Tag Archives: Bedtimes

Screen use at seven: overweight at 11. Why it’s time to say no to a TV in the bedroom for children

Since the launch of the Childhood Obesity Strategy in 2016, there has been much attention focused on the so-called ‘Sugar Tax’. The March 2017 Budget saw confirmation that sugary soft drinks would be taxed in an attempt to combat rising levels of obesity. This is an important move that has been met with widespread approval from public health professionals. Still, obesity is hugely complex and there are many other things at play in addition to the sugary drinks and snacks that children may consume. Researchers at UCL have been looking in detail at different factors associated with obesity and, in a recent paper, find that children who have a television in their bedroom have higher BMI and more body fat than those who do not. Lead researcher, Anja Heilmann, explains the research and why saying no to a TV in the bedroom could be another important strategy in combatting childhood obesity.

As our TV screens have got flatter, our children have got fatter. There is no getting away from it! Screen-based activities play a central role in our children’s lives. At a very young age, they have unparalleled access to television screens, computers, game consoles and a host of mobile devices. Among 5 to 11 year-olds, TV is still the most consumed medium, with gaming coming second.

At the same time, childhood obesity is not just a national, but a global health worry. In 2014/15 a third of 11 year-old children in England were overweight and a fifth were obese.

Research has repeatedly reported a link between TV viewing and obesity, but although some has hinted at the idea that a television in a child’s bedroom might exacerbate the problem, the evidence here has been rather contradictory. Other plausible pathways could include eating unhealthy snacks whilst watching TV, exposure to food advertising and insufficient and poor quality sleep.

Using information from the Millennium Cohort Study (MCS), which has followed the lives of more than 18,000 children born around the turn of the century, we had the opportunity to see whether having a TV in their bedroom when they were age 7 was, in any way, linked with a child being overweight when they were 11 years old. In other words, we wanted to get to grips with whether there were implications over a child’s lifetime of their screen use and if so, what those implications were.

Useful information

Using trained interviewers, the MCS collects a wide range of useful information including the independently measured height, weight and body fat of a child. These provided us with a set of obesity-related measurements: weight, Body Mass Index (BMI) and Fat Mass Index (FMI), a powerful set of measures for overweight and obesity.

When the children were age seven, parents were asked if their son or daughter had a TV in their bedroom, how many hours they spent watching TV or DVDs and how much time they spent playing on a computer.

 At age 7, more than half of the 12,556 boys and girls we looked at in our research had a TV in their room and it was these children who were more likely to be overweight when they turned 11 when we compared them with those without a TV. They were also more likely to have higher BMI and FMI. In total, a quarter of the boys and nearly a third of the girls were overweight at age 11 and the links between having a TV in the bedroom and overweight were stronger for the girls.

Another strength of the research is that we controlled for the child’s BMI at age 3 and maternal BMI, that way adjusting for genetic factors, as well as food environment in the family. We also adjusted for family income and mother’s education – both of which are important as overweight/obesity is socially patterned, as is TV use.

Interestingly, there was no link between overweight and the time a child, whether they were a boy or a girl, spent playing on a computer.

Clear link

So, given the size of our sample and the robustness of the methods employed here, we can say with considerable confidence that there is a clear link between having a TV in the bedroom as a young child and being overweight a few years down the line. For girls, this represents a 30 per cent increase in the risk of being overweight at 11 compared with their peers who do not have one. For boys the risk increases by around 20 per cent.

Another interesting point to note is that the size of this risk or effect is about the same as that of other things shown to be linked with obesity, such as not being breastfed and being physically inactive.

Nevertheless, policy makers looking to create and implement strategies to reduce obesity should certainly consider building access to television screens in children’s bedrooms into their thinking. Specific initiatives focused on young girls could also be important.

Meanwhile, for parents who may consider it a good idea for a young child to have their own TV in their bedroom or feel under pressure to provide one, the message is quite clear: resist the idea and you may be doing even more to set your child on a healthier path into their teenage years and beyond.

