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September 2003

Association of Maternal Obesity and Depressive Symptoms With Television-Viewing Time in Low-Income Preschool Children

Author Affiliations

From the Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center (Drs Burdette, Whitaker, and Kahn), and the Department of Pediatrics, University of Cincinnati College of Medicine (Drs Whitaker and Kahn), Cincinnati, Ohio; and the Department of Nutrition and Food Sciences, University of Vermont, Burlington (Dr Harvey-Berino). Drs Burdette, Whitaker, Kahn, and Harvey-Berino have no relevant financial interest in this article.

Arch Pediatr Adolesc Med. 2003;157(9):894-899. doi:10.1001/archpedi.157.9.894

Background  Decreasing television (TV)-viewing time may improve child health and well-being. These viewing patterns are shaped during the preschool years. Because mothers play an important role in determining how much TV their preschool children watch, a better understanding is needed of the maternal factors that influence children's TV viewing.

Objective  To examine the relationship of depressive symptoms and obesity in low-income mothers with TV-viewing time in their preschool children.

Methods  Cross-sectional, self-administered survey of 295 low-income mothers of 3- and 4-year-old children (92% white) enrolled in the Vermont Special Supplemental Nutrition Program for Women, Infants, and Children. Mothers reported children's usual weekday and weekend-day TV-viewing time. Maternal depressive symptoms were measured with the Center for Epidemiologic Studies Depression Scale (CES-D). Maternal body mass index was calculated from self-reported height and weight measurements (weight in kilograms divided by height in meters squared).

Results  Children watched a mean of 2.2 ±1.2 hours of TV per day. Those in the upper quartile of TV-viewing time (high TV viewers) watched 3 or more hours of TV per day. Of the mothers, 12% had both obesity (BMI ≥30) and depressive symptoms (CES-D score ≥16), 19% were obese only, and 18% had depressive symptoms only. Children were more likely to be high TV viewers if their mothers had clinically significant depressive symptoms (35% vs 23%; P = .03) or if their mothers were obese (35% vs 22%; P = .03). Forty-two percent of children were high TV viewers if the mother had both depressive symptoms and obesity, 30% if the mother had only depressive symptoms, 29% if the mother had only obesity, and 20% if the mother had neither depressive symptoms nor obesity (P = .06 overall; P for trend = .009 using the χ2 test).

Conclusions  Among low-income preschool children, those whose mothers had either depressive symptoms or obesity were more likely to watch 3 or more hours of TV a day. Strategies to reduce TV viewing in young children should consider the role that maternal obesity and depressive symptoms may play in how preschool children spend their time.

TELEVISION (TV) viewing in school-aged children has been associated with obesity,14 aggression,57 and poorer school performance.8 Decreasing TV-viewing time may improve child health and well-being. For this reason, the American Academy of Pediatrics recommends that young children limit TV viewing to no more than 2 hours each day and that children younger than 2 years watch no television.9 Because TV-viewing patterns are shaped during the preschool years,10 interventions to reduce TV viewing should begin at an early age. Mothers play a large role in determining how preschool children spend their time. Therefore, a better understanding is needed of the maternal factors associated with TV viewing in young children.

We hypothesized that 2 such maternal factors might be obesity and symptoms of depression. Both maternal obesity11,12 and maternal depressive symptoms11 are associated with greater maternal TV viewing, and a mother's TV-viewing habits may influence those of her child. Mothers with depressive symptoms may have reduced levels of cognitive and emotional engagement with their children,13 and children's TV viewing could be greater in such circumstances. Maternal obesity and maternal depressive symptoms have been linked1416; the combination of obesity and depressive symptoms could affect children's TV viewing more than either factor alone. In studying the relationship between maternal depression, maternal obesity, and children's TV viewing, we considered maternal level of education and smoking status as important covariates to evaluate. Maternal level of education has been associated with maternal depression,17 maternal obesity,18 and children's TV viewing.10 Maternal smoking is also strongly related to maternal depressive symptoms19,20 and maternal obesity.21

Among low-income preschool children, we examined the hypotheses that hours of TV viewing would be greater in those whose mothers had either clinically significant depressive symptoms or obesity and would be greatest in mothers who had both. We tested these hypotheses in low-income families because obesity,18 depressive symptoms,22,23 and TV viewing11 are more common in low-income women.

