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Methods Inf Med 2005; 44(02): 303-309
DOI: 10.1055/s-0038-1633968
Original Article
Schattauer GmbH

Behavioral Interventions and the Role of Television in the Growing Epidemic of Adolescent Obesity

Data from the 2001 Youth Risk Behavioral Survey
M. Fleming-Moran
1   Department of Applied Health Science, Indiana University, Bloomington, Indiana, USA
,
K. Thiagarajah
1   Department of Applied Health Science, Indiana University, Bloomington, Indiana, USA
› Author Affiliations
Further Information

Publication History

Publication Date:
05 February 2018 (online)

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Summary

Objective: To test television exposure’s contribution to overweight (BMI> 95th percentile /age) status in 11.3% of 2001 YRBS respondents, when controlling for moderate/vigorous activity, and eating habits.

Methods: Controlling for age, ethnicity, smoking, moderate/vigorous activity, and diet habits, gender-specific SUDAAN models estimate likelihood (O.R.) for overweight in teens watching 2+ hours of TV/day.

Results: TV exposure independently increases odds of overweight by 50% for both genders (boys: OR 1.5 [1.2-1.8]; girls: OR 1.6 [1.2-2.0]), when other covariates are controlled. Low vigorous activity rate (1.39 [1.1-1.86]) and smoking independently promote obesity in girls, while boys with fewer fruit/ vegetable servings are less likely to be overweight (.76 [.60-.96]).

Conclusion: Current school-based interventions promote environmental and curricular changes for healthier diets and increased activity rates. TV exposure, however, is rarely targeted as a separate risk factor, and requires attention at the individual, family, and community levels.

