Fellow Johns Hopkins University School of Medicine Baltimore, Maryland, United States
Background: Prior research, from nearly a decade ago, demonstrated the association between TV time and dietary practices in young children. However, there is limited current research on this topic since other forms of screen time have grown in popularity. Objective: To evaluate the current association between 1) daily TV time and 2) mealtime TV use and the dietary habits of 2-year-old children. Design/Methods: We conducted a cross-sectional analysis of data from the control arm of the Greenlight Plus Study, a randomized trial of an obesity prevention program at 6 US academic pediatric primary care clinics. Parents completed questionnaires about their child’s TV time and dietary practices at the 24-month well visit (collected 2021-2023). Exposures were total minutes of daily TV watching and TV use during mealtimes (often, sometimes, hardly ever/never). Outcomes were counts of fruit, vegetables, fried potatoes, pizza, salty snacks, sweets, and sugar-sweetened beverages (SSB) consumed by the child on an average day (using the CDC dietary screener). Separate ordinal regression models examined associations between TV exposure and each dietary practice and adjusted for annual household income, parent employment status and education level, number of adults and children in the home, daycare attendance, food insecurity, and child WIC enrollment. Results: A total of 306 children with complete data were included in analyses (44% had annual household income <$50,000, 17% reported food insecurity, 55% were enrolled in WIC). Median daily TV watching time was 45 minutes (IQR 20, 90); 15% reported that TV was “often on” during meals. Adjusting for covariates, every 30-minute increase in daily TV time was associated with increased odds of child consuming more fried potatoes, pizza, salty snacks, sweets, and SSB per day. Additionally, even adjusting for covariates, compared to those who report the TV was hardly ever/never on during meals, those the TV was often on during meals consumed more fried potatoes, pizza, salty snacks, and sweets per day (Table 1). There was no significant association between daily TV time or mealtime TV and fruit or vegetable consumption.
Conclusion(s): Daily TV time and mealtime TV were both associated with reported consumption of more calorie-dense, nutrient-poor foods in 2-year-old children, even in an era when other forms of screen time are more widespread. These results add to previously identified associations and underscore the importance of pediatric providers counseling on minimizing TV time at young ages. Future research should examine the same associations for mobile device use and diet.