Research design and setting

We conducted a cross-sectional, self-administered survey of 295 low-income mothers of 3- and 4-year-old children enrolled in the Vermont Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). This is a federal program that provides supplemental food and nutrition counseling to low-income mothers and their children from birth through age 4 years. To be eligible for WIC, the family income must be at or lower than 185% of the federal poverty level.

Sample and questionnaire administration

Our survey was administered to mothers of 3- and 4-year-old children at 4 Vermont WIC clinics (2 urban and 2 rural) as part of a baseline assessment for a controlled trial. The aim of the trial was to examine the effectiveness of an intervention to promote physical activity in these children. To be eligible for participation, mothers were required to be English speaking, to have a working telephone, and to have a child who was free of any chronic health condition that clearly affected physical activity (eg, cerebral palsy). From January 2001 through November 2001, recruitment occurred in separate 8-week blocks at each of the 4 clinics. During each recruitment block, we attempted to enroll all eligible mothers bringing their children to that clinic for their biannual WIC recertification visit. Of the 360 mothers identified as eligible, 65 (18%) refused to participate. The most common reason for refusal was lack of time at that visit to complete the baseline questionnaire. This study was approved by the Committee on Human Research in the Behavioral Sciences at the University of Vermont (Burlington) and by the Vermont Department of Health. Each mother provided written informed consent before participation.

Main outcome measure

A child's daily TV-viewing time was obtained from the maternal response to 2 questions on the survey that were adapted from those used in the National Longitudinal Survey of Youth.24 The 2 questions on our survey were as follows: (1) "Think for a moment about a typical weekday for your family in the last month. How much time would you say your child spends watching television on a typical weekday?" (2) "Now think about a typical weekend day for your family in the last month. How much time would you say your child spends watching television on a typical weekend day?" Mothers were asked to record their responses in hours and minutes.

Predictor measures

The Center for Epidemiologic Studies Depression Scale (CES-D) was used to measure depressive symptoms among the mothers. The reliability and validity of this scale for detecting depressive symptoms has been established in previous studies.25,26 The scale produces possible scores from 0 to 60 based on responses to 20 self-administered items. A higher score indicates more depressive symptoms, and a score of 16 or higher is commonly used as the cutoff point for defining clinically significant depressive symptoms.25 Because the CES-D is a screening tool, it cannot be used to make a definitive diagnosis of depression. However, to make our results easier to report and understand, we have chosen to refer to mothers with a score of 16 or higher as depressed or having depression.

Maternal body mass index (BMI) was calculated from self-reported height and weight measurements (weight in kilograms divided by height in meters squared). Pregnant mothers were asked to report their prepregnancy weight, and these values were used to calculate the BMI. Obesity was defined as a BMI of 30 or higher.27,28

Additional variables

At the end of the maternal questionnaire, there were self-report items for sociodemographic variables such as maternal age, level of education, marital status, pregnancy status, and smoking status. The mother also reported the child's date of birth and race and was asked if she had delivered a child within the past 12 weeks.

Data analysis

The main outcome measure, TV-viewing time, was analyzed as both a continuous (in minutes) and dichotomous variable (upper quartile vs lower quartiles). To enhance the clinical relevance and interpretation of our findings, maternal BMI values and maternal CES-D score were treated as dichotomous variables (maternal obesity, BMI ≥30; maternal depression, CES-D score ≥16) in the analyses. Children were placed into 1 of the following 4 groups based on the obesity and depression status of their mothers: neither obese nor depressed, obese but not depressed, depressed but not obese, or both obese and depressed.