Keywords

Adolescents - obesity - physical activity - television - diet
 

  • References

  • 1 Centers for Disease Control and Prevention (CDC). Prevalence of overweight among children and adolescents, United States 1999-2000. National Center for Health Statistics. Health E-Stats. www.cdc.gov/nchs/products/pubs/pubd/hestats/overweight99.htm Accessed July 15 2003
    PubMedGoogle Scholar
  • 2 Ogden CL, Flegal K, Carroll MD, Johnson CJ. Prevalence and trends in overweight among US children and adolescents, 1999-2000. JAMA 2002; 288: 1728-32.
    CrossrefPubMedGoogle Scholar
  • 3 Troiano RP, Flegal KM. Overweight children and adolescents: description, epidemiology, and demographics. Pediatrics 1998; 101 (03) 497-504.
    PubMedGoogle Scholar
  • 4 Centers for Disease Control and Prevention (CDC). National Center for Chronic Disease Prevention and Health Promotion, Division of Nutrition and Physical Activity, at. www.cdc.gov/nccdphp/dnpa/bmi/bmi-for-age.htm Accessed March 10 2003
    PubMedGoogle Scholar
  • 5 Strauss RS, Pollack HA. Epidemic increase in childhood overweight 1986-1998. JAMA 2001; 286: 2845-8.
    CrossrefPubMedGoogle Scholar
  • 6 Berkey CS, Gardner JD, Frazier AL, Colditz GA. Relation of Childhood Diet and Body Size to Menarche and Adolescent Growth in Girls. Am J Epidemiol. 2000; 152 (05) 446-52.
    CrossrefPubMedGoogle Scholar
  • 7 Dietz WH. Health consequences of obesity in youth: childhood predictors of adult disease. Pediatrics 1998; 10: 518-25.
    PubMedGoogle Scholar
  • 8 Freedman DS, Dietz WH, Srinivasan SR, Berenson GS. The relation of overweight to cardiovascular risk factors among children and adolescents: The Bogalusa Heart Study. Pediatrics 1999; 103: 1175-82.
    CrossrefPubMedGoogle Scholar
  • 9 Whitaker RC, Wright JA, Pepe MS, Seidel KD, Dietz WH. Predicting obesity in young adulthood from childhood and parental obesity. New Engl J Med 1997; 337: 869-73.
    CrossrefPubMedGoogle Scholar
  • 10 Serdula MK, Ivery D, Coates RJ, Freedman DS, Williamson DF, Byers T. Do obese children become obese adults? A review of the literature. Prev Med 1993; 22: 167-77.
    CrossrefPubMedGoogle Scholar
  • 11 Pi-Sunyer FX. National Institutes of Health Technology Assessment Conference: medical hazards of obesity. Ann Intern Med 1993; 119 7S 655-60.
    CrossrefPubMedGoogle Scholar
  • 12 Gunnell DJ, Frankel SJ, Nanchahal K, Peters TJ, Davey Smith G. Childhood obesity and adult cardiovascular mortality. Am J Clin Nutr 1996; 67: 1111-8.
    PubMedGoogle Scholar
  • 13 Allison D, Fontaine K, Manson J, Stevens J, Van- Itallie T. Annual deaths attributable to obesity in the United States. JAMA 1999; 282: 1530-8.
    CrossrefPubMedGoogle Scholar
  • 14 Hill JO, Peters JC. Environmental contributions to the obesity epidemic. Science 1998; 280: 1371-4.
    CrossrefPubMedGoogle Scholar
  • 15 Rosenbaum M, Leibel RI. The physiology of body weight regulation: relevance to the etiology of obesity in children. Pediatrics 1998; 101 suppl 525-39.
    PubMedGoogle Scholar
  • 16 Gortmaker SL, Must A, Sobol AM, Peterson K, Colditz GA, Dietz WH. Television viewing as a cause of increasing obesity among children in the United States, 1986-1990. Arch Pediatr Adolesc Med 1996; 150 (04) 356-62.
    CrossrefPubMedGoogle Scholar
  • 17 Lowry R, Wechsler H, Galuska DA, Fulton JE, Khan L. Television viewing and its associations with overweight, sedentary lifestyle, and insufficient consumption of fruits and vegetables among US high school students: Differences by race, ethnicity, and gender. J Sch Health 2002; 72 (10) 413-21.
    CrossrefPubMedGoogle Scholar
  • 18 Crespo CJ, Smit E, Troiano RP, Bartlett SJ, Macera CA, Andersen RE. Television watching, energy intake, and obesity in US children: results from the third National Health and Nutrition Examination Survey,1988-1994. Arch Pediatr Adolesc Med 2001; 15 (03) 360-5.
    PubMedGoogle Scholar
