Yi Liu, Ke-Xin Wang, Yu-Xi Zhou, Shi-Yu Yan, Antje Hebestreit, Hai-Jun Wang
{"title":"基于可穿戴摄像头的客观屏幕时间及其与儿童肥胖相关的饮食和身体活动因素的联合关联。","authors":"Yi Liu, Ke-Xin Wang, Yu-Xi Zhou, Shi-Yu Yan, Antje Hebestreit, Hai-Jun Wang","doi":"10.3390/nu17182990","DOIUrl":null,"url":null,"abstract":"<p><p><b>Background and objectives</b>: The objective of this study was to test the effects of objectively measured screen time using wearable cameras, along with dietary intake and physical activity level (and their interaction), on obesity among Chinese school-aged children. <b>Methods</b>: This study was conducted among 52 fourth-grade children (age: 9.76 ± 0.44; 50% boy) in Beijing, including children with obesity and age- and sex-matched normal-weight controls. Screen time (min/day) was coded from wearable camera images collected over one week using image recognition, physical activity measured using accelerometers, and dietary intake via camera-assisted 3-day 24 h dietary recalls. Logistic regression and generalized additive models assessed associations with obesity indicators, including general (obesity; percentage of body fat, BF%) and central (waist circumference; weight-to-height ratio). The combined effects of screen time with dietary and physical activity factors were also analyzed. <b>Results</b>: Children with obesity had longer daily screen time (94.91 ± 35.44 vs. 83.15 ± 36.86 min). Longer screen time was associated with higher energy and carbohydrate intake, more average duration per meal, a higher proportion of meals with screen, increased sedentary time, and a lower proportion of time spent in moderate-to-vigorous physical activity (MVPA). After adjusting for dietary intake and demographic covariates, longer screen time (≥1.3 h/day) was linked to higher odds of obesity (OR = 4.25, 95% CI = 1.09, 16.53) and BF% (OR = 6.14, 95% CI = 1.29, 29.10). Less protein intake (OR = 9.57, 95% CI = 1.31, 70.14), more proportion of meals with screen (OR = 6.40, 95% CI: 1.22, 33.61), less proportion of meals with social interaction (OR = 5.90, 95% CI: 1.01, 34.59), and less MVPA (OR = 5.21, 95% CI = 1.11, 24.43) with more screen time increased obesity risk. <b>Conclusions</b>: Objectively measured screen time was positively associated with the risk of childhood obesity. Longer screen time combined with lower protein intake, a higher proportion of meals consumed while watching screens, less meals with social interaction, and lower MVPA may collectively increase obesity risk. These findings call for efforts to reduce screen exposure, promote MVPA, and increase dietary protein intake. 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Screen time (min/day) was coded from wearable camera images collected over one week using image recognition, physical activity measured using accelerometers, and dietary intake via camera-assisted 3-day 24 h dietary recalls. Logistic regression and generalized additive models assessed associations with obesity indicators, including general (obesity; percentage of body fat, BF%) and central (waist circumference; weight-to-height ratio). The combined effects of screen time with dietary and physical activity factors were also analyzed. <b>Results</b>: Children with obesity had longer daily screen time (94.91 ± 35.44 vs. 83.15 ± 36.86 min). Longer screen time was associated with higher energy and carbohydrate intake, more average duration per meal, a higher proportion of meals with screen, increased sedentary time, and a lower proportion of time spent in moderate-to-vigorous physical activity (MVPA). After adjusting for dietary intake and demographic covariates, longer screen time (≥1.3 h/day) was linked to higher odds of obesity (OR = 4.25, 95% CI = 1.09, 16.53) and BF% (OR = 6.14, 95% CI = 1.29, 29.10). Less protein intake (OR = 9.57, 95% CI = 1.31, 70.14), more proportion of meals with screen (OR = 6.40, 95% CI: 1.22, 33.61), less proportion of meals with social interaction (OR = 5.90, 95% CI: 1.01, 34.59), and less MVPA (OR = 5.21, 95% CI = 1.11, 24.43) with more screen time increased obesity risk. <b>Conclusions</b>: Objectively measured screen time was positively associated with the risk of childhood obesity. Longer screen time combined with lower protein intake, a higher proportion of meals consumed while watching screens, less meals with social interaction, and lower MVPA may collectively increase obesity risk. These findings call for efforts to reduce screen exposure, promote MVPA, and increase dietary protein intake. 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引用次数: 0
