There is more to combating obesity than ensuring that children eat healthy food. There are other factors that can increase children's risk of obesity — and they can be addressed within a family.
A recent study found that adjusting a couple household routines in low-income, racially diverse families could help reduce children's weight.
The most successful routines involved increasing the amount of time that children sleep and decreasing the time they spend watching TV on weekdays.
Children in families making these changes saw a small but significant drop in their average body mass index (BMI). BMI is a ratio of a person's height to weight that is used to determine if they are a healthy weight or not.
This study, led by Jess Haines, PhD, MHSc, RD, of the Department of Family Relations and Applied Nutrition at the University of Guelph in Ontario, Canada, looked at whether improving children's home routines reduced their risk of obesity.
The researchers focused on 121 low-income families comprised of racial/ethnic minorities for the study.
The families all had children aged 2 to 5 who also had a television in the room where they slept, which is a risk factor for obesity.
Nearly all of these families (111 of them) were tracked for six months, with 55 families participating in a specific program and 56 families servings as a "control" comparison group.
The average age of the children involved was 4, and 45 percent of them were overweight or obese. Almost 60 percent of the families had household incomes of $20,000 or less.
In addition, 52 percent of the families were Hispanic, 34 percent were black and 14 percent were white/other.
During the six-month study, the program for the 55 "intervention" families focused on four household routines that targeted known obesity risk factors.
These routines included having family meals together, ensuring that children got adequate sleep, limiting children's TV time and removing the TV from the children's bedrooms.
The families were supported through motivational coaching at home and by phone, mailed educational materials and text message reminders.
Meanwhile, the 56 comparison families were mailed materials that focused on child development. These families' outcomes would be compared to those of the families participating in the household routines program.
The researchers measured the effectiveness of the program in two main ways: how well the families adhered to the new routines and whether there was a change in the children's BMI.
The researchers found that the intervention families improved routines and that the children's BMI decreased compared to the comparison families.
Children in the families receiving the household routine coaching increased their sleep by about 0.75 additional hours each night compared to the comparison families' children.
The intervention families' children also decreased their television viewing by about an hour more each weekday compared to the families not receiving household routine coaching.
The children in the families with household routine changes had an average decrease in their BMI of about 0.4 points.
For reference, a BMI of 18.5 to 24.9 is considered normal/healthy in adults, but a healthy BMI in children depends on their age.
The researchers did not find that the frequency of family meals differed between the two groups or that there was a difference in the number of children with a TV in their rooms.
"Our results suggest that promoting household routines, particularly increasing sleep duration and reducing TV viewing, may be an effective approach to reduce body mass index among low-income, racial/ethnic minority children," the researchers wrote.
However, they noted that longer studies are needed to see if the behavioral changes can be maintained over a longer period of time than just six months.
"This is another study confirming the importance of sleep as far as contributing to a person's overall heath," said William Kohler, MD, the medical director of the Florida Sleep Institute in Spring Hill, Florida.
"The bottom line is that improving a child's sleep will improve their potential for getting to or maintaining an ideal weight whereas insufficient sleep has been shown previously to lead to increased weight," Dr. Kohler said.
This study was published September 9 in the journal JAMA Pediatrics. The research was funded by the Centers for Disease Control and Prevention (CDC) and the National Center for Chronic Disease Prevention and Health Promotion. The authors declared no conflicts of interest.