Background:
There are disproportionately higher rates of overweight and obesity in poor ruralcommunities but studies exploring children’s health-related behaviors that may assist indesigning effective interventions are limited. We examined the association betweenoverweight and obesity prevalence of 401 ethnically/racially diverse, rural school-agedchildren and healthy-lifestyle behaviors: improving diet quality, obtaining adequate sleep,limiting screen-time viewing, and consulting a physician about a child’s weight.
Methods:
A cross-sectional analysis was conducted on a sample of school-aged children (6-11 years) inrural regions of California, Kentucky, Mississippi, and South Carolina participating inCHANGE (Creating Healthy, Active, and Nurturing Growing-up Environments) Programwhose objective was to reduce unhealthy weight gain in school-aged children (grades 1-6) inrural America created by Save the Children (an independent organization that works withcommunities to improve overall child health). After measuring children’s height and weight,we assessed overweight and obesity (BMI [greater than or equal to] 85th percentile) associations with thesebehaviors: improving diet quality (>2 servings of fruits and vegetables/day), reducing wholemilk, sweetened beverage consumption/day; obtaining adequate night-time sleep onweekdays ([greater than or equal to] 10 hours/night); limiting screen-time (i.e., television, video, computer,videogame) viewing on weekdays ([less than or equal to]2 hours/day); and consulting a physician about weight.Analyses were adjusted for state of residence, children’s race/ethnicity, gender, age, andgovernment assistance.
Results:
Overweight or obesity prevalence was 37 percent in Mississippi and nearly 60 percent inKentucky. Adjusting for covariates, obese children were twice as likely to eat > 2 servings ofvegetables per day (OR=2.0,95% CI 1.1-3.4), less likely to consume whole milk(OR=0.4,95% CI 0.2-0.70), more likely to be told by their doctor that their child was obese(OR=108.0,95% CI 21.9-541.6), and less likely for their parents to report talking to theirchild about fruits and vegetables a lot/sometimes vs. not very much/never (OR=0.4, 95%CI0.2-0.98) compared to healthy-weight children.
Conclusions:
Rural children are not meeting recommendations to improve diet, reduce screen time andobtain adequate sleep. Although we expected obese children to be more likely to engage inunhealthy behaviors, we found the opposite to be true. It is possible that these groups ofrespondent parents were highly aware of their weight status and have been advised to changetheir children’s health behaviors. Perhaps given the opportunity to participate in anintervention study in combination with a physician recommendation could have resulted inactual behavior change.