Health Disparities
Adherence to the 9-5-2-1-0 Guidelines and Childhood Obesity in a Racially and Ethnically Diverse Sample of Children: An Ecological Momentary Assessment Study Junia de Brito* Junia de Brito Yasemin Inceoglu Allan Tate Mark Pereira Jerica Berge
Background: In the United States, pediatric guidelines recommend daily adherence to 9 hours of sleep, 5 portions of fruits and vegetables, 2 hours or less of screen time, 1 hour of physical activity, and zero sugar-sweetened beverages (9-5-2-1-0 guidelines) to aid in the prevention of obesity and promote cardiometabolic health. This study aimed to 1) identify the sociodemographic characteristics of children who adhered to 9-5-2-1-0 guidelines and 2) examine the association between adherence to these guidelines and overweight/obesity in a socioeconomically and racially and ethnically diverse sample of children.
Methods: The analytic sample included baseline sociodemographic data from the Family Matters cohort of 1307 families with children (aged 7±1.5 yrs) from Minneapolis–St. Paul, MN. Pediatric 9-5-2-1-0 guidelines data were collected via a 7-day ecological momentary assessment for a subsample (n= 562; 3,596 observation days). BMI data were retrieved from electronic medical records. Descriptive statistics characterized children who adhered to the guidelines. Logistic regression models adjusted by sociodemographic factors examined the association between adherence to these guidelines and child weight status (overweight/obese vs. healthy weight).
Results: Ten, 7, 27, 23, 24, and 18% of the sample met none to 5 guidelines, respectively, across the observation period. Children who met all 5 guidelines were more likely to have a parent self-report White race, higher incomes, advanced education, and hold full-time employment. We did not find evidence that children meeting all 5 guidelines (vs. meeting 0-4) were more likely to have healthy weight status (OR 0.98, 95% CI 0.86-1.13).
Conclusions: There was no evidence indicating that meeting all guidelines was associated with lower weight status, highlighting complex relationships between adherence to recommended health behaviors, sociodemographic factors, and weight outcomes for children living in diverse households.