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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Nowadays&#44; children spend a considerable part of their time with sedentary entertainment&#44; such as watching television &#40;TV&#41;&#44; playing computer games&#44; and surfing the Internet&#46; In the United States&#44; Australia&#44; and Europe&#44; the average time spent watching TV has been estimated to be about 5&#44; 4&#44; and 3&#46;5<span class="elsevierStyleHsp" style=""></span>h&#44; respectively&#46;<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">1</span></a> Increasing sedentary activity is accompanied with less daily energy expenditure&#44; energy imbalance&#44; fat accumulation&#44; overweight&#44; and obesity&#46;<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">2</span></a> Obesity is a major risk factor of poor health among all age groups of school children worldwide&#44; and has significantly increased over the last decades&#44; especially in industrialized countries&#46; Obesity among children and adolescents has more than doubled and quadrupled in the past three decades&#46;<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">3</span></a> In Iran&#44; the prevalence of overweight and obesity was reported as 21&#46;1&#37; and 7&#46;8&#37; among adolescents&#46;<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">4</span></a> Studies have indicated that daily physical activity plays an important role in preventing obesity among children&#44; while a sedentary lifestyle increases the risk of obesity and related diseases&#46;<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">5</span></a> Parents have an essential role in children&#39;s health behaviors&#44; such as the physical activity&#44; eating pattern&#44; and sedentary behaviors&#46;<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">6</span></a> Studies have revealed that parental obesity can be closely associated with childhood obesity&#46;<a class="elsevierStyleCrossRefs" href="#bib0185"><span class="elsevierStyleSup">7&#8211;9</span></a> Children from obese parents had a higher preference for sedentary activities&#44; and spent more time in sedentary entertainments&#46;<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">10</span></a> In addition to the genetic predisposition of children with obese parents&#44; parental obesity can influence their children&#39;s weight in many ways&#44; including modeling unhealthy behaviors&#44; as well as providing a shared family environment that stimulates and supports unhealthy eating patterns and sedentary lifestyles&#46;<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">11</span></a> However&#44; the association of parental weight status as an independent factor with the joint association of children&#39;s activities and sedentary times has yet to be determined&#46; Therefore&#44; the present study was conducted to evaluate the effect of parental obesity on children&#39;s physical activities and sedentary behaviors&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Methods</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Study population</span><p id="par0010" class="elsevierStylePara elsevierViewall">This cross-sectional study was conducted on the participants of the fifth phase of the Childhood and Adolescence Surveillance and Prevention of Adult Non-communicable Disease &#40;CASPIAN&#41; study&#44; a national school-based surveillance program implemented in Iran from 2003 onwards&#46;<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">12</span></a> The fifth phase of study &#40;CASPIAN-V&#41; was performed in 2015 the in urban and rural areas of 30 provinces of Iran&#44; and participants included of 14&#44;440 primary and secondary schools students&#44; aged 7&#8211;18 years&#44; and one of their parents&#44; who were selected by multistage random cluster sampling method&#46; Protocol details of the CASPIAN-V study have been explained previously&#46;<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">13</span></a></p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Data collection</span><p id="par0015" class="elsevierStylePara elsevierViewall">A validated questionnaire obtained from the World Health Organization&#39;s Global School Student Health Survey &#40;WHO-GSHS&#41;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">14</span></a> was used to collect data on the student&#39;s characteristics and social and health behaviors&#46; Another questionnaire including family characteristics&#44; medical history&#44; dietary habits&#44; and leisure time activities was also completed by parents&#46; The presence of one of the parents was considered sufficient&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Definitions</span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">TV time&#44; computer time&#44; screen time &#40;ST&#41;&#44; and physical activity &#40;PA&#41;</span><p id="par0020" class="elsevierStylePara elsevierViewall">Each individual was asked about the number of hours per day that spent watching television or videos &#40;TV time&#41;&#44; as well as working with a personal computer or playing electronic games &#40;computer time&#41;&#44; and then the ST was calculated by adding TV time to computer time&#46; Based on the international ST recommendations&#44; TV time&#44; computer time&#44; and ST were categorized into two groups&#59; less than 2<span class="elsevierStyleHsp" style=""></span>h&#47;day was considered low&#44; and 2<span class="elsevierStyleHsp" style=""></span>h&#47;day or more was considered high&#46;<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">15</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">For assessing the weekly frequency of leisure time physical activity outside the school during the past week&#44; a validated questionnaire was used&#46; Having sufficient physical activity was considered as at least 30<span class="elsevierStyleHsp" style=""></span>min duration of exercises per day that led to sweating and large increases in breathing or heart rate&#46;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">14</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">The joint associations of PA and ST were considered according to the following possible mixed conditions&#58; low PA &#38; low ST&#44; low PA &#38; high ST&#44; high PA &#38; low ST&#44; and high PA &#38; high ST&#46; High PA &#38; low ST and low PA &#38; high ST were considered as the ideal and the worst combinations&#44; respectively&#46; High PA &#38; high ST and low PA &#38; low ST both were considered as the intermediate combinations&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Overweight&#44; obesity&#44; and abdominal obesity in parents</span><p id="par0035" class="elsevierStylePara elsevierViewall">A team of health care professionals recorded anthropometric measurements both in children and in parents&#44; using standard procedures&#46; Weight was measured to the nearest 0&#46;1<span class="elsevierStyleHsp" style=""></span>kg using scales on flat ground&#44; while the participants were minimally clothed&#46; Height was measured to the nearest 0&#46;1<span class="elsevierStyleHsp" style=""></span>cm&#44; in a standing position&#44; without shoes&#46; Waist circumference &#40;WC&#41; was measured to the nearest 0&#46;1<span class="elsevierStyleHsp" style=""></span>cm&#44; using a non-elastic tape meter&#44; at a point midway between the lower border of the rib cage and the iliac crest at the end of normal expiration&#46; Hip circumference was measured to the nearest 0&#46;1<span class="elsevierStyleHsp" style=""></span>cm at the widest part of the hip at the level of the greater trochanter&#46; Body mass index &#40;BMI&#41; was calculated as weight &#40;kg&#41; divided by the square of height &#40;m<span class="elsevierStyleSup">2</span>&#41;&#46; Overweight and obesity in parents were defined according to BMI &#8805;25<span class="elsevierStyleHsp" style=""></span>kg&#47;m<span class="elsevierStyleSup">2</span> and BMI &#8805;30<span class="elsevierStyleHsp" style=""></span>kg&#47;m<span class="elsevierStyleSup">2</span>&#44; respectively&#46; Abdominal obesity in parents was defined as WC &#8805;95<span class="elsevierStyleHsp" style=""></span>cm and waist to hip ratio &#40;WHR&#41; &#8805;0&#46;5 for both sexes&#46;<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">16</span></a></p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Socioeconomic status &#40;SES&#41;</span><p id="par0040" class="elsevierStylePara elsevierViewall">For calculating SES&#44; an approved method was used&#44; which previously provided for the Progress in the International Reading Literacy Study &#40;PIRLS&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">17</span></a> Some variables such as parental occupation&#44; parental education&#44; school type &#40;public&#47;private&#41;&#44; owning a private car&#44; and possessing personal computer at home were summarized in one main component&#44; by the principle component analysis &#40;PCA&#41; method&#46; This main component was classified into three levels&#46; The first level was considered as low SES&#44; the second level as intermediate&#44; and the third level as high SES&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Ethical concerns</span><p id="par0045" class="elsevierStylePara elsevierViewall">Ethical committees of the Isfahan University of Medical Sciences and other relevant national regulatory organizations approved this survey &#40;Project number&#58; 194049&#41;&#46; Written informed consent and verbal consent were obtained from all participants&#46;</p></span></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Statistical analysis</span><p id="par0050" class="elsevierStylePara elsevierViewall">STATA software &#40;StataCorp&#46; 2009&#46; <span class="elsevierStyleItalic">Stata Statistical Software</span>&#58; version 11&#46; College Station&#44; TX&#44; USA&#41; was used for data analysis&#46; Quantitative variables were expressed as mean<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>standard deviation &#40;SD&#41;&#44; and their mean differences were compared by Student&#39;s <span class="elsevierStyleItalic">t</span>-test&#46; Qualitative variables were expressed as number &#40;percentage&#41;&#44; and the association between them was assessed by the chi-squared test&#46; Odds ratios &#40;95&#37; confidence interval &#91;CI&#93;&#41; for computer time&#44; TV time&#44; ST&#44; PA&#44; and joint associations of ST and PA categories according to parental weight status were assessed by logistic regression analyses in two different models&#59; in model I&#44; the association assessed without adjustment&#44; while in model II&#44; the association was adjusted for age&#44; gender&#44; region&#44; and SES&#46; In both models&#44; the high PA &#38; low ST group was considered as the reference&#46; All statistical analysis was performed using survey analysis method&#46; <span class="elsevierStyleItalic">p</span>-values &#60;0&#46;05 were considered statistically significant&#46;</p></span></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Results</span><p id="par0055" class="elsevierStylePara elsevierViewall">In total&#44; 14&#44;274 students &#40;50&#46;6&#37; boys&#44; 49&#46;4&#37; girls&#41; and one of their parents completed the survey &#40;participation rate&#58; 99&#37;&#41;&#46; The mean age of students was 12&#46;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#46;2 years&#59; 71&#46;3&#37; were from urban areas and 28&#46;7&#37; from rural areas&#46; Demographic characteristics and anthropometric measures according to the range of PA and ST are presented in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#46; It shows that there were no significant differences in the mean weight&#44; height&#44; BMI&#44; WC&#44; and SES between students with low or high PA&#59; however&#44; the mean age of students with high PA was significantly lower than those with low PA&#46; Most of the students had low PA levels &#40;58&#46;2&#37; of all students&#41;&#44; which was different between boys and girls &#40;56&#46;2&#37; of boys and 60&#46;4&#37; of girls&#41; &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41; and between urban and rural areas &#40;58&#46;8&#37; in urban areas and 56&#46;7&#37; in rural areas&#41; &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#41;&#46; Most of the students had low ST levels &#40;82&#46;3&#37; of all students&#41;&#46; The mean age&#44; weight&#44; height&#44; and BMI were significantly higher in students with high ST compared with low ST &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0060" class="elsevierStylePara elsevierViewall">The means of parental BMI and WC according to children&#39;s PA and ST categories are illustrated in <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#46; As it is shown&#44; the mean of parental BMI is significantly higher in students with high computer time &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;005&#41; and low PA &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#59; the mean of parental WC was significantly higher in students with high TV time &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#41; and high ST &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#46; Regarding joint association of ST and PA&#44; the means of parental BMI and WC were significantly higher in the combination of low PA&#47;high ST &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;005 and <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#44; respectively&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0065" class="elsevierStylePara elsevierViewall">The prevalence of different categories of children&#39;s PA and ST according to parental weight status is shown in <a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#46; The prevalence of students with high computer time and a combination of low PA&#47;high ST was significantly higher in the parents with overweight&#44; general obesity&#44; and abdominal obesity&#46; The prevalence of students with high ST was significantly higher in the parents with overweight and abdominal obesity&#46; The prevalence of students with low PA was significantly higher in the parents with general obesity and abdominal obesity &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001 and <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;005&#44; respectively&#41;&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0070" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a> presents the odds ratios and 95&#37; confidence intervals of children&#39;s computer time&#44; TV time&#44; ST&#44; PA&#44; and joint associations of ST and PA categories associated with parental weight status&#44; using two logistic regression models&#46; Parental overweight was significantly associated with high computer time and high ST in children &#40;OR&#58; 1&#46;18&#44; 95&#37; CI&#58; 1&#46;04&#8211;1&#46;33 and OR&#58; 1&#46;17&#44; 95&#37; CI&#58; 1&#46;05&#8211;1&#46;27&#44; respectively&#41;&#46; These associations became non-significant after adjustment for age&#44; gender&#44; region&#44; and SES&#46; Parental general obesity increased the odds of children&#39;s low PA&#44; by 21&#37; in both models&#46; Parental abdominal obesity was significantly associated with children&#39;s high computer time and low PA &#40;OR&#58; 1&#46;35&#44; 95&#37; CI&#58; 1&#46;19&#8211;1&#46;52 and OR&#58; 1&#46;30&#44; 95&#37; CI&#58; 1&#46;14&#8211;1&#46;47&#44; respectively&#41; and also remained significant after adjustment for age&#44; gender&#44; region&#44; and SES &#40;OR&#58; 1&#46;12&#44; 95&#37; CI&#58; 1&#46;04&#8211;1&#46;20 and OR&#58; 1&#46;13&#44; 95&#37; CI&#58; 1&#46;05&#8211;1&#46;22&#44; respectively&#41;&#46; Parental over weight&#44; general obesity&#44; and abdominal obesity increased the odds of the combination of low PA&#47;high ST in children by 40&#37;&#44; 29&#37;&#44; and 27&#37;&#44; respectively&#44; which declined to 33&#37;&#44; 26&#37;&#44; and 20&#37; after adjustment for age&#44; gender&#44; region&#44; and SES&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Discussion</span><p id="par0075" class="elsevierStylePara elsevierViewall">The current study indicated that parental obesity was associated with increased sedentary behaviors and low PA in children&#46; It was also revealed that low PA and high ST were more common in older students&#59; the mean weight&#44; height&#44; and BMI were significantly higher in students with prolonged ST compared with those with shorter ST&#46; These findings are consistent with some previous studies&#46; A study conducted on 766 European children&#44; aged 10&#8211;12 years&#44; found that those involved in more moderate to vigorous PA and with lower ST had a more favorable weight status than their counterparts&#46;<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">18</span></a> It is also indicated that when children become older&#44; they are usually more prone to sedentary behaviors and show more interest in screen-based activities&#44; such as computer games or watching TV&#46;<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">19</span></a></p><p id="par0080" class="elsevierStylePara elsevierViewall">One of the most important factors in child obesity is parental obesity&#46;<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">7</span></a> A cross-sectional study in Korea revealed that in 2- to 12-year-old children with obese parents&#44; the risk of obesity increased more than fourfold&#46;<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">20</span></a> In addition to the influence of genetic