Publication - Progress report

Growing up in Scotland: overweight obesity and activity

Published: 10 May 2012

Report describing the influences of parental factors and family and neighbourhood factors on childrens's weight and sedentary behayiour.

Growing up in Scotland: overweight obesity and activity
CHAPTER 4 PHYSICAL ACTIVITY AND SEDENTARY BEHAVIOUR

CHAPTER 4 PHYSICAL ACTIVITY AND SEDENTARY BEHAVIOUR

4.1 Key findings

  • 15% of children exercised for less than the recommended level of 60 minutes daily, and 31% of children had 3 or more hours of screen time on a typical weekday.
  • Children who were less physically active at age 6 were likely to have been less active when they were younger. Similarly, high sedentary behaviour as measured by screen time at age 6 reflected earlier high levels of screen use.
  • However, it did not appear that high levels of screen time led to lower physical activity, or vice versa. The two behaviours appeared to have different sets of associated factors at age 6.
  • Factors associated with low physical activity included winter season, child characteristics (being an only child, minority ethnic group), maternal characteristics (lower concern for and modelling of physical activity), neighbourhood characteristics (no swimming pool) and a less warm mother-child relationship.
  • High screen time was more common in boys, in families with lower socio-economic status (low maternal education, mother smoking) and in neighbourhoods with poor quality local green spaces. High screen time was also associated with mothers' own screen use and a TV in the child's bedroom. General parenting was also involved, as screen use was greater in families where mothers did fewer activities with their children or had fewer rules for the child's behaviour.
  • Being overweight or obese at age 4 was not a risk factor for either low physical actvity or high screen time at age 6.

4.2 Levels of physical activity and sedentary behaviour at age 6

According to mothers' reports, most children (85%) at age 6 met UK recommended targets for at least 60 minutes of moderate to vigorous physical activity every day (Table 4.1). 15% of the children were exercising for less than the recommended target . There was only a small increase in this figure (to 16%) when school-based activities were excluded. The proportion of children exercising for less than 60 minutes daily in the GUS data set was lower than found in the 2010 Scottish Health Survey ( SHeS). Taking school-based activity into account, the SHeS found that 27% of 5-7 year-olds exercised for less than the recommended amount. Excluding school-based actvities, this figure rose to 37% of 5-7 year olds (Marryat 2011) 13 .

There are no firm guidelines for sedentary behaviour in children, except that it should be limited. Most children (61%) watched TV and/or used a computer or games console for between 1 and 3 hours on a weekday, with just under a third using screens for 3 hours or more (Table 4.1). At the weekend, levels of children's screen use were higher, with around half the sample using screens for 3 hours or more on a Saturday. The SHeS did not have a measure of sedentary behaviour to compare with the GUS measure.

Table 4.1 Levels of physical activity and screen time in the age 6 sample

% Bases
Wtd Uwtd
Physical activity including school-based activity 60+ min on all 7 days 86 2512 2581
30-59 min on all 7 days 8 230 225
Lower level of activity 7 191 184
Total 100 2933 2990
Physical activity excluding school-based activity 60+ min on all 7 days 83 2432 2497
30-59 min on all 7 days 8 245 245
Lower level of activity 8 243 236
Total 100 2920 2978
Weekday screen time Under 1 hour 8 190 212
1 hour to under 2 hours 30 734 803
2 hours to under 3 hours 31 744 757
3 hours plus 31 763 698
Total 100 2431 2470
Saturday screen time Under 1 hour 8 198 201
1 hour to under 2 hours 16 394 421
2 hours to under 3 hours 24 575 608
3 hours plus 52 1248 1228
Total 100 2415 2458

Note: Due to rounding, percentages may not sum to 100.

4.3 Are sedentary behaviour and physical activity interrelated at age 6?

Children with higher levels of screen time were less likely to meet recommended targets for 60 minutes a day of moderate to vigorous physical activity at age 6 (see Figure 4.1 A and Figure 4.1 B). However, even among those children with screen time of 3 hours or more on a weekday, the majority (83%) still met the target.

Figure 4.1 Associations between weekday and Saturday screen time and physical activity level at age 6

A Weekday screen time

Figure 4.1 Associations between weekday and Saturday screen time and physical activity level at age 6 (a)

B Saturday screen time

Figure 4.1 Associations between weekday and Saturday screen time and physical activity level at age 6 (b)

4.4 Associations between activity levels and children's health

Physical activity did not vary systematically according to the child's general health (as reported by mothers at age 6), see Figure 4.2. However, children with poorer health had higher levels of screen time, see Figure 4.3.