  • 19 Berkey CS, Rockett HR, Field AE, Gillman MW, Frazier AL, Camargo Jr. CA, Colditz GA. Activity, dietary intake, and weight changes in a longitudinal study of preadolescent and adolescent boys and girls. Pediatrics 2001; 105 (04) e56.
    PubMedGoogle Scholar
  • 20 Robinson TN. Reducing children’s television viewing to prevent obesity – A Randomized controlled trial. JAMA 1999; 282 (016) 1561-7.
    CrossrefPubMedGoogle Scholar
  • 21 Coates TJ, Killen JD, Slinkard LA. Parent participation in a treatment program for overweight adolescents. Int J Eat Disord 1982; 1: 37-48.
    CrossrefPubMedGoogle Scholar
  • 22 Robinson TN, Hammer LD, Killen JD, Kraemer HC, Wilson DM, Hayward C, Taylor CB. Does television viewing increase obesity and reduce physical activity? Cross-sectional and longitudinal analyses among adolescent girls. Pediatrics 1993; 91 (02) 273-80.
    PubMedGoogle Scholar
  • 23 Nader PR, Stone EJ, Lytle LA. et al. Three-year maintenance of improved diet and physical activity: the CATCH cohort. Arch Pediatr Adolesc Med. 1999; 153: 695-704.
    CrossrefPubMedGoogle Scholar
  • 24 Luepker RV, Perry CL, McKinlay SM. et al. Outcomes of a field trial to improve children’s dietary patterns and physical activity: the Child and Adolescent Trial of Cardiovascular Health (CATCH). JAMA 1996; 275: 768-76.
    CrossrefPubMedGoogle Scholar
  • 25 Gortmaker SL, Peterson K, Wiecha J. et al. Reducing obesity via a school-based interdisciplinary intervention among youth: Planet Health. Arch Pediatr Adolesc Med 1999; 153 (04) 409-18.
    CrossrefPubMedGoogle Scholar
  • 26 Kelderman E. Childhood Obesity: States Neglect Phys Ed. www.stateline.org Accessed April 15 2004
    PubMedGoogle Scholar
  • 27 Andersen RE, Crespo CJ, Bartlett SJ, Cheskin LJ, Pratt M. Relationship of physical activity and television watching with body weight and level of fatness among children: Results from the Third National Health and Nutrition Examination Study. JAMA 1998; 279: 938-42.
    CrossrefPubMedGoogle Scholar
  • 28 Centers for Disease Control and Prevention. CDC Surveillance Summaries, Youth Risk Behavior Surveillance – United States, 2001. MMWR 2002; 51: SS 04.
    PubMedGoogle Scholar
  • 29 Strauss RS. Comparison of measured and self reported weight and height in a cross-section of adolescents. Int J Obes Relat Metab Disord 1998; 23: 904-8.
    PubMedGoogle Scholar
  • 30 Kuczmarski RJ, Ogden CL, Grummer-Strawn LM. CDC growth charts: United States. Advance data from Vital and Health statistics; no. 314. Hyattsville, Maryland: National Center for Health Statistics. 2000
    Google Scholar
  • 31 Flegal KM, Ogden CL, Wei R, Kuczmarski RL, Johnson CL. Prevalence of overweight in children: Comparison of US growth charts from the Centers for Disease Control and Prevention with other reference values for body mass index. Am J Clin Nutr 2001; 73: 1086-93.
    CrossrefPubMedGoogle Scholar
  • 32 Eisenmann JC, Bartee RT, Wang MQ. Physical activity, TV viewing, and weight in U.S. youth: 1999 Youth Risk Behavioral Survey. Obesity Research 2002; 10 (05) 379-85.
    CrossrefPubMedGoogle Scholar
  • 33 McMurray RG, Harrell JS, Deng S, Bradley CB, Cox LM, Bangdiwala S. The influence of physical activity, socioeconomic status, and ethnicity on the weight status of adolescents. Obesity Research 2000; 8 (02) 130-9.
    CrossrefPubMedGoogle Scholar
  • 34 Gordon LP, Adair LS, Popkin BM. Ethnic differences in physical activity and inactivity patterns and overweight status. Obesity Research 2002; 10 (03) 141-9.
    CrossrefPubMedGoogle Scholar
  • 35 Lowry R, Khan L, Collins JL, Kolbe LJ. The effect of socioeconomic status on chronic disease behavior among US adolescents. JAMA 1996; 276: 792-7.
    CrossrefPubMedGoogle Scholar
  • 36 Subar AF, Ziegler RG, Patterson BH, Ursin G, Graubard B. US dietary pattern associated with fat intake: The 1987 National Health Interview Survey. Am J Pub Health 1993; 84: 359-66.
    PubMedGoogle Scholar