predisposition to obesity&#44;<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">21</span></a> environmental and behavioral factors play an important role in the recent rapid rise of childhood obesity&#46;<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">22</span></a> Parents have a major role in changing their children&#39;s obesogenic lifestyle&#59; children&#39;s health behaviors&#44; including their physical activity&#44; eating habits&#44; and TV watching or other sedentary behaviors are highly influenced by their parents&#46;<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">6</span></a> Adoption and twin studies have indicated that although genes are a major factor in early expression of obesity risk&#44; but children from obese parents had a higher preference for sedentary activities&#44; and spent more time in sedentary entertainments compared to their counterparts&#46; A study on 428 children from a population sample of families with twin births demonstrated that the children from the obese parents had more frequent unhealthy eating habits&#44; as well as higher preferences for sedentary activities&#44; and spent more time in sedentary pastimes&#46;<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">10</span></a></p><p id="par0085" class="elsevierStylePara elsevierViewall">Studies have suggested that joint effect of PA&#47;ST should be evaluated for obesity and have emphasized the importance of decreasing ST along with increasing PA for reducing the risk of obesity and related complications&#46; This is suggested because the negative effect of high ST on obesity may disappear without considering PA&#46;<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">23</span></a> Therefore&#44; in the current study&#44; all possible mixed conditions were assessed for the joint associations of PA and ST&#44; which showed that parental obesity was strongly associated with increased odds of low PA&#47;high ST and&#44; after that&#44; with low PA&#47;low ST&#44; while no association was observed between parental obesity with high PA&#47;high ST&#46; These finding can be justified by the fact that parental obesity is due to an obesogenic lifestyle&#44; including unhealthy food patterns&#44; lower levels of PA&#44; and prolonged TV watching&#44;<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">24</span></a> which&#44; in turn&#44; would be used as a role model for sedentary habits in their children&#46;<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">25</span></a> Moreover&#44; parents&#8217; encouragement represents a motivational support which can increase children&#39;s capability and behavioral intentions and result in increased PA&#46; Moreover&#44; parents&#8217; participation in PA is a conditional support&#44; which not only helps children to become fitter&#44; but also can lead to increased interest PA&#46;<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">26</span></a> Furthermore&#44; it has been shown that ST is increased in children whose the parents spend more time watching TV&#44; whereas parents can reduce the amount screen-based activities by involving their children in PA&#46;<a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">27</span></a></p><p id="par0090" class="elsevierStylePara elsevierViewall">The present findings propose that although the genetic characteristics transmitted from parents can lead to sedentary lifestyle in their children&#44; the lifestyle habits of obese parents also play a major role in children&#39;s behaviors&#46; Children and their parents live in similar environments and experience similar lifestyles that are mainly determined by parents&#46;<a class="elsevierStyleCrossRef" href="#bib0290"><span class="elsevierStyleSup">28</span></a> All environmental conditions which lead to decreased PA increased sedentary behaviors and consequently obesity in parents&#44; may have direct consequences on the lifestyle of children&#46;<a class="elsevierStyleCrossRef" href="#bib0295"><span class="elsevierStyleSup">29</span></a> Parents should consider that they are the role model for their children in choosing lifestyle habits&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">The current study was a novel survey on the data of a large national representative sample of Iranian children and adolescents&#44; which for the first time evaluated the association of parental weight status as an independent factor with children&#39;s PA and ST&#46; However&#44; it had some limitations&#59; first&#44; because of the cross-sectional nature of study no causality can be indicated between the parental obesity and PA&#47;ST in children&#46; Besides&#44; children&#39;s lifestyle is influenced by both parents&#8217; behaviors&#44; but data was collected from only one of the parents &#40;in most cases their mothers&#41;&#44; which may affect the results of this study&#46; In this study&#44; only one of the parents was assessed as the representative&#46; Therefore&#44; future studies should explore the role of all family members on the lifestyle of children&#46; Moreover&#44; data about PA&#47;ST were self-reported&#44; which is subject to recall bias&#46; Studies have shown that individuals tended to over report their amount of physical activity in self-report surveys compared to an objective monitoring device&#46;<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">30</span></a> Moreover&#44; some potential confounding factors such as parental support or sedentary behaviors were not assessed in this survey&#46; The authors suggest future prospective studies that consider a range of items for each category of parental support&#44; as well as other aspects of their lifestyle in relation to PA&#47;ST in children&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">The results of this study indicated that parental overweight and general or abdominal obesity can increase sedentary behaviors and low PA in children&#44; which in turn may lead to higher risk of child obesity&#46; Therefore&#44; to prevent sedentary lifestyle and related complications in children&#44; it is necessary to focus on parents&#8217; lifestyle behaviors and weight status&#46;</p></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Funding</span><p id="par0105" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleGrantSponsor" id="gs1">Isfahan University of Medical Sciences</span> and other relevant national regulatory organizations &#40;Project number&#58; 194049&#41;&#46;</p></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">Conflicts of interest</span><p id="par0110" class="elsevierStylePara elsevierViewall">The authors declare no conflicts of interest&#46;</p></span></span>"
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                  "titulo" => "Ethical concerns"
                ]
              ]
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            3 => array:2 [
              "identificador" => "sec0050"
              "titulo" => "Statistical analysis"
            ]
          ]
        ]
        6 => array:2 [
          "identificador" => "sec0055"
          "titulo" => "Results"
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        7 => array:2 [
          "identificador" => "sec0060"
          "titulo" => "Discussion"
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        8 => array:2 [
          "identificador" => "sec0065"
          "titulo" => "Funding"
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        9 => array:2 [
          "identificador" => "sec0070"
          "titulo" => "Conflicts of interest"
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        10 => array:1 [
          "titulo" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2017-02-02"
    "fechaAceptado" => "2017-05-17"
    "PalabrasClave" => array:2 [
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec1011155"
          "palabras" => array:4 [
            0 => "Parental obesity"
            1 => "Physical activity"
            2 => "Screen time"
            3 => "Children"
          ]
        ]
      ]
      "pt" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palavras-chave"
          "identificador" => "xpalclavsec1011154"
          "palabras" => array:1 [
            0 => "Obesidade dos pais&#44; Atividade f&#237;sica&#44; Tempo de tela&#44; Crian&#231;as"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "en" => array:3 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objective</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Low physical activity and sedentary behaviors&#44; two important determinants of childhood obesity&#44; may be influenced by parental lifestyle and weight status&#46; This study aims to determine the association of parental weight status with children&#39;s physical activity and screen time&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">This study was conducted on 14&#44;440 Iranian schools students&#44; aged 7&#8211;18 years&#44; and one of their parents&#44; who participated in the large national school-based surveillance program&#46; The children&#39;s screen-based and physical activities were evaluated based on the World Health Organization&#39;s Global School Student Health Survey&#46; Children and parental height&#44; weight&#44; and waist circumference were measured using standardized methods&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Overall&#44; 14&#44;274 students and one of their parents completed the survey &#40;participation rate&#58; 99&#37;&#41;&#46; Mean &#40;standard deviation&#41; age of students was 12&#46;3 &#40;3&#46;2&#41; years&#44; and the prevalence of low physical activity and high screen time was 58&#46;2&#37; and 17&#46;7&#37;&#44; respectively&#46; In multivariate model&#44; the parental general obesity and abdominal obesity increased the odds of children having low physical activity&#44; by 21&#37; and 13&#37;&#44; respectively&#46; Parental overweight&#44; general obesity&#44; and abdominal obesity increased the odds of the combination of low physical activity&#47;high screen time in children by 33&#37;&#44; 26&#37;&#44; and 20&#37;&#44; respectively&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">This study showed that parental obesity was associated with increased screen-based activities and low physical activity in children&#46; Focus on parental weight status&#44; as an important factor influenced by their lifestyle&#44; can be helpful for preventing sedentary behaviors in their children&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0005"
            "titulo" => "Objective"
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          1 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "Methods"
          ]
          2 => array:2 [
            "identificador" => "abst0015"
            "titulo" => "Results"
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          3 => array:2 [
            "identificador" => "abst0020"
            "titulo" => "Conclusions"
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      ]
      "pt" => array:3 [
        "titulo" => "Resumo"
        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Objetivo</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">A baixa atividade f&#237;sica e comportamentos sedent&#225;rios&#44; dois importantes fatores determinantes de obesidade infantil&#44; podem ser influenciados pelo estilo de vida e o status do peso dos pais&#46; Este estudo visa determinar a associa&#231;&#227;o do status do peso dos pais ao n&#237;vel de atividade f&#237;sica e ao tempo de tela das crian&#231;as&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">M&#233;todos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Este estudo &#233; realizado em 14&#46;440 estudantes de escolas iranianas&#44; com idades entre 7-18 anos e um de seus pais inscritos no grande programa nacional de vigil&#226;ncia escolar&#46; As atividades f&#237;sicas e em tela das crian&#231;as foram avaliadas com base no question&#225;rio da Pesquisa Global de Sa&#250;de do Escolar da Organiza&#231;&#227;o Mundial de Sa&#250;de&#46; A estatura&#44; o peso e a circunfer&#234;ncia da cintura das crian&#231;as e dos pais foram medidos utilizando m&#233;todos padronizados&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">De modo geral&#44; 14&#46;274 estudantes e um de seus pais conclu&#237;ram a pesquisa &#40;taxa de participa&#231;&#227;o&#58; 99&#37;&#41;&#46; A idade m&#233;dia &#40;desvio padr&#227;o&#41; dos estudantes foi 12&#44;3 &#40;3&#44;2&#41; anos e a preval&#234;ncia de baixa atividade f&#237;sica e alto tempo de tela foi 58&#44;2&#37; e 17&#44;7&#37;&#44; respectivamente&#46; Em um modelo multivariado&#44; a obesidade geral dos pais e obesidade abdominal aumentaram as chances de as crian&#231;as com baixo n&#237;vel de atividade f&#237;sica em 21&#37; e 13&#37;&#44; respectivamente&#46; Sobrepeso dos pais&#44; obesidade geral e obesidade abdominal aumentaram as chances de combina&#231;&#227;o de baixo n&#237;vel de atividade f&#237;sica&#47;alto tempo de tela nas crian&#231;as em 33&#37;&#44; 26&#37; e 20&#37;&#44; respectivamente&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclus&#245;es</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Este estudo mostrou que a obesidade dos pais foi associada ao aumento nas atividades de tela e ao baixo n&#237;vel de atividade f&#237;sica nas crian&#231;as&#46; O foco no status do peso dos pais&#44; como um importante fator influenciado por seu estilo de vida&#44; pode ser &#250;til na preven&#231;&#227;o de comportamentos sedent&#225;rios em seus filhos&#46;</p></span>"
        "secciones" => array:4 [
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            "identificador" => "abst0025"
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            "identificador" => "abst0030"
            "titulo" => "M&#233;todos"
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          2 => array:2 [
            "identificador" => "abst0035"
            "titulo" => "Resultados"
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          3 => array:2 [
            "identificador" => "abst0040"
            "titulo" => "Conclus&#245;es"
          ]
        ]
      ]
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    "NotaPie" => array:2 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Please cite this article as&#58; Angoorani P&#44; Heshmat R&#44; Ejtahed H-S&#44; Motlagh ME&#44; Ziaodini H&#44; Taheri M&#44; et al&#46; The association of parental obesity with physical activity and sedentary behaviors of their children&#58; the CASPIAN-V study&#46; J Pediatr &#40;Rio J&#41;&#46; 2018&#59;94&#58;410&#8211;8&#46;</p>"
      ]
      1 => array:2 [
        "etiqueta" => "&#9734;&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0015">Study conducted at Ministry of Health and Medical Education&#44; Ministry of Education and Training&#44; Isfahan University of Medical Sciences&#44; and Endocrinology and Metabolism Research Institute of Tehran University of Medical Sciences&#44; Tehran&#44; Iran&#46;</p>"
      ]
    ]
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        "tipo" => "MULTIMEDIATABLA"
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          "leyenda" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Data are expressed as means<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>SD or number &#40;&#37;&#41;&#46;</p><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">BMI&#44; body mass index&#59; WC&#44; waist circumference&#59; ST&#44; screen time&#59; PA&#44; physical activity&#59; SES&#44; socioeconomic status&#46;</p><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Low ST&#58; &#60;2<span class="elsevierStyleHsp" style=""></span>h&#47;day&#59; high ST&#58; &#8805;2<span class="elsevierStyleHsp" style=""></span>h&#47;day&#59; low PA&#58; 0&#8211;2<span class="elsevierStyleHsp" style=""></span>days&#47;week&#59; high PA&#58; 3&#8211;7<span class="elsevierStyleHsp" style=""></span>days&#47;week&#46;</p><p id="spar0065" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">p</span>-value &#60;0&#46;05 was considered statistically significant&#46;</p>"
