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April 1996, Vol 150, No. 4 >
Article | April 1996

Television Viewing as a Cause of Increasing Obesity Among Children in the United States, 1986-1990 FREE

Steven L. Gortmaker, PhD; Aviva Must, PhD; Arthur M. Sobol, AM; Karen Peterson, RD, ScD; Graham A. Colditz, MD, DrPH; William H. Dietz, MD, PhD
Arch Pediatr Adolesc Med. 1996;150(4):356-362. doi:10.1001/archpedi.1996.02170290022003.
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Background and Methods:  The prevalence of obesity among children and adolescents has increased, and television viewing has been suggested as a cause. We examined the relation between hours of television viewed and the prevalence of overweight in 1990, and the incidence and remission of overweight from 1986 to 1990 in a nationally representative cohort of 746 youths aged 10 to 15 years in 1990 whose mothers were 25 to 32 years old. Overweight was defined as a body mass index higher than the 85th percentile for age and gender.

Results:  We observed a strong dose-response relationship between the prevalence of overweight in 1990 and hours of television viewed. The odds of being overweight were 4.6 (95% confidence interval, 2.2 to 9.6) times greater for youth watching more than 5 hours of television per day compared with those watching for 0 to 2 hours. When adjustments were made for previous overweight (in 1986), baseline maternal overweight, socioeconomic status, household structure, ethnicity, and maternal and child aptitude test scores, results were similar (odds ratio, 5.3; 95% confidence interval, 2.3 to 12.1). We also found significant relations between television viewing and increased incidence and decreased remission of overweight during this 4-year period, adjusted for baseline covariates. The adjusted odds of incidence were 8.3 (95% confidence interval, 2.6 to 26.5) times greater for youth watching more than 5 hours of television per day compared with those watching for 0 to 2 hours. Estimates of attributable risk indicate that more 60% of overweight incidence in this population can be linked to excess television viewing time.

Conclusion:  Television viewing affects overweight among youth, and reductions in viewing time could help prevent this increasingly common chronic health condition.(Arch Pediatr Adolesc Med. 1996;150:356-362)