Figure 4.2 Percentage of children with low (< 60 minutes daily) physical activity according to child's health at age 6

Figure 4.2 Percentage of children with low (< 60 minutes daily) physical activity according to child's health at age 6

Figure 4.3 Percentage of children with high (3+ hours weekday) screen time according to their health at age 6

Figure 4.3 Percentage of children with high (3+ hours weekday) screen time according to their health at age 6

4.5 Associations between activity levels and season of the year

Children were physically active for longer periods in the second and third quarters of the year, when longer daylight hours permit more outdoor activity (Figure 4.4).

Use of screens showed less seasonal variation than physical activity, but was highest in the first, third and fourth quarters of the year (Figure 4.5). High screen time in the third quarter is likely to reflect increased leisure time during the school summer holidays in July and August.

Figure 4.4 Percentage of children with low (< 60 minutes daily) physical activity according to quarter of the year surveyed at age 6

Figure 4.4 Percentage of children with low (< 60 minutes daily) physical activity according to quarter of the year surveyed at age 6

Figure 4.5 Percentage of children with high (3+ hours weekday) screen time according to quarter of the year surveyed

Figure 4.5 Percentage of children with high (3+ hours weekday) screen time according to quarter of the year surveyed

4.6 Associations between age 6 activity levels and overweight or obesity

Current physical activity levels did not show clear associations with overweight or obesity at age 6 (Table 4.2). Further investigation with more sensitive measures (total minutes per week in all activities) also failed to find an association with overweight and obesity.

Screen time was not associated with overweight and obesity. Again, further investigation of weekend screen time allowing two further extended exposure categories of between 5 and 7 hours (13% of the sample) and 7 or more hours (5% of the sample) also failed to find an association with overweight and obesity.

Although there were no clear associations between either individual activity measure and overweight/obesity, it is possible that children who were less physically active AND used screens for long periods were most at risk. However, further investigation did not support the view that a combination of low activity and high sedentary behaviour, at age 6, is associated with greater risk of being overweight and/or obese (not shown here).

Table 4.2 Physical activity and sedentary behaviour at age 6: associations with age 6 overweight and obesity

% Overweight % Obese Bases
Wtd Uwtd
Physical activity including school-based 60+ min on all 7 days 23 9 2512 2581
30-59 min on all 7 days 20 7 230 225
Lower level of activity 20 9 191 184
Physical activity excluding school-based 60+ min on all 7 days 23 9 2432 2497
30-59 min on all 7 days 20 8 245 245
Lower level of activity 21 9 243 236
Weekday screen time Under 1 hour 19 8 190 212
1 hour to under 2 hours 19 7 734 803
2 hours to under 3 hours 24 9 744 757
3 hours plus 25 11 763 698
Saturday screen time Under 1 hour 18 8 198 201
1 hour to under 2 hours 23 8 394 421
2 hours to under 3 hours 20 9 575 608
3 hours plus 24 10 1248 1228

Note: No differences between groups were statistically significant. Note that associations are measured separately for each factor and do not control for other influences.

A recent UK study found that being overweight led to lower physical activity in children (Metcalf et al. 2011). We also explored whether overweight and obesity at age 4 was associated with later physical activity and sedentary behaviour at age 6. We did not find that children in the GUS sample who were overweight or obese at age 4 adopted different activity patterns from their healthy weight peer group two years later (not shown).

4.7 Exploration of factors associated with age 6 physical activity and sedentary behaviour

This analysis focused on two outcomes:

1. Low physical activity (defined as not meeting recommended guidelines of at least 60 minutes every day, including school-based activity) 14

2. High weekday sedentary behaviour of 3 hours or more screen time 15 .

Associations explored in this section do not take account of possible confounding influences (other factors that simultaneously may play a role).

4.7.1 Child and family characteristics associated with physical activity and sedentary behaviour

Girls and boys were equally likely to meet physical activity targets at age 6, but boys were more likely than girls to spend longer periods using screens. Lower levels of physical activity were seen in children from minority ethnic groups, but there were no ethnic differences in screen time. Children without any siblings had lower physical activity than those from larger families. There appeared to be a U-shaped relationship between the number of children in the family and screen use. The only child, and those in larger families had greater levels of screen time than children with one or two siblings (Table 4.3).

