Screen-based sedentary time: Association with soft drink consumption and the moderating effect of parental education in European children: The ENERGY study.
OBJECTIVE
The aim of the present study was to explore if children who spend more time on screen-based sedentary behaviors (i.e.TV viewing and computer use) drink more sugar-sweetened soft drinks. The study also assessed whether these associations were independent of individual and home environmental correlates of soft drink consumption and whether they were moderated by parental education.


METHODS
Data were collected from 7886 children participating in the EuropeaN Energy balance Research to prevent excessive weight Gain among Youth (ENERGY) survey conducted in eight European countries. Self-report questionnaires were used. Multilevel linear regression analyses with soft drink consumption as dependent variable, TV viewing and computer use as independent variables and age, gender, parental education, attitude towards soft drinks, self-efficacy, parental modelling, parental rules and home availability of soft drinks as covariates were conducted. Further interactions were tested to explore if these associations were moderated by parental education. Country-specific analyses were conducted.


RESULTS
In six of the eight included countries, a significant positive association was observed between TV viewing (min/day) and soft drink consumption (ml/day), independent of individual and home environmental correlates of soft drink consumption (B = 0.46 (0.26-0.66) in Greece, B = 0.77 (0.36-1.17) in Norway, B = 0.82 (0.12-1.51) in Hungary, B = 1.06 (0.67-1.46) in Spain, B = 1.21 (0.67-1.74) in Belgium and B = 1.49 (0.72-2.27) in Switzerland). There was no significant association between computer use and soft drink consumption in six of the eight included countries in the final models. Moderation effects of parental education in the association between TV viewing and soft drink consumption were found in Norway and Hungary, the association being stronger among those with low parental education.


CONCLUSIONS
TV viewing appears to be independently associated with soft drink consumption and this association was moderated by parental education in two countries only. Reducing TV time might therefore favorably impact soft drink consumption.
Department of Nutrition, Faculty of Medicine, University of Oslo, Oslo, Norway.
Mekdes K
MK
Gebremariam
Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
Mai J
MJ
Chinapaw
Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland.|University of Basel, Basel, Switzerland.
Bettina
B
Bringolf-Isler
Department of Public Health, Sport and Nutrition, University of Agder, Kristiansand, Norway.
Elling
E
Bere
Department of Paediatrics, Medical Faculty, University of Pécs, Pécs, Hungary.|Institute for Medical Information Processing, Biometrics and Epidemiology German Centre for Vertigo and Balance Disorders, Ludwig Maximilian University, Munich, Germany.
Eva
E
Kovacs
Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium.
Maïté
M
Verloigne
Department of Psychological Assessment and Health Psychology, University of Konstanz, Konstanz, Germany.
F Marijn
FM
Stok
School of Health Science & Education, Department of Nutrition and Dietetics, Harokopio University, Athens, Greece.
Yannis
Y
Manios
Faculty of Social and Behavioral Sciences, University of Amsterdam, Amsterdam, The Netherlands.
Johannes
J
Brug
Department of Nutrition, Faculty of Medicine, University of Oslo, Oslo, Norway.
Nanna
N
Lien
D000293:Adolescent; D000328:Adult; D002253:Carbonated Beverages / Q000706:statistics & numerical data*; D002648:Child; D004522:Educational Status; D005060:Europe; D005260:Female; D006801:Humans; D008297:Male; D010290:Parents / Q000193:education*; D057185:Sedentary Behavior; D013690:Television / Q000706:statistics & numerical data*