REFERENCES

1 +
Gortmaker SL, Dietz WH Jr, Sobol AM, Wehler CA.  Increasing pediatric obesity in the United States . AJDC . 1987;;141:535-540.
2 +
Ross JG, Pate RR, Lohman TG, Christenson GM.  Changes in the body composition of children . J Phys Educ Recreational Dance . 1987;;58:74-77.
3 +
Shear CL, Freedman DS, Burke GL, Harsha DW, Webber LS, Berenson GS.  Secular trends of obesity in early life: the Bogalusa Heart Study . Am J Public Health . 1988;;78:75-77.
4 +
Harlan WR, Landis JR, Flegal KM, Davis CS, Miller ME.  Secular trends in body mass index in the United States: 1960-1980 . Am J Epidemiol . 1988;;128:1065-1074.
5 +
Yip R, Scanlon K, Trowbridge F.  Trends and patterns in height and weight status of low-income US children . Crit Rev Food Sci Nutr . 1993;;33:409-421.
6 +
Centers for Disease Control and Prevention.  Prevalence of overweight for adolescents: Third National Health and Nutrition Examination Survey, Phase I,1988-1991 . MMWR Morb Mortal Wkly Rep . 1994;;43:819-821.
7 +
Dietz WH, Gortmaker SL.  Do we fatten our children at the TV set? obesity and television viewing in children and adolescents . Pediatrics . 1985;;75:807-812.
8 +
Gortmaker SL, Dietz WH, Cheung L.  Inactivity, diet and the fattening of America . JAm Diet Assoc . 1990;;90:1247-1255.
9 +
Shannon B, Peacock J, Brown MJ.  Body fatness, television viewing and calorie intake of a sample of Pennsylvania sixth grade school children . J Nutr Educ . 1991;;23:262-268.
10 +
Robinson TN, Hammer LD, Killen JD, et al.  Does television viewing increase obesity and decrease physical activity? cross-sectional and longitudinal analyses among female adolescents . Pediatrics . 1993;;91:273-280.
11 +
Wolf AM, Gortmaker SL, Cheung L, Gray HM, Herzog DB, Colditz GA.  Activity, inactivity, and obesity: differences related to race, ethnicity, and age among girls, grades 5 to 12 . Am J Public Health . 1993;;83:1625-1627.
12 +
DuRant RH, Baranowski T, Johnson M, Thompson WO.  The relationship among television watching, physical activity, and body composition of young children . Pediatrics . 1994;;94:449-445.
13 +
Garn SM, Clark DC.  Trends in fatness and the origins of obesity . Pediatrics . 1976;;56:443-456.
14 +
Ravelli GP, Belmont L.  Obesity in nineteen-year-old-men: family size and birth order associations . Am J Epidemiol . 1979;;109:66-70.
15 +
Gortmaker SL, Salter CA, Walker DK, Dietz WH Jr.  The impact of television viewing on mental aptitude and achievement: a longitudinal study . Public Opin Q . 1990;;54:594-604.
16 +
Center for Human Resource Research. NLS Users' Guide: 1993 . Columbus, Ohio: Center for Human Resource Research, Ohio State University; 1992;:36.
17 +
Baker PC, Keck CK, Mott FL, Quinlan SV. NLYS Child Handbook: A Guide to the 1986-90 National Longitudinal Survey of Youth Child Data . Revised ed. Columbus, Ohio: Ohio State University; 1993;:12.
18 +
National Center for Health Statistics.  Current Estimates from the National Health Interview Survey; United States, 1988 . Vital Health Stat 10 . 1989;:173.
19 +
Baker PC, Mott FL. NLSY Child Handbook 1989 . Columbus, Ohio: Center for Human Resource Research, Ohio State University; 1989;.
