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Increased sleep, decreased TV improved BMI in preschoolers
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Increased sleep and decreased TV viewing may effectively reduce BMI among low-income, racial/ethnic minority preschool-aged children, according to recent study results.
Jess Haines, PhD, MHSc, RD, of the department of family relations and applied nutrition at the University of Guelph in Ontario, Canada, and colleagues, randomly assigned 121 families with children aged 2 to 5 years to an intervention comprised of coaching home visits and calls, besides text messages twice weekly for 16 weeks and then weekly for the last 8 weeks of the program, or a control condition. Those in the control group received four monthly mailed packages that included educational materials on early childhood developmental milestones. A total of 111 families completed 6-month follow-up.
Jess Haines
The Healthy Habits, Happy Homes intervention program encouraged parents to increase frequency of family meals per week, the child’s sleep duration, and to decrease TV viewing and the presence of a TV in the child’s bedroom.
At 6-month follow-up, the children in the intervention group demonstrated increased sleep duration (0.75 hours daily; 95% CI, 0.06-1.44) compared with those in the control group. There also were decreases in TV viewing on weekend days (–1.06 hours daily; 95% CI, –1.97 to –0.15) and decreased BMI (–0.4; 95% CI, –0.79 to 0), according to data.
“Families in both the intervention (20%) and control (12%) conditions reported removing the TV from the room where their child slept, with no significant intervention effect (P=.29),” researchers wrote. Further studies are warranted to determine continued maintenance of behavioral changes, they added.
In an accompanying editorial, Aaron E. Carroll, MD, MS, of the Indiana University School of Medicine, wrote that Haines and colleagues provide the research community with a desirable intervention.
“Of course, further work is needed to see how such an intervention could scale up into a larger program, let alone into public policy,” Carroll wrote.
For more information:
Carroll AE. JAMA Pediatr. 2013;doi:10.1001/jamapediatrics.2013.2405.
Haines J. JAMA Pediatr. 2013;doi:10.1001/jamapediatrics.2013.2356.
Disclosure: The researchers report no relevant financial disclosures. Carroll reports no relevant financial disclosures.
Perspective
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Nancy F. Butte, PhD
I found the significant changes in BMI to be impressive for what was a fairly minimal intervention. The prevalence of childhood obesity has stabilized, but it’s still at a high level in the United States. There is the perception that obesity prevention efforts will be more effective at an earlier age. As a result, there have been several recent studies attempting to reverse or prevent childhood obesity among preschool-aged children.
This group of researchers has been focusing on this area for quite some time. The intervention targets in this study emphasizing increasing sleep duration, sleep quality and establishing healthy routines within the family arose from their earlier studies.
During the past decade, there has been a trend toward having multiple TVs in homes, including in children’s bedrooms. This study focused on decreasing TV viewing during the week and on the weekend and trying to get the TV removed from the bedroom. Here, there was no effect of removing the TV on changes in the children’s BMI; however, only 20% of families removed the TV from the bedroom. What was interesting about this study population was that 80% of the parents reported they slept in the same room as the children. This may explain why the TV was not removed from the bedroom. Could it be that the parents wanted the TV in the bedroom for themselves?
The intervention also promoted family meals and health food choices such as water instead of sugar-sweetened beverages, low-fat milk, fruits and vegetables. However, the study did not assess changes in the children’s food intake. There were no changes in family meal frequency, but changes in dietary intake may have contributed to the changes seen in the children’s BMI.
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