Bivariate analyses were first conducted to evaluate the relationship between TV-viewing time and the other study variables. Only variables significantly related to TV-viewing time were considered to potentially confound the relationship between this outcome measure and either maternal depression or maternal obesity. We used multivariate linear regression with TV-viewing time (in minutes) as the dependent variable to control for confounding and explore possible interactions among study variables. To assess interactions in each model, we included the main effects and assessed the statistical significance (P<.05) of the interaction term. The following interaction terms were evaluated: maternal depression × maternal obesity, maternal depression × child sex, maternal obesity × child sex, maternal depression × maternal level of education, and maternal obesity × maternal level of education.

We used analysis of variance to compare the mean children's TV-viewing times across the 4 groups defined by maternal obesity and depression status (with and without covariate adjustments), and we used the Newman-Keuls test for pairwise comparison of group means. Finally, using the χ2 statistic, the proportion of children in the upper quartile of TV viewing was compared with that of children in the remaining 3 quartiles according to maternal depression and obesity status.


The questionnaire was completed by 295 mothers, 276 (94%) of whom were the biological mother. The mean ± SD age of the children was 46 ± 8 months, 92% were white, and 55% were boys. Forty-four percent attended 1 of the 2 rural WIC clinics, and 48% of the children spent some part of their week in day care.

The mean ± SD age of the mothers was 30 ± 6 years. The education levels of the mothers were as follows: 10% had completed less than high school, 43% had completed high school only, 36% had completed some college or a technical school, and 11% had at least a college degree. Sixty-one percent of mothers were married, 37% reported more than 2 children living in the home, and 7% had delivered a child within the past 12 weeks.

Thirty percent of the mothers were obese, and 31% were depressed. Children watched approximately the same amount of TV on weekend days and weekdays; therefore, a summary measure of mean daily TV-viewing time was computed as the average of each child's weekend and weekday TV-viewing hours (Table 1). This summary measure was used in all subsequent analyses.

Table 1. 
Descriptive Statistics of Predictors and Outcome
Descriptive Statistics of Predictors and Outcome

Bivariate analyses revealed that children watched more TV if their mothers were obese or depressed (Table 2). Several variables showed no significant relationship to TV-viewing time. These included marital status, maternal smoking status, and child sex (Table 2) in addition to day care attendance, recent delivery of a child, and number of children in the household (data not shown). However, maternal level of education was related to children's TV viewing (Table 2). Therefore, we controlled for this variable in our subsequent analyses.

Table 2. 
Relationship of Predictor Variables to Mean TV-Viewing Time and Percentage of Children in Upper Quartile of TV-Viewing Time
Relationship of Predictor Variables to Mean TV-Viewing Time and Percentage of Children in Upper Quartile of TV-Viewing Time

In multivariate regression analyses with TV-viewing time (in minutes) as the dependent variable, none of the interaction terms evaluated were statistically significant. After adjusting for maternal level of education, children whose mothers were depressed watched 23 more minutes of TV per day than children whose mothers were not depressed (95% confidence interval, 4-42 minutes), and children whose mothers were obese watched 26 more minutes of TV than those whose mothers were not obese (95% confidence interval, 8-45 minutes).

Finally, we evaluated children's TV-viewing time according to 4 distinct groups based on the obesity and depression status of their mothers (Table 3). Children of mothers who were both obese and depressed watched on average an additional 50 minutes of TV per day compared with children of mothers who were neither obese nor depressed (Table 3). The children of mothers who were either obese or depressed, but not both, watched an intermediate amount of TV. These same findings persisted after controlling for maternal education level. Forty-two percent of children whose mothers were both obese and depressed watched 3 or more hours of TV per day (upper quartile of TV viewing) compared with only 20% of those whose mothers were neither obese nor depressed.

