p = 0.018) and less sugar sweetened beverages (p = 0.024). The completers only analyses showed that the children of parents in the intervention group eat more vegetables and fruit, drink more water and less sugar sweetened beverages, and had less screentime than the children in the control group. Conclusions The e-learning program showed small indications to be effective. A second effectiveness study is currently being investigated. If the e-learning proves to be effective it can be easily incorporated into existing overweight prevention programs for children, as well as activities regarding Youth Health Care. Key messages The e-learning can easily incorporated into existing overweight prevention programs for children. www.gezondeafsprakenmetjekind.nl