Longitudinal associations between television in the bedroom and body fatness in a UK cohort study is research by Anja Heilmann, Patrick Rouxel, Emla Fitzsimons, Yvonne Kelly, and Richard Watt and is published in the International Journal of Obesity.

  • Tvs in the bedroom linked to childhood obesity, study finds, The Guardian

Tackling the childhood obesity epidemic: Can regular bedtimes help?

Nearly one in five 10 and 11-year-olds in England is obese, according to NHS figures. With childhood obesity posing not just a nationwide, but a worldwide health threat, public health researchers around the globe are striving to establish which aspects of a young child’s life might set them on a path to being obese later on. Associate Professor Sarah Anderson from The Ohio State University College of Public Health and colleagues from University College London outline the first research to try to disentangle the role of children’s routines and behaviour at age 3 on obesity at age 11 and show that bedtime routines and learning to manage emotions really do matter.

The UK’s Chief Medical Officer Professor Dame Sally Davies has warned that the health of millions of children is in jeopardy and is concerned that being overweight is becoming the norm. She fears half the population could be obese by 2050 at a cost of billions of pounds to the health service and wider economy.

The latest statistics highlight a stark contrast between the wealthiest and poorest families, with childhood obesity rates in the most deprived areas more than double those in the most affluent areas.

Despite the publication in August 2016 of the Government’s long-awaited childhood obesity strategy, charities and health organisations remain highly critical, describing it as a watered-down effort that puts business interests ahead of those of public health. Even the recent introduction of the so-called ‘sugar-tax’ on soft drinks has been met with scepticism in some quarters.

To help inform public health strategies going forward, our researchers looked at the bedtime, mealtime and tv/video routines of very young children and their emotional and behavioural development to see if, at this early stage, it is possible to identify those most at risk of becoming obese.

The study includes information on nearly 11,000 children collected through the UK Millennium Cohort Study (MCS). When the children were three, their parents reported whether children always, usually, sometimes, or never or almost never had a regular bedtime and mealtime, and the amount of television and video they watched each day.

They were also asked a series of questions about the child’s behaviour during the previous six months. Questions were about how children cope with emotions and their persistence and independence in play, including how easily the child became frustrated and whether they sought help from adults when faced with a difficult task. This was to get an idea of how well the child was able to ‘self-regulate’ their behaviour in these areas.

Regular routines

Children with regular bed and mealtimes and who watched less television were better able to control their emotions than their peers with less regular and consistent routines.

At 11-years-old, 6.2 per cent (682) of the children in the MCS were obese, with obesity more common in lower income and less educated families.

Of the routines we studied, inconsistent bedtime was most strongly associated with the risk of obesity, supporting recent findings by our UCL colleagues which showed that young children who skipped breakfast and went to bed at irregular times were more likely to be obese at age 11, stressing the importance of adequate sleep for preventing childhood obesity.

Even children who ‘usually’ had a regular bedtime were 20 per cent more likely to be obese than those who ‘always’ went to bed at around the same time.

Regular bedtimes and obesity

Surprisingly, toddlers with irregular meal times had a lower risk of obesity at age 11. Once other routines were factored in, television viewing was not related to obesity, although it is important to note that computer use was not taken into account, and the media environment for young children today is different than it was when children in MCS were young.

There was also a clear link between lower levels of emotional self-control in early childhood and obesity later on. Children with poor emotion regulation at age 3 were over 50 per cent more likely to be obese when studied at age 11.

Children’s level of persistence and independence was not linked to later obesity, however, and it is possible that this could be explained by the relative immaturity of the parts of the brain responsible for a child’s cognitive compared with their emotional development at this young age.

Strongest risk

Our study is the first to look at the relationship between a child’s routines, their ability to regulate their emotions and behaviour and how these factors work together to predict obesity.

