Research Current Research| Volume 107, ISSUE 1, P53-61, January 2007

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Television Watching and Frequency of Family Meals Are Predictive of Overweight Onset and Persistence in a National Sample of School-Aged Children



      To identify eating and activity factors associated with school-aged children’s onset of overweight and persistent overweight.


      Data were gathered at four time points between kindergarten entry and spring of third grade. Children were directly weighed and measured and categorized as not overweight (<95th percentile of body mass index) or overweight (≥95th percentile body mass index); parents were interviewed by telephone or in person.


      Subjects were participants in the Early Childhood Longitudinal Study–Kindergarten Cohort, a nationally representative sample of children who entered kindergarten during 1998-1999. Children who weighed <2,000 g at birth, received therapeutic services before kindergarten, skipped or repeated a grade, or without complete height and weight data were excluded, resulting in 8,459 participants. Children with intermittent overweight were not examined (n=459); analyses addressed 8,000 children.

      Main Outcome Measures

      Three mutually exclusive groups of children were identified: never overweight, overweight onset, and persistent overweight.

      Statistical Analyses Performed

      Multilevel, multivariate logistic regression analyses estimated the effects of eating and activity factors on the odds of overweight onset and persistent overweight above child sex, race, and family socioeconomic status.


      Children who watched more television (odds ratio [OR] 1.02) and ate fewer family meals (OR 1.08) were more likely to be overweight for the first time at spring semester of third grade. Children who watched more television (OR 1.03), ate fewer family meals (OR 1.08), and lived in neighborhoods perceived by parents as less safe for outdoor play (OR 1.32) were more likely to be persistently overweight. Child aerobic exercise and opportunities for activity were not associated with a greater likelihood of weight problems.