Table 4.3 Child and family characteristics associated with physical activity and sedentary behaviour at age 6

Not active for 60 mins/day (including school activity) Screen time 3+hours weekday
% p Bases % p Bases
Wtd Uwtd Wtd Uwtd
Gender Male 14 NS 1500 1519 34 ** 1293 1306
Female 14 1433 1471 28 1137 1164
Child's ethnic group White 14 *** 2812 2890 31 NS 2333 2390
Minority 30 120 99 35 97 79
Children in household One 19 * 584 551 35 * 482 454
Two 13 1537 1642 29 1293 1373
Three 14 621 635 31 507 519
Four + 12 192 162 39 148 124
Birth order First born 16 * 1471 1444 32 NS 1194 1162
Other children 13 1462 1546 30 1236 1308

Notes: p=probability based on adjusted F where NS=not significant, † p<0.1, * p<0.05, ** p<0.01, *** p<0.001. Note that associations are measured separately for each factor and do not control for other influences.

4.7.2 Parental factors associated with physical activity and sedentary behaviour

Parental modelling

Parental modelling of specific behaviours appeared to be important. There were strong associations between mothers' physical activity at sweep 5 and children's physical activity at age 6. There were also strong associations between between mothers' screen time at sweep 5 and children's screen time at age 6 (Table 4.4). However, mothers' screen time did not predict children's physical activity, nor conversely did mothers' physical activity predict children's screen time.

Mothers' overweight or obesity at age 6 was not associated with children's physical activity or sedentary behaviour (not shown).

Table 4.4 Associations between parental modelling and children's physical activity and sedentary behaviour at age 6

Not active for 60 mins/day (including school activity) Screen time 3+hours weekday
% p Bases % p Bases
Wtd Uwtd Wtd Uwtd
Mother's weekly physical activity sweep 5 (quintiles) q1 - Bottom 20% 21 *** 550 584 31 NS 462 484
q2 17 623 646 29 512 533
q3 11 452 478 28 369 391
q4 10 528 541 28 445 455
q5 - Top 20% 9 574 552 35 472 448
Mother's weekly screen time sweep 5 (tertiles) Low 13 NS 926 1005 21 *** 724 784
Medium 13 978 1021 27 818 856
High 17 1027 961 43 885 827

Notes: p=probability based on adjusted F where NS=not significant, † p<0.1, * p<0.05, ** p<0.01, *** p<0.001. Note that associations are measured separately for each factor and do not control for other influences.

Health-related practices

Earlier measures of children's physical activity gathered at previous sweeps were associated with greater physical activity at age 6, but not with screen time at age 6. Frequency of visiting local green spaces (measured at age 6) was associated with both higher children's physical activity and reduced screen time (Table 4.5).

Children who had a TV in their bedroom at earlier sweeps and who spent a lot of time watching TV and/or playing with a computer or games console at earlier sweeps were more likely to use screens for 3 hours or more at age 6. However, there were no clear associations between earlier screen time and age 6 physical activity (Table 4.6).

Table 4.5 Associations between health practices related to active behaviour and children's physical activity and sedentary behaviour at age 6

Not active for 60 mins/day (including school activity) Screen time 3+hours weekday
% p Bases % p Bases
Wtd Uwtd Wtd Uwtd
Weekly duration child's active behaviour (sweep 3) Less than 1 hr 41 *** 58 55 36 NS 46 44
1 to under 3 hrs 25 251 253 35 211 209
3 to under 5 hrs 21 544 537 36 454 445
5 to under 7 hrs 15 604 620 29 505 519
7 hrs plus 9 1446 1495 30 1191 1230
Physical activity level sweep 5 (quintiles) q1 - Lowest 20% 28 *** 60 1 593 35 NS 507 503
q2 19 557 565 33 462 467
q3 11 598 616 31 512 519
q4 8 592 606 27 476 490
q5 - Top 20% 6 579 601 29 469 484
Frequency mother and child visit local green spaces/month (age 6) Every day 8 *** 488 522 27 ** 391 421
Several times a week 12 747 784 30 615 644
Once a week 16 569 578 30 478 482
Several times a month 13 515 523 30 442 443
Once a month 19 266 263 36 216 216
Less often 22 217 200 40 179 163
Not at all 27 130 119 45 109 100

Notes: p=probability based on adjusted F where NS=not significant, † p<0.1, * p<0.05, ** p<0.01, *** p<0.001. Note that associations are measured separately for each factor and do not control for other influences.

