This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on ISI (424)  • Contact me when this article is cited  Related Content  • Related article  • Similar articles in JAMA  Topic Collections  • Obesity  • Humanities  • Medicine and the Media  • Alert me on articles by topic

Results From the Third National Health and Nutrition Examination Survey

Ross E. Andersen, PhD; Carlos J. Crespo, DrPH, MS; Susan J. Bartlett, PhD; Lawrence J. Cheskin, MD; Michael Pratt, MD, MPH

JAMA. 1998;279:938-942.

Context.— Physical inactivity contributes to weight gain in adults, but whether this relationship is true for children of different ethnic groups is not well established.

Objective.— To assess participation in vigorous activity and television watching habits and their relationship to body weight and fatness in US children.

Design.— Nationally representative cross-sectional survey with an in-person interview and medical examination.

Setting and Participants.— Between 1988 and 1994, 4063 children aged 8 through 16 years were examined as part of the National Health and Nutrition Examination Survey III. Mexican Americans and non-Hispanic blacks were oversampled to produce reliable estimates for these groups.

Main Outcome Measures.— Episodes of weekly vigorous activity and daily hours of television watched, and their relationship to body mass index and body fatness.

Results.— Eighty percent of US children reported performing 3 or more bouts of vigorous activity each week. This rate was lower in non-Hispanic black and Mexican American girls (69% and 73%, respectively). Twenty percent of US children participated in 2 or fewer bouts of vigorous activity per week, and the rate was higher in girls (26%) than in boys (17%). Overall, 26% of US children watched 4 or more hours of television per day and 67% watched at least 2 hours per day. Non-Hispanic black children had the highest rates of watching 4 or more hours of television per day (42%). Boys and girls who watch 4 or more hours of television each day had greater body fat (P<.001) and had a greater body mass index (P<.001) than those who watched less than 2 hours per day.

Conclusions.— Many US children watch a great deal of television and are inadequately vigorously active. Vigorous activity levels are lowest among girls, non-Hispanic blacks, and Mexican Americans. Intervention strategies to promote lifelong physical activity among US children are needed to stem the adverse health consequences of inactivity.

From the Divisions of Geriatric Medicine and Gerontology (Dr Andersen) and Gastroenterology (Drs Bartlett and Cheskin), Johns Hopkins University School of Medicine, Baltimore, Md; Department of Health and Fitness, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Md (Dr Crespo); and the Physical Activity and Health Branch, Centers for Disease Control and Prevention, Atlanta, Ga (Dr Pratt). Dr Crespo is now with the American University Department of Health and Fitness, Washington, DC.

RELATED ARTICLE

Does Television Cause Childhood Obesity?
Thomas N. Robinson
JAMA. 1998;279(12):959-960.
EXTRACT | FULL TEXT  

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Effect of Peers and Friends on Youth Physical Activity and Motivation to be Physically Active
Salvy et al.
J Pediatr Psychol 2008;0:jsn071v1-jsn071.
ABSTRACT | FULL TEXT  

Relationship between screen time and metabolic syndrome in adolescents
Mark and Janssen
J Public Health (Oxf) 2008;30:153-160.
ABSTRACT | FULL TEXT  

Amount of Time Spent in Sedentary Behaviors in the United States, 2003-2004
Matthews et al.
Am J Epidemiol 2008;167:875-881.
ABSTRACT | FULL TEXT  

Themed Review: Clinical Interventions to Promote Physical Activity in Youth
Meriwether et al.
AMERICAN JOURNAL OF LIFESTYLE MEDICINE 2008;2:7-25.
ABSTRACT  

The Effects of Food Marketing on Children's Preferences: Testing the Moderating Roles of Age and Gender
Chernin
The ANNALS of the American Academy of Political and Social Science 2008;615:101-118.
ABSTRACT  

Children, Television Viewing, and Weight Status: Summary and Recommendations from an Expert Panel Meeting
Jordan and Robinson
The ANNALS of the American Academy of Political and Social Science 2008;615:119-132.
ABSTRACT  

Assessment of Child and Adolescent Overweight and Obesity
Krebs et al.
Pediatrics 2007;120:S193-S228.
ABSTRACT | FULL TEXT  

Effects of Modifying Physical Activity and Sedentary Behavior on Psychosocial Adjustment in Overweight/Obese Children
Goldfield et al.
J Pediatr Psychol 2007;32:783-793.
ABSTRACT | FULL TEXT  