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Total&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span>-value&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span>-value&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Age &#40;year&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">12&#46;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">12&#46;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">12&#46;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#46;2&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">12&#46;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">12&#46;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#46;2&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">41&#46;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>17&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">41&#46;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>17&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;38&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">41&#46;0<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>17&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">43&#46;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>17&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Height &#40;cm&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">146&#46;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>17&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">146&#46;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>17&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">146&#46;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>17&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">146&#46;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>17&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">148&#46;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>17&#46;9&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">18&#46;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">18&#46;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>5&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;97&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">18&#46;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">18&#46;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;001&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">66&#46;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>12&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">66&#46;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>12&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">66&#46;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>12&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;51&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">66&#46;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>12&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">67&#46;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>12&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;18&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="8" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="8" align="left" valign="top"><span class="elsevierStyleItalic">Sex</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Male&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7158 &#40;50&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4020 &#40;56&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3138 &#40;43&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5863 &#40;83&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1164 &#40;16&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;18&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Female&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6983 &#40;49&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4215 &#40;60&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2768 &#40;39&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5781 &#40;84&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1079 &#40;15&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="8" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="8" align="left" valign="top"><span class="elsevierStyleItalic">Region</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Urban&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10&#44;086 &#40;71&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5934 &#40;58&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4152 &#40;41&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;023&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8274 &#40;83&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1631 &#40;16&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Rural&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4055 &#40;28&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2301 &#40;56&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1754 &#40;43&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3370 &#40;84&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">612 &#40;15&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="8" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="8" align="left" valign="top"><span class="elsevierStyleItalic">SES</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Low&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4515 &#40;33&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2646 &#40;58&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1869 &#40;41&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;63&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3793 &#40;85&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">640 &#40;14&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;002&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Medium&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4492 &#40;33&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2628 &#40;58&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1864 &#40;41&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3695 &#40;84&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">705 &#40;16&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>High&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4493 &#40;33&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2592 &#40;57&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1901 &#40;42&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3676 &#40;82&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">760 &#40;17&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
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                0 => "xTab1812107.png"
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        "descripcion" => array:1 [
          "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Demographic characteristics and anthropometric measures of children and adolescents according to the range of physical activity and screen time&#46;</p>"
        ]
      ]
      1 => array:8 [
        "identificador" => "tbl0010"
        "etiqueta" => "Table 2"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at2"
            "detalle" => "Table "
            "rol" => "short"
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          "leyenda" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Data are expressed as mean<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>SD&#46;</p><p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">BMI&#44; body mass index&#59; WC&#44; waist circumference&#59; ST&#44; screen time&#59; PA&#44; physical activity&#59; SD&#44; standard deviation&#59; TV&#44; television&#46;</p><p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">Low computer time&#58; &#60;2<span class="elsevierStyleHsp" style=""></span>h&#47;day&#59; high computer time&#58; &#8805;2<span class="elsevierStyleHsp" style=""></span>h&#47;day&#59; low TV time&#58; &#60;2<span class="elsevierStyleHsp" style=""></span>h&#47;day&#59; high TV time&#58; &#8805;2<span class="elsevierStyleHsp" style=""></span>h&#47;day&#59; low ST&#58; &#60;2<span class="elsevierStyleHsp" style=""></span>h&#47;day&#59; high ST&#58; &#8805;2<span class="elsevierStyleHsp" style=""></span>h&#47;day&#59; low PA&#58; 0&#8211;2<span class="elsevierStyleHsp" style=""></span>days&#47;week&#59; high PA&#58; 3&#8211;7<span class="elsevierStyleHsp" style=""></span>days&#47;week&#46;</p><p id="spar0090" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">p</span>-value &#60;0&#46;05 was considered statistically significant&#46;</p>"
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                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Parental BMI&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Parental waist circumference&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " colspan="3" align="left" valign="top"><span class="elsevierStyleItalic">Computer time</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>High&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">26&#46;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>5&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">88&#46;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>15&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Low&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">26&#46;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">87&#46;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>14&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">p</span>-value&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;003&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;07&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="3" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="3" align="left" valign="top"><span class="elsevierStyleItalic">TV time</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>High&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">26&#46;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">87&#46;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>14&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Low&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">26&#46;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">87&#46;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>14&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">p</span>-value&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;36&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;007&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="3" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="3" align="left" valign="top"><span class="elsevierStyleItalic">Screen time</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>High&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">26&#46;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">88&#46;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>15&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Low&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">26&#46;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">87&#46;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>14&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">p</span>-value&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="3" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="3" align="left" valign="top"><span class="elsevierStyleItalic">Physical activity</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>High&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">26&#46;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">87&#46;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>14&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Low&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">26&#46;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>5&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">87&#46;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>15&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">p</span>-value&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;32&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="3" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="3" align="left" valign="top"><span class="elsevierStyleItalic">Joint association of PA and ST</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>High PA &#38; low ST&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">26&#46;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">87&#46;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>14&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>High PA &#38; high ST&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">26&#46;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">88&#46;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>14&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Low PA &#38; low ST&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">26&#46;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>5&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">87&#46;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>14&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Low PA &#38; high ST&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">26&#46;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>5&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">88&#46;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>16&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">p</span>-value&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;002&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab1812106.png"
              ]
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        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Mean<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>SD of parental BMI and waist circumference according to physical activity and screen time categories&#46;</p>"
        ]
      ]
      2 => array:8 [
        "identificador" => "tbl0015"
        "etiqueta" => "Table 3"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at3"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0100" class="elsevierStyleSimplePara elsevierViewall">Data are expressed as number &#40;&#37;&#41;&#46;</p><p id="spar0105" class="elsevierStyleSimplePara elsevierViewall">ST&#44; screen time&#59; PA&#44; physical activity&#46;</p><p id="spar0110" class="elsevierStyleSimplePara elsevierViewall">High computer time&#58; &#8805;2<span class="elsevierStyleHsp" style=""></span>h&#47;day&#59; high TV time&#58; &#8805;2<span class="elsevierStyleHsp" style=""></span>h&#47;day&#59; high ST&#58; &#8805;2<span class="elsevierStyleHsp" style=""></span>h&#47;day&#59; low PA&#58; 0&#8211;2 days&#47;week&#46; Parental overweight&#58; BMI &#8805;25<span class="elsevierStyleHsp" style=""></span>kg&#47;m<span class="elsevierStyleSup">2</span>&#59; parental general obesity&#58; BMI &#8805;30<span class="elsevierStyleHsp" style=""></span>kg&#47;m<span class="elsevierStyleSup">2</span>&#59; parental abdominal obesity&#58; waist circumference &#8805;95<span class="elsevierStyleHsp" style=""></span>cm&#46;</p><p id="spar0115" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">p</span>-value &#60;0&#46;05 was considered statistically significant&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col">High computer time&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col">High TV time&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col">High screen time&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col">Low physical activity&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " colspan="4" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Joint association of PA and ST</th></tr><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">High PA &#38; low ST&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">High PA &#38; high ST&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Low PA &#38; low ST&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Low PA &#38; high ST&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " colspan="9" align="left" valign="top"><span class="elsevierStyleItalic">Parental overweight</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">778 &#40;9&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4502 &#40;54&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6760 &#40;83&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4851 &#40;57&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2664 &#40;33&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">677 &#40;8&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4038 &#40;50&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">690 &#40;8&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">454 &#40;8&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3088 &#40;54&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4684 &#40;85&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3233 &#40;57&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1880 &#40;34&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">471 &#40;8&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2793 &#40;50&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">374 &#40;6&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">p</span>-value&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;008&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;39&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;003&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;18&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="9" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="9" align="left" valign="top"><span class="elsevierStyleItalic">Parental general obesity</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">295 &#40;9&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1633 &#40;53&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">473 &#40;15&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1854 &#40;61&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">903 &#40;30&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">220 &#40;57&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1568 &#40;53&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">252 &#40;8&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">937 &#40;8&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5957 &#40;54&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1729 &#40;16&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6230 &#40;57&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3641 &#40;34&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">928 &#40;8&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5263 &#40;49&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">785 &#40;7&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">p</span>-value&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;05&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;65&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;73&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="9" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="9" align="left" valign="top"><span class="elsevierStyleItalic">Parental abdominal obesity</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">457 &#40;10&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2362 &#40;54&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">723 &#40;17&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2588 &#40;60&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1319 &#40;31&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">367 &#40;8&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2172 &#40;51&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">352 &#40;8&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">766 &#40;8&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5197 &#40;54&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1457 &#40;15&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5472 &#40;57&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3215 &#40;34&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">769 &#40;8&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4646 &#40;49&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">675 &#40;7&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">p</span>-value&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;91&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;03&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;003&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
