title: The complexity of obesity in U.K. adolescents: relationships with quantity and type of technology, sleep duration and quality, academic performance and aspiration.
abstract: BACKGROUND
  Contemporary technology and multiple device use may link to increased body mass index (BMI). The sleep-obesity relationship is inconsistent in adolescents. Sleep duration and quality may have crucial connections to obesity development, particularly in adolescents where sleep alterations are common. Elevated BMI in adolescents may influence academic performance and aspiration, but data are limited.
  
  
  OBJECTIVE
  The objectives of this study was to assess the linear associations between BMI z-score and (i) quantity/type of technology used; (ii) sleep quantity/quality and (iii) academic performance/aspiration.
  
  
  METHODS
  Consenting adolescents (n = 624; 64.9% girls, aged 11-18 years) were recruited. The Schools Sleep Habits Survey and Technology Use Questionnaire were administered. Objective measures of height/weight were obtained.
  
  
  RESULTS
  Quantity of technology was positively associated with BMI z-score β = 0.10, P < 0.01. Those who always engaged in video gaming had significantly higher BMI z-score vs. never-users, β = 1.00, P < 0.001. Weekday sleep duration and sleep onset latency were related to BMI z-score, β = -0.24, P < 0.001 and β = 0.01, P < 0.001, respectively. An inverse linear association was observed between BMI z-score and academic performance, β = -0.68, P < 0.001.
  
  
  CONCLUSIONS
  If confirmed prospectively, reducing bedtime use of technology and improving sleep hygiene in adolescents could be an achievable intervention for attenuating obesity with potentially positive effects on academic performance.
authors.affiliation: Birmingham and Black Country NIHR CLAHRC, University of Birmingham, Birmingham, UK; School of Clinical and Experimental Medicine, University of Birmingham, Birmingham, UK.
authors.forename: T
authors.initials: T
authors.lastname: Arora
authors.forename: M
authors.initials: M
authors.lastname: Hosseini-Araghi
authors.forename: J
authors.initials: J
authors.lastname: Bishop
authors.forename: G L
authors.initials: GL
authors.lastname: Yao
authors.forename: G N
authors.initials: GN
authors.lastname: Thomas
authors.forename: S
authors.initials: S
authors.lastname: Taheri
mesh_terms: D000293:Adolescent; D015992:Body Mass Index; D002648:Child; D003201:Computers; D003430:Cross-Sectional Studies; D004521:Educational Measurement; D005260:Female; D006801:Humans; D008297:Male; D009765:Obesity / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D011634:Public Health; D012307:Risk Factors; D057185:Sedentary Behavior; D012892:Sleep Deprivation / Q000209:etiology*; D013690:Television; D013997:Time Factors; D006113:United Kingdom / Q000453:epidemiology