Background
Methods
Active play
Screen time
Weight status – BMI-for-age ≥95th
Race/ethnicity
Covariates
Analytic approach
Results
Age category ‡
| ||||
---|---|---|---|---|
4 to 11 years overall | 4–5 years | 6–8 years | 9–11 years | |
n
§
| 2964 | 777 | 1109 | 1078 |
Mean age (months)
| 96.1 | 59.6 | 89.7 | 125.5 |
% male
| 50.6% | 48.2% | 50.4% | 52.3% |
% Non-Hispanic white
| 57.8% | 57.3% | 57.2% | 58.5% |
% Non-Hispanic black
| 15.5% | 14.4% | 15.5% | 16.3% |
% Mexican-American
| 13.4% | 14.3% | 13.4% | 12.9% |
Median Poverty income ratio
| 2.0 | 1.9 | 2.0 | 2.1 |
% Born in US
| 95.0% | 95.7% | 94.9% | 95.8% |
% Obese
†
| 16.9% | 15.2% | 15.1% | 19.6% |
Mean BMI
| 18.0 | 16.4 | 17.3 | 19.8 |
Age category ‡
| ||||
---|---|---|---|---|
4 to 11 years overall | 4–5 years | 6–8 years | 9–11 years | |
Boys
| ||||
n
§
| 1442 | 375 | 528 | 539 |
Active Play (times per week) †
| 7 (5, 7) | 7 (5, 7) | 7 (5, 7) | 7 (5, 7) |
Active Play (times per week)**
| 7.0 (6.5 – 7.4) | 6.9 (6.3 – 7.4) | 6.9 (6.5 – 7.3) | 7.1 (6.0 – 8.1) |
Television (hours per day)**
| 2.3 (2.2 – 2.5) | 2.3 (2.0 – 2.5) | 2.2 (2.0 – 2.4) | 2.4 (2.2–2.6) |
Computer/video games (hours per day)**
| 0.9 (0.9 – 1.0) | 0.7 (0.6 – 0.8) | 0.8 (0.8 – 0.9) | 1.2 (1.0 – 1.4) |
Girls
| ||||
n
§
| 1522 | 402 | 581 | 539 |
Active Play (times per week) †
| 7 (4, 7) | 7 (5, 7) | 7 (4, 7) | 6 (3, 7) |
Active Play (times per week)**
| 6.4 (5.8 – 7.0) | 7.3 (6.2 – 8.3) | 6.2 (5.7 – 6.7) | 6.2 (5.4 – 6.9) |
Television (hours per day)**
| 2.2 (2.1 – 2.3) | 2.2 (2.0 – 2.3) | 2.1 (1.9 – 2.3) | 2.4 (2.2 – 2.5) |
Computer/video games (hours per day)**
| 0.7 (0.7 – 0.8) | 0.6 (0.5 – 0.7) | 0.7 (0.6 – 0.8) | 0.8 (0.7 – 0.9) |
Comparisons by gender and age
Gender | ||
---|---|---|
Boys | Girls | |
Percentage (95% confidence interval) †
| ||
Low active play
§
| ||
4 to 11 years overall
| 31.4% (28.0% – 34.7%) | 43.4% (39.3% – 47.6%)*** |
4–5 years | 27.2% (21.2% – 33.2%) | 35.1% (29.5% – 40.6%)+
|
6–8 years | 25.7% (21.5% – 30.0%) | 39.4% (34.3% – 44.6%)*** |
9–11 years | 39.3% (32.0% – 46.6%) | 52.9% (45.6% – 60.2%)*** |
p trend age
§§
| 0.008 | <0.0001 |
High screen time ‡
| ||
4 to 11 years overall
| 67.7% (63.6% – 72.1%) | 62.0% (58.1% – 65.8%)*** |
4–5 years | 60.6% (53.0% – 68.2%) | 55.6% (48.4% – 62.9%) |
6–8 years | 65.4% (60.0% – 70.8%) | 62.0% (55.9% – 68.2%) |
9–11 years | 74.4% (68.3% – 80.6%) | 66.3% (61.0% – 71.6%)+
|
p trend age
§§
| <0.0001 | 0.011 |
Both low active play & high screen time
| ||
4 to 11 years overall
| 23.7% (21.0% – 26.3%) | 29.1% (25.5% – 32.7%)*** |
4–5 years | 18.9% (13.2% – 24.6%) | 19.4% (14.7% – 24.2%) |
6–8 years | 18.8% (15.4% – 22.2%) | 26.9% (22.0% – 31.8%)*** |
9–11 years | 31.2% (24.9% – 37.5%) | 37.7% (31.0% – 44.3%) |
p trend age
§§
| 0.004 | <0.0001 |
Comparisons by weight status
Weight status | ||
---|---|---|
BMI < 95th percentile (non obese) | BMI ≥95th percentile (obese) | |
Percentage (95% confidence interval)†
| ||
Low active play
§
|
Boys
| |
4 to 11 years overall