Table 3. 
Children's TV-Viewing Time by Maternal Obesity and Depression Status
Children's TV-Viewing Time by Maternal Obesity and Depression Status

Among 3- and 4-year-old children enrolled in the Vermont WIC Program, we found greater TV viewing in those whose mothers had either depressive symptoms or obesity and the greatest TV viewing in children whose mothers were both depressed and obese. In its Guidelines for Health Supervision III,29 the American Academy of Pediatrics recommends that those providing health care to children counsel parents about their child's TV viewing. However, most research on TV viewing in children has focused on the consequences of its excess rather than on identifying its behavioral determinants.

In our study of primarily white low-income families, maternal depressive symptoms were positively associated with hours of TV viewing in 3- and 4-year-old children even after controlling for maternal level of education. However, in a nationally representative sample of children from birth to age 35 months, low levels of maternal education (but not maternal depressive symptoms) were associated with greater TV viewing in children.10 These 2 studies may have different findings because the children in our study were older and were typically living in families with lower incomes.

Although our study was limited to a predominantly white population of low-income mothers and their preschool children, the amount of children's TV viewing30 and the prevalence of maternal depressive symptoms22 and maternal obesity18,31 were comparable with those found in studies of other low-income families. The WIC Program currently serves more than 7 million women and children in the United States, and almost half of all US children are enrolled in WIC at some point in their lives.32 Our findings have potential implications for the WIC Program given its extensive contact with low-income mothers and their children, the growing problem of obesity in the program,33,34 and the potential value in beginning obesity prevention efforts early in life.

There were limitations to each of our study measures. Maternal obesity was assessed by self-report rather than measured height and weight. However, self-report measures have been shown to provide valid classification of obesity status among adults.3537 The CES-D is not meant to be a diagnostic tool but has been shown to perform well as a screening tool,38 and such measures are likely to be used in an office setting to assess maternal depressive symptoms. Maternal report of children's TV viewing may produce slight overestimates of TV-viewing hours when compared with daily logs and direct observation.3941 Although logs and direct observation may theoretically be more valid measures of TV-viewing time, obtaining these measures could influence TV-viewing behavior. An additional limitation of our TV-viewing questions was that they did not specifically ask about the time children spend viewing videotapes or playing video games. Mothers may or may not have included these activities in their estimates of TV-viewing time. Thus, possible variations in interpretation of the questions may have led to some misclassification of TV-viewing time. Nonetheless, we have no evidence that such misclassification was systematic. Finally, without data on maternal TV viewing, we were unable to determine whether maternal TV-viewing habits mediated the relationships we identified in our study.

We cannot determine from this cross-sectional study whether either maternal obesity or maternal depressive symptoms cause increased TV viewing in children and, if so, what other factors may mediate these relationships. However, our findings do suggest that trying to shape the TV-viewing patterns of young children will require attention to maternal well-being because mothers are the likely mediators of these behavioral changes. Maternal well-being may be a primary determinant of whether mothers can provide their preschool children with alternative activities to TV viewing.

Alternatives to TV, such as the parent reading to or playing outdoors with the child, are likely to be more cognitively enriching and may improve the quality of maternal-child interaction. Strauss and Knight42 demonstrated that low levels of cognitive stimulation are a potent risk factor for the development of childhood obesity, even after controlling for social class and maternal obesity. It remains to be shown whether the effect of low cognitive stimulation on childhood obesity is mediated by higher levels of TV viewing.

Many alternatives to TV viewing may also improve maternal well-being if the mother can engage her child in these activities. By joining young children in gross motor play and turning off the TV, mothers may be able to increase their own physical activity and receive some improvement in weight maintenance43 and mood.44,45 If children are able to engage in free play outdoors with parental supervision, it may lessen parental concerns about children's safety outdoors. According to observations from animal experiments,46 exposure to varied physical environments may increase cognitive stimulation for the child. In addition, being outside the home and in public spaces can promote social interaction for the mother and improve her own sense of well-being.

