Daily Screen Time Associated With Diabetes Risk in Children

Pam Harrison

March 14, 2017

Children who spend more than 3 hours a day glued to a screen are more likely to be fatter and have early risk factors for type 2 diabetes, especially insulin resistance, than those who spend an hour a day or less, new research underscores.

"Recommendations from the American Academy of Pediatrics (AAP) previously suggested that children should limit daily screen time to <2 hours," lead author Claire Nightingale, PhD, University of London, the United Kingdom, and colleagues write in their paper, published online in the Archives of Disease in Childhood.

"Our findings suggest that reducing screen time may be beneficial in reducing type 2 diabetes risk factors in both boys and girls and in different ethnic groups from an early age," they add.

Boys and Black Children Reported Most Screen Time

The Child Heart and Health Study in England (CHASE) is a cross-sectional survey of heart health carried out in children between 9 and 10 years of age attending 200 primary schools in London, Birmingham, and Leicester.

A total of 4495 children were included in this analysis, which was performed from 2004 to 2007 and included anthropometric measurements and fasting blood glucose levels. Physical activity was assessed in a subset of the cohort (n = 2031).

"Overall, 4% of the study population reported no screen time," Dr Nightingale and coauthors report; 37% of the children reported spending an hour or less of daily screen time, while 28% reported they spent between 1 and 2 hours a day.

Some 13% of the group said they spent between 2 and 3 hours of screen time a day while the final 18% reported spending more than 3 hours a day.

Boys were more likely than girls to engage in more than 3 hours of daily screen time at 22% vs 14%, respectively, the investigators note.

And black children (African-Caribbean) were also more likely to report more than 3 hours of daily screen time, at 23% vs 16% of both white and South Asian kids, respectively.

Using children who spent an hour a day or less in screen time as a reference group, those who spent more than 3 hours a day in screen time had a 1.9% higher ponderal index, an indicator of weight in relation to height.

Skinfold thickness was also 4.5% higher and the fat mass index 3.3% higher in children who engaged in the most screen time compared with those who engaged in the least.

And levels of leptin, a hormone that controls appetite, were 9.2% higher in children who engaged in the most vs the least screen time, as were insulin levels, which were 10.7% higher, and levels of insulin resistance (IR), which were 10.5% higher in those with the most vs those with the least screen time.

"Adjustment for fat mass index reduced effect sizes for insulin and IR by approximately one-quarter," the researchers observe.

Importantly, the associations seen between risk markers for diabetes and daily screen time were not affected by either socioeconomic status or, somewhat surprisingly, by levels of physical activity as assessed in the subset of children in the cohort.

But there was "no formal evidence of a trend between screen time and HbA1c, fasting glucose, and other cardiovascular risk factors, including lipids and blood pressure (even with further adjustment for height)," the authors state.

They point out that while the use of electronic devices was already pervasive when their analysis was carried out, more options such as tablets and smartphones have since become available, extending screen time options to many more children.

Thus, these findings may be of "considerable potential public-health interest," given that recent trends indicate screen time–related activities are increasing in childhood and that these activities could have harmful health-related consequences in adulthood, they conclude.

The authors had no relevant financial relationships.

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Arch Dis Child. Published online March 13, 2017. Abstract

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