The Global Epidemic of Obesity: An Overview
Caballero
Epidemiol Rev 2007;0:mxm012v1.
FULL TEXT  

Children's usage of media technologies and psychosocial factors
Heim et al.
New Media Society 2007;9:425-454.
ABSTRACT  

Exposure to Food Advertising on Television Among US Children
Powell et al.
Arch Pediatr Adolesc Med 2007;161:553-560.
ABSTRACT | FULL TEXT  

Trends in vigorous physical activity and TV watching of adolescents from 1986 to 2002 in seven European Countries
Samdal et al.
Eur J Public Health 2007;17:242-248.
ABSTRACT | FULL TEXT  

Childhood Overweight: Parental Perceptions and Readiness for Change
Howard
The Journal of School Nursing 2007;23:73-79.
ABSTRACT  

Perceived parenting style and practices and the consumption of sugar-sweetened beverages by adolescents
van der Horst et al.
Health Educ Res 2007;22:295-304.
ABSTRACT | FULL TEXT  

A comprehensive view of sex-specific issues related to cardiovascular disease
Pilote et al.
CMAJ 2007;176:S1-S44.
ABSTRACT | FULL TEXT  

Longitudinal Relationship Between Television Viewing and Leisure-Time Physical Activity During Adolescence
Taveras et al.
Pediatrics 2007;119:e314-e319.
ABSTRACT | FULL TEXT  

Lessons from sports: children's socialization to values through family interaction during sports activities
Kremer-Sadlik and Kim
Discourse Society 2007;18:35-52.
ABSTRACT  

Estimating the Energy Gap Among US Children: A Counterfactual Approach
Wang et al.
Pediatrics 2006;118:e1721-e1733.
ABSTRACT | FULL TEXT  

Reducing Children's Television-Viewing Time: A Qualitative Study of Parents and Their Children
Jordan et al.
Pediatrics 2006;118:e1303-e1310.
ABSTRACT | FULL TEXT  

Food-Related Advertising on Preschool Television: Building Brand Recognition in Young Viewers
Connor
Pediatrics 2006;118:1478-1485.
ABSTRACT | FULL TEXT  

Television Viewing and Pedometer-Determined Physical Activity Among Multiethnic Residents of Low-Income Housing
Bennett et al.
Am. J. Public Health 2006;96:1681-1685.
ABSTRACT | FULL TEXT  

Effects of Open-Loop Feedback on Physical Activity and Television Viewing in Overweight and Obese Children: A Randomized, Controlled Trial
Goldfield et al.
Pediatrics 2006;118:e157-e166.
ABSTRACT | FULL TEXT  

Active Healthy Living: Prevention of Childhood Obesity Through Increased Physical Activity
Council on Sports Medicine and Fitness and Council
Pediatrics 2006;117:1834-1842.
ABSTRACT | FULL TEXT  

When Children Eat What They Watch: Impact of Television Viewing on Dietary Intake in Youth
Wiecha et al.
Arch Pediatr Adolesc Med 2006;160:436-442.
ABSTRACT | FULL TEXT  

Physical Activity and Sedentary Behavior Patterns Are Associated With Selected Adolescent Health Risk Behaviors
Nelson and Gordon-Larsen
Pediatrics 2006;117:1281-1290.
ABSTRACT | FULL TEXT  

Exercise Locus of Control, Behavior, and Intention Among Mexican American Youth
Guinn et al.
Hispanic Journal of Behavioral Sciences 2006;28:115-126.
ABSTRACT  

Inequality in the Built Environment Underlies Key Health Disparities in Physical Activity and Obesity
Gordon-Larsen et al.
Pediatrics 2006;117:417-424.
ABSTRACT | FULL TEXT  

Do children from an inner city British school meet the recommended levels of physical activity? Results from a cross sectional survey using objective measurements of physical activity
Trayers et al.
Arch. Dis. Child. 2006;91:175-176.
ABSTRACT | FULL TEXT  

Longitudinal Trends in Race/Ethnic Disparities in Leading Health Indicators From Adolescence to Young Adulthood
Harris et al.
Arch Pediatr Adolesc Med 2006;160:74-81.
ABSTRACT | FULL TEXT  