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          "en" => "<p id="spar0095" class="elsevierStyleSimplePara elsevierViewall">Prevalence of different categories of children&#39;s physical activity and screen time according to parental weight status&#46;</p>"
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        "etiqueta" => "Table 4"
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          "leyenda" => "<p id="spar0125" class="elsevierStyleSimplePara elsevierViewall">Data are expressed as OR &#40;95&#37; CI&#41;&#46;</p><p id="spar0130" class="elsevierStyleSimplePara elsevierViewall">ST&#44; screen time&#59; PA&#44; physical activity&#59; high computer time&#58; &#8805;2<span class="elsevierStyleHsp" style=""></span>h&#47;day&#59; high TV time&#58; &#8805;2<span class="elsevierStyleHsp" style=""></span>h&#47;day&#59; high ST&#58; &#8805;2<span class="elsevierStyleHsp" style=""></span>h&#47;day&#59; low PA&#58; 0&#8211;2<span class="elsevierStyleHsp" style=""></span>days&#47;week&#46; Parental overweight&#58; BMI &#8805;25<span class="elsevierStyleHsp" style=""></span>kg&#47;m<span class="elsevierStyleSup">2</span>&#59; parental general obesity&#58; BMI &#8805;30<span class="elsevierStyleHsp" style=""></span>kg&#47;m<span class="elsevierStyleSup">2</span>&#59; parental abdominal obesity&#58; waist circumference &#8805;95<span class="elsevierStyleHsp" style=""></span>cm&#46;</p><p id="spar0135" class="elsevierStyleSimplePara elsevierViewall">Model 1 is a crude model&#59; Model 2 is adjusted for age&#44; gender&#44; region&#44; socio-economic status&#44; and body mass index&#46;</p>"
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                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col">High computer time&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col">High TV time&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col">High ST&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col">Low PA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " colspan="4" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Joint association of PA and ST</th></tr><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</th><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">High PA &#38; low ST&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">High PA &#38; high ST&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Low PA &#38; low ST&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Low PA &#38; high ST&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " colspan="9" align="left" valign="top"><span class="elsevierStyleItalic">Parental overweight</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Model 1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;18 &#40;1&#46;04&#8211;1&#46;33&#41;<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;01 &#40;0&#46;89&#8211;1&#46;16&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;02 &#40;0&#46;94&#8211;1&#46;10&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;40 &#40;1&#46;22&#8211;1&#46;62&#41;<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;09 &#40;0&#46;96&#8211;1&#46;24&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;95 &#40;0&#46;83&#8211;1&#46;09&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;02 &#40;0&#46;94&#8211;1&#46;10&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;33 &#40;1&#46;14&#8211;1&#46;54&#41;<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="9" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="9" align="left" valign="top"><span class="elsevierStyleItalic">Parental general obesity</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Model 1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;15 &#40;0&#46;99&#8211;1&#46;32&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;98 &#40;0&#46;90&#8211;1&#46;06&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;98 &#40;0&#46;88&#8211;1&#46;09&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;21 &#40;1&#46;11&#8211;1&#46;31&#41;<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;96 &#40;0&#46;81&#8211;1&#46;13&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;20 &#40;1&#46;13&#8211;1&#46;32&#41;<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;29 &#40;1&#46;10&#8211;1&#46;52&#41;<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Model 2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;13 &#40;0&#46;98&#8211;1&#46;30&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;97 &#40;0&#46;89&#8211;1&#46;06&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;93 &#40;0&#46;85&#8211;1&#46;07&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46; 21 &#40;1&#46;11&#8211;1&#46;32&#41;<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;93 &#40;0&#46;78&#8211;1&#46;10&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;20 &#40;1&#46;09&#8211;1&#46;32&#41;<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;26 &#40;1&#46;07&#8211;1&#46;49&#41;<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="9" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="9" align="left" valign="top"><span class="elsevierStyleItalic">Parental abdominal obesity</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Model 1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;35 &#40;1&#46;19&#8211;1&#46;52&#41;<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;00 &#40;0&#46;93&#8211;1&#46;08&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;12 &#40;1&#46;04&#8211;1&#46;20&#41;<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;16 &#40;1&#46;01&#8211;1&#46;34&#41;<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;14 &#40;1&#46;05&#8211;1&#46;24&#41;<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;27 &#40;1&#46;10&#8211;1&#46;47&#41;<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Model 2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;30 &#40;1&#46;14&#8211;1&#46;47&#41;<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;97 &#40;0&#46;90&#8211;1&#46;05&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
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          "en" => "<p id="spar0120" class="elsevierStyleSimplePara elsevierViewall">Odds ratios and 95&#37; confidence intervals of children&#39;s computer time&#44; TV time&#44; screen time&#44; physical activity&#44; and joint associations of ST and PA categories associated with parental weight status&#46;</p>"
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    ]
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      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0015"
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            0 => array:3 [
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A study of effect of the compound physical activity therapy on muscular strength in obese women"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "H&#46;B&#46; Kak"
                            1 => "S&#46;H&#46; Cho"
                            2 => "Y&#46;H&#46; Lee"
                            3 => "B&#46;J&#46; Cho"
                            4 => "J&#46;W&#46; Kim"
                            5 => "B&#46;D&#46; Oh"
                          ]
                        ]
                      ]
                    ]
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                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1589/jpts.25.1039"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Phys Ther Sci"
                        "fecha" => "2013"
                        "volumen" => "25"
                        "paginaInicial" => "1039"
                        "paginaFinal" => "1041"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24259911"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
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              "identificador" => "bib0160"
              "etiqueta" => "2"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Systematic review of sedentary behaviour and health indicators in school-aged children and youth"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46;S&#46; Tremblay"
                            1 => "A&#46;G&#46; LeBlanc"
                            2 => "M&#46;E&#46; Kho"
                            3 => "T&#46;J&#46; Saunders"
                            4 => "R&#46; Larouche"
                            5 => "R&#46;C&#46; Colley"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1186/1479-5868-8-98"
                      "Revista" => array:5 [
                        "tituloSerie" => "Int J Behav Nutr Phys Act"
                        "fecha" => "2011"
                        "volumen" => "8"
                        "paginaInicial" => "98"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21936895"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib0165"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prevalence of childhood and adult obesity in the United States&#44; 2011&#8211;2012"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "C&#46;L&#46; Ogden"
                            1 => "M&#46;D&#46; Carroll"
                            2 => "B&#46;K&#46; Kit"
                            3 => "K&#46;M&#46;v Flegal"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1001/jama.2014.732"
                      "Revista" => array:6 [
                        "tituloSerie" => "JAMA"
                        "fecha" => "2014"
                        "volumen" => "311"
                        "paginaInicial" => "806"
                        "paginaFinal" => "814"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24570244"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0170"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prevalence of overweight and obesity in adolescent Tehrani students&#44; 2000&#8211;2001&#58; an epidemic health problem"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "B&#46; Mohammadpour-Ahranjani"
                            1 => "A&#46; Rashidi"
                            2 => "M&#46; Karandish"
                            3 => "M&#46;R&#46; Eshraghian"
                            4 => "N&#46; Kalantari"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Public Health Nutr"
                        "fecha" => "2004"
                        "volumen" => "7"
                        "paginaInicial" => "645"
                        "paginaFinal" => "648"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15251055"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0175"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Reliability and validity of the Japanese version of the short questionnaire to assess health-enhancing physical activity &#40;SQUASH&#41; scale in older adults"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "S&#46; Makabe"
                            1 => "K&#46; Makimoto"
                            2 => "T&#46; Kikkawa"
                            3 => "H&#46; Uozumi"
                            4 => "M&#46; Ohnuma"
                            5 => "T&#46; Kawamata"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1589/jpts.27.517"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Phys Ther Sci"
                        "fecha" => "2015"
                        "volumen" => "27"
                        "paginaInicial" => "517"
                        "paginaFinal" => "522"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25729206"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0180"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The impact of different types of parental support behaviours on child physical activity&#44; healthy eating&#44; and screen time&#58; a cross-sectional study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "E&#46; Pyper"
                            1 => "D&#46; Harrington"
                            2 => "H&#46; Manson"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1186/s12889-016-3245-0"
                      "Revista" => array:5 [
                        "tituloSerie" => "BMC Public Health"
                        "fecha" => "2016"
                        "volumen" => "16"
                        "paginaInicial" => "568"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27554089"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0185"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Obesity in adolescence is associated with perinatal risk factors&#44; parental BMI and sociodemographic characteristics"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "M&#46; Birbilis"
                            1 => "G&#46; Moschonis"
                            2 => "V&#46; Mougios"
                            3 => "Y&#46; Manios"
                            4 => "Healthy Growth Study&#8217; group"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1038/ejcn.2012.176"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur J Clin Nutr"
                        "fecha" => "2013"
                        "volumen" => "67"
                        "paginaInicial" => "115"
                        "paginaFinal" => "121"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23232586"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0190"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Metabolic syndrome is strictly associated with parental obesity beginning from childhood"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46; Monzani"
                            1 => "A&#46; Rapa"
                            2 => "N&#46; Fuiano"
                            3 => "G&#46; Diddi"
                            4 => "F&#46; Prodam"
                            5 => "S&#46; Bellone"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Clin Endocrinol"
                        "fecha" => "2014"
                        "volumen" => "81"
                        "paginaInicial" => "45"
                        "paginaFinal" => "51"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0195"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Fat intake and adiposity in children of lean and obese parents"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "V&#46;T&#46; Nguyen"
                            1 => "D&#46;E&#46; Larson"
                            2 => "R&#46;K&#46; Johnson"
                            3 => "M&#46;I&#46; Goran"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/ajcn/63.4.507"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Clin Nutr"
                        "fecha" => "1996"
                        "volumen" => "63"
                        "paginaInicial" => "507"
                        "paginaFinal" => "513"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8599313"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0200"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Food and activity preferences in children of lean and obese parents"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "J&#46; Wardle"
                            1 => "C&#46; Guthrie"
                            2 => "S&#46; Sanderson"
                            3 => "L&#46; Birch"
                            4 => "R&#46; Plomin"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1038/sj.ijo.0801661"
                      "Revista" => array:6 [
                        "tituloSerie" => "Int J Obes Relat Metab Disord"
                        "fecha" => "2001"
                        "volumen" => "25"
                        "paginaInicial" => "971"
                        "paginaFinal" => "977"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11443494"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0205"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The family environment and American adolescents&#8217; risk of obesity as young adults"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "A&#46; Crossman"
                            1 => "D&#46; Anne Sullivan"
                            2 => "M&#46; Benin"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.socscimed.2006.05.027"
                      "Revista" => array:6 [
                        "tituloSerie" => "Soc Sci Med"
                        "fecha" => "2006"
                        "volumen" => "63"
                        "paginaInicial" => "2255"
                        "paginaFinal" => "2267"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16828216"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0210"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "An overview on the successes&#44; challenges and future perspective of a national school-based surveillance program&#58; the CASPIAN study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "Z&#46; Ahadi"
