Obesogenic behaviors in U.S. school children across geographic regions from 2003-2007

Background: Increasing levels of obesity are likely associated with obesogenic behaviors such as physical activity (PA) and media time. Examination of regional and state differences in meeting recommendations for obesogenic behaviors would be useful for understanding con- current variations in prevalence of childhood obesity. Therefore the purpose of this study was to analyze the prevalence of boys and girls meeting vigorous physical activity (VPA), daily media (TV/video viewing/video game playing) recommendations, and association with over-weight and obesity across regions of the U.S. between 2003 and 2007. Methods: Data from the 2003 and 2007 National Survey of Children’s Health (n = 109,151; 55,540 in 2003 and 53,611 in 2007; 51.3% boys, mean (SE) age 11.5 (0.02) years) were used. Prevalence of meeting weekday media (≤ 2 hr/day) and VPA (≥ 3 days/week of minimum 20 minutes) recommendations were calculated. Logistic regression analyses were used to examine differences across regions, dates, sexes, and obesity status. Results: In 2007, the range for met the recommendations among regions was 74.2% - 82.1% for VPA and 77.2% - 83.7% for media viewing. The regions with the highest positive behavior levels were Alaska and Hawaii for VPA and both the Northeast and West regions for media viewing. In 2007 fewer children met media viewing recom- mendations than in 2003 (78.3% versus 83.6%, respectively, p < 0.0001) but those meeting VPA recommendations increased (74.6% versus 79.2%, p < 0.0001). In most states girls were less likely to meet VPA guidelines, and boys were less likely to meet media guidelines. The adjusted odds of being overweight or obese, in those children aged 10 years and older, were 1.13 (95% CI: 1.05, 1.21) for 0 - 2 days/wk of VPA versus 3 - 7 days/wk and 1.27 (1.17, 1.37) for > 2hr/day versus ≤ 2 hr/day of media time. Further, the interaction between media time and VPA had a significant (p < 0.0001) association with being overweight or obese. Conclusions: Obesogenic behaviors vary by region in the U.S., appear to be changing over time, and are associated overweight and obesity status, though differences between boys and girls are stable.