Assessment of Foods Advertised on Children's TV Programs
Hargunani
AAP Grand Rounds 2005;14:66-66.
FULL TEXT  

Psychosocial and Environmental Correlates of Adolescent Sedentary Behaviors
Norman et al.
Pediatrics 2005;116:908-916.
ABSTRACT | FULL TEXT  

A National Study of Neighborhood Safety, Outdoor Play, Television Viewing, and Obesity in Preschool Children
Burdette and Whitaker
Pediatrics 2005;116:657-662.
ABSTRACT | FULL TEXT  

Effects of Dietary Macronutrient Intake on Insulin Sensitivity and Secretion and Glucose and Lipid Metabolism in Healthy, Obese Adolescents
Sunehag et al.
J. Clin. Endocrinol. Metab. 2005;90:4496-4502.
ABSTRACT | FULL TEXT  

Association of physical activity with body-composition indexes in children aged 6-8 y at varied risk of obesity
Rennie et al.
Am. J. Clin. Nutr. 2005;82:13-20.
ABSTRACT | FULL TEXT  

Channel One, the Anti-Commercial Principle, and the Discontinuous Ethos
Brighouse
Educational Policy 2005;19:528-549.
ABSTRACT  

Food advertising on Australian television: the extent of children's exposure
Neville et al.
HEALTH PROMOT INT 2005;20:105-112.
ABSTRACT | FULL TEXT  

Arkansas School Nurses' Role in Statewide Assessment of Body Mass Index to Screen for Overweight Children and Adolescents
Gance-Cleveland and Bushmiaer
The Journal of School Nursing 2005;21:64-69.
ABSTRACT  

A Review of Family and Social Determinants of Children's Eating Patterns and Diet Quality
Patrick and Nicklas
J. Am. Coll. Nutr. 2005;24:83-92.
ABSTRACT | FULL TEXT  

Major differences in prevalence of overweight according to nationality in preschool children living in Germany: determinants and public health implications
Kuepper-Nybelen et al.
Arch. Dis. Child. 2005;90:359-363.
ABSTRACT | FULL TEXT  

Reducing sedentary behaviour and increasing physical activity among 10-year-old children: overview and process evaluation of the 'Switch-Play' intervention
SALMON et al.
HEALTH PROMOT INT 2005;20:7-17.
ABSTRACT | FULL TEXT  

Prevention of the Epidemic Increase in Child Risk of Overweight in Low-Income Schools: The El Paso Coordinated Approach to Child Health
Coleman et al.
Arch Pediatr Adolesc Med 2005;159:217-224.
ABSTRACT | FULL TEXT  

Does Disadvantage Start at Home?: Racial and Ethnic Disparities in Health-Related Early Childhood Home Routines and Safety Practices
Flores et al.
Arch Pediatr Adolesc Med 2005;159:158-165.
ABSTRACT | FULL TEXT  

Factors affecting Nutritional Status of Malaysian Primary School Children
Anuar Zaini et al.
Asia Pac J Public Health 2005;17:71-80.
ABSTRACT  

The Metabolic Syndrome: Look for It in Children and Adolescents, Too!
Jessup and Harrell
Clin. Diabetes 2005;23:26-32.
FULL TEXT  

Promoting Lifestyle and Behavior Change in Overweight Children and Adolescents With Type 2 Diabetes
Schreiner
Diabetes Spectr. 2005;18:9-12.
FULL TEXT  

Type 2 diabetes mellitus in children and adolescents--the beginning of a renal catastrophe?
Kiess et al.
Nephrol Dial Transplant 2004;19:2693-2696.
FULL TEXT  

Physical Activity and Television Viewing in Relation to Risk of Undiagnosed Abnormal Glucose Metabolism in Adults
Dunstan et al.
Diabetes Care 2004;27:2603-2609.
ABSTRACT | FULL TEXT  

Well-Child Visits in the Video Age: Pediatricians and the American Academy of Pediatrics' Guidelines for Children's Media Use
Gentile et al.
Pediatrics 2004;114:1235-1241.
ABSTRACT | FULL TEXT  

Body image and physical activity in British secondary school children
Duncan et al.
European Physical Education Review 2004;10:243-260.
ABSTRACT  

Diet, Physical Activity, and Sedentary Behaviors as Risk Factors for Overweight in Adolescence
Patrick et al.
Arch Pediatr Adolesc Med 2004;158:385-390.
ABSTRACT | FULL TEXT  