                            1 => "G&#46; Shafiee"
                            2 => "M&#46; Qorbani"
                            3 => "S&#46; Sajedinejad"
                            4 => "R&#46; Kelishadi"
                            5 => "S&#46;M&#46; Arzaghi"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "J Diabetes Metab"
                        "fecha" => "2014"
                        "volumen" => "13"
                        "paginaInicial" => "120"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0215"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Methodology and early findings of the Fifth Survey of Childhood and Adolescence Surveillance and Prevention of Adult Non-communicable Disease&#58; the CASPIAN-V study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46; Motlagh"
                            1 => "H&#46; Ziaodini"
                            2 => "M&#46; Qorbani"
                            3 => "M&#46; Taheri"
                            4 => "T&#46; Aminaei"
                            5 => "A&#46; Goodarzi"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.4103/2008-7802.198915"
                      "Revista" => array:5 [
                        "tituloSerie" => "Int J Prev Med"
                        "fecha" => "2017"
                        "volumen" => "8"
                        "paginaInicial" => "4"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28217266"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0220"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Development and evaluation of a questionnaire for assessment of determinants of weight disorders among children and adolescents&#58; the Caspian-IV study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "R&#46; Kelishadi"
                            1 => "R&#46; Majdzadeh"
                            2 => "M&#46;-E&#46; Motlagh"
                            3 => "R&#46; Heshmat"
                            4 => "T&#46; Aminaee"
                            5 => "G&#46; Ardalan"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Int J Prev Med"
                        "fecha" => "2012"
                        "volumen" => "3"
                        "paginaInicial" => "699"
                        "paginaFinal" => "705"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23112896"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib0225"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Television viewing habits associated with obesity risk factors&#58; a survey of Melbourne schoolchildren"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "J&#46; Salmon"
                            1 => "K&#46;J&#46; Campbell"
                            2 => "D&#46;A&#46; Crawford"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Med J Aust"
                        "fecha" => "2006"
                        "volumen" => "184"
                        "paginaInicial" => "64"
                        "paginaFinal" => "67"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16411870"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib0230"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Appropriate definition of metabolic syndrome among Iranian adults&#58; report of the Iranian National Committee of Obesity"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "F&#46; Azizi"
                            1 => "F&#46; Hadaegh"
                            2 => "D&#46; Khalili"
                            3 => "A&#46; Esteghamati"
                            4 => "F&#46; Hosseinpanah"
                            5 => "A&#46; Delavari"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "010135/AIM.0011"
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Iran Med"
                        "fecha" => "2010"
                        "volumen" => "13"
                        "paginaInicial" => "426"
                        "paginaFinal" => "428"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20804311"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib0235"
              "etiqueta" => "17"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Measuring family socioeconomic status&#58; an illustration using data from PIRLS 2006"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "D&#46;H&#46; Caro"
                            1 => "D&#46; Cort&#233;s"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:3 [
                        "fecha" => "2012"
                        "paginaInicial" => "9"
                        "paginaFinal" => "33"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib0240"
              "etiqueta" => "18"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Associations of physical activity and sedentary time with weight and weight status among 10- to 12-year-old boys and girls in Europe&#58; a cluster analysis within the ENERGY project"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "I&#46; De Bourdeaudhuij"
                            1 => "M&#46; Verloigne"
                            2 => "L&#46; Maes"
                            3 => "W&#46; Van Lippevelde"
                            4 => "M&#46;J&#46; Chinapaw"
                            5 => "S&#46;J&#46; Te Velde"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.2047-6310.2012.00117.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "Pediatr Obes"
                        "fecha" => "2013"
                        "volumen" => "8"
                        "paginaInicial" => "367"
                        "paginaFinal" => "375"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23239600"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib0245"
              "etiqueta" => "19"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Profiles of sedentary behavior in children and adolescents&#58; the US National Health and Nutrition Examination Survey&#44; 2001&#8211;2006"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "S&#46;B&#46; Sisson"
                            1 => "T&#46;S&#46; Church"
                            2 => "C&#46;K&#46; Martin"
                            3 => "C&#46; Tudor-Locke"
                            4 => "S&#46;R&#46; Smith"
                            5 => "C&#46; Bouchard"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3109/17477160902934777"
                      "Revista" => array:6 [
                        "tituloSerie" => "Int J Pediatr Obes"
                        "fecha" => "2009"
                        "volumen" => "4"
                        "paginaInicial" => "353"
                        "paginaFinal" => "359"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19922052"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib0250"
              "etiqueta" => "20"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Childhood obesity and familial environmental factor according to the developmental stages&#58; the Korea NHANES study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "J&#46;A&#46; Ko"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Korean Acad Fam Med"
                        "fecha" => "2008"
                        "volumen" => "29"
                        "paginaInicial" => "939"
                        "paginaFinal" => "947"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib0255"
              "etiqueta" => "21"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Common variants near MC4R are associated with fat mass&#44; weight and risk of obesity"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "R&#46;J&#46; Loos"
                            1 => "C&#46;M&#46; Lindgren"
                            2 => "S&#46; Li"
                            3 => "E&#46; Wheeler"
                            4 => "J&#46;H&#46; Zhao"
                            5 => "I&#46; Prokopenko"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1038/ng.140"
                      "Revista" => array:6 [
                        "tituloSerie" => "Nat Genet"
                        "fecha" => "2008"
                        "volumen" => "40"
                        "paginaInicial" => "768"
                        "paginaFinal" => "775"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18454148"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib0260"
              "etiqueta" => "22"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Substantial intergenerational increases in body mass index are not explained by the fetal overnutrition hypothesis&#58; the Cardiovascular Risk in Young Finns Study"
                      "autores" => array:1 [
                        0 => array:2 [
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                            3 => "M&#46; Elovainio"
                            4 => "M&#46; Jokela"
                            5 => "L&#46; Keltikangas-Jarvinen"
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                        "paginaFinal" => "1514"
                        "link" => array:1 [
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                      "titulo" => "Joint association of screen time and physical activity with cardiometabolic risk factors in a national sample of Iranian adolescents&#58; the CASPIANIII study"
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                          "autores" => array:6 [
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                            4 => "A&#46; Ataei-Jafari"
                            5 => "M&#46;E&#46; Motlagh"
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                        "volumen" => "11"
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                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27167372"
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                ]
              ]
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                    0 => array:2 [
                      "titulo" => "Lifestyle correlates of overweight in adults&#58; a hierarchical approach &#40;the SPOTLIGHT project&#41;"
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                          "etal" => true
                          "autores" => array:6 [
                            0 => "C&#46; Roda"
                            1 => "H&#46; Charreire"
                            2 => "T&#46; Feuillet"
                            3 => "J&#46;D&#46; Mackenbach"
                            4 => "S&#46; Compernolle"
                            5 => "K&#46; Glonti"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1186/s12966-016-0439-x"
                      "Revista" => array:5 [
                        "tituloSerie" => "Int J Behav Nutr Phys Act"
                        "fecha" => "2016"
                        "volumen" => "13"
                        "paginaInicial" => "114"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27809926"
                            "web" => "Medline"
                          ]
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                      ]
                    ]
                  ]
                ]
              ]
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              "etiqueta" => "25"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Associations between screen-based sedentary behavior and cardiovascular disease risk factors in Korean youth"
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                          "etal" => false
                          "autores" => array:3 [
                            0 => "W&#46; Byun"
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                            2 => "R&#46;R&#46; Pate"
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                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
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                        "tituloSerie" => "J Korean Med Sci"
                        "fecha" => "2012"
                        "volumen" => "27"
                        "paginaInicial" => "388"
                        "paginaFinal" => "394"
                        "link" => array:1 [
                          0 => array:2 [
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                ]
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                0 => array:2 [
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "M&#46;W&#46; Beets"
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                            2 => "B&#46;L&#46; Alderman"
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                      ]
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                        "paginaInicial" => "621"
                        "paginaFinal" => "644"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20729347"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "etiqueta" => "27"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "How parents can affect excessive spending of time on screenbased activities"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "D&#46; Brindova"
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                            2 => "A&#46; Sevcikova"
                            3 => "I&#46; Zezula"
                            4 => "J&#46;P&#46; van Dijk"
                            5 => "S&#46;A&#46; Reijneveld"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1186/1471-2458-14-1261"
                      "Revista" => array:5 [
                        "tituloSerie" => "BMC Public Health"
                        "fecha" => "2014"
                        "volumen" => "14"
                        "paginaInicial" => "1261"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25494708"
                            "web" => "Medline"
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                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "etiqueta" => "28"
              "referencia" => array:1 [
                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Familial aggregation of physical activity levels in the Quebec Family Study"
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                        0 => array:2 [
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                          "autores" => array:6 [
                            0 => "R&#46;L&#46; Simonen"
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                            3 => "T&#46; Rice"
                            4 => "D&#46;C&#46; Rao"
                            5 => "C&#46; Bouchard"
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                      ]
                    ]
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                  "host" => array:1 [
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                        "tituloSerie" => "Med Sci Sports Exerc"
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                        "volumen" => "34"
                        "paginaInicial" => "1137"
                        "paginaFinal" => "1142"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12131254"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "etiqueta" => "29"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Childhood obesity&#58; public-health crisis&#44; common sense cure"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "C&#46;B&#46; Ebbeling"
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                      ]
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                        "fecha" => "2002"
                        "volumen" => "360"
                        "paginaInicial" => "473"
                        "paginaFinal" => "482"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12241736"
                            "web" => "Medline"
                          ]
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                      ]
                    ]
                  ]
                ]
              ]
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                      "titulo" => "A comparison of self-reported and objective physical activity measures in young Australian women"
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                          "etal" => true
                          "autores" => array:6 [
                            0 => "S&#46; Hartley"
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                            2 => "E&#46; Young"
                            3 => "K&#46;L&#46; Bennell"
                            4 => "I&#46; Tay"
                            5 => "A&#46; Gorelik"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.2196/publichealth.4259"
                      "Revista" => array:5 [
                        "tituloSerie" => "JMIR Public Health Surveill"
                        "fecha" => "2015"
                        "volumen" => "1"
                        "paginaInicial" => "e14"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27227132"
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Journal Information
Vol. 94. Issue 4.
Pages 410-418 (July - August 2018)
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3019
Vol. 94. Issue 4.
Pages 410-418 (July - August 2018)
Original article
Open Access
The association of parental obesity with physical activity and sedentary behaviors of their children: the CASPIAN-V study
Associação da obesidade parental a atividade física e comportamentos sedentários de seus filhos: o estudo CASPIAN-V
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3019
Pooneh Angoorania, Ramin Heshmata, Hanieh-Sadat Ejtahedb, Mohammad Esmaeil Motlaghc, Hasan Ziaodinid, Majzoubeh Taherie, Tahereh Aminaeee, Gita Shafieea, Azam Godarzif, Mostafa Qorbanig,h,
Corresponding author
mqorbani1379@yahoo.com