Table 4.6 Associations between earlier screen use and its related factors and children's physical activity and sedentary behaviour at age 6

Not active for 60 mins/day (including school activity) Screen time 3+ hours weekday
% p Bases % p Bases
Wtd Uwtd Wtd Uwtd
TV in bedroom (sweep 5) Yes 14 NS 1511 1367 40 *** 1288 1169
No 15 1413 1612 21 1136 1294
TV in bedroom (age 4) Yes 15 NS 1331 1179 41 *** 1118 996
No 14 1572 1782 23 1293 1458
Hours watching TV on weekday (sweep 3) None 10 NS 15 18 <1 *** 11 13
Up to 30 minutes 14 299 311 23 229 236
30 minutes to 1 hour 11 464 491 22 365 387
1 to 2 hours 15 1015 1063 25 849 882
2 to 3 hours 16 692 689 40 595 595
3 to 4 hours 15 188 180 49 169 163
4 to 5 hours 16 82 71 59 72 65
5 hours or more 11 69 57 53 64 54
Hours watching TV on weekday (age 4) None 13 NS 152 165 17 *** 111 119
Up to 30 minutes 11 78 84 11 59 63
30 minutes to 1 hour 10 155 170 7 114 126
1 to 2 hours 14 1120 1189 22 917 972
2 to 3 hours 15 841 851 38 715 729
3 to 4 hours 16 318 296 46 291 267
4 to 5 hours 24 130 115 63 112 102
5 hours or more 17 104 86 57 88 71
Screen time weekday (sweep 5) Under 1 hour 11 NS 279 314 7 *** 188 211
1 to under 2 hours 14 875 955 14 684 746
2 to under 3 hours 16 903 917 30 776 791
3 to under 5 hours 15 691 656 50 618 590
5 hours or more 11 157 125 65 145 116

Notes: p=probability based on adjusted F where NS=not significant, † p<0.1, * p<0.05, ** p<0.01, *** p<0.001. Note that associations are measured separately for each factor and do not control for other influences.

General patterns of parenting

Aspects of connection, control and conflict were each associated with screen time at age 6. Connection and conflict were associated with physical activity (Table 4.7).

Mothers who had a warm relationship with their child, who engaged in many joint activities and who experienced low levels of conflict were more likely to have physically active children with relatively low levels of screen use. In addition, mothers who had rules to guide their children's behaviour and a more organised home environment were less likely to have children who spent long periods watching TV or playing electronic games.

Parental supervision did not have a clear association with physical activity, although there was a trend for low supervision to be associated with higher levels of screen use.

Table 4.7 Associations between general patterns of parenting and children's physical activity and sedentary behaviour at age 6

Not active for 60 mins/day (including school activity) Screen time 3+ hours weekday
% p Bases % p Bases
Wtd Uwtd Wtd Uwtd
Connection Pianta warmth (quartiles) a q1 - low 17 ** 730 686 38 *** 609 561
q2 and 3 16 871 896 33 725 743
q4 - high 12 1314 1392 26 1084 1154
Mother-child joint activities (quartiles) q1 - low 16 ** 770 721 43 *** 620 579
q2 20 291 290 29 248 247
q3 15 1089 1109 30 900 910
q4 - high 10 783 870 23 663 734
Control Supervision (quintiles) a q1 - low 17 NS 568 534 36 ? 471 445
q2 14 921 906 31 758 741
q3 and 4 14 1015 1065 31 853 897
q5 - high 12 430 485 26 348 387
Number of rules (quintiles) a q1 and q2 - low 15 NS 1055 1017 40 *** 897 867
q3 15 759 788 30 613 633
q4 13 846 904 25 694 741
q5 - high 13 274 281 20 226 229
Home chaos (quintiles) q1 - low 15 NS 766 820 26 *** 639 681
q2 16 676 701 31 558 578
q3 14 474 490 29 393 406
q4 12 628 622 32 518 511
q5 - high 16 390 357 46 323 294
Conflict Pianta conflict (quintiles) q1 - low 13 ** 751 798 27 *** 634 668
q2 17 409 425 27 328 350
q3 11 581 600 27 485 500
q4 13 633 637 34 521 521
q5 - high 18 540 513 42 449 419

Notes: p=probability based on adjusted F where NS=not significant, † p<0.1, * p<0.05, ** p<0.01, *** p<0.001. Note that associations are measured separately for each factor and do not control for other influences. aDue to lack of subdivisions in measures, some percentiles are combined.