Television viewing is an attractive behavioral target because it is so prevalent, has been tied to the childhood obesity epidemic, and is associated with varied aspects of child well-being. Furthermore, there appears to be no danger to children in eliminating TV viewing altogether and no time in a child's life when it is too early to counsel parents about TV. However, providing parents with a realistic menu of alternative activities to TV requires an understanding of how and why TV has achieved its role within a particular family. For mothers to be successful mediators of such important family changes, we must pay attention to the well-being of mothers and to the current role TV plays in their own lives, in their parenting, and in the culture of the entire household. Early childhood could be an opportune developmental period for the primary prevention of excessive TV viewing, and understanding the family context in which TV viewing occurs will enlighten these prevention efforts.


Corresponding author and reprints: Hillary L. Burdette, MD, Division of General and Community Pediatrics, ML-7035, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH 45229-3039 (e-mail: hillary.burdette@chmcc.org).

Accepted for publication March 20, 2003.

This study was supported in part by cooperative agreement 59-3198-8-500 (Drs Whitaker and Harvey-Berino) for the Fit WIC Project from the US Department of Agriculture's Food and Nutrition Service, Alexandria, Va. Other support was provided by grants R01-HD41141 (Drs Whitaker and Kahn) and K23-HD40362 (Dr Kahn) from the National Institutes of Health, Bethesda, Md; and by the Center for Health and Wellbeing, Woodrow Wilson School of Public and International Affairs, Princeton University, Princeton, NJ (Dr Whitaker).

This study was presented in part at the annual meeting of the North American Association for the Study of Obesity, October 8, 2001; Quebec City, Quebec; and at the annual meeting of the Pediatric Academic Societies, May 7, 2002; Baltimore, Md.

We thank the mothers who participated in this study. We also thank Karen Flynn, Linda Walfield, and Lynne Bortree from the Vermont WIC Program and Jane Khoury for her statistical advice.

The contents of this article do not necessarily reflect the views or policies of the US Department of Agriculture, nor does the mention of trade names, commercial products, or organizations imply endorsement by the US government.

What This Study Adds

Studies have shown the adverse effects of excessive TV viewing on the health and well-being of young children. These viewing patterns are shaped during the preschool years when mothers have significant influence on how children spend their time. Therefore, we wanted to understand some of the maternal factors that influence children's TV viewing.

Studying a low-income population, we found that maternal obesity and depressive symptoms were related to high levels of TV viewing in preschool children. Health care professionals trying to limit TV viewing in preschoolers should consider the influence of maternal health and well-being on how children spend their time.