Corresponding authors.
, Roya Kelishadii,
Corresponding author
kelishadi@med.mui.ac.ir

Corresponding authors.
a Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
b Obesity and Eating Habits Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
c Department of Pediatrics, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
d Health Psychology Research Center, Education Ministry, Tehran, Iran
e Office of Adolescents and School Health, Ministry of Health and Medical Education, Tehran, Iran
f Medical Faculty, Tarbiat Modarres University, Tehran, Iran
g Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
h Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
i Child Department of Pediatrics, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
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Tables (4)
Table 1. Demographic characteristics and anthropometric measures of children and adolescents according to the range of physical activity and screen time.
Table 2. Mean±SD of parental BMI and waist circumference according to physical activity and screen time categories.
Table 3. Prevalence of different categories of children's physical activity and screen time according to parental weight status.
Table 4. Odds ratios and 95% confidence intervals of children's computer time, TV time, screen time, physical activity, and joint associations of ST and PA categories associated with parental weight status.
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Abstract
Objective

Low physical activity and sedentary behaviors, two important determinants of childhood obesity, may be influenced by parental lifestyle and weight status. This study aims to determine the association of parental weight status with children's physical activity and screen time.

Methods

This study was conducted on 14,440 Iranian schools students, aged 7–18 years, and one of their parents, who participated in the large national school-based surveillance program. The children's screen-based and physical activities were evaluated based on the World Health Organization's Global School Student Health Survey. Children and parental height, weight, and waist circumference were measured using standardized methods.

Results

Overall, 14,274 students and one of their parents completed the survey (participation rate: 99%). Mean (standard deviation) age of students was 12.3 (3.2) years, and the prevalence of low physical activity and high screen time was 58.2% and 17.7%, respectively. In multivariate model, the parental general obesity and abdominal obesity increased the odds of children having low physical activity, by 21% and 13%, respectively. Parental overweight, general obesity, and abdominal obesity increased the odds of the combination of low physical activity/high screen time in children by 33%, 26%, and 20%, respectively.

Conclusions

This study showed that parental obesity was associated with increased screen-based activities and low physical activity in children. Focus on parental weight status, as an important factor influenced by their lifestyle, can be helpful for preventing sedentary behaviors in their children.

Keywords:
Parental obesity
Physical activity
Screen time
Children
Resumo
Objetivo

A baixa atividade física e comportamentos sedentários, dois importantes fatores determinantes de obesidade infantil, podem ser influenciados pelo estilo de vida e o status do peso dos pais. Este estudo visa determinar a associação do status do peso dos pais ao nível de atividade física e ao tempo de tela das crianças.

Métodos

Este estudo é realizado em 14.440 estudantes de escolas iranianas, com idades entre 7-18 anos e um de seus pais inscritos no grande programa nacional de vigilância escolar. As atividades físicas e em tela das crianças foram avaliadas com base no questionário da Pesquisa Global de Saúde do Escolar da Organização Mundial de Saúde. A estatura, o peso e a circunferência da cintura das crianças e dos pais foram medidos utilizando métodos padronizados.

Resultados

De modo geral, 14.274 estudantes e um de seus pais concluíram a pesquisa (taxa de participação: 99%). A idade média (desvio padrão) dos estudantes foi 12,3 (3,2) anos e a prevalência de baixa atividade física e alto tempo de tela foi 58,2% e 17,7%, respectivamente. Em um modelo multivariado, a obesidade geral dos pais e obesidade abdominal aumentaram as chances de as crianças com baixo nível de atividade física em 21% e 13%, respectivamente. Sobrepeso dos pais, obesidade geral e obesidade abdominal aumentaram as chances de combinação de baixo nível de atividade física/alto tempo de tela nas crianças em 33%, 26% e 20%, respectivamente.

Conclusões

Este estudo mostrou que a obesidade dos pais foi associada ao aumento nas atividades de tela e ao baixo nível de atividade física nas crianças. O foco no status do peso dos pais, como um importante fator influenciado por seu estilo de vida, pode ser útil na prevenção de comportamentos sedentários em seus filhos.

Palavras-chave:
Obesidade dos pais, Atividade física, Tempo de tela, Crianças
Full Text
Introduction

Nowadays, children spend a considerable part of their time with sedentary entertainment, such as watching television (TV), playing computer games, and surfing the Internet. In the United States, Australia, and Europe, the average time spent watching TV has been estimated to be about 5, 4, and 3.5h, respectively.1 Increasing sedentary activity is accompanied with less daily energy expenditure, energy imbalance, fat accumulation, overweight, and obesity.2 Obesity is a major risk factor of poor health among all age groups of school children worldwide, and has significantly increased over the last decades, especially in industrialized countries. Obesity among children and adolescents has more than doubled and quadrupled in the past three decades.3 In Iran, the prevalence of overweight and obesity was reported as 21.1% and 7.8% among adolescents.4 Studies have indicated that daily physical activity plays an important role in preventing obesity among children, while a sedentary lifestyle increases the risk of obesity and related diseases.5 Parents have an essential role in children's health behaviors, such as the physical activity, eating pattern, and sedentary behaviors.6 Studies have revealed that parental obesity can be closely associated with childhood obesity.7–9 Children from obese parents had a higher preference for sedentary activities, and spent more time in sedentary entertainments.10 In addition to the genetic predisposition of children with obese parents, parental obesity can influence their children's weight in many ways, including modeling unhealthy behaviors, as well as providing a shared family environment that stimulates and supports unhealthy eating patterns and sedentary lifestyles.11 However, the association of parental weight status as an independent factor with the joint association of children's activities and sedentary times has yet to be determined. Therefore, the present study was conducted to evaluate the effect of parental obesity on children's physical activities and sedentary behaviors.

MethodsStudy population

This cross-sectional study was conducted on the participants of the fifth phase of the Childhood and Adolescence Surveillance and Prevention of Adult Non-communicable Disease (CASPIAN) study, a national school-based surveillance program implemented in Iran from 2003 onwards.12 The fifth phase of study (CASPIAN-V) was performed in 2015 the in urban and rural areas of 30 provinces of Iran, and participants included of 14,440 primary and secondary schools students, aged 7–18 years, and one of their parents, who were selected by multistage random cluster sampling method. Protocol details of the CASPIAN-V study have been explained previously.13

Data collection

A validated questionnaire obtained from the World Health Organization's Global School Student Health Survey (WHO-GSHS)14 was used to collect data on the student's characteristics and social and health behaviors. Another questionnaire including family characteristics, medical history, dietary habits, and leisure time activities was also completed by parents. The presence of one of the parents was considered sufficient.

DefinitionsTV time, computer time, screen time (ST), and physical activity (PA)

Each individual was asked about the number of hours per day that spent watching television or videos (TV time), as well as working with a personal computer or playing electronic games (computer time), and then the ST was calculated by adding TV time to computer time. Based on the international ST recommendations, TV time, computer time, and ST were categorized into two groups; less than 2h/day was considered low, and 2h/day or more was considered high.15

For assessing the weekly frequency of leisure time physical activity outside the school during the past week, a validated questionnaire was used. Having sufficient physical activity was considered as at least 30min duration of exercises per day that led to sweating and large increases in breathing or heart rate.14

The joint associations of PA and ST were considered according to the following possible mixed conditions: low PA & low ST, low PA & high ST, high PA & low ST, and high PA & high ST. High PA & low ST and low PA & high ST were considered as the ideal and the worst combinations, respectively. High PA & high ST and low PA & low ST both were considered as the intermediate combinations.

Overweight, obesity, and abdominal obesity in parents

A team of health care professionals recorded anthropometric measurements both in children and in parents, using standard procedures. Weight was measured to the nearest 0.1kg using scales on flat ground, while the participants were minimally clothed. Height was measured to the nearest 0.1cm, in a standing position, without shoes. Waist circumference (WC) was measured to the nearest 0.1cm, using a non-elastic tape meter, at a point midway between the lower border of the rib cage and the iliac crest at the end of normal expiration. Hip circumference was measured to the nearest 0.1cm at the widest part of the hip at the level of the greater trochanter. Body mass index (BMI) was calculated as weight (kg) divided by the square of height (m2). Overweight and obesity in parents were defined according to BMI ≥25kg/m2 and BMI ≥30kg/m2, respectively. Abdominal obesity in parents was defined as WC ≥95cm and waist to hip ratio (WHR) ≥0.5 for both sexes.16

Socioeconomic status (SES)

For calculating SES, an approved method was used, which previously provided for the Progress in the International Reading Literacy Study (PIRLS).17 Some variables such as parental occupation, parental education, school type (public/private), owning a private car, and possessing personal computer at home were summarized in one main component, by the principle component analysis (PCA) method. This main component was classified into three levels. The first level was considered as low SES, the second level as intermediate, and the third level as high SES.

Ethical concerns

Ethical committees of the Isfahan University of Medical Sciences and other relevant national regulatory organizations approved this survey (Project number: 194049). Written informed consent and verbal consent were obtained from all participants.

Statistical analysis

STATA software (StataCorp. 2009. Stata Statistical Software: version 11. College Station, TX, USA) was used for data analysis. Quantitative variables were expressed as mean±standard deviation (SD), and their mean differences were compared by Student's t-test. Qualitative variables were expressed as number (percentage), and the association between them was assessed by the chi-squared test. Odds ratios (95% confidence interval [CI]) for computer time, TV time, ST, PA, and joint associations of ST and PA categories according to parental weight status were assessed by logistic regression analyses in two different models; in model I, the association assessed without adjustment, while in model II, the association was adjusted for age, gender, region, and SES. In both models, the high PA & low ST group was considered as the reference. All statistical analysis was performed using survey analysis method. p-values <0.05 were considered statistically significant.

Results

In total, 14,274 students (50.6% boys, 49.4% girls) and one of their parents completed the survey (participation rate: 99%). The mean age of students was 12.3±3.2 years; 71.3% were from urban areas and 28.7% from rural areas. Demographic characteristics and anthropometric measures according to the range of PA and ST are presented in Table 1. It shows that there were no significant differences in the mean weight, height, BMI, WC, and SES between students with low or high PA; however, the mean age of students with high PA was significantly lower than those with low PA. Most of the students had low PA levels (58.2% of all students), which was different between boys and girls (56.2% of boys and 60.4% of girls) (p<0.001) and between urban and rural areas (58.8% in urban areas and 56.7% in rural areas) (p<0.05). Most of the students had low ST levels (82.3% of all students). The mean age, weight, height, and BMI were significantly higher in students with high ST compared with low ST (p<0.05).

Table 1.

Demographic characteristics and anthropometric measures of children and adolescents according to the range of physical activity and screen time.

