title: The effect of the home environment on physical activity and dietary intake in preschool children.
abstract: BACKGROUND
  The effects of the home environment on child health behaviors related to obesity are unclear.
  
  
  OBJECTIVE
  To examine the role of the home physical activity (PA) and food environment on corresponding outcomes in young children, and assess maternal education/work status as a moderator.
  
  
  METHODS
  Overweight or obese mothers reported on the home PA and food environment (accessibility, role modeling and parental policies). Outcomes included child moderate-vigorous PA (MVPA) and sedentary time derived from accelerometer data and two dietary factors ('junk' and healthy food intake scores) based on factor analysis of mother-reported food intake. Linear regression models assessed the net effect (controlling for child demographics, study arm, supplemental time point, maternal education/work status, child body mass index and accelerometer wear time (for PA outcomes)) of the home environment on the outcomes and moderation by maternal education/work status. Data were collected in North Carolina from 2007 to 2011.
  
  
  RESULTS
  Parental policies supporting PA increased MVPA time, and limiting access to unhealthy foods increased the healthy food intake score. Role modeling of healthy eating behaviors increased the healthy food intake score among children of mothers with no college education. Among children of mothers with no college education and not working, limiting access to unhealthy foods and role modeling reduced 'junk' food intake scores whereas parental policies supporting family meals increased 'junk' food intake scores.
  
  
  CONCLUSIONS
  To promote MVPA, parental policies supporting child PA are warranted. Limited access to unhealthy foods and role modeling of healthy eating may improve the quality of the child's food intake.
authors.affiliation: 1] Department of Community and Family Medicine, Duke University Medical Center, Durham, NC, USA [2] Program in Health Services and Systems Research, Duke-National University of Singapore Graduate Medical School, Singapore.
authors.forename: T
authors.initials: T
authors.lastname: Østbye
authors.forename: R
authors.initials: R
authors.lastname: Malhotra
authors.forename: M
authors.initials: M
authors.lastname: Stroo
authors.forename: C
authors.initials: C
authors.lastname: Lovelady
authors.forename: R
authors.initials: R
authors.lastname: Brouwer
authors.forename: N
authors.initials: N
authors.lastname: Zucker
authors.forename: B
authors.initials: B
authors.lastname: Fuemmeler
mesh_terms: D000328:Adult; D015992:Body Mass Index; D002664:Child Nutritional Physiological Phenomena; D002675:Child, Preschool; D004522:Educational Status; D004651:Employment; D002149:Energy Intake; D015444:Exercise; D005247:Feeding Behavior; D005260:Female; D005500:Follow-Up Studies; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D009035:Mothers / Q000523:psychology / Q000706:statistics & numerical data; D009765:Obesity / Q000453:epidemiology / Q000517:prevention & control* / Q000523:psychology; D010287:Parent-Child Relations; D016487:Parenting / Q000523:psychology; D012931:Social Environment; D014481:United States / Q000453:epidemiology