Screen-time in preschool children from the Melbourne InFANT program: Associations with other early life energyrelated behaviors

Purpose: Preschoolers engage in more screen-time than recommended, yet associations with other energy-balance related behaviors (EBRB) is unknown.

Methods: Data were from 181 control participants in the cluster-randomised controlled Melbourne Infant Feeding, Activity and Nutrition Trial (InFANT) Program. Daily television, computer game, and hand-held e-game use were assessed by parent-report at child age 3.5yrs and summed to provide daily screen-time. Other EBRBs assessed at 9 and 18mths and at 3.5yrs included physical activity (accelerometry; not assessed at 9mths) and outdoor time (parent-report), fruit, vegetable, sweet snack and savoury snack intake (3x24hr diet recall) and zBMI (measured). Associations were assessed using linear regression with bootstrapping and controlling for clustering.

Results: With only ~25% of children reported to use hand-held e-games and 5% computer games, these outcomes were not considered separately. Boys and girls spent an average of 118 and 117min/day, respectively, watching television and 134 and 122min/day in total screen-time with no significant sex differences. Cross-sectional associations with television viewing were shown for outdoor time (B=0.29, 95% CI: 0.03, 0.54) at 3.5 years of age. This association was maintained in the multivariable model (B=0.43, 95% CI: 0.13, 0.73) and observed in the multivariable model for total screen-time also (B=0.52, 95% CI: 0.18, 0.85). Television viewing (positive) and fruit intake (negative) at earlier ages showed longitudinal associations with preschoolers’ television viewing and screen-time.

Conclusions: Findings indicate some clustering of EBRBs and point to potential early life indicators of individuals at risk of high preschool screen-time.