|
30.1% (26.2% – 33.9%)
|
38.1% (29.2% – 47.0%)
+
|
4–5 years | 25.3% (19.3% – 31.2%) | 37.6% (19.9% – 55.3%) |
6–8 years | 26.3% (21.2% – 31.5%) | 21.7% (11.4% – 32.0%) |
9–11 years | 36.5% (28.6% – 44.5%) | 53.3% (40.1% – 66.4%)** |
High screen time
‡
| ||
4 to 11 years overall
|
67.9% (62.6% – 73.3%)
|
70.0% (63.4% – 76.6%)
|
4–5 years | 62.8% (55.2% – 70.3%) | 55.5% (40.2% – 70.6%) |
6–8 years | 64.2% (57.3% – 71.0%) | 74.5% (64.1% – 84.9%) |
9–11 years | 74.6% (67.7% – 81.6%) | 73.7% (63.6% – 83.8%) |
Both low active play & high screen time
| ||
4 to 11 years overall
|
23.0% (19.3% – 26.7%)
|
28.5% (20.3% – 36.8%)
|
4–5 years | 17.0% (11.3% – 22.7%) | 30.3% (14.6% – 46.1%) |
6–8 years | 19.4% (15.2% – 23.6%) | 16.2% (6.9% – 25.5%) |
9–11 years | 29.9% (21.9% – 37.9%) | 38.6% (25.9% – 51.4%) |
Low active play
§
|
Girls
| |
4 to 11 years overall
|
42.7% (38.0% – 47.4%)
|
47.9% (38.9% – 56.9%)
|
4–5 years | 36.0% (30.1% – 41.9%) | 32.2% (18.3% – 46.1%) |
6–8 years | 38.4% (33.1% – 43.6%) | 49.0% (31.2% – 66.8%) |
9–11 years | 52.2% (44.7% – 59.7%) | 53.6% (39.8% – 67.4%) |
High screen time
‡
| ||
4 to 11 years overall
|
60.7% (56.8% – 64.6%)
|
72.0% (64.5% – 79.5%)***
|
4–5 years | 55.0% (47.2% – 62.7%) | 62.8% (47.7% – 77.9%) |
6–8 years | 60.5% (54.4% – 66.7%) | 77.8% (68.4% – 87.1%)** |
9–11 years | 65.2% (59.1% – 71.2%) | 72.0% (63.5% – 80.6%) |
Both low active play & high screen time
| ||
4 to 11 years overall
|
27.5% (23.7% – 31.3%)
|
38.1% (30.3% – 45.9%)**
|
4–5 years | 19.3% (14.7% – 23.8%) | 21.2% (6.8% – 35.6%) |
6–8 years | 25.1% (20.5% – 29.7%) | 40.1% (23.2% – 57.0%) |
9–11 years | 36.0% (28.9% – 43.1%) | 43.7% (31.5% – 55.9%) |
Comparisons by race/ethnicity
Mexican American | non-Hispanic white | non-Hispanic black | |
---|---|---|---|
Percentage (95% confidence interval)†
| |||
Low active play
§
|
Boys
| ||
4 to 11 years overall
|
36.4% (30.5% – 42.2%)
|
29.8% (24.9% – 34.7%)
|
31.5% (25.9% – 37.1%)
|
4–5 years
| 36.2% (23.6% – 48.7%) | 23.8% (15.3% – 32.4%) | 31.0% (18.8% – 43.3%) |
6–8 years
| 37.1% (28.9% – 45.3%) | 24.1% (18.5% – 29.6%) | 28.2% (22.0% – 34.4%)+b
|
9–11 years
| 35.7% (25.8% – 45.6%) | 38.8% (27.7% – 49.8%) | 34.5% (27.4% – 41.6%) |
High screen time
‡
| |||
4 to 11 years overall
|
60.6% (54.5% – 66.7%)
|
66.3% (61.1% – 71.4%)
|
78.7% (74.6% – 82.8%)***
ac
|
4–5 years
| 50.1% (40.0% – 60.2%) | 62.6% (52.8% – 72.4%) | 70.0% (61.4% – 77.9%)**c
|
6–8 years
| 63.4% (54.9% – 71.9%) | 61.5% (54.2% – 68.9%) | 76.4% (69.3% – 83.4%)**ac
|
9–11 years
| 64.4% (55.9% – 73.0%) | 73.0% (64.4% – 81.6%) | 85.3% (79.1% – 91.5%)***ac
|
Both low active play & high screen time
| |||
4 to 11 years overall
|
24.5% (20.2% – 28.9%)
|
21.8% (17.7% – 25.9%)
|
27.2% (22.2% – 32.2%)
|
4–5 years
| 22.5% (12.7% – 32.3%) | 15.3% (6.7% – 23.9%) | 26.5% (15.9% – 37.2%) |
6–8 years
| 25.2% (18.2% – 32.3%) | 16.6% (11.7% – 21.6%) | 23.8% (17.2% – 30.3%)+b
|
9–11 years
| 25.1% (17.8% – 32.4%) | 30.6% (20.1% – 41.0%) | 30.4% (24.1% – 36.7%) |
