Tag Archives: Children

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.

A risky problem: what can keep young people away from alcohol and cigarettes?

Smoking and drinking among very young people has been declining in recent years, but it’s not all good news. There is still a lot of public health concern around the numbers of older children who are consuming alcohol and cigarettes, as these are the young people most likely to come to harm as a result of drinking too much. Their risky behaviours are also likely to persist and intensify into adulthood. So what factors might prevent a young person from smoking and drinking in the first place? New research published in BMC Public Health shows that levels of happiness among children and awareness of the risks may be key to success. Lead author on the research, Noriko Cable, explains more. 

According to Public Health England (PHE), alcohol is now the leading risk factor for ill-health, early mortality and disability among those aged 15 to 49 in England. It wants to “prevent and reduce” the harms caused by alcohol. It also has ambitions to create “a tobacco-free generation” by 2025.

The most recent figures from the Survey of Smoking, Drinking and Drug Use Among Young People in England show that around 90,000 children aged between 11 and 15 are regular smokers and 240,000 have drunk alcohol in the past week. These figures are the lowest they have been since the survey began in 1982.

However, recent research published in BMC Public Health by colleagues at UCL, shows that around one in seven 11 year-olds is drinking alcohol and that having peers who consume alcohol makes them four times more likely to drink that their peers who don’t. We also know that smokers start young, two thirds of them before the age of 18.

So we wanted to examine more closely the sorts of things that might drive young people away from cigarettes and alcohol. In this way we hope to arm policy makers, health practitioners and those working directly with or caring for children and young people with information that can help with the development of clear policies and interventions.

Protective role

We focused on three factors thought to play a protective role in preventing young people from starting to smoke and drink. These were: their awareness of the harms, their well-being or happiness and how supportive their networks of friends and family were.

Information came from Understanding Society, a large UK survey, which, in addition to collecting a wide range of social and economic information from everyone in the household aged 16 and over, has a special self-completion questionnaire for 10-15 year olds. Our sample contained 1,729 boys and girls.

We examined answers at two time points (approximately a year apart) to questions about their smoking and drinking. With these two sets of information, we were able to see whether they had started but then stopped smoking or drinking, whether they were persistent users of cigarettes and alcohol, whether they had started between the first and second surveys (initiation) or whether they had not smoked or drunk alcohol at either point.

The children were also asked about how happy they were with different aspects of their lives, including how they were getting on at school, how they felt about their appearance, family and friends and life in general.

On a scale of 1-4, the children were asked to rate how risky they thought different levels of smoking and drinking were. They were also asked how many supportive friends they had; friends they could confide in.

Harm awareness and happiness

Nearly 70 per cent of the study participants described themselves as persistent non-users of alcohol and cigarettes, and around 13 per cent categorized themselves as persistent users. Persistent non-users scored highest on harm awareness and happiness tests compared to the other groups.

About 8 per cent of the study group labelled themselves as ex-users and about 13 per cent had started using alcohol or cigarettes between the first and second time they completed the survey. Young people aged 10 to 12 were more likely to be in the persistent non-use group, whereas participants aged 13 and above were more likely to be in the persistent user and initiation groups.

We were surprised that while, for most young people, knowledge of the potential and actual harms of alcohol and smoking was linked with them never drinking or smoking, for some it seemed to be associated with them starting to drink or smoke. It is possible that positive expectations from drinking alcohol or smoking cigarettes may, in some way, have overridden their awareness of what harm they could do.

The happier the young person was, and more aware of the harms of alcohol and cigarettes, the more likely they were never to drink or smoke. Having supportive friends to confide in did not play a role in preventing adolescents from using alcohol or cigarettes.

Promoting happiness and harms

So it seems that promoting young people’s happiness and well-being and making them aware of the harms of smoking and drinking may be key to keeping them away from alcohol and cigarettes. In terms of possible timings for information and interventions, another takeaway from the study might be that working with children between the ages of 10 and 12, before they start trying cigarettes and alcohol, could be important.