  Total  Low PA  High PA  p-value  Low ST  High ST  p-value 
Age (year)  12.3±3.2  12.3±3.2  12.2±3.2  0.036  12.2±3.2  12.6±3.2  0.001 
Weight (kg)  41.4±17.1  41.5±17.1  41.2±17.1  0.38  41.0±17.0  43.3±17.8  0.001 
Height (cm)  146.6±17.5  146.7±17.4  146.3±17.6  0.2  146.2±17.4  148.3±17.9  0.001 
BMI (kg/m218.5±4.7  18.5±4.5  18.5±5.0  0.97  18.4±4.7  18.9±4.6  0.001 
WC (cm)  66.7±12.2  66.8±12.1  66.6±12.3  0.51  66.6±12.1  67.5±12.4  0.18 
Sex
Male  7158 (50.6)  4020 (56.2)  3138 (43.8)  0.001  5863 (83.4)  1164 (16.6)  0.18 
Female  6983 (49.4)  4215 (60.4)  2768 (39.6)    5781 (84.3)  1079 (15.7)   
Region
Urban  10,086 (71.3)  5934 (58.8)  4152 (41.2)  0.023  8274 (83.5)  1631 (16.5)  0.11 
Rural  4055 (28.7)  2301 (56.7)  1754 (43.3)    3370 (84.6)  612 (15.4)   
SES
Low  4515 (33.4)  2646 (58.6)  1869 (41.4)  0.63  3793 (85.6)  640 (14.4)  0.002 
Medium  4492 (33.3)  2628 (58.5)  1864 (41.5)    3695 (84.0)  705 (16.0)   
High  4493 (33.3)  2592 (57.7)  1901 (42.3)    3676 (82.9)  760 (17.1)   

Data are expressed as means±SD or number (%).

BMI, body mass index; WC, waist circumference; ST, screen time; PA, physical activity; SES, socioeconomic status.

Low ST: <2h/day; high ST: ≥2h/day; low PA: 0–2days/week; high PA: 3–7days/week.

p-value <0.05 was considered statistically significant.

The means of parental BMI and WC according to children's PA and ST categories are illustrated in Table 2. As it is shown, the mean of parental BMI is significantly higher in students with high computer time (p<0.005) and low PA (p<0.001); the mean of parental WC was significantly higher in students with high TV time (p<0.05) and high ST (p<0.001). Regarding joint association of ST and PA, the means of parental BMI and WC were significantly higher in the combination of low PA/high ST (p<0.005 and p<0.001, respectively).

Table 2.

Mean±SD of parental BMI and waist circumference according to physical activity and screen time categories.

  Parental BMI  Parental waist circumference 
Computer time
High  26.8±5.1  88.4±15.2 
Low  26.4±4.9  87.6±14.7 
p-value  0.003  0.07 
TV time
High  26.4±4.9  87.9±14.6 
Low  26.5±4.8  87.2±14.9 
p-value  0.36  0.007 
Screen time
High  26.6±4.8  88.7±15.4 
Low  26.4±4.9  87.5±14.6 
p-value  0.11  0.001 
Physical activity
High  26.3±4.8  87.4±14.4 
Low  26.5±5.0  87.7±15.0 
p-value  0.001  0.32 
Joint association of PA and ST
High PA & low ST  26.3±4.8  87.1±14.3 
High PA & high ST  26.4±4.6  88.7±14.7 
Low PA & low ST  26.5±5.0  87.6±14.8 
Low PA & high ST  26.9±5.1  88.8±16.0 
p-value  0.002  0.001 

Data are expressed as mean±SD.

BMI, body mass index; WC, waist circumference; ST, screen time; PA, physical activity; SD, standard deviation; TV, television.

Low computer time: <2h/day; high computer time: ≥2h/day; low TV time: <2h/day; high TV time: ≥2h/day; low ST: <2h/day; high ST: ≥2h/day; low PA: 0–2days/week; high PA: 3–7days/week.

p-value <0.05 was considered statistically significant.

The prevalence of different categories of children's PA and ST according to parental weight status is shown in Table 3. The prevalence of students with high computer time and a combination of low PA/high ST was significantly higher in the parents with overweight, general obesity, and abdominal obesity. The prevalence of students with high ST was significantly higher in the parents with overweight and abdominal obesity. The prevalence of students with low PA was significantly higher in the parents with general obesity and abdominal obesity (p<0.001 and p<0.005, respectively).

Table 3.

Prevalence of different categories of children's physical activity and screen time according to parental weight status.

  High computer time  High TV time  High screen time  Low physical activity  Joint association of PA and ST
          High PA & low ST  High PA & high ST  Low PA & low ST  Low PA & high ST 
Parental overweight
Yes  778 (9.6)  4502 (54.0)  6760 (83.1)  4851 (57.7)  2664 (33.0)  677 (8.4)  4038 (50.0)  690 (8.6) 
No  454 (8.2)  3088 (54.7)  4684 (85.0)  3233 (57.5)  1880 (34.2)  471 (8.6)  2793 (50.9)  374 (6.3) 
p-value  0.008  0.39  0.003  0.18    0.001     
Parental general obesity
Yes  295 (9.9)  1633 (53.9)  473 (15.9)  1854 (61.8)  903 (30.7)  220 (57.5)  1568 (53.3)  252 (8.6) 
No  937 (8.8)  5957 (54.4)  1729 (16.2)  6230 (57.2)  3641 (34.3)  928 (8.7)  5263 (49.6)  785 (7.4) 
p-value  0.05  0.65  0.73  0.001    0.001     
Parental abdominal obesity
Yes  457 (10.7)  2362 (54.3)  723 (17.0)  2588 (60.0)  1319 (31.3)  367 (8.7)  2172 (51.6)  352 (8.4) 
No  766 (8.2)  5197 (54.2)  1457 (15.6)  5472 (57.4)  3215 (34.6)  769 (8.3)  4646 (49.9)  675 (7.3) 
p-value  0.001  0.91  0.03  0.003    0.001     

Data are expressed as number (%).

ST, screen time; PA, physical activity.

High computer time: ≥2h/day; high TV time: ≥2h/day; high ST: ≥2h/day; low PA: 0–2 days/week. Parental overweight: BMI ≥25kg/m2; parental general obesity: BMI ≥30kg/m2; parental abdominal obesity: waist circumference ≥95cm.

p-value <0.05 was considered statistically significant.

Table 4 presents the odds ratios and 95% confidence intervals of children's computer time, TV time, ST, PA, and joint associations of ST and PA categories associated with parental weight status, using two logistic regression models. Parental overweight was significantly associated with high computer time and high ST in children (OR: 1.18, 95% CI: 1.04–1.33 and OR: 1.17, 95% CI: 1.05–1.27, respectively). These associations became non-significant after adjustment for age, gender, region, and SES. Parental general obesity increased the odds of children's low PA, by 21% in both models. Parental abdominal obesity was significantly associated with children's high computer time and low PA (OR: 1.35, 95% CI: 1.19–1.52 and OR: 1.30, 95% CI: 1.14–1.47, respectively) and also remained significant after adjustment for age, gender, region, and SES (OR: 1.12, 95% CI: 1.04–1.20 and OR: 1.13, 95% CI: 1.05–1.22, respectively). Parental over weight, general obesity, and abdominal obesity increased the odds of the combination of low PA/high ST in children by 40%, 29%, and 27%, respectively, which declined to 33%, 26%, and 20% after adjustment for age, gender, region, and SES.

Table 4.

Odds ratios and 95% confidence intervals of children's computer time, TV time, screen time, physical activity, and joint associations of ST and PA categories associated with parental weight status.

  High computer time  High TV time  High ST  Low PA  Joint association of PA and ST
          High PA & low ST  High PA & high ST  Low PA & low ST  Low PA & high ST 
Parental overweight
Model 1  1.18 (1.04–1.33)a  0.97 (0.91–1.04)  1.15 (1.05–1.27)a  1.05 (0.98–1.12)  –  1.01 (0.89–1.16)  1.02 (0.94–1.10)  1.40 (1.22–1.62)a 
Model 2  1.09 (0.96–1.24)  0.51 (0.98–1.04)  1.08 (0.98–1.19)  1.05 (0.98–1.13)  –  0.95 (0.83–1.09)  1.02 (0.94–1.10)  1.33 (1.14–1.54)a 
Parental general obesity
Model 1  1.15 (0.99–1.32)  0.98 (0.90–1.06)  0.98 (0.88–1.09)  1.21 (1.11–1.31)a  –  0.96 (0.81–1.13)  1.20 (1.13–1.32)a  1.29 (1.10–1.52)a 
Model 2  1.13 (0.98–1.30)  0.97 (0.89–1.06)  0.93 (0.85–1.07)  1. 21 (1.11–1.32)a  –  0.93 (0.78–1.10)  1.20 (1.09–1.32)a  1.26 (1.07–1.49)a 
Parental abdominal obesity
Model 1  1.35 (1.19–1.52)a  1.00 (0.93–1.08)  1.11 (1.01–1.22)a  1.12 (1.04–1.20)a  –  1.16 (1.01–1.34)a  1.14 (1.05–1.24)a  1.27 (1.10–1.47)a 
Model 2  1.30 (1.14–1.47)a  0.97 (0.90–1.05)  1.06 (0.95–1.17)  1.13 (1.05–1.22)a  –  1.14 (0.99–1.32)  1.16 (1.07–1.26)a  1.20 (1.03–1.39)a 

Data are expressed as OR (95% CI).

ST, screen time; PA, physical activity; high computer time: ≥2h/day; high TV time: ≥2h/day; high ST: ≥2h/day; low PA: 0–2days/week. Parental overweight: BMI ≥25kg/m2; parental general obesity: BMI ≥30kg/m2; parental abdominal obesity: waist circumference ≥95cm.

Model 1 is a crude model; Model 2 is adjusted for age, gender, region, socio-economic status, and body mass index.

a

Statistically significant.

Discussion

The current study indicated that parental obesity was associated with increased sedentary behaviors and low PA in children. It was also revealed that low PA and high ST were more common in older students; the mean weight, height, and BMI were significantly higher in students with prolonged ST compared with those with shorter ST. These findings are consistent with some previous studies. A study conducted on 766 European children, aged 10–12 years, found that those involved in more moderate to vigorous PA and with lower ST had a more favorable weight status than their counterparts.18 It is also indicated that when children become older, they are usually more prone to sedentary behaviors and show more interest in screen-based activities, such as computer games or watching TV.19

One of the most important factors in child obesity is parental obesity.7 A cross-sectional study in Korea revealed that in 2- to 12-year-old children with obese parents, the risk of obesity increased more than fourfold.20 In addition to the influence of genetic predisposition to obesity,21 environmental and behavioral factors play an important role in the recent rapid rise of childhood obesity.22 Parents have a major role in changing their children's obesogenic lifestyle; children's health behaviors, including their physical activity, eating habits, and TV watching or other sedentary behaviors are highly influenced by their parents.6 Adoption and twin studies have indicated that although genes are a major factor in early expression of obesity risk, but children from obese parents had a higher preference for sedentary activities, and spent more time in sedentary entertainments compared to their counterparts. A study on 428 children from a population sample of families with twin births demonstrated that the children from the obese parents had more frequent unhealthy eating habits, as well as higher preferences for sedentary activities, and spent more time in sedentary pastimes.10

Studies have suggested that joint effect of PA/ST should be evaluated for obesity and have emphasized the importance of decreasing ST along with increasing PA for reducing the risk of obesity and related complications. This is suggested because the negative effect of high ST on obesity may disappear without considering PA.23 Therefore, in the current study, all possible mixed conditions were assessed for the joint associations of PA and ST, which showed that parental obesity was strongly associated with increased odds of low PA/high ST and, after that, with low PA/low ST, while no association was observed between parental obesity with high PA/high ST. These finding can be justified by the fact that parental obesity is due to an obesogenic lifestyle, including unhealthy food patterns, lower levels of PA, and prolonged TV watching,24 which, in turn, would be used as a role model for sedentary habits in their children.25 Moreover, parents’ encouragement represents a motivational support which can increase children's capability and behavioral intentions and result in increased PA. Moreover, parents’ participation in PA is a conditional support, which not only helps children to become fitter, but also can lead to increased interest PA.26 Furthermore, it has been shown that ST is increased in children whose the parents spend more time watching TV, whereas parents can reduce the amount screen-based activities by involving their children in PA.27

The present findings propose that although the genetic characteristics transmitted from parents can lead to sedentary lifestyle in their children, the lifestyle habits of obese parents also play a major role in children's behaviors. Children and their parents live in similar environments and experience similar lifestyles that are mainly determined by parents.28 All environmental conditions which lead to decreased PA increased sedentary behaviors and consequently obesity in parents, may have direct consequences on the lifestyle of children.29 Parents should consider that they are the role model for their children in choosing lifestyle habits.

