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Eur J Pediatr. 2015 May;174(5):631-9. doi: 10.1007/s00431-014-2443-y. Epub 2014 Nov 1.

Television, sleep, outdoor play and BMI in young children: the GECKO Drenthe cohort.

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Department of Epidemiology (FA40), University of Groningen, University Medical Center Groningen, P.O. Box 30.001, 9700 RG, Groningen, The Netherlands,


In this study, we investigated the interplay between screen time, sleep duration, outdoor play, having a television in the bedroom and the number of televisions at home and their association with body mass index (BMI) in preschool children. All participants, 3-4 years of age (n = 759), were part of the Groningen expert center for kids with obesity (GECKO) Drenthe birth cohort. Weight and height were measured. Total screen time, number of televisions at home, a television in the bedroom, sleep duration and time of outdoor play were self-reported by parents in a questionnaire. Ordinary least square (OLS) regression-based path analysis was used to estimate direct and indirect effects on BMI in mediation models. A television in the bedroom or more televisions at home gave a higher screen time, which were associated with decreased sleep duration and resulted in higher BMI (indirect effect = 0.0115, 95% bootstrap interval = 0.0016; 0.0368 and indirect effect = 0.0026, 95% bootstrap interval = 0.0004; 0.0078, respectively). In contrast to the direct effect of screen time, sleep duration and a television in the bedroom on BMI, no direct effect was found for outdoor play and number or televisions at home on BMI.


Short sleep duration, long screen time and a television in the bedroom were associated with the presence of overweight in preschool children.

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