Influence of Siblings on Child Health Behaviors and Obesity: A Systematic Review

The authors review the literature on sibling relationships in childhood and adolescence, starting by tracing themes from foundational research and theory and then focusing on empirical research during the past 2 decades. This literature documents siblings' centrality in family life, sources of variation in sibling relationship qualities, and the significance of siblings for child and adolescent development and adjustment. Sibling influences emerge not only in the context of siblings' frequent and often emotionally intense interactions but also by virtue of siblings' role in larger family system dynamics. Although siblings are building blocks of family structure and key players in family dynamics, their role has been relatively neglected by family scholars and by those who study close relationships. Incorporating study of siblings into family research provides novel insights into the operation of families as social and socializing systems.

To assess the effects of early and late bedtimes and wake up times on use of time and weight status in Australian school-aged children. Observational cross-sectional study involving use of time interviews and pedometers. Free-living Australian adolescents. 2200 9- to 16-year-olds from all states of Australia NA. Bedtimes and wake times were adjusted for age and sex and classified as early or late using median splits. Adolescents were allocated into 4 sleep-wake pattern groups: Early-bed/Early-rise; Early-bed/Late-rise; Late-bed/Early-rise; Late-bed/Late-rise. The groups were compared for use of time (screen time, physical activity, and study-related time), sociodemographic characteristics, and weight status. Adolescents in the Late-bed/Late-rise category experienced 48 min/d more screen time and 27 min less moderate-to-vigorous physical activity (MVPA) (P<0.0001) than adolescents in the Early-bed/Early-rise category, in spite of similar sleep durations. Late-bed/Late-rise adolescents had a higher BMI z-score (0.66 vs. 0.45, P=0.0015). Late-bed/Late-rise adolescents were 1.47 times more likely to be overweight or obese than Early-bed/Early-rise adolescents, 2.16 times more likely to be obese, 1.77 times more likely to have low MVPA, and 2.92 times more likely to have high screen time. Late-bed/Late-rise adolescents were more likely to come from poorer households, to live in major cities, and have fewer siblings. Late bedtimes and late wake up times are associated with an unfavorable activity and weight status profile, independent of age, sex, household income, geographical remoteness, and sleep duration.

This integrative review described recent published data addressing parental perceptions of their child's overweight. Seventeen studies met the inclusion criteria for the study. Parents of overweight children underestimate their child's weight status or are not concerned about the risks associated with overweight. Child age, gender, and ethnicity may influence parental perceptions of child overweight. Some parents may use criteria other than growth charts to perceive overweight as a problem. Health care providers need to understand parents' perceptions to tailor effective child weight loss interventions. A formalized tool is needed to aid practitioners in identifying parental perceptions of child overweight.