The two strongest risk factors for obesity were irregular bedtime and a poor ability to control emotions and these were completely independent of each other. In other words, the link between bedtimes and obesity could not be explained away by a child’s inability to regulate their emotions.

There is a need to look more closely at the timing and regularity of children’s mealtimes and how they impact obesity later on, as we think there may be a lot more factors at play than we have considered here. We also need to better understand how the development of emotional and cognitive self-regulation interacts with metabolic, behavioural and social pathways to obesity.

However, our study supports previous research showing that children’s emotional regulation develops within a family context which includes routines.

One message from our study is crystal clear. To be effective, obesity strategies must target early childhood, and must find a way to support parents, especially those from the most deprived areas, to introduce and maintain consistent bedtimes and other home routines, as well as help children regulate emotions and respond to stress.

Another key message is that one size does not fit all. There is a lot going on in children’s lives that is important for their health and development. Saying that, it would seem that getting our children to bed at the same time every night could be a simple, cost-effective tool in the tool-kit to get them off to a good start and maybe in the larger battle against obesity.

Self-regulation and household routines at age three and obesity at age 11: Longitudinal analysis of the Millennium Cohort Study is research by Sarah Anderson from The Ohio State University College of Public Health; Amanda Sacker and Yvonne Kelly from University College London and Robert Whitaker of Temple University, Philadelphia.

Giving children the best possible start – what matters most?

Child of our Time Editor Yvonne Kelly spoke to a 500-strong audience of politicians and professionals in Gothenburg recently on what matters when it comes to giving children the best possible start in life.

Yvonne was the keynote speaker at the conference hoping to identify the best strategies for making Gothenburg a more equal and socially sustainable city.

Yvonne, Professor of Lifecourse Epidemiology at the ESRC International Centre for Lifecourse Studies at UCL  explained which factors are most closely linked with a child’s health and well-being and presented her research findings on children’s verbal skills, behaviour, bedtimes, reading and obesity.

Better start for children

Giving children the best possible start in life is the topic of a keynote talk today by our editor Yvonne Kelly.

Yvonne will be presenting a range of new evidence from the ESRC International Centre for Lifecourse Studies  to politicians, business leaders, and other professionals and key decision makers at an event discussing how Gothenburg can be made an equal and socially sustainable city.

Yvonne will talk about the factors which are most closely linked with a child’s health and well-being and present findings on children’s verbal skills, behaviour, bedtimes, reading and obesity. She will make the case that signs of social inequalities are evident early in a child’s life and that it is important to intervene early to tackle those inequalities.

BMI development and early adolescent psychosocial well-being

Research looking at how and when children become overweight is helping to shed new light on ongoing efforts by the Government and others to tackle the childhood obesity epidemic.

A team of researchers at the ESRC International Centre for Lifecourse Studies at UCL has also been asking whether children who are overweight are more likely to go on to smoke and drink alcohol and if their mental health suffers as they become adolescents.

The research, published in Pediatrics, shows clearly that when it comes to the likelihood of a child becoming overweight or obese in the first decade of their life, there are many more influences than just sugar (a main plank in the Government’s Childhood Obesity Strategy).

The research also shows that  influences are at play in families even before children are born and indicates that helping pregnant women to stop smoking and maintain a healthy weight, making sure all young children have healthy eating and sleeping routines may be key, together with targeted support for ethnic and social groups identified as being most at risk.

Lead researcher, Yvonne Kelly presented the findings at the Society for Longitudinal and Life Course Studies 2016 conference in Bamberg.

A bedtime story

Reading is key to giving children the best possible start in life. That’s what Child of our Time Editor Professor Yvonne Kelly will be telling representatives of the Swedish Government and European Commission today when she delivers the key note presentation at a seminar highlighting the importance and benefits of early interventions in children’s lives.

The seminar in Brussels has been organised by the City of Gothenburg in Sweden as part of its efforts to achieve the political goal of becoming an equal city and of its commitment to reduce inequalities.