  • 37 Smith-Warner SA, Elmer PJ, Tharp TM, Fosdick L, Randall B, Gross M, Wood J, Potter JD. Increasing vegetables and fruit intake: Randomized intervention and monitoring in an at-risk population. Cancer Epidemiology, Biomarkers & Prevention 2000; 9: 307-17.
    PubMedGoogle Scholar
  • 38 Epstein LH, Gordy CC, Raynor HA, Beddome M, Kilanwski CK, Paluch R. Increasing fruit and vegetable intake and decreasing fat and sugar i in families at risk for childhood obesity. Obesity Research 2001; 9 (03) 171-8.
    CrossrefPubMedGoogle Scholar
  • 39 McCrory MA, Fuss PJ, McCallum JE, Yao M, Vinken AG, Hays NP, Roberts S. Dietary variety within food groups: association with energy intake and body fatness in men and women. Am J Clin Nutr 1999; 69: 440-7.
    CrossrefPubMedGoogle Scholar
  • 40 Peterson KE, Field AE, Fox MK. Validation of the Youth Risk Behavioral Surveillance System (YRBSS). Questions on Dietary Behaviors and Physical Activity among Adolescents in Grades 9 through 12. Boston MA: Harvard School of Public Health, Division of School and Adolescent Health at the Centers for Disease Control and Prevention. 1996
    Google Scholar
  • 41 Subar AF, Heimendinger J, Patterson BH, Krebs- Smith SM, Pivonka E, Kessler R. Fruits and vegetable intake in the United States: the baseline survey of the Five a Day for Better Health Program. Am J Health Promotion 1995; 9: 352-60.
    CrossrefPubMedGoogle Scholar
  • 42 U.S. Dept. of Health and Human Services. Physical Activity and Health: A Report of the Surgeon General. Atlanta, GA: Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion. 1996
    Google Scholar
  • 43 Sallis JF, Patrick K. Physical activity guidelines for adolescents: Consensus statement. Pediatric Exercise Science 1994; 6: 302-14.
    CrossrefPubMedGoogle Scholar
  • 44 American Academy of Pediatrics. Committee on Public Education. Children. Adolescents, and Television. Pediatrics 2001; 107: 423-6.
    PubMedGoogle Scholar
  • 45 Palaniappan U, Starkey LJ, O’Loughlin J, Gray- Donald K. Fruit and vegetable consumption is lower and saturated fat intake is higher among Canadians reporting smoking. J Nutr 2001; 131: 1952-8.
    CrossrefPubMedGoogle Scholar
  • 46 Shah BV, Barnwell BG, Bieler GS. SUDAAN User’s Manual Release 7.5 Research Triangle Park NC: Research Triangle Institute. 1997
    Google Scholar
  • 47 Mokdad A, Serdula M, Dietz WH, Bowman B, Marks J, Koplan J. The continuing obesity epidemic in the United States. JAMA 2000; 284: 1650-1.
    CrossrefPubMedGoogle Scholar
  • 48 Fortenberry JD. Reliability of adolescents’reports of height and weight. Journal of Adolescent Health 1992; 13: 114-7.
    CrossrefPubMedGoogle Scholar
  • 49 Goodman E, Hinden BR, Khandelwal S. Accuracy of teen and parental reports of obesity and body mass index. Pediatrics 2000; 106: 52-8.
    CrossrefPubMedGoogle Scholar
  • 50 Robinson TN, Killen JD. Ethnic and gender differences in the relationships between television viewing and obesity, physical activity and dietary fat intake. J Health Educ 1995; 26: S91-S98.
    PubMedGoogle Scholar
  • 51 De Vito E, La Torre G, Langiano E, Berardi D, Ricciardi G. Overweight and Obesity among secondary school children in Central Italy. Eur J Epidemiol 1999; (07) 649-54.
    PubMedGoogle Scholar
  • 52 Wang Y, Monteiro C, Popkin BM. Trends of obesity and underweight in older children and adolescents in the United States, Brazil, China, and Russia. Am J Clin Nutr 2002; 75 (06) 971-7.
    CrossrefPubMedGoogle Scholar
  • 53 Yanovski JA, Yanovski SZ. Treatment of Pediatric and Adolescent Obesity. JAMA 2003; 289: 1851-3.
    CrossrefPubMedGoogle Scholar
  • 54 Field AE, Cheung L, Wolf AM, Herzog DB, Gortmaker SL, Colditz GA. Exposure to the mass media and weight concerns among girls. Pediatrics 1999; 103: E36.
    CrossrefPubMedGoogle Scholar
  • 55 Schwimmer JB, Burwinkle TM, Varni JW. Healthrelated quality of life of severely obese children and adolescents. JAMA 2003; 289: 1813-9.
