title: Screen viewing and diabetes risk factors in overweight and obese adolescents.
abstract: BACKGROUND
  Sedentary behavior has been associated with deleterious cardiometabolic health indicators in adults, but very little research has examined this relationship in youth.
  
  
  OBJECTIVE
  To examine the association between the duration and type of sedentary screen behavior with diabetes risk factors (fasting glucose, insulin, homeostasis model-insulin resistance [HOMA-IR], 2-hour postload glucose, hemoglobin A1c) in a sample of overweight and obese adolescents.
  
  
  METHODS
  A cross-sectional study of 307 overweight or obese adolescents aged 14-18 years (90 boys, 217 girls) assessed at baseline of a lifestyle intervention for weight control conducted from 2005 to 2010. Sedentary screen behaviors, defined as hours per day spent watching TV, playing seated video games, recreational computer use, and total screen time were measured by self-report. Data were analyzed using linear regression analyses in 2012.
  
  
  RESULTS
  TV viewing was the only type of sedentary screen behavior associated with elevated diabetes risk factors before and after adjustment for confounders. Specifically, TV viewing remained positively associated with fasting insulin (adjusted r=0.11, β=0.10, p=0.048) and HOMA-IR (adjusted r=0.11, β=0.10, p=0.05) after adjustment for age, gender, waist-to-hip ratio, caloric intake, percentage of intake in carbohydrates, physical activity duration, and physical activity intensity.
  
  
  CONCLUSIONS
  TV watching may be independently associated with an increase in diabetes risk factors in a high-risk sample of overweight and obese adolescents. These findings provide support for interventions designed to reduce time spent watching TV as a possible means to attenuating diabetes risk factors in this high-risk population.
authors.affiliation: Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada. ggoldfield@cheo.on.ca
authors.forename: Gary S
authors.initials: GS
authors.lastname: Goldfield
authors.forename: Travis J
authors.initials: TJ
authors.lastname: Saunders
authors.forename: Glen P
authors.initials: GP
authors.lastname: Kenny
authors.forename: Stasia
authors.initials: S
authors.lastname: Hadjiyannakis
authors.forename: Penny
authors.initials: P
authors.lastname: Phillips
authors.forename: Angela S
authors.initials: AS
authors.lastname: Alberga
authors.forename: Mark S
authors.initials: MS
authors.lastname: Tremblay
authors.forename: Ronald J
authors.initials: RJ
authors.lastname: Sigal
mesh_terms: D000293:Adolescent; D003201:Computers / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000209:etiology*; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D009765:Obesity / Q000453:epidemiology*; D050177:Overweight / Q000453:epidemiology*; D012307:Risk Factors; D057185:Sedentary Behavior; D013690:Television / Q000706:statistics & numerical data; D013997:Time Factors; D018910:Video Games / Q000706:statistics & numerical data