Yvonne will be sharing research by herself and colleagues at the ESRC International Centre for Lifecourse Studies looking at factors associated with children’s poor verbal skills and behaviour problems. The research shows the links between regular bedtimes and reading with children and better outcomes for them in terms of behaviour and how well they get on at school.

Organisers of the event hope their efforts will encourage other cities in Europe to join them in their ambition to create health equality and a good start in life for all.

Photo credit: Lars Plougmann

Giving children a better start

Child of our Time Editor, Yvonne Kelly will today be discussing why poorer children are more likely to be obese than their better off peers at a Big Lottery Fund event looking at how to give young children a better start in life.

She will be sharing recent research from the team at the ESRC International Centre for Lifecourse Studies at UCL looking at patterns of obesity in  young children using data from the Millennium Cohort Study.

The research finds that children from poorer backgrounds are the most likely to be obese and that the inequalities between richer and poorer children increase over time (between the ages of 5 and 11).

The research also identifies a number of other important factors associated with childhood obesity including smoking during pregnancy, mother’s obesity, skipping breakfast and irregular bedtimes.

The event, A Better Start ‘Focus on Diet and Nutrition is part of a programme of evaluation of the Lottery Funded ‘A Better Start’ initiative which aims to improve the life chances of babies and very young children by delivering a significant increase in the use of preventative approaches in pregnancy and first three years of life.

Yvonne is one of a group of experts and innovators in the field of child health and development to be invited to participate in the first of the initiative’s Learning and Development events. Other speakers include Eustace de Sousa, the lead for children, young people and families at Public Health England and Michael Hallsworth, director for Health at the Government’s Behavioural Insights Team, Chris Cuthbert, Director of the Big Lottery Development Fund and Celia Supiah, CEO of the charity Parents 1st.

Why poorer children are at greater risk of obesity

Obesity may be the biggest public health crisis facing the UK today. Levels have risen more than three fold since 1980. Being obese makes you vulnerable to a range of health risks. Being an overweight child makes it more likely you will become an obese adult. And you are much more likely to be an overweight child, if you come from a poor family. If current trends continue, half the population of Britain could be obese by 2050. Early intervention is the most effective way to break this cycle. And that requires a better understanding of why children become overweight. A new study by a team at the ESRC funded International Centre for Lifecourse Studies in Society and Health at UCL and LSE makes clear the scale of the problem and points to some crucial factors likely to lead less-well-off children to gain excess weight, as co-author Professor Yvonne Kelly explains.

A link between poverty and childhood obesity has been found in many developed countries. Intuitively, it seems likely this link is the result of poorer parents not being able to afford healthier food, like fruit, or outings involving exercise for their children. It could also be that those parents know less about healthy lifestyles and that they themselves eat less healthily and exercise less. But intuition is an insufficient basis for the scale of intervention required. This study is the first attempt to examine and compare in detail why children in poorer families are more likely to be overweight.

Our data comes from the Millennium Cohort Study (MCS). This tracks nearly 20,000 families from across the UK. We used measurements made when the children were aged 5 (when just entering primary school) and 11 (the point at which they leave primary school and are on the cusp of adolescence). We used standard definitions for ‘obese’ and ‘overweight’.

‘Stark’ link between poverty and obesity

The first thing we found was that the link between relative poverty and childhood obesity is stark. At age 5, poor children were almost twice as likely to be obese compared with their better off peers (6.6% of children from families in the poorest fifth of the sample were obese while the figure for the richest fifth is just 3.5%). By the age of 11, the gap has widened- nearly tripling (7.9% of the poorest fifth are obese; for the best-off, the figure is 2.9%).

Given that obesity is linked to the development of numerous chronic diseases and that there is evidence overweight and obese children are less likely to grow into economically and socially successful adults, this is a significant burden to be borne by the children of the less-well-off. And unless we can weaken the link our chances of reversing the overall obesity trend are much reduced.

Potential causes of that link

The MCS collects a broad range of data, allowing us to dig beneath these headline numbers to identify some of the specific ways in which relative poverty in childhood leads to an increased risk of obesity.