Low active play
§
|
Girls
| ||
4 to 11 years overall
|
44.0% (37.5% – 50.4%)
|
42.5% (36.4% – 48.5%)
|
40.6% (34.8% – 46.4%)
|
4–5 years
| 35.9% (26.6% – 45.2%) | 34.7% (24.7% – 44.6%) | 31.7% (22.4% – 41.0%) |
6–8 years
| 43.6% (29.8% – 44.4%) | 37.1% (29.8% – 44.4%) | 37.3% (29.7% – 44.9%) |
9–11 years
| 49.9% (39.0% – 60.9%) | 52.5% (41.7% – 63.4%) | 49.6% (41.9% – 57.3%) |
High screen time
‡
| |||
4 to 11 years overall
|
56.9% (51.3% – 62.5%)
|
60.3% (55.1% – 65.5%)
|
76.2% (71.6% – 80.7%)***
ac
|
4–5 years
| 48.9% (40.5% – 57.3%) | 53.7% (43.1% – 64.3%) | 71.1% (63.2% – 79.0%)***ac
|
6–8 years
| 60.0% (52.2% – 67.3%) | 59.3% (50.6% – 67.9%) | 79.3% (73.9% – 84.8%)***ac
|
9–11 years
| 59.8% (51.3% – 68.2%) | 65.8% (58.4% – 73.2%) | 75.6% (66.1% – 85.1%)+c
|
Both low active play & high screen time
| |||
4 to 11 years overall
|
24.7% (20.6% – 28.8%)
|
27.8% (22.7% – 33.0%)
|
31.9% (27.9% – 36.0%)
+c
|
4–5 years
| 18.1% (11.2% – 24.9%) | 18.1% (10.6% – 25.7%) | 24.0% (17.1% – 30.9%) |
6–8 years
| 26.6% (20.9% – 32.3%) | 24.3% (17.4% – 31.1%) | 30.9% (23.4% – 38.3%) |
9–11 years
| 27.4% (19.6% – 35.1%) | 37.3% (27.3% – 47.3%) | 37.8% (30.1% – 45.5%) |
Multivariate models: sociodemographic and weight status risk factors
Parameter estimate | SE | P value Chi-square | Odds ratio | 95% Wald Confidence Limits | |
---|---|---|---|---|---|
Low active play§
| |||||
Age (years) | 0.128 | 0.029 | <0.0001 | 1.14 | 1.07 – 1.20 |
Female † | 0.547 | 0.103 | <0.0001 | 1.73 | 1.41 – 2.12 |
Non-Hispanic black * | 0.179 | 0.128 | 0.162 | 1.20 | 0.93 – 1.54 |
Mexican American * | 0.472 | 0.127 | 0.0002 | 1.60 | 1.25 – 2.06 |
Other race/ethnicity* | 0.412 | 0.217 | 0.057 | 1.51 | 0.99 – 2.31 |
Obese ** | 0.218 | 0.132 | 0.099 | 1.24 | 0.96 – 1.61 |
Poverty to income ratio | 0.136 | 0.042 | 0.001 | 1.15 | 1.06 – 1.25 |
Born outside US‡ | -0.307 | 0.263 | 0.243 | 0.74 | 0.45 – 1.23 |
High screen time
§§
| |||||
Age (years) | 0.104 | 0.022 | <0.0001 | 1.11 | 1.06 – 1.16 |
Female † | -0.265 | 0.098 | 0.007 | 0.77 | 0.63 – 0.93 |
Non-Hispanic black * | 0.694 | 0.124 | <0.0001 | 2.00 | 1.57 – 2.55 |
Mexican American * | -0.130 | 0.121 | 0.283 | 0.88 | 0.69 – 1.11 |
Other race/ethnicity* | 0.134 | 0.167 | 0.421 | 1.14 | 0.83 – 1.59 |
Obese ** | 0.226 | 0.160 | 0.158 | 1.25 | 0.92 – 1.71 |
Poverty to income ratio | -0.010 | 0.040 | 0.811 | 0.99 | 0.92 – 1.07 |
Born outside US‡ | -0.682 | 0.221 | 0.002 | 0.51 | 0.33 – 0.78 |
Both low active play & high screen time
| |||||
Age (years) | 0.144 | 0.033 | <0.0001 | 1.16 | 1.08 – 1.23 |
Female † | 0.283 | 0.105 | 0.007 | 1.33 | 1.08 – 1.63 |
Non-Hispanic black + | 0.358 | 0.137 | 0.009 | 1.43 | 1.09 – 1.87 |
Mexican American + | 0.223 | 0.139 | 0.109 | 1.25 | 0.95 – 1.64 |
Other race/ethnicity+ | 0.517 | 0.233 | 0.026 | 1.68 | 1.06 – 2.65 |
Obese ** | 0.330 | 0.166 | 0.047 | 1.39 | 1.01 – 1.93 |
Poverty to income ratio | 0.071 | 0.045 | 0.115 | 1.07 | 0.98 – 1.17 |
Born outside US‡ | -0.592 | 0.236 | 0.012 | 0.55 | 0.35 – 0.88 |