The current study was a novel survey on the data of a large national representative sample of Iranian children and adolescents, which for the first time evaluated the association of parental weight status as an independent factor with children's PA and ST. However, it had some limitations; first, because of the cross-sectional nature of study no causality can be indicated between the parental obesity and PA/ST in children. Besides, children's lifestyle is influenced by both parents’ behaviors, but data was collected from only one of the parents (in most cases their mothers), which may affect the results of this study. In this study, only one of the parents was assessed as the representative. Therefore, future studies should explore the role of all family members on the lifestyle of children. Moreover, data about PA/ST were self-reported, which is subject to recall bias. Studies have shown that individuals tended to over report their amount of physical activity in self-report surveys compared to an objective monitoring device.30 Moreover, some potential confounding factors such as parental support or sedentary behaviors were not assessed in this survey. The authors suggest future prospective studies that consider a range of items for each category of parental support, as well as other aspects of their lifestyle in relation to PA/ST in children.

The results of this study indicated that parental overweight and general or abdominal obesity can increase sedentary behaviors and low PA in children, which in turn may lead to higher risk of child obesity. Therefore, to prevent sedentary lifestyle and related complications in children, it is necessary to focus on parents’ lifestyle behaviors and weight status.

Funding

Isfahan University of Medical Sciences and other relevant national regulatory organizations (Project number: 194049).

Conflicts of interest

The authors declare no conflicts of interest.

Acknowledgments

The authors would like to acknowledge of the Ministry of Health and Medical Education, the Ministry of Education and Training, the Isfahan University of Medical Sciences, and the Endocrinology and Metabolism Research Institute of Tehran University of Medical Sciences, as well as all those who participated in this study.

References
[1]
H.B. Kak, S.H. Cho, Y.H. Lee, B.J. Cho, J.W. Kim, B.D. Oh, et al.
A study of effect of the compound physical activity therapy on muscular strength in obese women.
J Phys Ther Sci, 25 (2013), pp. 1039-1041
[2]
M.S. Tremblay, A.G. LeBlanc, M.E. Kho, T.J. Saunders, R. Larouche, R.C. Colley, et al.
Systematic review of sedentary behaviour and health indicators in school-aged children and youth.
Int J Behav Nutr Phys Act, 8 (2011), pp. 98
[3]
C.L. Ogden, M.D. Carroll, B.K. Kit, K.M.v Flegal.
Prevalence of childhood and adult obesity in the United States, 2011–2012.
JAMA, 311 (2014), pp. 806-814
[4]
B. Mohammadpour-Ahranjani, A. Rashidi, M. Karandish, M.R. Eshraghian, N. Kalantari.
Prevalence of overweight and obesity in adolescent Tehrani students, 2000–2001: an epidemic health problem.
Public Health Nutr, 7 (2004), pp. 645-648
[5]
S. Makabe, K. Makimoto, T. Kikkawa, H. Uozumi, M. Ohnuma, T. Kawamata.
Reliability and validity of the Japanese version of the short questionnaire to assess health-enhancing physical activity (SQUASH) scale in older adults.
J Phys Ther Sci, 27 (2015), pp. 517-522
[6]
E. Pyper, D. Harrington, H. Manson.
The impact of different types of parental support behaviours on child physical activity, healthy eating, and screen time: a cross-sectional study.
BMC Public Health, 16 (2016), pp. 568
[7]
M. Birbilis, G. Moschonis, V. Mougios, Y. Manios, Healthy Growth Study’ group.
Obesity in adolescence is associated with perinatal risk factors, parental BMI and sociodemographic characteristics.
Eur J Clin Nutr, 67 (2013), pp. 115-121
[8]
A. Monzani, A. Rapa, N. Fuiano, G. Diddi, F. Prodam, S. Bellone, et al.
Metabolic syndrome is strictly associated with parental obesity beginning from childhood.
Clin Endocrinol, 81 (2014), pp. 45-51
[9]
V.T. Nguyen, D.E. Larson, R.K. Johnson, M.I. Goran.
Fat intake and adiposity in children of lean and obese parents.
Am J Clin Nutr, 63 (1996), pp. 507-513
[10]
J. Wardle, C. Guthrie, S. Sanderson, L. Birch, R. Plomin.
Food and activity preferences in children of lean and obese parents.
Int J Obes Relat Metab Disord, 25 (2001), pp. 971-977
[11]
A. Crossman, D. Anne Sullivan, M. Benin.
The family environment and American adolescents’ risk of obesity as young adults.
Soc Sci Med, 63 (2006), pp. 2255-2267
[12]
Z. Ahadi, G. Shafiee, M. Qorbani, S. Sajedinejad, R. Kelishadi, S.M. Arzaghi, et al.
An overview on the successes, challenges and future perspective of a national school-based surveillance program: the CASPIAN study.
J Diabetes Metab, 13 (2014), pp. 120
[13]
M. Motlagh, H. Ziaodini, M. Qorbani, M. Taheri, T. Aminaei, A. Goodarzi, et al.
Methodology and early findings of the Fifth Survey of Childhood and Adolescence Surveillance and Prevention of Adult Non-communicable Disease: the CASPIAN-V study.
Int J Prev Med, 8 (2017), pp. 4
[14]
R. Kelishadi, R. Majdzadeh, M.-E. Motlagh, R. Heshmat, T. Aminaee, G. Ardalan, et al.
Development and evaluation of a questionnaire for assessment of determinants of weight disorders among children and adolescents: the Caspian-IV study.
Int J Prev Med, 3 (2012), pp. 699-705
[15]
J. Salmon, K.J. Campbell, D.A. Crawford.
Television viewing habits associated with obesity risk factors: a survey of Melbourne schoolchildren.
Med J Aust, 184 (2006), pp. 64-67
[16]
F. Azizi, F. Hadaegh, D. Khalili, A. Esteghamati, F. Hosseinpanah, A. Delavari, et al.
Appropriate definition of metabolic syndrome among Iranian adults: report of the Iranian National Committee of Obesity.
Arch Iran Med, 13 (2010), pp. 426-428
[17]
D.H. Caro, D. Cortés.
Measuring family socioeconomic status: an illustration using data from PIRLS 2006.
(2012), pp. 9-33
[18]
I. De Bourdeaudhuij, M. Verloigne, L. Maes, W. Van Lippevelde, M.J. Chinapaw, S.J. Te Velde, et al.
Associations of physical activity and sedentary time with weight and weight status among 10- to 12-year-old boys and girls in Europe: a cluster analysis within the ENERGY project.
Pediatr Obes, 8 (2013), pp. 367-375
[19]
S.B. Sisson, T.S. Church, C.K. Martin, C. Tudor-Locke, S.R. Smith, C. Bouchard, et al.
Profiles of sedentary behavior in children and adolescents: the US National Health and Nutrition Examination Survey, 2001–2006.
Int J Pediatr Obes, 4 (2009), pp. 353-359
[20]
J.A. Ko.
Childhood obesity and familial environmental factor according to the developmental stages: the Korea NHANES study.
J Korean Acad Fam Med, 29 (2008), pp. 939-947
[21]
R.J. Loos, C.M. Lindgren, S. Li, E. Wheeler, J.H. Zhao, I. Prokopenko, et al.
Common variants near MC4R are associated with fat mass, weight and risk of obesity.
Nat Genet, 40 (2008), pp. 768-775
[22]
M. Kivimaki, D.A. Lawlor, G.D. Smith, M. Elovainio, M. Jokela, L. Keltikangas-Jarvinen, et al.
Substantial intergenerational increases in body mass index are not explained by the fetal overnutrition hypothesis: the Cardiovascular Risk in Young Finns Study.
Am J Clin Nutr, 86 (2007), pp. 1509-1514
[23]
R. Heshmat, M. Qorbani, A.E. Shahr Babaki, S. Djalalinia, A. Ataei-Jafari, M.E. Motlagh, et al.
Joint association of screen time and physical activity with cardiometabolic risk factors in a national sample of Iranian adolescents: the CASPIANIII study.
PLOS ONE, 11 (2016), pp. e0154502
[24]
C. Roda, H. Charreire, T. Feuillet, J.D. Mackenbach, S. Compernolle, K. Glonti, et al.
Lifestyle correlates of overweight in adults: a hierarchical approach (the SPOTLIGHT project).
Int J Behav Nutr Phys Act, 13 (2016), pp. 114
[25]
W. Byun, M. Dowda, R.R. Pate.
Associations between screen-based sedentary behavior and cardiovascular disease risk factors in Korean youth.
J Korean Med Sci, 27 (2012), pp. 388-394
[26]
M.W. Beets, B.J. Cardinal, B.L. Alderman.
Parental social support and the physical activity-related behaviors of youth: a review.
Health Educ Behav, 37 (2010), pp. 621-644
[27]
D. Brindova, J. Pavelka, A. Sevcikova, I. Zezula, J.P. van Dijk, S.A. Reijneveld, et al.
How parents can affect excessive spending of time on screenbased activities.
BMC Public Health, 14 (2014), pp. 1261
[28]
R.L. Simonen, L. Perusse, T. Rankinen, T. Rice, D.C. Rao, C. Bouchard.
Familial aggregation of physical activity levels in the Quebec Family Study.
Med Sci Sports Exerc, 34 (2002), pp. 1137-1142
[29]
C.B. Ebbeling, D.B. Pawlak, D.S. Ludwig.
Childhood obesity: public-health crisis, common sense cure.
[30]
S. Hartley, S. Garland, E. Young, K.L. Bennell, I. Tay, A. Gorelik, et al.
A comparison of self-reported and objective physical activity measures in young Australian women.
JMIR Public Health Surveill, 1 (2015), pp. e14

Please cite this article as: Angoorani P, Heshmat R, Ejtahed H-S, Motlagh ME, Ziaodini H, Taheri M, et al. The association of parental obesity with physical activity and sedentary behaviors of their children: the CASPIAN-V study. J Pediatr (Rio J). 2018;94:410–8.

Study conducted at Ministry of Health and Medical Education, Ministry of Education and Training, Isfahan University of Medical Sciences, and Endocrinology and Metabolism Research Institute of Tehran University of Medical Sciences, Tehran, Iran.

Copyright © 2017. Sociedade Brasileira de Pediatria
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