摘要
背景和目的:本研究的目的是测试使用可穿戴相机客观测量的屏幕时间,以及饮食摄入量和身体活动水平(及其相互作用)对中国学龄儿童肥胖的影响。方法:本研究以北京地区52名四年级儿童(年龄:9.76±0.44,50%为男生)为研究对象,包括肥胖儿童和年龄、性别匹配的正常体重对照。屏幕时间(分钟/天)由一周内使用图像识别收集的可穿戴相机图像编码,使用加速度计测量身体活动,并通过相机辅助的3天24小时饮食回忆进行饮食摄入。Logistic回归和广义加性模型评估了与肥胖指标的关联,包括一般指标(肥胖;体脂百分比,BF%)和中心指标(腰围;体重与身高比)。还分析了屏幕时间与饮食和体育活动因素的综合影响。结果:肥胖儿童每日屏幕时间较长(94.91±35.44 min vs. 83.15±36.86 min)。较长的屏幕时间与较高的能量和碳水化合物摄入量、较长的平均每餐持续时间、较高的屏幕用餐比例、增加的久坐时间以及较低的中高强度身体活动(MVPA)时间相关。在调整饮食摄入和人口统计学协变量后,较长的屏幕时间(≥1.3小时/天)与较高的肥胖几率(OR = 4.25, 95% CI = 1.09, 16.53)和BF% (OR = 6.14, 95% CI = 1.29, 29.10)相关。更少的蛋白质摄入(OR = 9.57, 95% CI = 1.31, 70.14),更多的屏幕用餐比例(OR = 6.40, 95% CI: 1.22, 33.61),更少的社交用餐比例(OR = 5.90, 95% CI: 1.01, 34.59),以及更少的MVPA (OR = 5.21, 95% CI = 1.11, 24.43)随着屏幕时间的增加,肥胖风险增加。结论:客观测量的屏幕时间与儿童肥胖的风险呈正相关。较长的屏幕时间加上较低的蛋白质摄入量、较高的看屏幕用餐比例、较少的社交用餐以及较低的MVPA可能会增加肥胖风险。这些发现呼吁人们努力减少屏幕暴露,促进MVPA,增加膳食蛋白质摄入量。此外,鼓励儿童在吃饭时避免使用屏幕,并在吃饭时促进父母或同伴的陪伴,可能有助于降低儿童肥胖的风险。
Wearable Camera-Based Objective Screen Time and Its Combined Associations with Dietary and Physical Activity Factors in Relation to Childhood Obesity.
Background and objectives: The objective of this study was to test the effects of objectively measured screen time using wearable cameras, along with dietary intake and physical activity level (and their interaction), on obesity among Chinese school-aged children. Methods: This study was conducted among 52 fourth-grade children (age: 9.76 ± 0.44; 50% boy) in Beijing, including children with obesity and age- and sex-matched normal-weight controls. Screen time (min/day) was coded from wearable camera images collected over one week using image recognition, physical activity measured using accelerometers, and dietary intake via camera-assisted 3-day 24 h dietary recalls. Logistic regression and generalized additive models assessed associations with obesity indicators, including general (obesity; percentage of body fat, BF%) and central (waist circumference; weight-to-height ratio). The combined effects of screen time with dietary and physical activity factors were also analyzed. Results: Children with obesity had longer daily screen time (94.91 ± 35.44 vs. 83.15 ± 36.86 min). Longer screen time was associated with higher energy and carbohydrate intake, more average duration per meal, a higher proportion of meals with screen, increased sedentary time, and a lower proportion of time spent in moderate-to-vigorous physical activity (MVPA). After adjusting for dietary intake and demographic covariates, longer screen time (≥1.3 h/day) was linked to higher odds of obesity (OR = 4.25, 95% CI = 1.09, 16.53) and BF% (OR = 6.14, 95% CI = 1.29, 29.10). Less protein intake (OR = 9.57, 95% CI = 1.31, 70.14), more proportion of meals with screen (OR = 6.40, 95% CI: 1.22, 33.61), less proportion of meals with social interaction (OR = 5.90, 95% CI: 1.01, 34.59), and less MVPA (OR = 5.21, 95% CI = 1.11, 24.43) with more screen time increased obesity risk. Conclusions: Objectively measured screen time was positively associated with the risk of childhood obesity. Longer screen time combined with lower protein intake, a higher proportion of meals consumed while watching screens, less meals with social interaction, and lower MVPA may collectively increase obesity risk. These findings call for efforts to reduce screen exposure, promote MVPA, and increase dietary protein intake. Additionally, encouraging children to avoid screen use during meals and promoting parent or peer companionship during eating may help reduce the risk of childhood obesity.
期刊介绍:
Nutrients (ISSN 2072-6643) is an international, peer-reviewed open access advanced forum for studies related to Human Nutrition. It publishes reviews, regular research papers and short communications. Our aim is to encourage scientists to publish their experimental and theoretical results in as much detail as possible. There is no restriction on the length of the papers. The full experimental details must be provided so that the results can be reproduced.