Because the information used in this study is self-reported, we need to interpret the findings with caution, but they do suggest that making adolescents aware of alcohol and smoking related harm can be helpful in preventing them from engaging in risky health behaviors.

Colleagues at the Centre are now getting to grips with the new age 14 data from the Millennium Cohort Study and, in collaboration with Mentor, a charity working on the ground in schools to tackle alcohol and drug abuse, are hoping to develop our growing body of evidence in this area that will help formulate policies and activities to make some of Public Health England’s ambitions around smoking and alcohol a reality.

Further information

What could keep young people away from alcohol and cigarettes? Findings from the UK Household Longitudinal Study is research by Noriko Cable, Maria Francisca Roman Mella and Yvonne Kelly and is published in BMC Public Health.

 

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.

Sugar-coating the childhood obesity problem

Child obesity figures appear to be on the rise again, causing much concern after earlier signs they had levelled off.  The proportion of  10- and 11-year-olds who were obese in 2015-16 was 19.8 percent, up 0.7 percent on the year before. There was a rise of 0.2 percent among four- and five-year-olds. The announcement comes as researchers at the ESRC International Centre for Lifecourse Studies at UCL have been looking in detail at how and when children become overweight. The team 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. Yvonne Kelly explains the research findings, and considers their implications for the Government’s recent strategy for tackling the childhood obesity epidemic.

The Government’s much-awaited and much-debated childhood obesity strategy was published in August. In the end, it was less comprehensive than had been anticipated, less draconian too. It focuses on two things – reducing sugar consumption and increasing physical activity. But will it be effective in reversing this worrying obesity trend among our children?

It’s fair to say we don’t fully understand what things influence whether, when and why a child might become overweight. Research to date has shown three distinct weight pathways for children: a healthy BMI throughout childhood; becoming overweight during childhood and being overweight/obese throughout childhood.

Previous research has also shown that the child’s mother’s weight, smoking in pregnancy, mental health and other social and economic factors have some link to childhood obesity. But the evidence is far from complete and, where a child’s own mental health is concerned, it’s not at all clear which way the association works.

To try to get a clearer picture of all these things, our research looked at the BMI paths of the participants in the Millennium Cohort Study, which has tracked the lives of nearly 20,000 children born between 2000-2002. We used data collected at birth, 9 months, age 3, 5, 7 and 11.

Once we had established who was on which BMI path, we were able to look at what factors were at play in their lives and to see whether a tendency to overweight and obesity was an indication that a child would go on to face mental health difficulties in early adolescence or start smoking and drinking.

Four pathways to obesity

The BMI data for the 17,000 children we were able to look at for our study showed four distinct groups of children. More than 80 per cent of them stayed on an average non-overweight path throughout their childhood – we call it the ‘stable’ path. There was a small group (0.6 percent) of children who were obese at age 3 but were then in the stable group by age 7. We call them the the ‘decreasing’ group. There was a ‘moderate increasing group’ (13.1 percent) where children were not overweight at age 3 but whose BMIs increased throughout childhood into the overweight (but not obese) range. Finally we had a ‘high increasing’ group of children (2.5 percent) who were obese at age 3 and whose BMIs continued to increase.

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Girls were 30 percent more likely to be in the ‘moderate increasing’ group than boys and were half as likely to be on the ‘decreasing’ path. Indian, Pakistani and Black African children were up to two times more likely to be on the ‘moderate increasing’ path whilst Pakistani, Black Caribbean and Black African children were up to three times more likely to belong to the ‘high increasing’ group.

The wealthiest children were least likely to be in the ‘moderate increasing’ BMI group and children of mums who smoked during pregnancy were up to two times as likely to belong to increasing BMI groups. Children with overweight mums were most likely to be on the moderate and high increasing paths.

Children on the moderate and high increasing paths were less likely to have regular family routines – they were more likely to skip breakfast or have non-regular bedtime schedules. Interestingly, however, no strong links emerged with some of the things more readily linked with childhood obesity such as sugary drinks and snacks, watching TV and lack of physical activity such as sports, the main focus of the newly published childhood obesity strategy.