4.7.3 Distal family constraints on children's physical activity and sedentary behaviour

There appeared to be no clear social inequalities in the patterning of children's physical activity, according to the distal family constraints examined. There was a trend (bordering on statistical significance) for families on lower incomes and families where the mother had not worked to have lower physical activity levels.

In contrast, children's screen time varied strongly by factors at the family level. These suggest social inequalities in the patterning of children's sedentary behaviour. Children were more likely to use screens for 3 or more hours if their mother did not work, had a relatively low educational level, was a lone parent and had lower levels of household income. Children were also more likely to use screens for longer if their mother was in poor mental or physical health, or if their mother smoked when pregnant. However, mother's working hours were not clearly associated with greater screen use (Table 4.8).

Table 4.8 Family distal constraints associated with children's physical activity and sedentary behaviour at age 6

Not active for 60 mins/day (including school activity) Screen time 3+ hours weekday
% p Bases % p Bases
Wtd Uwtd Wtd Uwtd
Maternal employment per week (sweep 5) 35 hrs or more 11 NS 446 498 25 *** 367 409
16 to less than 35 hrs 14 1183 1271 27 994 1064
Less than 16 hrs 14 307 351 24 251 284
Not working 16 993 865 42 814 708
Mother's education Up to Standard Grades or equivalent 15 NS 1102 934 44 *** 923 782
Higher Grades or equivalent 15 649 669 31 536 555
Upper level VQs ( e.g. HNC, HND) 12 370 400 25 316 340
Degree or equivalent 13 805 980 17 648 787
Biological father in household No 14 NS 849 639 43 *** 682 507
Yes 14 2085 2351 27 1749 1963
Household income (quintiles) Top 60% 13 ? 1499 1784 21 *** 1242 1476
Bottom 40% 15 1418 1192 40 1176 983
Mother's occupational class Managerial and professional occupations 13 ? 1066 1269 19 *** 872 1035
Intermediate occupations 16 570 604 30 475 507
Small employers and own account workers 12 118 134 24 97 110
Lower supervisory and technical occupations 9 163 155 36 137 127
Semi-routine and routine occupations 16 883 746 45 734 623
Never worked 22 132 81 47 115 67
Mother's age at birth of first child Under 20 15 NS 518 360 49 *** 431 298
20 to 29 15 1504 1496 31 1251 1242
30 to 39 14 885 1099 22 728 903
40 or over 16 27 35 30 21 27
Mother's mental health Poor 16 NS 1001 987 35 * 842 823
Average 14 944 997 29 769 815
Good 13 979 1000 30 812 827
Mother's physical health Poor 15 NS 995 980 35 * 814 797
Average 15 1003 1022 29 839 860
Good 13 927 982 30 771 808
Mother's smoking in pregnancy No 14 NS 2221 2395 26 *** 1834 1968
Yes 15 702 585 47 588 494

Notes: p=probability based on adjusted F where NS=not significant, † p<0.1, * p<0.05, ** p<0.01, *** p<0.001. Note that associations are measured separately for each factor and do not control for other influences.

4.7.4 Proximal family constraints

We explored two family level constraints that might affect how mothers managed their child's physical activity and sedentary behaviour. These were mothers' awareness of current guidelines ("target levels") for physical activity in children, and mothers' concerns about their child's weight.

Mothers' views on desirable amount of physical activity in children

At age 6, mothers were asked two questions about the desirable amount of physical activity for children:

  • "How many days a week do you think children of [childname]'s age should do physical activity? Please include all moderate physical activity, including physical activity at school."
  • "On each of the days someone of [childname]'s age does moderate physical activity, how many minutes a day should they do it for it to be good for their health?"

These questions were asked after questions on the child's actual physical activity had been completed. This helped to avoid the possibility of bias in the mothers' responses to the physical activity measures, after raising the issue of desirable levels of physical activity.