20 +
Must A, Dallal GE, Dietz WH.  Reference data for obesity: 85th and 95th percentiles of body mass index (wt/ht2) and triceps skinfold thickness . Am J Clin Nutr . 1991;;53:839-846.
21 +
 Erratum : Am J Clin Nutr . 1991;;54:773.
22 +
Roche AF, Siervogel RM, Chumlea WC, Webb P.  Grading body fatness from limited anthropometric data . Am J Clin Nutr . 1981;;34:2831-2838.
23 +
Revicki DA, Israel RG.  Relationship between body mass indices and measures of body adiposity . Am J Public Health . 1986;;76:992-994.
24 +
Stunkard AJ, Albaum JM.  The accuracy of self-reported weights . Am J Clin Nutr . 1981;;34:1593-1599.
25 +
Willett WC, Browne ML, Bain C, et al.  Relative weight and the risk of breast cancer among premenopausal women . Am J Epidemiol . 1985;;122:731-740.
26 +
American Academy of Pediatrics. Television and the Family . Elk Grove Village, III: American Academy of Pediatrics; 1986;.
27 +
Nunnally J. Psychometric Theory . New York, NY: McGraw-Hill International Book Co; 1978;.
28 +
Robinson TN, Killen JD.  Ethnic and gender differences in the relationships between television viewing and obesity, physical activity and dietary fat intake . J Sch Health . 1995;;26:91-98.
29 +
Ching PL. Physical Activity and Inactivity in Men and Preadolescent Girls. Boston, Mass: Harvard School of Public Health; 1992.
30 +
Schlesselman J. Case-Control Studies . New York, NY: Oxford University Press Inc; 1982;.
31 +
SAS Institute Inc. SAS/STAT Guide for Personal Computers, Version 6 Edition . Cary, NC: SAS Institute Inc; 1987;.
32 +
Center for Human Resources Research. NLS Users' Guide: 1992. Columbus , Ohio: Ohio State University; 1992;.
33 +
Wacholder S, Benichou J, Henineman EF, Hartge P, Hoover RN.  Attributable risk: advantages of a broad definition of exposure . Am J Epidemiol . 1994;;140: 303-309.
34 +
Dietz WH, Bandini LG, Morelli JA, Peers KF, Ching PL.  Effect of sedentary activity on resting metabolic rate . Am J Clin Nutr . 1994;;59:556-559.
35 +
Epstein LH, Valoski AM, Smith JA, et al.  Sedentary behavior and child weight control . Health Psychol . 1995;;14:1-7.
36 +
Dietz WH, Strasburger VC.  Children, adolescents and television . Curr Probl Pediatr . 1991;;21:8-31.
37 +
Epstein LH, Smith JA, Vara LS, Rodefer JS.  Behavioral economic analysis of activity choice in obese children . Health Psychol . 1991;;10:311-316.
38 +
Vara LS, Epstein LH.  Laboratory assessment of choice between exercise or sedentary behaviors . Res Q Exerc Sport . 1993;;64:356-360.
39 +
US Dept of Health and Human Services. Healthy People 2000: National Health Promotion and Disease Prevention Objectives . Washington DC: US Dept of Health and Human Services, Public Health Service; 1990;.
40 +
Pate RR, Pratt M, Blair SN, et al.  Physical activity and public health: a recommendation from the Centers for Disease Control and the American College of Sports Medicine . JAMA . 1995;;273:402-407.
41 +
Heath GW, Pratt M, Waren CW, Kann L.  Physical activity patterns in American high school students: results from the 1990 Youth Risk Behavior Survey . Arch Pediatr Adolesc Med . 1994;;148:1131-1136.

