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Traditional Family Routines Reduce Childhood Obesity?

So, as Michelle Obama yesterday announced her childhood obesity initiative, another piece of news on childhood obesity crowded the news wires.

This was a study by Sarah Anderson (Ohio State) and Robert Whitaker (Temple) published as an early release in Pediatrics.

The researchers performed a cross-sectional analysis of a nationally representative sample of 8550 four-year-old US children who were assessed in 2005 in the Early Childhood Longitudinal Study.

The study focussed on the relationship between obesity and three household routines: regularly eating the evening meal as a family (>5 nights per week); obtaining adequate nighttime sleep on weekdays (10.5 hours per night); and having limited screen-viewing (television, video, digital video disk) time on weekdays (2 hours/day).

Analyses were adjusted for the child’s race/ethnicity, maternal obesity, maternal education, household income, and living in a single-parent household.

While the prevalence of obesity was 14.3% among children exposed to all 3 routines (14.5% of the sample), it was 24.5% among those exposed to none of the routines (12.4%).

The odds of obesity associated with exposure to all 3, any 2, or only 1 routine (compared with none) were 0.63, 0.64, and 0.84, respectively.

So if you do have kids ask yourself:

1) Do we regularly sit down for supper as a family?
2) Do my kids regularly get at least 10.5 hrs of sleep?
3) Do my kids have less than 2 hrs of screen time on weekdays?

A “no” to all of the above, probably puts your kids in the high-risk category, a “yes” to all of the above, and your kids are probably doing fine.

Now comes the tough part, i.e. wether or not, if you are not doing all of the above, simply doing these three things will actually change your kids risk for obesity. Or in other words, if you did nothing else, except sit down for dinner, have the kids in bed by 8.30, and limit their screen time, would your kids actually have healthy weights?

I am guessing that it will take far more than that. In fact I would not at all be surprised if the families that do any of the above were probably quite different from the families that don’t. I would indeed expect that these families are different in so many ways that really, these three factors are probably just “markers” rather than the actual explanation for the lower obesity risk.

Indeed, if you did have the time and parenting skills to ensure that your whole family sits down for supper, your kids don’t watch too much TV, and are off to bed at bedtime, then you are probably also doing a lot of other things right.

On the other hand, if your family meals are chaotic, you have no control over your kids’ screen time, and they are still running around at midnight, there are probably other issues that need to be addressed.

So while the findings are interesting (and by no means surprising), I am not exactly sure how they will help us address the childhood epidemic.

Perhaps a well-designed intervention study will show wether or not simply adopting these three “routines” will actually make a difference.

I certainly appreciate any comments or opinions on whether or not any of my readers think this will work.

Hamburg, Germany


  1. Your remarks are well taken Doc. You are so right.Family life is much more than sitting down for supper.Lifestyles have changed dramatically over the last 40 years or so. Do parents really want the kids they have is a question we must ask.Parenting does not come with an instruction manual. How you teach love, spirituality, doing on to others as you want done to you are all part of a family value system. That is so important.
    You meet Taylor Lebaron lately. How does he measure up to expectations?
    Great article as always.
    Pierre for the Thee Quest team.

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  2. Greetings Dr. Sharma,
    I think really what is important here is the dialog that is taking place about effective strategies to manage and control obesity in the young. We may or may not agree with studies like this or even what Mrs. Obama is trying to do but it’s getting people talking and debating. Personally, I think it will lead to action and hopefully better parenting on the nutrition front.

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  3. I agree that these routines are more likely merely markers…however, for families adopting these routines, wouldn’t many other aspects of family life shift as well? e.g. the relationships between early bed times and parental authority, time spent outdoors, etc. (I personally find bed time more of a challenge on bad weather days when the kids have not been outside). Also, the 3 routines are closely integrated: a four year old who is in all day pre-school/JK or day care, eats a family dinner (sans TV) and goes to bed at a reasonable hour does not have time to fit in 2 hours of tv.

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  4. They are not just markers when they adjust weight the way this study shows. They are essential interactive behaviors which I believe is the leading cause of Obesity. Once you incorporate these types of changes, you can add family exercise, nutrition values and daily activity to help maintain healthy body weight. On closer examination of these behaviors, you might find that that those not eating together and watching more then 2 hours of tv, are eating in front of the tv and likely consuming more calories too.

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  5. The data on the benefits of routine family meals has been consistently strong in terms of average higher grades, lower drug use, and numerous other measures. The daily communication piece and connection among family members is important. One of the factors that is commonly sited in the obesity epidemic is fewer home cooked meals.

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  6. Your point is well taken. I agree, we do need well-designed intervention studies to find out all factors/routines that will actually make a difference. On the other hand, common sense and current knowledge tells us these 3 factors are important and do help us to partly address the childhood epidemic. Lets us start with translating the current knowledge and move forward with conducting additional studies.

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  7. Hi Dr. Sharme
    If I may, in the interest of giving additional information on that topic.
    Let me suggest two texts from Statistic Canada that could bring a historical and social lighting on Canadian families:

    1) Martin Turcotte and Statistic Canada. (2007). Time spent with family during a typical workday, 1986 to 2005 At

    2) René Morissette, Garnett Picot and Statistic Canada.(2005). Low-paid Work and Economically Vulnerable Families over the Last Two Decades


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  8. Yes Dr. Sharma, It seems family have changed of course, in a study conducted in a private school and another public by Quintero et al. (2009) in Porlamar (Margarita Island, Venezuela). The study was conducted by surveying the children and both parents, the results showed the prevalence was higher in children whose parents had higher educational level. This is due to the absence of parents at home so the children spent more time watching TV, less physical activity, eating more snacks and in this case salary income of the parents allowed to buy high calorie fast food which is not cheap in this country.

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