Helping Parents Reduce Children's Television Viewing
Jason and Fries
Research on Social Work Practice 2004;14:121-131.
ABSTRACT  

Differences in Body Fat of British Children from Various Ethnic Groups
Duncan et al.
European Physical Education Review 2004;10:41-52.
ABSTRACT  

Association Between Clinically Meaningful Behavior Problems and Overweight in Children
Lumeng et al.
Pediatrics 2003;112:1138-1145.
ABSTRACT | FULL TEXT  

Television Watching and Soft Drink Consumption: Associations With Obesity in 11- to 13-Year-Old Schoolchildren
Giammattei et al.
Arch Pediatr Adolesc Med 2003;157:882-886.
ABSTRACT | FULL TEXT  

Association of Maternal Obesity and Depressive Symptoms With Television-Viewing Time in Low-Income Preschool Children
Burdette et al.
Arch Pediatr Adolesc Med 2003;157:894-899.
ABSTRACT | FULL TEXT  

Pediatric Obesity Policy: The Danger of Skepticism
Cuttler et al.
Arch Pediatr Adolesc Med 2003;157:722-724.
FULL TEXT  

Is Physical Activity Differentially Associated With Different Types of Sedentary Pursuits?
Feldman et al.
Arch Pediatr Adolesc Med 2003;157:797-802.
ABSTRACT | FULL TEXT  

Prevention of Pediatric Overweight and Obesity
Committee on Nutrition
Pediatrics 2003;112:424-430.
ABSTRACT | FULL TEXT  

Television Watching and Other Sedentary Behaviors in Relation to Risk of Obesity and Type 2 Diabetes Mellitus in Women
Hu et al.
JAMA 2003;289:1785-1791.
ABSTRACT | FULL TEXT  

Surveillance of Insulin Resistance in Children
Pereira and Ludwig
Clin. Chem. 2003;49:540-541.
FULL TEXT  

One-Year Changes in Activity and in Inactivity Among 10- to 15-Year-Old Boys and Girls: Relationship to Change in Body Mass Index
Berkey et al.
Pediatrics 2003;111:836-843.
ABSTRACT | FULL TEXT  

Behavioral Correlates of Television Viewing in Primary School Children Evaluated by the Child Behavior Checklist
Ozmert et al.
Arch Pediatr Adolesc Med 2002;156:910-914.
ABSTRACT | FULL TEXT  

Television Viewing and Initiation of Smoking Among Youth
Gidwani et al.
Pediatrics 2002;110:505-508.
ABSTRACT | FULL TEXT  

Evaluation of the Institutionalization of the Coordinated Approach to Child Health (CATCH) in a U.S./Mexico Border Community
Heath and Coleman
Health Educ Behav 2002;29:444-460.
ABSTRACT  

Assessing Risk Factors for Obesity Between Childhood and Adolescence: II. Energy Metabolism and Physical Activity
Salbe et al.
Pediatrics 2002;110:307-314.
ABSTRACT | FULL TEXT  

Management of Child and Adolescent Obesity: Psychological, Emotional, and Behavioral Assessment
Jonides et al.
Pediatrics 2002;110:215-221.
ABSTRACT | FULL TEXT  

The educational experiments of school health promotion for the youth in Japan: analysis of the 'sport test' over the past 34 years
Shingo and Takeo
HEALTH PROMOT INT 2002;17:147-160.
ABSTRACT | FULL TEXT  

School journeys and leisure activities in rural and urban adolescents in Norway
Sjolie and Thuen
HEALTH PROMOT INT 2002;17:21-30.
ABSTRACT | FULL TEXT  

Fitness camp for obese children
Tso and Wong
Promotion & Education 2002;9:44-44.
 