Andersen  RECrespo  CJBartlett  SJCheskin  LJPratt  M Relationship of physical activity and television watching with body weight and level of fatness among children: results from the Third National Health and Nutrition Examination Survey.  JAMA. 1998;279938- 942PubMedGoogle ScholarCrossref
Gortmaker  SLPeterson  KWiecha  J  et al.  Reducing obesity via a school-based interdisciplinary intervention among youth: Planet Health.  Arch Pediatr Adolesc Med. 1999;153409- 418PubMedGoogle ScholarCrossref
Robinson  TN Reducing children's television viewing to prevent obesity: a randomized controlled trial.  JAMA. 1999;2821561- 1567PubMedGoogle ScholarCrossref
Gortmaker  SLMust  ASobol  AMPeterson  KColditz  GADietz  WH Television viewing as a cause of increasing obesity among children in the United States, 1986-1990.  Arch Pediatr Adolesc Med. 1996;150356- 362PubMedGoogle ScholarCrossref
Robinson  TNWilde  MLNavracruz  LCHaydel  KFVarady  A Effects of reducing children's television and video game use on aggressive behavior: a randomized controlled trial.  Arch Pediatr Adolesc Med. 2001;15517- 23PubMedGoogle ScholarCrossref
Villani  S Impact of media on children and adolescents: a 10-year review of the research.  J Am Acad Child Adolesc Psychiatry. 2001;40392- 401PubMedGoogle ScholarCrossref
Sege  RDietz  W Television viewing and violence in children: the pediatrician as agent for change.  Pediatrics. 1994;94600- 607PubMedGoogle Scholar
Strasburger  VC Does television affect learning and school performance?  Pediatrician. 1986;13141- 147PubMedGoogle Scholar
American Academy of Pediatrics, Committee on Public Education, Children, adolescents, and television.  Pediatrics. 2001;107423- 426PubMedGoogle ScholarCrossref
Certain  LKKahn  RS Prevalence, correlates, and trajectory of television viewing among infants and toddlers.  Pediatrics. 2002;109634- 642PubMedGoogle ScholarCrossref
Sidney  SSternfeld  BHaskell  WLJacobs Jr  DRChesney  MAHulley  SB Television viewing and cardiovascular risk factors in young adults: the CARDIA study.  Ann Epidemiol. 1996;6154- 159PubMedGoogle ScholarCrossref
Tucker  LABagwell  M Television viewing and obesity in adult females.  Am J Public Health. 1991;81908- 911PubMedGoogle ScholarCrossref
Lovejoy  MCGraczyk  PAO'Hare  ENeuman  G Maternal depression and parenting behavior: a meta-analytic review.  Clin Psychol Rev. 2000;20561- 592PubMedGoogle ScholarCrossref
Carpenter  KMHasin  DSAllison  DBFaith  MS Relationships between obesity and DSM-IV major depressive disorder, suicide ideation, and suicide attempts: results from a general population study.  Am J Public Health. 2000;90251- 257PubMedGoogle ScholarCrossref
Istvan  JZavela  KWeidner  G Body weight and psychological distress in NHANES I.  Int J Obes Relat Metab Disord. 1992;16999- 1003PubMedGoogle Scholar
Friedman  MABrownell  KD Psychological correlates of obesity: moving to the next research generation.  Psychol Bull. 1995;1173- 20PubMedGoogle ScholarCrossref
Lorant  VDeliege  DEaton  WRobert  APhilippot  PAnsseau  M Socioeconomic inequalities in depression: a meta-analysis.  Am J Epidemiol. 2003;15798- 112PubMedGoogle ScholarCrossref
Pamuk  EMakuc  DHeck  KReuben  CLochner  K Socioeconomic Status and Health Chartbook: Health, United States, 1998.  Hyattsville, Md National Center for Health Statistics1998;
Glassman  AHHelzer  JECovey  LS  et al.  Smoking, smoking cessation, and major depression.  JAMA. 1990;2641546- 1549PubMedGoogle ScholarCrossref
Hurt  RDSachs  DPGlover  ED  et al.  A comparison of sustained-release bupropion and placebo for smoking cessation.  N Engl J Med. 1997;3371195- 1202PubMedGoogle ScholarCrossref
Williamson  DFMadans  JAnda  RFKleinman  JCGiovino  GAByers  T Smoking cessation and severity of weight gain in a national cohort.  N Engl J Med. 1991;324739- 745PubMedGoogle ScholarCrossref
Lanzi  RGPascoe  JMKeltner  BRamey  SL Correlates of maternal depressive symptoms in a national Head Start program sample.  Arch Pediatr Adolesc Med. 1999;153801- 807PubMedGoogle ScholarCrossref
Kahn  RSZuckerman  BBauchner  HHomer  CJWise  PH Women's health after pregnancy and child outcomes at age 3: a prospective cohort study.  Am J Public Health. 2002;921312- 1318PubMedGoogle ScholarCrossref
