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Changes in Household Routines Help Reduce Kids' Obesity: Study
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TUESDAY, Sept. 10 (HealthDay News) -- Small changes in household routines, such as limiting TV time and increasing sleep time, can help minimize excess weight gain in young children at high risk of obesity, according to new research.
"Improving household routines led to a reduction of the risk of childhood obesity," said study researcher Dr. Elsie Taveras, chief of general pediatrics at Massachusetts General Hospital for Children in Boston.
"We were able to improve sleep time (and) reduce time spent watching television, and we were able to show that in the intervention group, children had a lower rate of weight gain," Taveras said.
"Already by age 2, we see higher rates of obesity among low-income, racial and ethnic minority families," Taveras said.
Both lack of sleep and too much "screen time" are linked to childhood obesity. So Taveras wanted to see if simple changes in household routines could make a difference.
Her team recruited 121 families with 2- to 5-year-old children and assigned half to make these small changes with the help of "health coaches," who made a few home visits and phone calls. The other families got information on child development, such as playing with a child to prepare him or her for school.
Close to half of the children were already overweight for their age and sex, the study authors noted.
After six months, children in the intervention group were sleeping about three-quarters of an hour more at night and watching TV for one hour less on weekends, according to the study published online Sept. 9 in JAMA Pediatrics.
What's more, they had a slower rate of weight gain: After six months, their body mass index (BMI) -- a measure of weight in relation to height -- had dipped. Weight loss was not the goal, the researchers stressed -- just healthier weight gain.
"We would not expect them to lose weight," Taveras said. "They are growing in height and weight. We aimed to slow down the rate of their gaining."
The changes that families made were simple, Taveras said. To encourage more sleep, parents could give their child a warm bath or read a book before bed, acclimating the children to the routine and a consistent bedtime. (Experts say 2- to 5-year-olds need 11 or more hours of sleep to be well-rested.)
Parents said they often used TV as a way to occupy their children while they did household chores. So the researchers supplied the families with simple arts-and-crafts sets and suggested they substitute that for TV.
The researchers also mapped out each family's neighborhood, to help them find nearby playgrounds and parks, as an alternative to TV time.
Taveras said pediatricians and other health care providers might consider suggesting the program -- minus the coaches -- to their patients.
The study is an important one, said Dr. Thomas Robinson, a professor of pediatrics and medicine at Stanford University and Lucile Packard Children's Hospital at Stanford.
"It demonstrates that it may be possible to influence some important health-related behaviors -- sleep and TV watching time -- along with body mass index, with a counseling program for the parents of preschoolers," he said.
"These behaviors and BMI have not been easy to change in a world where junk food and screen time are so heavily marketed, and families are dealing with tremendous financial and social challenges," Robinson said. "I think it is exciting to see studies like this one showing positive results."
Much more research on "possible solutions" is still needed, Robinson said. "But studies like this one demonstrate that the science is progressing and can help us design programs to help slow and hopefully reverse the obesity epidemic."
The families in the study were mostly minority: Just over half of the children were Hispanic, one-third were black, and about 15 percent were classified as "other." The intervention worked equally well across those groups, Taveras said, but it is not clear how well it would work for more-advantaged families.
Another expert who reviewed the findings noted that the study had limitations.
"I think the study findings are encouraging," said Simone French, professor of epidemiology and community health director of the University of Minnesota Obesity Prevention Center. "Researchers are starting to realize that the home environment is an important setting to try to intervene with parents."
However, she said, limitations of the study include the self-reports of changes, although that is a standard way of measuring the behaviors. The challenges, she said, include obtaining funding for the home visits so parents can have support in making the changes.
SOURCES: Elsie Taveras, M.D., M.P.H., chief, general pediatrics, Massachusetts General Hospital for Children, Boston; Thomas Robinson, M.D., M.P.H., professor, pediatrics and medicine, director, Center for Healthy Weight, Stanford University and Lucile Packard Children's Hospital at Stanford, Calif.; Simone French, Ph.D., professor, epidemiology, andcommunity health director, University of Minnesota Obesity PreventionCenter, University of Minnesota School of Public Health, Minneapolis; Sept. 9, 2013, JAMA Pediatrics, online