Do Weight Status and Television-Viewing Influence Children’s Subsequent Dietary Changes? A National Longitudinal Study in the United States

OBJECTIVE: It is unknown how children’s dietary changes would vary by overweight/obese status and length of TV-viewing. This study examined whether US children’s weight status and TV-viewing duration influenced their subsequent dietary behavioral changes. METHODS: A national representative sample of the Early Childhood Longitudinal Study – Kindergarten Cohort were followed between 5(th) and 8(th) grades during 2004–2007 (N=7,720). Children’s daily TV-viewing hour and weight status were measured at 5(th) grade. Children reported their dietary behaviors at the 5(th) and 8(th) grades, including fruit/vegetable consumption ≥5 times/day (five-a-day), daily fast food and soft drink consumption. Logistic models were used to estimate the odds ratio (OR) of dietary behavioral changes by children’s baseline weight status and TV-viewing duration. Gender and race/ethnicity differences in the ORs were examined. Sampling weight and design effect were considered for the analysis. RESULTS: Among those without five-a-day at 5(th) grade, overweight/obese children were more likely to develop the five-a-day behavior at 8(th) grade than normal weight children (for overweight: OR=1.65, 95% CI=1.14-2.39; obese: OR=1.35, 95% CI=0.81-2.23). Among girls, overweight group was more likely to develop eating vegetable ≥3 times/day than normal weight group, but 1 more hour/day of TV-viewing at baseline was associated with lower odds of developing eating vegetable ≥3 times/day. Overweight/obese black and Hispanic children were significantly more likely to develop five-a-day than their normal weight counterparts. TV-viewing did not show modification effect on the association between weight status and subsequent dietary changes. CONCLUSIONS: Overweight/obese children were more likely to improve their subsequent FV consumption than normal weight children, but TV-viewing’s independent relationship with dietary changes may counteract the weight status-associated dietary improvement.