Baker  PCKeck  CKMott  FLQuinlan  SV NLSY Child Handbook. Rev ed Columbus Ohio State University1993;353- 355
Radloff  LS The CES-D Scale: a self-report depression scale for research in the general population.  Appl Psychol Meas. 1977;1385- 401Google ScholarCrossref
Weissman  MMSholomskas  DPottenger  MPrusoff  BALocke  BZ Assessing depressive symptoms in five psychiatric populations: a validation study.  Am J Epidemiol. 1977;106203- 214PubMedGoogle Scholar
World Health Organization Expert Committee, Physical Status: The Use and Interpretation of Anthropometry.  Geneva, Switzerland World Health Organization1995;WHO Technical Report Series, No. 854.
National Institutes of Health, National Heart Lung and Blood Institute, Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults: The Evidence Report.  Rockville, Md US Dept of Health and Human Services1998;NIH publication 98-4083.
Committee on Psychosocial Aspects of Child and Family Health, American Academy of Pediatrics, Guidelines for Health Supervision III.  Elk Grove Village, Ill American Academy of Pediatrics1997;
Dennison  BAErb  TAJenkins  PL Television viewing and television in bedroom associated with overweight risk among low-income preschool children.  Pediatrics. 2002;1091028- 1035PubMedGoogle ScholarCrossref
Randall  BBoast  LHolst  L Study of WIC Participant and Program Characteristics, 1994.  Cambridge, Mass Abt Associates Inc1995;
Besharov  DJGermanis  P Evaluating WIC.  Eval Rev. 2000;24123- 190PubMedGoogle ScholarCrossref
Mei  ZScanlon  KSGrummer-Strawn  LMFreedman  DSYip  RTrowbridge  FL Increasing prevalence of overweight among US low-income preschool children: the Centers for Disease Control and Prevention Pediatric Nutrition Surveillance, 1983-1995.  Pediatrics [serial online]. 1998;101e12Available athttp://www.pediatrics.org/cgi/content/full/101/1/e12Accessed April 24, 2003Google Scholar
Cole  N The Prevalence of Overweight Among WIC Children: WIC-01-PCOM.  Alexandria, Va US Dept of Agriculture, Food and Nutrition Service, Office of Analysis, Nutrition, and Evaluation2001;
Rowland  ML Reporting bias in height and weight data.  Stat Bull Metrop Insur Co. 1989;702- 11PubMedGoogle Scholar
Rowland  ML Self-reported weight and height.  Am J Clin Nutr. 1990;521125- 1133PubMedGoogle Scholar
Stewart  AL The reliability and validity of self-reported weight and height.  J Chronic Dis. 1982;35295- 309PubMedGoogle ScholarCrossref
Mulrow  CDWilliams Jr  JWGerety  MBRamirez  GMontiel  OMKerber  C Case-finding instruments for depression in primary care settings.  Ann Intern Med. 1995;122913- 921PubMedGoogle ScholarCrossref
Anderson  DRField  DECollins  PALorch  EPNathan  JG Estimates of young children's time with television: a methodological comparison of parent reports with time-lapse video home observation.  Child Dev. 1985;561345- 1357PubMedGoogle ScholarCrossref
Hollenbeck  AR Television viewing patterns of families with young infants.  J Soc Psychol. 1978;105259- 264Google ScholarCrossref
Borzekowski  DLGRobinson  TN Viewing the viewers: ten video cases of children's television viewing behaviors.  J Broadcasting Electronic Media. 1999;43506- 528Google ScholarCrossref
Strauss  RSKnight  J Influence of the home environment on the development of obesity in children.  Pediatrics [serial online]. 1999;103e85Available athttp://www.pediatrics.org/cgi/content/full/103/6/e85Accessed April 24, 2003Google Scholar
Kayman  SBruvold  WStern  JS Maintenance and relapse after weight loss in women: behavioral aspects.  Am J Clin Nutr. 1990;52800- 807PubMedGoogle Scholar
Dunn  ALDishman  RK Exercise and the neurobiology of depression.  Exerc Sport Sci Rev. 1991;1941- 98PubMedGoogle ScholarCrossref
O'Neal  HADunn  ALMartinsen  EW Depression and exercise.  Int J Sport Psychol. 2000;31110- 135Google Scholar
Greenough  WTBlack  JEGunnar  MRedNelson  CAed Induction of brain structure by experience: substrates for cognitive development.  Minnesota Symposia on Child Psychology: Developmental Neuroscience Vol 24 Hillsdale, NJ Erlbaum1992;155- 200Google Scholar