To measure the degree to which the mother followed a healthy life-style we looked at factors previously shown to be linked to the increased risk of obesity, such as whether the mother smoked during pregnancy, how long she breastfed for and whether the child was introduced to solid food before the age of four months.

We could also factor in the degree to which the mother was herself overweight or obese. To assess the impact of physical behaviour, we compared the frequency of sport or exercise, active play with a parent, hours spent watching TV or playing on a computer, journeys by bike and the time that children went to bed. We compared dietary habits via data on whether the child skipped breakfast and on fruit and sweet drink consumption.

Multiple factors

What we found was that a lot of these factors were relevant. Maternal behaviour in early childhood was certainly important. Markers of ‘unhealthy’ lifestyle here could mean as much as a 20% additional risk of obesity for a child. Measures of physical activity and diet were also relevant at both 5 and 11 years of age, as were early bedtimes and fewer hours in front of the TV or games console. Skipping breakfast and eating more fruit were factors at 5 but less significant at 11. Doing sport more frequently played a more important and protective role at age 11 than at age 5.

Further examination of the differences between the children aged 5 and aged 11 revealed that poorer children aged 5 were much more likely to gain excess weight up to age 11 than richer children. The earlier certain lifestyle factors can be challenged, therefore, the greater the chance of positive impact.

Multiple responses

Assuming that income inequality is not going to disappear, we can only tackle ‘inherited’ obesity via the lifestyle choices that tend to go with lower incomes. Early intervention with mothers clearly has huge potential. And evidence from our work suggests that this should start before birth or even conception. It is clear, too, that campaigns to encourage family physical activity and healthier diets would help.

The Government is already trying to persuade families to eat more healthily and take more exercise. But these efforts are widely targeted and their effectiveness only broadly assessed. Our analysis has already suggested better targeting. More research should be undertaken to narrow the aim and increase effectiveness still further.

Why are poorer children at higher risk of obesity and overweight? A UK cohort study is research by Alice Goisis, Amanda Sacker and Yvonne Kelly and is published in the European Journal of Public Health.

Photo credit: Playing on the computer,  John Watson

 

 

Bringing up Britain and bedtimes

Can what time a child goes to bed affect how they get on at school was one of the topics under discussion in the first of BBC Radio 4’s Bringing up Britain series, which this week considered whether and how it is possible to boost a child’s IQ. The programme featured research by Child of Our Time Editor, Professor Yvonne Kelly into whether the time a child goes to bed has any influence on their reading and maths ability and spatial awareness.

Presenter Mariella Frostrup and a panel of experts discussed a range of research and views about the role of parenting on intelligence – from the effect of exercise and diet to the difference can breastfeeding, flashcards, violin lessons and superfoods really make.

When it came to looking at the effect of bedtimes, the programme interviewed Professor Kelly, who talked them through findings from her recent work looking at the effects of regular and irregular bedtimes and some 10,000 children in the Millennium Cohort Study.

Speaking on the programme, she explained that that children with irregular bedtimes did not do so well as their counterparts with more regular bedtimes and that the difference was “not trivial”, equating to a difference of around 2-3 IQ points.

The research has also looked at the effects of irregular bedtimes on children’s behaviour as well as how well they are getting on.

If you are interested in finding out more about how the bedtimes research was carried out, you  can listen to Yvonne Kelly in one of our Child of our Time Research Talks here on the blog.

Photo credit: Lars Plougmann

Parenting before and after separation

Do more involved dads have more contact with their child in the event of a separation? And does a mother’s confidence in her ability as a parent take a knock on separation? Researchers Professor Lucinda Platt from the London School of Economics and Political Science and Dr Tina Haux from the University of Kent  have been investigating these questions, using the Millennium Cohort Study, in a Nuffield Foundation funded research project looking at parenting before and after separation.

 

Photo credit: Dani Vazquez