      This study supports theories regarding the contributions of television watching, family meals, and neighborhood safety to childhood weight status. When working with families to prevent and treat childhood weight problems, food and nutrition professionals should attend to children’s time spent with screen media, the frequency of family mealtimes, and parents’ perceptions of neighborhood safety for children’s outdoor play.
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        • Committee on Prevention of Obesity in Children and Youth
        Preventing Childhood Obesity: Health in the Balance. National Academies Press, Washington, DC2005
        • Sallis J.F.
        • Nader P.R.
        Family determinants of health behaviors.
        in: Gochman D.S. Health Behavior: Emerging Research Perspectives. Plenum Press, New York, NY1988: 107-129
        • Ritchie L.D.
        • Welk G.
        • Styne D.
        • Gerstein D.E.
        • Crawford P.B.
        Family environment and pediatric overweight: What is a parent to do?.
        J Am Diet Assoc. 2005; 105: S70-S79
        • Hill J.O.
        • Wyatt H.R.
        • Reed G.W.
        • Peters J.C.
        Obesity and the environment: Where do we go from here?.
        Science. 2003; 299: 853-855
        • Andersen R.E.
        • Crespo C.J.
        • Bartlett S.J.
        • Cheskin L.J.
        • Pratt M.
        Relationship of physical activity and television watching with body weight and level of fatness among children.
        JAMA. 1998; 279: 938-942
        • Crespo C.J.
        • Smith E.
        • Troiano R.P.
        • Bartlett S.J.
        • Macera C.A.
        • Andersen R.E.
        Television watching, energy intake, and obesity in US children.
        Arch Pediatr Adolesc Med. 2001; 155: 360-365
        • Proctor M.H.
        • Moore L.L.
        • Gao D.
        • Cupples L.A.
        • Bradlee M.L.
        • Hood M.Y.
        • Ellison R.C.
        Television viewing and change in body fat from preschool to early adolescence: The Framingham Children’s Study.
        Int J Obes. 2003; 27: 827-833
        • Gable S.
        • Lutz S.
        Household, parent, and child contributions to childhood obesity.
        Fam Relat. 2000; 49: 293-300
        • Gillman M.W.
        • Rifas-Shiman S.L.
        • Frazier A.L.
        • Rockett H.R.H.
        • Camargo C.A.
        • Field A.E.
        • Berkey C.S.
        • Colditz G.A.
        Family dinner and diet quality among older children and adolescents.
        Arch Pediatr Adolesc Med. 2000; 154: 235-240
        • Neumark-Sztainer D.
        • Hannan P.J.
        • Story M.
        • Croll J.
        • Perry C.
        Family meal patterns: Associations with sociodemographic characteristics and improved dietary intake among adolescents.
        J Am Diet Assoc. 2003; 103: 317-322
        • Molnar B.E.
        • Gortmaker S.L.
        • Bull F.C.
        • Buka S.L.
        Unsafe to play?.
        Am J Health Promot. 2004; 18: 378-386
        • Booth K.M.
        • Pinkston M.M.
        • Poston W.S.C.
        Obesity and the built environment.
        J Am Diet Assoc. 2005; 105: S110-S117
        • West J.
        Early Childhood Longitudinal Study: Kindergarten class 1998-1999. Project Summary. 2006 (Available at: Accessed October 20)
        • Whitaker R.C.
        • Wright J.A.
        • Pepe M.S.
        • Seidel K.D.
        • Dietz W.
        Predicting obesity in young adulthood from childhood and parental obesity.
        N Engl J Med. 1997; 337: 869-873
        • Freedman D.S.
        • Khan L.K.
        • Dietz W.H.
        • Srinivasan S.R.
        • Berenson G.S.
        Relationship of childhood obesity to coronary heart disease risk factors in adulthood: The Bogalusa Heart Study.
        Pediatrics. 2001; 108: 712-718
        • Magarey A.M.
        • Daniels L.A.
        • Boulton T.J.
        • Cockington R.A.
        Predicting obesity in early adulthood from childhood and parental obesity.
        Int J Obes. 2003; 27: 505-513
        • Johnson D.B.
        • Gerstein D.E.
        • Evans A.E.
        • Woodward-Lopez G.
        Preventing obesity: A life cycle perspective.
        J Am Diet Assoc. 2006; 106: 97-102
        • US Department of Education
        • National Center for Education Statistics
        ECLS-K Restricted-Use Base Year Data Files and Electronic Codebook. US Department of Education, Washington, DC2001
        • United States Department of Education
        • National Center for Education Statistics
        ECLS-K Restricted-Use Third Grade Data Files and Electronic Codebook. US Department of Education, Washington, DC2003
        • Jefferis B.J.M.H.
        • Power C.
        • Hertzman C.
        Birth weight, childhood socioeconomic environment, and cognitive development in the 1958 British birth cohort study.
        BMJ. 2002; 325: 1-6
        • McCormick M.C.
        • Gortmaker S.L.
        • Sobol A.M.
        Very low birthweight children: Behavior problems and school difficulties in a national sample.
        J Pediatr. 1990; 117: 687-693
        • Kuczmarski R.J.
        • Ogden C.L.
        • Guo S.S.
        2000 CDC growth charts for the United States: Methods and development.
        Vital Health Stat. 2002; 11: 246
        • Dietz W.H.
        Critical periods in childhood for the development of obesity.
        Am J Clin Nutr. 1994; 59: 955-959
        • Ogden C.L.
        • Carroll M.D.
        • Curtin L.R.
        • McDowell M.A.
        • Tabak C.J.
        • Flegal K.M.
        Prevalence of overweight in the United States, 1999-2004.
        JAMA. 2006; 295: 1549-1555
        • Polhamus B.
        • Dalenius K.
        • Thompson D.
        • Scanlon K.
        • Borland E.
        • Smith B.
        • Grummer-Strawn L.
        Pediatric Nutrition Surveillance 2001 Report. US Department of Health and Human Services, Centers for Disease Control and Prevention, Atlanta, GA2003
        • Raudenbush S.W.
        • Bryk A.S.
        Hierarchical Linear Models: Applications and Data Analysis Methods. 2nd ed. Sage Publications, Newbury Park: CA2002
        • Goldstein H.
        Nonlinear multilevel models with an application to discrete response data.
        Biometrika. 1991; 78: 45-51
        • Goldstein H.
        • Rasbash J.
        Improved approximations for multilevel models with binary responses.
        J Royal Stat Soc. 1996; 159: 505-513
        • Golan M.
        • Crow S.
        Targeting parents exclusively in the treatment of childhood obesity: Long-term results.
        Obes Res. 2004; 12: 357-361
        • Robinson T.N.
        Television viewing and childhood obesity.
        Pediatr Clin North Am. 2001; 48: 1017-1025
        • Taras H.L.
        • Sallis J.F.
        • Patterson T.L.
        • Nader P.R.
        • Nelson J.A.
        Television’s influence on children’s diet and physical activity.
        Dev Behav Pediatr. 1989; 10: 176-180
        • Marshall S.J.
        • Biddle S.J.H.
        • Gorely T.
        • Cameron N.
        • Murdey I.
        Relationships between media use, body fatness and physical activity in children and youth: A meta-analysis.
        Int J Obes. 2004; 28: 1238-1246
        • Robinson T.N.
        Reducing children’s television viewing to prevent obesity.
        JAMA. 1999; 282: 1561-1567
        • Birch L.L.
        • Fisher J.O.
        • Davison K.K.
        Learning to overeat: Maternal use of restrictive feeding practices promotes girls’ eating in the absence of hunger.
        Am J Clin Nutr. 2003; 78: 215-220
        • Spruijt-Metz D.
        • Lindquist C.H.
        • Birch L.L.
        • Fisher J.O.
        • Goran M.I.
        Relation between mothers’ child-feeding practices and children’s adiposity.
        Am J Clin Nutr. 2002; 75: 581-586
        • Lin B.H.
        • Frazão E.
        • Guthrie J.
        Away-from-Home Foods Increasingly Important to Quality of American Diet. US Department of Agriculture, Washington, DC1999 (Agriculture Information Bulletin No. 749)
        • Spear B.A.
        The need for family meals.
        J Am Diet Assoc. 2006; 106: 218-219
        • Romero A.J.
        • Robinson T.N.
        • Kraemer H.C.
        • Erickson S.J.
        • Haydel F.
        • Mendoza F.
        • Killen J.D.
        Are perceived neighborhood hazards a barrier to physical activity in children?.
        Arch Pediatr Adolesc Med. 2001; 155: 1143-1148
        • Burdette H.L.
        • Whitaker R.C.
        Neighborhood playgrounds, fast food restaurants, and crime: Relationships to overweight in low-income preschool children.
        Prev Med. 2004; 38: 57-63
        • Dietz W.H.
        • Gortmaker S.L.
        TV or not TV: Fat is the question.
        Pediatrics. 1993; 91: 499-501


      S. Gable is an associate professor and state extension specialist, Human Development and Family Studies Extension, and J. L. Krull is an associate professor, Department of Psychological Sciences, University of Missouri, Columbia.


      Y. Chang is a senior research analyst, Center for Research, Assessment, and Planning, Adelphi University, Garden City, NY; at the time of the study, she was a doctoral candidate, Human Development and Family Studies, University of Missouri, Columbia.