TV Time, Especially During Meals, is Associated with Less Healthy Dietary Practices in Toddlers

Melissa R Lutz; Colin J Orr; H Shonna Yin; William J Heerman; Kori B Flower; Lee M Sanders; Russell L Rothman; Jonathan S Schildcrout; Aihua Bian; Melissa C Kay; Charles T Wood; Alan M Delamater; Eliana M Perrin

doi:10.1016/j.acap.2023.09.019

TV Time, Especially During Meals, is Associated with Less Healthy Dietary Practices in Toddlers

Acad Pediatr. 2023 Oct 4:S1876-2859(23)00370-4. doi: 10.1016/j.acap.2023.09.019. Online ahead of print.

Authors

Affiliations

¹ Department of Pediatrics, Johns Hopkins University School of Medicine. Electronic address: mlutz13@jhmi.ed.
² Department of Pediatrics, University of North Carolina at Chapel Hill. Electronic address: cjo1@email.unc.edu.
³ Department of Pediatrics and Population Health, New York University Grossman School of Medicine. Electronic address: yinh02@med.nyu.edu.
⁴ Department of Pediatrics, Vanderbilt University Medical Center. Electronic address: bill.heerman@vumc.org.
⁵ Department of Pediatrics, University of North Carolina at Chapel Hill. Electronic address: kflower@unc.edu.
⁶ Departments of Pediatrics and Health Policy, Stanford University. Electronic address: lsanders@stanford.edu.
⁷ Department of Pediatrics, Vanderbilt University Medical Center; Department of Internal Medicine, Vanderbilt University Medical Center. Electronic address: russell.rothman@vumc.org.
⁸ Department of Biostatistics, Vanderbilt University Medical Center. Electronic address: jonny.schild@vumc.org.
⁹ Department of Biostatistics, Vanderbilt University Medical Center. Electronic address: anna.bian@vumc.org.
¹⁰ Duke Center for Childhood Obesity Research and Duke Global Digital Health Science Center, Duke University School of Medicine, and Duke Global Health Institute. Electronic address: melissa.kay@duke.edu.
¹¹ Department of Pediatrics, Duke University School of Medicine. Electronic address: charles.wood@duke.edu.
¹² Mailman Center for Child Development, University of Miami Miller School of Medicine. Electronic address: adelamater@med.miami.edu.
¹³ Department of Pediatrics, Johns Hopkins University School of Medicine; Johns Hopkins School of Nursing. Electronic address: eperrin@jhmi.edu.

PMID: 37802249
DOI: 10.1016/j.acap.2023.09.019

Abstract

Background: While several studies examine the relationship between screen time and dietary practices in children and teenagers, there is limited research in toddlers. This study evaluates the association between television (TV) exposure and dietary practices in two-year-old children.

Methods: We conducted a cross-sectional, secondary data analysis from the Greenlight Intervention Study. Toddlers' daily TV watching time, mealtime TV, and dietary practices were assessed by caregiver report at the 24-month well child visit. Separate regression models were used and adjusted for sociodemographic/household characteristics and clinic site.

Results: 532 toddlers were included (51% Latino; 30% non-Latino Black; 59% ≤$20,000 annual household income). Median daily TV watching time was 42 minutes [IQR: 25, 60]; 25% reported the TV was "usually on" during mealtimes. After adjustment, toddlers who watched more TV daily had higher odds of consuming sugar-sweetened beverages (SSB), fast food, and more junk food; those watching less TV had higher odds of consuming more fruits/vegetables. Those with the TV "usually on" during mealtimes were more likely to consume SSB [aOR 3.72 (95%CI 2.16-6.43)], fast food [aOR 2.83 (95%CI 1.54-5.20)], and more junk food [aOR 4.25 (95%CI 2.71-6.65)].

Conclusions: Among toddlers from primarily minoritized populations and of lower socioeconomic status, those who watched more TV daily and usually had the TV on during meals had significantly less healthy dietary practices, even after adjusting for known covariates. This study supports the current American Academy of Pediatrics screen time guidelines and underscores the importance of early counseling on general and mealtime TV.

Keywords: Diet; Screen time; Toddlers.