    CrossrefPubMedGoogle Scholar
  • 56 Berkowitz RI, Wadden TA, Tershakovec AM, Cronquist Y. Behavior therapy and sibutramine for the treatment of adolescent obesity: a randomized, placebo-controlled trial. JAMA 2003; 289: 1805-12.
    CrossrefPubMedGoogle Scholar
  • 57 Epstein LH, Valoski A, Wing RR, McCurley J. Ten-year outcomes of behavioral family-based treatment for childhood obesity. Health Psychol 1994; 13: 373-83.
    CrossrefPubMedGoogle Scholar
  • 58 Barlow SE, Dietz WH. Obesity evaluation and treatment: expert committee recommendations. Pediatrics 1998; 102: E29.
    CrossrefPubMedGoogle Scholar
  • 59 The Annenberg Public Policy Center of the University of Pennsylvania. Television in the Home: The 1997 Survey of Parents and Children. Philadelphia: University of Pennsylvania; 1997
    Google Scholar
  • 60 Cavadini C, Siega-Riz AM, Popkin BM. US adolescent food intake trends from 1965 to 1996. Archives of Disease in Childhood 2000; 83 (01) 18-24.
    CrossrefPubMedGoogle Scholar
  • 61 Yanovski JA. Obesity. N Engl J Med 2002; 346: 591-602.
    CrossrefPubMedGoogle Scholar
  • 62 Coon KA, Goldberg J, Rogers BL, Tucker KL. Relationships between use of television during meals and children’s food consumption patterns. Pediatrics 2001; 107: E7.
    CrossrefPubMedGoogle Scholar
  • 63 Borzekowski DL, Robinson TN. The 30-second effect: an experiment revealing the impact of television commercials on food preferences of preschoolers. J Am Diet Assoc 2001; 101: 42-6.
    CrossrefPubMedGoogle Scholar
  • 64 Francis LA, Lee Y, Birch LL. Parental Weight Status and Girls’ Television Viewing, Snacking, and Body Mass Indexes. Obesity Research 2003; 11: 143-51.
    CrossrefPubMedGoogle Scholar
  • 65 Story M, Faulkner P. The prime time diet: a content analysis of eating behavior and food messages in television program content and commercials. Am J Pub Health 1999; 80: 738-40.
    PubMedGoogle Scholar
  • 66 Taras HL, Gage M. Advertised foods on children’s television. Arch Pediatr Adolesc Med 1995; 149: 649-52.
    CrossrefPubMedGoogle Scholar
  • 67 Roberts DF, Foehr UG, Rideout VJ, Brodie M. Kids & media @ the new millennium. Menlo Park, CA, A Kaiser Family Foundation Report . 1999
    Google Scholar
  • 68 French SA, Story M, Neumark-Sztainer D, Fulkerson JA, Hannan P. Fast food restaurant use among adolescents: associations with nutrient intake, food choices and behavioral and psychosocial variables. Int J Obes Relat Metab Disord 2001; 25 (12) 1823-33.
    CrossrefPubMedGoogle Scholar
  • 69 Epstein LH, Paluch RA, Consalvi A, Riordan K, Scholl T. Effects of manipulating sedentary behavior on physical activity and food intake. J Pediatr 2002; 140 (03) 334-9.
    CrossrefPubMedGoogle Scholar
  • 70 Nestle M, Jacobson MF. Halting the Obesity Epidemic: A Public Health Policy Approach. Public Health Reports 2000; 115 (01) 12-24.
    CrossrefPubMedGoogle Scholar
  • 71 Resnicow K, Robinson TN. School-based cardiovascular disease prevention studies: review and synthesis. Ann Epidemiol 1997; 7 (Suppl. 07) suppl S14-S31.
    CrossrefPubMedGoogle Scholar
  • 72 Gordon-Larsen P, McMurray RG, Popkin BM. Determinants of adolescent physical activity and inactivity patterns. Pediatrics 2000; 105 (06) E83.
    CrossrefPubMedGoogle Scholar
  • 73 Fulton JE, McGuire MT, Caspersen CJ, Dietz WH. Weight Gain Prevention Among Youth. Sports Med 2001; 31 (03) 153-65.
    CrossrefPubMedGoogle Scholar
  • 74 Golan M, Weizman A. Familial approach to the treatment of childhood obesity: conceptual model. J Nutr Edu 2001; 33: 102-7.
    CrossrefPubMedGoogle Scholar
  • 75 Epstein LH. Family based behavioral intervention for obese children. Int J Obes Relat Metab Disord 1996; 20 (Suppl. 01) Sppl s14-S21.
    PubMedGoogle Scholar
  • 76 American Academy of Pediatrics. Committee on Nutrition. Policy Statement: Prevention of pediatric overweight and obesity. Pediatrics 2003; 112 (02) 424-30.
    CrossrefPubMedGoogle Scholar