title: Longitudinal relations of television, electronic games, and digital versatile discs with changes in diet in adolescents.
abstract: BACKGROUND
  Youth spend more time with screens than any activity except sleeping. Screen time is a risk factor for obesity, possibly because of the influence of food and beverage advertising on diet.
  
  
  OBJECTIVE
  We sought to assess longitudinal relations of screen time [ie, television, electronic games, digital versatile discs (DVDs)/videos, and total screen time] with the 2-y changes in consumption of foods of low nutritional quality (FLNQ) that are commonly advertised on screens [ie, sugar-sweetened beverages, fast food, sweets, salty snacks, and the sum of these foods (total FLNQ)] and fruit and vegetables.
  
  
  METHODS
  With the use of 2004, 2006, and 2008 waves of the Growing Up Today Study II, which consisted of a cohort of 6002 female and 4917 male adolescents aged 9-16 y in 2004, we assessed screen time (change and baseline) in relation to the 2-y dietary changes. Regression models included 4604 girls and 3668 boys with complete screen time and diet data on ≥2 consecutive questionnaires.
  
  
  RESULTS
  Each hour-per-day increase in television, electronic games, and DVDs/videos was associated with increased intake of total FLNQ (range: 0.10-0.28 servings/d; P < 0.05). Each hour-per-day increase in total screen time predicted increased intakes of sugar-sweetened beverages, fast food, sweets, and salty snacks (range: 0.02-0.06 servings/d; P < 0.001) and decreased intakes of fruit and vegetables (range: -0.05 to -0.02 servings/d; P < 0.05). Greater screen time at baseline (except electronic games in boys) was associated with subsequent increased intake of total FLNQ, and greater screen time at baseline (except DVDs/videos) was associated with decreased intake of fruit and vegetables (P < 0.05). Across sex and food groups and in sensitivity analyses, television was most consistently associated with dietary changes.
  
  
  CONCLUSIONS
  Increases in screen time were associated with increased consumption of foods and beverages of low nutritional quality and decreased consumption of fruit and vegetables. Our results caution against excessive use of screen media, especially television, in youth.
authors.affiliation: From the Departments of Nutrition (JF and WCW), Epidemiology (JF, WCW, and AEF), and Social and Behavioral Sciences and Prevention Research Center (SLG), Harvard School of Public Health, Boston, MA; the Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (BR, WCW, and AEF); and the Division of Adolescent Medicine, Boston Children's Hospital, Boston, MA (AEF and KRS).
authors.forename: Jennifer
authors.initials: J
authors.lastname: Falbe
authors.affiliation: From the Departments of Nutrition (JF and WCW), Epidemiology (JF, WCW, and AEF), and Social and Behavioral Sciences and Prevention Research Center (SLG), Harvard School of Public Health, Boston, MA; the Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (BR, WCW, and AEF); and the Division of Adolescent Medicine, Boston Children's Hospital, Boston, MA (AEF and KRS).
authors.forename: Walter C
authors.initials: WC
authors.lastname: Willett
authors.affiliation: From the Departments of Nutrition (JF and WCW), Epidemiology (JF, WCW, and AEF), and Social and Behavioral Sciences and Prevention Research Center (SLG), Harvard School of Public Health, Boston, MA; the Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (BR, WCW, and AEF); and the Division of Adolescent Medicine, Boston Children's Hospital, Boston, MA (AEF and KRS).
authors.forename: Bernard
authors.initials: B
authors.lastname: Rosner
authors.affiliation: From the Departments of Nutrition (JF and WCW), Epidemiology (JF, WCW, and AEF), and Social and Behavioral Sciences and Prevention Research Center (SLG), Harvard School of Public Health, Boston, MA; the Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (BR, WCW, and AEF); and the Division of Adolescent Medicine, Boston Children's Hospital, Boston, MA (AEF and KRS).
authors.forename: Steve L
authors.initials: SL
authors.lastname: Gortmaker
authors.affiliation: From the Departments of Nutrition (JF and WCW), Epidemiology (JF, WCW, and AEF), and Social and Behavioral Sciences and Prevention Research Center (SLG), Harvard School of Public Health, Boston, MA; the Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (BR, WCW, and AEF); and the Division of Adolescent Medicine, Boston Children's Hospital, Boston, MA (AEF and KRS).
authors.forename: Kendrin R
authors.initials: KR
authors.lastname: Sonneville
authors.affiliation: From the Departments of Nutrition (JF and WCW), Epidemiology (JF, WCW, and AEF), and Social and Behavioral Sciences and Prevention Research Center (SLG), Harvard School of Public Health, Boston, MA; the Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (BR, WCW, and AEF); and the Division of Adolescent Medicine, Boston Children's Hospital, Boston, MA (AEF and KRS).
authors.forename: Alison E
authors.initials: AE
authors.lastname: Field
mesh_terms: D000293:Adolescent; D001628:Beverages; D015992:Body Mass Index; D002648:Child; D004032:Diet; D002149:Energy Intake; D005247:Feeding Behavior; D005260:Female; D005638:Fruit; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009753:Nutritive Value; D009765:Obesity / Q000378:metabolism; D062410:Snacks; D011795:Surveys and Questionnaires; D013690:Television; D014675:Vegetables; D018910:Video Games