Overweight factors

So it seems quite a large range of factors influence the likelihood of a child becoming overweight or obese over the first decade of their life. On top of this, being overweight or obese would also seem to point to a less happy and fulfilling early adolescence and a tendency to explore risky behaviours like smoking and drinking.

Although our research did not show a clear link with sugary drinks and snacks, there are nevertheless some compelling arguments for reducing the sugar intake of our children. These are not only related to problems of obesity, but to wider issues including the major issue of tooth decay and associated emergency hospital admissions. There is also increasing evidence of the ‘addictive’ nature of sugar with research suggesting that it stimulates a sort of ‘reward path’ in certain centres of the brain meaning that the more we have the more we want. It has been shown that people who reduce their sugar intake tend to crave it less.

Where sugar taxes have been introduced in other countries (Mexico, France, Denmark, South Africa amongst others), the intervention has been shown to help reduce the consumption of sugary drinks. As yet, there is no evidence that it helps reduce BMI and tackle obesity, but it’s argued it will take time for us to see an effect on whole populations.

Disadvantaged families

It is hard to predict how much impact the voluntary rather than mandatory reduction in sugar content of drinks and snacks agreed in the strategy will have. As for the sugar tax that will be introduced in two years’ time, there remain concerns that disadvantaged families more likely to purchase and consume sugary goods than their better off counterparts will be hardest hit. Policy makers will need to think hard about how any negative consequences of this might be counteracted.

Our research 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. Those influences are at play in families even before our children are born.

Helping pregnant women to stop smoking and maintain a healthy weight, making sure all young children have healthy eating and sleeping routines would seem to be key, together with targeted support for the ethnic and social groups identified as being most at risk.

Further information and resources

BMI development and early adolescent psychosocial well-being: UK Millennium Cohort Study is research by Yvonne Kelly, Praveetha Patalay, Scott Montgomery, and Amanda Sacker. The work, published in Pediatrics, is funded by the Economic and Social Research Council.

Media coverage

Photo credit: Kim Stromstad

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.

Young drinkers: using evidence to prevent alcohol abuse

Research by Child of our Time Editor Yvonne Kelly on 11 year-old drinking has caught the eye of Mentor, a charity working to build resilience among young people to prevent alcohol and drug misuse. The charity’s CEO, Michael O’Toole is now looking to collaborate with Yvonne in future research that will take a look a first look at data from the Millennium Cohort Study in the Autumn. In this episode of the Child of our Time podcast, Michael explains what Mentor is doing, why research based evidence is so important to the charity and how he hopes it will help prevent alcohol abuse among young children in the future.

Photo credit: Joseph Choi

 

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Mixed race kids: happier than we might think!

It’s been said and shown over the last few decades that mixed race and mixed ethnicity children tend not to do as well socially and emotionally as their non mixed peers. But new research casts a rather different light on the matter, showing that children both in the UK and US who are from mixed backgrounds are actually doing rather better.  James Nazroo from the University of Manchester has been looking at the issue with colleagues at the ESRC International Centre for Lifecourse Studies, UCL and discusses his surprising findings in our latest podcast episode.

Socioemotional wellbeing among mixed race/ethnicity children in the UK and US: Patterns and underlying mechanisms is published in the Journal of Health and Social Behaviour. It is part of a wider programme of ESRC funded research led by Child of Our Time editor, Yvonne Kelly at ICLS.

Photo credit: Philippe Put

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Born in Bradford

Born in Bradford is a fascinating child health development project following the lives of thousands of children in the city. It hopes to find out more about the causes of childhood illness by studying children from all cultures and backgrounds as their lives unfold.

In this Child of our Time Podcast episode, one of the project’s lead researchers, Professor Kate Pickett from the University of York, explains more about the study, what’s in it that researchers can use, what  it’s found so far and what we can expect to come out of it in the future.

Photo credit: Tim Green

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