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

References

1 +
Gortmaker SL, Dietz WH Jr, Sobol AM, Wehler CA.  Increasing pediatric obesity in the United States . AJDC . 1987;;141:535-540.
2 +
Ross JG, Pate RR, Lohman TG, Christenson GM.  Changes in the body composition of children . J Phys Educ Recreational Dance . 1987;;58:74-77.
3 +
Shear CL, Freedman DS, Burke GL, Harsha DW, Webber LS, Berenson GS.  Secular trends of obesity in early life: the Bogalusa Heart Study . Am J Public Health . 1988;;78:75-77.
4 +
Harlan WR, Landis JR, Flegal KM, Davis CS, Miller ME.  Secular trends in body mass index in the United States: 1960-1980 . Am J Epidemiol . 1988;;128:1065-1074.
5 +
Yip R, Scanlon K, Trowbridge F.  Trends and patterns in height and weight status of low-income US children . Crit Rev Food Sci Nutr . 1993;;33:409-421.
6 +
Centers for Disease Control and Prevention.  Prevalence of overweight for adolescents: Third National Health and Nutrition Examination Survey, Phase I,1988-1991 . MMWR Morb Mortal Wkly Rep . 1994;;43:819-821.
7 +
Dietz WH, Gortmaker SL.  Do we fatten our children at the TV set? obesity and television viewing in children and adolescents . Pediatrics . 1985;;75:807-812.
8 +
Gortmaker SL, Dietz WH, Cheung L.  Inactivity, diet and the fattening of America . JAm Diet Assoc . 1990;;90:1247-1255.
9 +
Shannon B, Peacock J, Brown MJ.  Body fatness, television viewing and calorie intake of a sample of Pennsylvania sixth grade school children . J Nutr Educ . 1991;;23:262-268.
10 +
Robinson TN, Hammer LD, Killen JD, et al.  Does television viewing increase obesity and decrease physical activity? cross-sectional and longitudinal analyses among female adolescents . Pediatrics . 1993;;91:273-280.
11 +
Wolf AM, Gortmaker SL, Cheung L, Gray HM, Herzog DB, Colditz GA.  Activity, inactivity, and obesity: differences related to race, ethnicity, and age among girls, grades 5 to 12 . Am J Public Health . 1993;;83:1625-1627.
12 +
DuRant RH, Baranowski T, Johnson M, Thompson WO.  The relationship among television watching, physical activity, and body composition of young children . Pediatrics . 1994;;94:449-445.
13 +
Garn SM, Clark DC.  Trends in fatness and the origins of obesity . Pediatrics . 1976;;56:443-456.
14 +
Ravelli GP, Belmont L.  Obesity in nineteen-year-old-men: family size and birth order associations . Am J Epidemiol . 1979;;109:66-70.
15 +
Gortmaker SL, Salter CA, Walker DK, Dietz WH Jr.  The impact of television viewing on mental aptitude and achievement: a longitudinal study . Public Opin Q . 1990;;54:594-604.
16 +
Center for Human Resource Research. NLS Users' Guide: 1993 . Columbus, Ohio: Center for Human Resource Research, Ohio State University; 1992;:36.
17 +
Baker PC, Keck CK, Mott FL, Quinlan SV. NLYS Child Handbook: A Guide to the 1986-90 National Longitudinal Survey of Youth Child Data . Revised ed. Columbus, Ohio: Ohio State University; 1993;:12.
18 +
National Center for Health Statistics.  Current Estimates from the National Health Interview Survey; United States, 1988 . Vital Health Stat 10 . 1989;:173.
19 +
Baker PC, Mott FL. NLSY Child Handbook 1989 . Columbus, Ohio: Center for Human Resource Research, Ohio State University; 1989;.
20 +
Must A, Dallal GE, Dietz WH.  Reference data for obesity: 85th and 95th percentiles of body mass index (wt/ht2) and triceps skinfold thickness . Am J Clin Nutr . 1991;;53:839-846.
21 +
 Erratum : Am J Clin Nutr . 1991;;54:773.
22 +
Roche AF, Siervogel RM, Chumlea WC, Webb P.  Grading body fatness from limited anthropometric data . Am J Clin Nutr . 1981;;34:2831-2838.
23 +
Revicki DA, Israel RG.  Relationship between body mass indices and measures of body adiposity . Am J Public Health . 1986;;76:992-994.
24 +
Stunkard AJ, Albaum JM.  The accuracy of self-reported weights . Am J Clin Nutr . 1981;;34:1593-1599.
25 +
Willett WC, Browne ML, Bain C, et al.  Relative weight and the risk of breast cancer among premenopausal women . Am J Epidemiol . 1985;;122:731-740.
26 +
American Academy of Pediatrics. Television and the Family . Elk Grove Village, III: American Academy of Pediatrics; 1986;.
27 +
Nunnally J. Psychometric Theory . New York, NY: McGraw-Hill International Book Co; 1978;.
28 +
Robinson TN, Killen JD.  Ethnic and gender differences in the relationships between television viewing and obesity, physical activity and dietary fat intake . J Sch Health . 1995;;26:91-98.
29 +
Ching PL. Physical Activity and Inactivity in Men and Preadolescent Girls. Boston, Mass: Harvard School of Public Health; 1992.
30 +
Schlesselman J. Case-Control Studies . New York, NY: Oxford University Press Inc; 1982;.
31 +
SAS Institute Inc. SAS/STAT Guide for Personal Computers, Version 6 Edition . Cary, NC: SAS Institute Inc; 1987;.
32 +
Center for Human Resources Research. NLS Users' Guide: 1992. Columbus , Ohio: Ohio State University; 1992;.
33 +
Wacholder S, Benichou J, Henineman EF, Hartge P, Hoover RN.  Attributable risk: advantages of a broad definition of exposure . Am J Epidemiol . 1994;;140: 303-309.
34 +
Dietz WH, Bandini LG, Morelli JA, Peers KF, Ching PL.  Effect of sedentary activity on resting metabolic rate . Am J Clin Nutr . 1994;;59:556-559.
35 +
Epstein LH, Valoski AM, Smith JA, et al.  Sedentary behavior and child weight control . Health Psychol . 1995;;14:1-7.
36 +
Dietz WH, Strasburger VC.  Children, adolescents and television . Curr Probl Pediatr . 1991;;21:8-31.
37 +
Epstein LH, Smith JA, Vara LS, Rodefer JS.  Behavioral economic analysis of activity choice in obese children . Health Psychol . 1991;;10:311-316.
38 +
Vara LS, Epstein LH.  Laboratory assessment of choice between exercise or sedentary behaviors . Res Q Exerc Sport . 1993;;64:356-360.
39 +
US Dept of Health and Human Services. Healthy People 2000: National Health Promotion and Disease Prevention Objectives . Washington DC: US Dept of Health and Human Services, Public Health Service; 1990;.
40 +
Pate RR, Pratt M, Blair SN, et al.  Physical activity and public health: a recommendation from the Centers for Disease Control and the American College of Sports Medicine . JAMA . 1995;;273:402-407.
41 +
Heath GW, Pratt M, Waren CW, Kann L.  Physical activity patterns in American high school students: results from the 1990 Youth Risk Behavior Survey . Arch Pediatr Adolesc Med . 1994;;148:1131-1136.

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