Although most (84%) mothers thought their children should take moderate to vigorous physical activity every day, many mothers (57%) did not think children needed to exercise for at least 60 minutes or more each day. 16

Views on desirable levels of physical activity were not associated with mothers' education or occupational class. Mothers who thought children should exercise for at least 60 minutes daily were likely to exercise more themselves, as measured at sweep 5. Mothers with an overweight child and who did not recognise the child's overweight were less likely to think at least an hour of daily physical activity was desirable.

Mothers' views were associated with whether their child met the physical activity target at age 6, but not with their child's sedentary behaviour (screen time):

  • 9% of children failed the target when their mother thought at least 60 minutes daily was desirable, compared to 18% when mothers thought less activity was sufficient
  • levels of screen time of 3 hours or more on a week day were almost identical whether mothers gave a 60-minute target level for physical activity (32%) or not (31%)

Mothers' concerns about their child's weight

At sweeps 4 and 6, mothers were asked: "How concerned are you about [childname]'s weight at the moment?" (with answers on a four-point scale of "not at all", "a little concerned", "quite concerned" and "very concerned"). Mothers were divided into those who were not at all concerned, and those who expressed some concern.

The GUS data do not appear to support the idea that mothers who are more concerned about a child's weight will encourage their child to exercise more and limit sedentary time watching television or using a computer.

There was no clear association between mothers' concern for their child's weight (measured at age 4 or age 6) and children's physical activity level at age 6. Mothers' concern was associated with greater sedentary behaviour: 42% of children with concerned mothers used screens for 3 or more hours, compared to 30% of children with unconcerned mothers ( p<0.001). A similar effect was seen with mother's concern measured at age 4. These findings suggest that the child's weight and/or sedentary behaviour may have led to mothers' concern, rather than mothers' concern succeeding in limiting the child's sedentary behaviour.

4.7.5 Distal neighbourhood constraints on children's physical activity and sedentary behaviour

Children had higher levels of screen use if they lived in an urban or small town setting rather than a rural setting, and if they lived in a deprived neighbourhood. However, meeting recommended physical activity levels was not clearly associated with these neighbourhood factors (Table 4.9).

Table 4.9 Distal neighbourhood constraints associated with children's physical activity and sedentary behaviour at age 6

Not active for 60 mins/day (including school activity) Screen time 3+ hours weekday
% p Bases % p Bases
Wtd Uwtd Wtd Uwtd
Urban-rural Urban 15 NS 2027 1937 33 * 1693 1612
Small town 12 370 407 33 307 339
Rural 15 536 645 25 430 518
Area deprivation quintile 1 - least deprived 12 NS 576 697 20 *** 482 578
2 16 615 706 26 496 571
3 14 565 617 29 461 506
4 12 551 510 38 468 430
5 - most deprived 17 627 459 43 524 384

Notes: p=probability based on adjusted F where NS=not significant, † p<0.1, * p<0.05, ** p<0.01, *** p<0.001. Note that associations are measured separately for each factor and do not control for other influences.

4.7.6 Proximal neighbourhood constraints on children's physical activity and sedentary behaviour

Social and physical aspects of the neighbourhood environment were explored in relation to children's physical activity and screen use at age 6.

Lower "child-friendliness", in terms of mothers' ratings at sweep 3 of the local social and physical environment for children, was associated with failing to meet the physical activity target and with greater screen time at age 6. However, child friendliness measured at age 6 did not show a clear asssociation with meeting the physical activity target at this age.

Some associations between access to local facilities and activity levels were found:

  • access to a playground or park (sweep 2) and access to a pool at age 6 (but not sweep 2) were associated with age 6 physical activity
  • access to a garden 17 was associated with lower screen time, but was not clearly associated with physical activity

Walking time to nearest green space (measured at age 6) was not associated either with physical activity or sedentary behaviour (not shown).

