Screen-based sedentary time: Association with soft drink consumption and the moderating effect of parental education in European children: The ENERGY study.

Aim: 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.