Evidence-Based Nutrition Principles and Recommendations for the Treatment and Prevention of Diabetes and Related Complications
Franz et al.
Diabetes Care 2002;25:148-198.
FULL TEXT  

Are Perceived Neighborhood Hazards a Barrier to Physical Activity in Children?
Romero et al.
Arch Pediatr Adolesc Med 2001;155:1143-1148.
ABSTRACT | FULL TEXT  

Physical activity in Dublin children aged 7-9 years
Hussey et al.
Br. J. Sports. Med. 2001;35:268-272.
ABSTRACT | FULL TEXT  

The Institute of Medicine's "Dietary Reference Intake" for Phosphorus: A Critical Perspective
Sax
J. Am. Coll. Nutr. 2001;20:271-278.
ABSTRACT | FULL TEXT  

Into the Mouths of Babes: The Diabetes Epidemic in Children
Levetan
Clin. Diabetes 2001;19:102-104.
FULL TEXT  

Physical Activity and Television Watching in Relation to Risk for Type 2 Diabetes Mellitus in Men
Hu et al.
Arch Intern Med 2001;161:1542-1548.
ABSTRACT | FULL TEXT  

Environmental Influences, Physical Activity, and Weight Status in 8- to 16-Year-Olds
Dowda et al.
Arch Pediatr Adolesc Med 2001;155:711-717.
ABSTRACT | FULL TEXT  

Coronary Heart Disease in the First 30 Years of the 21st Century: Challenges and Opportunities : The 33rd Annual James B. Herrick Lecture of the Council on Clinical Cardiology of the American Heart Association
Beller
Circulation 2001;103:2428-2435.
FULL TEXT  

Trends in Nutrient Intake of 10-Year-Old Children over Two Decades (1973-1994) : The Bogalusa Heart Study
Nicklas et al.
Am J Epidemiol 2001;153:969-977.
ABSTRACT | FULL TEXT  

Effects of Contingent Television on Physical Activity and Television Viewing in Obese Children
Faith et al.
Pediatrics 2001;107:1043-1048.
ABSTRACT | FULL TEXT  

The Need for Quality Physical Education
Gabbard
The Journal of School Nursing 2001;17:73-75.
ABSTRACT  

Children in Food-Insufficient, Low-Income Families: Prevalence, Health, and Nutrition Status
Casey et al.
Arch Pediatr Adolesc Med 2001;155:508-514.
ABSTRACT | FULL TEXT  

Television Watching, Energy Intake, and Obesity in US Children: Results From the Third National Health and Nutrition Examination Survey, 1988-1994
Crespo et al.
Arch Pediatr Adolesc Med 2001;155:360-365.
ABSTRACT | FULL TEXT  

Metabolic precursors and effects of obesity in children: a decade of progress, 1990-1999
Goran
Am. J. Clin. Nutr. 2001;73:158-171.
ABSTRACT | FULL TEXT  

Child Health in the Information Age: Media Education of Pediatricians
Rich and Bar-on
Pediatrics 2001;107:156-162.
ABSTRACT | FULL TEXT  

The spread of the childhood obesity epidemic
Andersen
CMAJ 2000;163:1461-1462.
FULL TEXT  

Relations of Parental Obesity Status to Physical Activity and Fitness of Prepubertal Girls
Treuth et al.
Pediatrics 2000;106:49e-49.
ABSTRACT | FULL TEXT  

Early risk factors for increased adiposity: a cohort study of African American subjects followed from birth to young adulthood
Stettler et al.
Am. J. Clin. Nutr. 2000;72:378-383.
ABSTRACT | FULL TEXT  

Biobehavioral Factors Are Associated with Obesity in Puerto Rican Children
Tanasescu et al.
J. Nutr. 2000;130:1734-1742.
ABSTRACT | FULL TEXT  

Early-Life Physical Activity and Postmenopausal Breast Cancer: Effect of Body Size and Weight Change
Shoff et al.
Cancer Epidemiol. Biomarkers Prev. 2000;9:591-595.
ABSTRACT | FULL TEXT  

Determinants of Adolescent Physical Activity and Inactivity Patterns
Gordon-Larsen et al.
Pediatrics 2000;105:83e-83.
ABSTRACT | FULL TEXT  

Effects of familial predisposition to obesity on energy expenditure in multiethnic prepubertal girls
Treuth et al.
Am. J. Clin. Nutr. 2000;71:893-900.
ABSTRACT | FULL TEXT  

Decreasing Sedentary Behaviors in Treating Pediatric Obesity
Epstein et al.
Arch Pediatr Adolesc Med 2000;154:220-226.
ABSTRACT | FULL TEXT  

Childhood obesity: time for action, not complacency
Frühbeck
BMJ 2000;320:328-329.
FULL TEXT  

Reducing Children's Television Viewing to Prevent Obesity: A Randomized Controlled Trial
Robinson
JAMA 1999;282:1561-1567.
ABSTRACT | FULL TEXT