Greater screen time (but not physical activity) was also associated with a lower quality neighbourhood environment, in terms of:

  • poorer quality of local green places
  • concerns over safety of neighbourhood and local play areas
  • greater levels of antisocial behaviour

Table 4.10 Proximal neighbourhood constraints associated with children's physical activity and sedentary behaviour at age 6

Not active for 60 mins/day (including school activity) Screen time 3+ hours weekday
% p Bases % p Bases
Wtd Uwtd Wtd Uwtd
Garden (sweep 1) Yes 14 NS 2653 2767 30 *** 2194 2283
No 18 280 223 44 237 187
Playground/park (sweep 2) Not in area 22 * 191 180 33 NS 155 148
In area 14 2732 2802 31 2267 2316
Swimming pool locally (sweep 6) Not in area 18 ** 740 750 34 NS 617 625
In area 13 2191 2238 31 1812 1844
Rating of local green places to walk/sit (sweep 6) 1 - highest 13 NS 1007 1139 23 *** 809 912
2 14 635 672 29 540 568
3 17 596 582 37 508 496
4 14 306 258 37 250 211
5 13 161 150 45 131 122
6 12 95 80 46 86 73
7 - lowest 22 121 97 42 99 80
Rating of safe places for children to play locally (sweep 6) 1 - highest 12 NS 715 808 23 *** 566 636
2 16 641 695 26 534 579
3 15 674 684 33 576 581
4 14 379 344 40 333 301
5 11 210 182 39 169 150
6 16 136 121 43 120 105
7 - lowest 21 166 144 40 126 111
Neighbourhood safety (sweep 3) High 14 NS 1885 2020 29 *** 1561 1663
Low 16 1048 969 36 869 806
Neighbourhood safety
(sweep 6)
High 14 ? 1470 1604 26 *** 1209 1315
Medium 13 692 697 35 564 569
Low 17   772 689 38   657 586
Safe public play areas locally (sweep 3) Yes 14 NS 2020 2180 27 *** 1655 1780
No 16 885 783 40 751 667
Neighbourhood antisocial behaviour problems (age 6) None 15 ? 1501 1636 28 *** 1233 1343
1 11 625 640 29 518 531
2 17 295 296 37 245 244
3 19 197 183 43 174 159
4 or more 12 312 233 41 258 191
Child friendly neighbourhood (sweep 3) Good 13 * 1100 1236 27 *** 906 1014
Average 12 760 795 30 641 667
Poor 17 1073 958 37 883 788
Child friendly neighbourhood (age 6) Good 14 NS 965 1082 26 *** 784 875
Average 14 989 1042 31 846 888
Poor 15 979 866 37 800 707

Notes: p=probability based on adjusted F where NS=not significant, † p<0.1, * p<0.05, ** p<0.01, *** p<0.001. Note that associations are measured separately for each factor and do not control for other influences. Bases: WTD = weighted, UWTD = unweighted.

4.8 Multivariate modelling of children's physical activity and sedentary behaviour at age 6

This section reports the main findings of multivariate analyses of children's low physical activity (below 60 minutes daily) and high sedentary behaviour (3 hours or more screen time on a weekday) at age 6.

Logistic regression models first investigated selected blocks of variables, before combining all factors in the final model. All models controlled for the child's gender, ethnic group, the number of children in the family, the child's general health and the season of the year when age 6 interviews took place. Detailed modelling results are provided in the Technical Appendix.

In the final model of physical activity, the following factors were significantly associated with the child exercising for less than 60 minutes daily:

  • ethnic minority group
  • being an only child
  • winter season (October-March)
  • no swimming pool in area
  • mother's view that less than 60 minutes' daily physical activity was sufficient for children
  • mother's lower level of physical activity
  • less warmth in the mother-child relationship

In the final model of screen time, the following factors were significantly associated with the child using screens for three hours or more on a weekday:

  • male gender
  • low maternal education
  • mother smoking in pregnancy
  • poor quality local green spaces
  • mother's greater screen time
  • TV in the child's bedroom
  • Fewer joint mother-child activities
  • Fewer rules for the child's behaviour

These findings are summarised in Figure 4.6.

Figure 4.6 Summary of risk factors for children's low physical activity and high screen time at age 6: results of final multivariate modelling

Figure 4.6 Summary of risk factors for children's low physical activity and high screen time at age 6: results of final multivariate modelling

Note: Dark shaded areas indicate associations with low physical activity and high screen time. Model adjusted for all factors together, see Technical Appendix for further details.

Parents who do not recognise that their child is overweight or obese are unlikely to help the child to lose weight. Research elsewhere has found that few parents seem to recognise overweight in their child (Parry et al. 2008; Jones et al. 2011a).

For the most part, this section focuses on the subgroup of GUS children who were defined as overweight or obese on the basis of their BMI at age 6. It explores the extent to which mothers recognised these children as overweight, and investigates factors associated with poor recognition and low levels of concern about children's overweight.


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